The Lady in the Cape

I was recently asked by a colleague, “Why do you direct almost all of your philanthropic efforts toward nursing?” I asked in return, “Have you heard of the Lady of the Lamp?” Her reply was, “Of course!” So I asked, “Well, have you ever heard of the Lady in the Cape?” When she responded “No,” I told her about the Lady in the Cape.

I first met the Lady in the Cape when I was about 4 years old. I remember her standing on the steps of a brownstone. She was pressed and dressed in white, her cap, with its design and ribbon identifying Bayonne Nursing School, perfectly placed on her head. The only thing from her head to her toes not spotlessly white was the long, flowing, navy blue cape she wore over her uniform. She explained to me that she was going to participate in a disaster drill. At my age, I could not get my mind around the concept of a disaster drill. I just heard the word “disaster” and pictured the Lady in the Cape walking straight into danger. I just could not understand how someone would leave family and put his or her life in danger for others because “it is the right thing to do.”

The Lady in the Cape

As I grew a little older, I sometimes saw less of the Lady in the Cape. To put me in a school where I would receive the best education, she often worked nights or double-shifts. What little time I saw her was further decreased by the fact that she was working to attain her first college degree. I told her I would gladly go to public school if it meant we could spend more time together. She explained to me that life is hard and, if we wanted a good life, it required sacrifice by both of us. She also reinforced the fact that the important things in life—the things that really make a difference—come from hard work and not cutting corners, that we were making the sacrifice together.

I grew into what must have been a challenging teenager for the Lady in the Cape who, by now, you probably realize is my mother. I was bright, but lacked focus. I never got into big trouble, except for the ‘67 Chevy and the telephone pole, but will save that story for another day. Meanwhile, I was discovering, that, in the world as it was, there were many things with which I was not happy. So, every morning on the way to school, I would BMW (bitch, moan, and whine) about the latest burr under my saddle, whatever it happened to be. One day, the Lady in the Cape turned to me and said, “If you don’t like something, don’t just whine about it, get out there and change it!” Coming from anyone else, this would have sounded ridiculous to a 15-year-old, but this was coming from a woman who had a child, house, mortgage and no husband, and she had recently lost her job because of standing up for her patients. I bought in, and that one statement changed my life!

The Lady in the Cape went on to obtain advanced degrees. When I asked her why, she said, if you are going to get a seat at the table to try and make a difference in the world, you have to have the credentials to be there. I did not realize it at the time but the Lady in the Cape was modeling lifelong learning. She has continued this practice and instilled it in me.

The Lady in the Cape has still not stopped learning or trying to make a difference in the world. After several successful careers within the nursing profession—staff nurse, nursing executive, and legal nurse consultant—the Lady in the Cape, now in her ‘70s, recently embarked on a new journey. With the support of several colleagues, she has established the Nightingale Society in Naples, Florida, USA. Wearing their uniforms, this group of retired and working nurses conduct ceremonies to recognize and honor nurses for their service to society, either before they part this life—so they can appreciate the recognition—or, after their passing, at the graveside on the day of the funeral. The Lady in the Cape never stops doing the work of her profession!

The act of nursing embodies everything that is good and decent in this world. These values were instilled in me and have been reinforced throughout my life. When I am asked why I chose nursing as my profession, the answer is simple, “The Lady in the Cape taught me many things, among them: Physicians treat diseases. Nurses provide care for patients and their families.” And when asked why nursing is the primary recipient of my personal philanthropy, the answer is also simple, “The Lady in the Cape.”

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Where are we getting our messaging wrong?

I recall attending a statewide meeting of nursing leaders about 15 years ago. The topic of discussion was nursing’s recognition by the U.S. public as the most respected profession. The Institute of Medicine’s (IOM) landmark report, To Err is Human, had recently been released, acknowledging that more than 100,000 avoidable deaths were occurring annually in the U.S. health care system. I wanted to find a way to pull the IOM report into the discussion, specifically nursing’s response.

When I asked if it was not our role, as nurses, to inform the public about the report and potential untoward outcomes that might arise as a result of our interacting with the health care system, my remarks were met with a resounding, “Yes, but ….” The “but” was, “We can’t scare anyone in the process, and we can’t anger anyone.” Confronted with what appeared to be substantial resistance to my effort to effect positive change, I determined it best to let my line of inquiry expire.

Where are we getting our messaging wrong?

Fast forward to today. Our ailing health care system is currently center stage due to fear of a pandemic. Because nursing’s proximity and frequency of exposure to the currently feared pathogen is higher than that of any other profession, we stand squarely in the spotlight. To stem the tide of this infection, nurses have put themselves in an unknown line of risk and have been proclaimed heroes by the media for their efforts. So when I hear nurse leaders, speaking on the subject of Ebola, state publicly that “we have been warning you for years we are not prepared for this,” part of me just wants to scream, “Florence!” or something else.

Nursing is the most respected profession in the United States, and it represents the largest single group of licensed health care professionals in the country. The profession’s very origin is public health. And yet, according to some of our nurse leaders who speak to the media on our behalf, we are not being heard. Which brings me to the question about which I would appreciate your thoughts: Where are we getting our messaging wrong?

One of nursing’s prime directives, and what the public expects of us, is patient advocacy. How can we advocate for our patients when our trusted voices cannot be heard over the din of verbal finger pointing and a message muddled by fear of alienation or retribution? By rising above the fear and mudslinging, I respectfully suggest.

At a pivotal point in the history of health care in the United States, nursing indeed stands in the spotlight. Given the limited time we have to occupy this enviable position, it’s crucial that we as a profession focus on the needs of the nation and not just ourselves. To benefit our patients and society, we must shine light on the U.S. health care system, even if it means illuminating situations that may not benefit our profession.

I am not suggesting we descend to the lowest common denominator and resort to fear mongering to achieve our goals. Quite the opposite. Without fear of retribution, we must embrace the evidence and share it with the public in a rational manner. We have a track record of credibility, the highest of any profession. We cannot and should not fear being messengers of truth. It is our duty!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

What's not to like?

Everywhere we turn we are being asked to “follow” or “like” something on social media. We all understand that the more “likes” a site gets, the more “Google juice”—higher search ranking—it gets. Companies hope that higher search rankings will help them achieve business objectives. Our likes, follows, and other electronic activities allow profiles to be built on us by anyone from marketers to employers to government agencies.

In return for sharing information, our searches are optimized or we are given things. More importantly, we are given the opportunity to offer personal opinions on everything from politics to products.

Recently, language has appeared in the terms and condition statements of many websites—even service contracts—stipulating that any negative statements made by users or their associates, anywhere on the Internet, will incur monetary charges. What used to be “likes only, please” has become “likes only, or pay the price.”

Igor Stevanovic/iStock/Thinkstock

As net neutrality has declined, so too, it appears, has the right to free speech. Having paid for my “free speech” through erosion of my privacy, I now get to pay more to honestly say something negative about a product or service. What’s next, a sliding price scale based on how unkind my opinion is? What about web services that provide recommendations based on customer feedback? What will they do in a world of nothing but likes? I sense the edge of a slippery slope.

I recently came across an article in the British media in which a general-practitioner surgery facility requested that all comments be directed to the administrator and not be posted on social media. A sign to that effect was even displayed in the waiting room. I wonder how long it will be before that same language makes it onto the hospital’s consent form? And how long will it take for the practice to “cross the pond” to the United States and other countries?

Have we indeed come so far that we have to pay if we express a negative opinion about what is truly bad service or an inferior product? I have searched Facebook high and low. Can anyone tell me where that darn “unlike” button is?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Colossal misdirection play?

We have learned of the games held in the Roman Colosseum, either through recorded history or as replicated by Hollywood and embellished for the viewer’s pleasure. To outshine their predecessors, Roman emperors would expend vast sums enhancing the imposing structure. There is evidence, according to some archeologists, that it was even modified to enable flooding for the purpose of reenacting victorious Roman sea battles. And, as people watched the games, for which no expense was spared, that great society fell into decline.

Sound familiar in a scary way? It does for me, too. It’s called the “misdirection play.” I learned it in fourth grade while playing “the game” of peewee football. It scared me then, too, just as it does today, because every time I was deceived by the misdirection play, I got hurt.

As I observe the world today, I wonder if I am witnessing the undoing of another great society. There are certainly many parallels that can be drawn between today and Roman times, and there are certainly many more coliseums. If history is on a path to repeat itself, what will the role of technology be? Savior or contributor to the destruction?

As people watched the games, for which no expense was spared,
that great society fell into decline.

The reason I ask this question is because of a recent vacation experience I had with two children, of whom I am not the parent. The purpose of this vacation was to expose these kids—ages 6 and 9—to the “Great Outdoors.” I applaud their parents for choosing this option over a theme park-based trip. But, as it turned out, when given a choice between going inside to play with technology or going outside to take a walk in the woods and experience nature—perhaps to see real animals in lieu of stuffed ones at gift shops in town—they chose technology.

As I processed these children’s interactions with technology, my mind was flooded with questions: Will they use it to cure cancer? Will they use it to go to Mars and back? Will they use it to find a way to solve the problem of the world’s ever-increasing demand for energy? One could ponder many other questions about the dark side of technology. But the question I kept coming back to was not how they might use technology, but how technology would be applied to them?

Recent events reported in the media have put “Personal Big Data” front and center in the public eye. There is no doubt that social media with all its underlying and associated technologies—one source of big data—have been demonstrated to have positive social benefits. But, in all fairness, we have also seen its negative social impact. So, two questions: 1) “Is technology in the hands of future generations going to have a net positive or negative effect on the future?” And 2) “Will technology, in this coliseum of the future, be a big misdirection play where everybody feels like they are in the game, but where no one goes outside to see the animals until, finally, they’re not there to see?”

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

A few words on time

Once upon a time, I taught a course on budget and finance for nurses. In the first session, I would introduce the concept of scarcity and ask the class to provide real-world examples of the concept. Every year, the conversation immediately would become lively.

One example mentioned consistently was the “gas crisis” of the 1970s. Some in the class had no idea what was being talked about, but there were always a few students my age that recalled sitting in the back seat of their parents’ car, waiting hours for a few gallons of gasoline. When stories about entertainment devised to pass the time waned, I would burst the bubble of this walk down memory lane with the fact that the energy crisis of the 1970s was a man-made supply crisis and that, to this date, oil has flowed endlessly.

Usually, a student would then bring up the disappearance of the dinosaurs that “became the oil,” and I would acknowledge that, yes, such creatures are scarce—if you don’t include animals such as the alligator, caiman, crocodile, and komodo dragon. I would also acknowledge that, through genetic engineering, the possibility of a real-life Jurassic Park is not far beyond mankind’s reach.

Like sands through the hourglass ...

— Serggn/iStock/Thinkstock

Land was often cited as another example of scarcity. “Location, location, location” was a never-miss contribution. As I have watched the planet change over the years since teaching this course, my perception of location, location, location has altered a bit, supported by Steven Hawking’s recommendation that we find another planet to live on. Today, as then, my response to perceived issues of scarcity is that human ingenuity will overcome such problems.

Usually, about the time discussion closed on the topic of land scarcity, the class would become frustrated and press me for my definition of scarcity. I would agree with the concept, as defined in the textbook of the semester. However, as far as a real-world example that would impact me in my lifetime, I thought of nothing more proximal and more in my control—yet, at the same time, completely out of my control—than time. As they say, once it’s behind you, there’s no getting it back, and you have no idea how much is in front of you.

Now, one could make the case that the issue of time scarcity will also be solved through human innovation, that we’ll be able to extend life by hundreds of years through genetically designed replacement parts. But do you really want a 240-year-old me hanging around the joint? I think not. And where would we put all the other billions of 240-year-olds, not to mention those middle-aged 150-year-olds? A discussion for another day.

Given current realities, our time is scarce. There never seems to be enough of it, and when it’s gone, it really is gone. We give so much of our time to others through work and service, but often don’t take time for ourselves—a topic widely discussed in the nursing profession. Feminists such as Mika Brzezinski and Ariana Huffington make the case that, even in a world of glass ceilings and disparities in pay, one metric of success to strive for lies beyond the title, the corner office, and the package. It is control over one’s own time.

Although I agree with this position, I readily recognize that control over one’s time is not easily attainable. However, the emotional component of how I spend my time should be within my control, and could easily be the driver behind why so many of us have chosen to enter caring professions. But have we lost sight of the fact that control over the emotional component of our day-to-day lives is in our hands?

In our hometowns, we are bombarded constantly with images from around the globe of absolutely horrifying situations. As human beings, we rise to these crises and respond to the best of our ability. However, I doubt there is a person reading this blog who does not agree that the overall stress level of our world has increased.

So, given the world we live in, we can spend our time being fearful, frustrated, and stressed. Or, we can take control of the emotional component of the moment and make our workplace, and maybe someone else’s workplace, a better place—by turning a negative into a positive, a moment of frustration into one of growth, and a moment of anger into a teaching moment.

We have all heard it said, “If I had just one more hour to live, I wouldn’t want to spend it at work.” Given just one more hour, on what random act of kindness would you spend your time?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Thank you, Eileen!

For this post, I would like to refrain from my usual stirring of the pot and, instead, in honor of the upcoming Nurses Week, share a story.

In May 2009, during Nurses Week, I was having lunch at my desk and reading the news online when I was struck by the headline ‘School nurse dies saving coach.’ I clicked on the link, and it took me to a clip on the website of a local news station in California. That’s where my relationship with Eileen Bowden and her family began.

Bowden, a school nurse for California’s Santa Clara School District, was responsible for covering five schools in the county. She just happened to be at the right school at the right time for one very fortunate soul. A softball coach collapsed on one of the fields of the school she was at that day. Nurse Bowden was summoned from her office and rushed to the scene where she performed CPR until paramedics arrived and transported the coach to the hospital. Minutes later, Bowden collapsed and died. The coach survived and is alive today, due to the quick action taken by Bowden. As a side note, the incident took place on the coach’s birthday.

Eileen Bowden

Not only was I moved to tears by this story; I was moved to action. Within minutes, I contacted the school where the incident had occurred, and the principal returned my call the following day. He was very kind and stated that he would make contact with the family on my behalf. Within a few days, Barbara Butler, Eileen Bowden’s sister, contacted me.

I explained to Barbara that I had seen Eileen’s story on the news. I also told her that, although I was not a runner, I was training for my first-ever half-marathon so I could experience running across the Golden Gate Bridge. But now, I said to Barbara, instead of running the San Francisco Half Marathon for the personal experience, I would like to do it to raise money to start a scholarship in Eileen’s memory. She agreed, and that call became the kickoff for the Eileen Bowden Memorial Scholarship, administered through the Foundation of the National Student Nurses Association, with which I have been involved ever since my days as a nursing student, 20-plus years ago.

I immediately went to work raising awareness of the need for school nurses and for funding students who have an interest in school nursing. I put up a website, emailed friends and colleagues, started blogging and tweeting, and, with my new purpose, rededicated myself to training for the half-marathon.

As I have stated, I am not a runner, and training was hard. Living in Austin, Texas, only compounded the difficulty. The race was to be held in San Francisco in July, where the average high temperature is 69 degrees Fahrenheit (21 degrees Celsius), but the average high in Austin in June, when I was training, is 92 degrees Fahrenheit. This meant getting up most mornings at 4 a.m. so I could get my training in before the Texas heat would get the best of me. Just about the time I was questioning my sanity and ability, my next round of motivation came. I received a handwritten letter and a check for $25. This gift—and it truly was a gift—was from an 80-plus-year old registered nurse on a fixed income. Her name was Betty Bowden. She is Eileen’s mother.

Well, the training didn’t get any easier, but my motivation was strong. Before I go further, I must acknowledge that my wife was with me on this journey every step of the way. The night before the run, we were sitting together in our hotel room contemplating a Wall Street Journal headline we had seen just days before—“The San Francisco Half Marathon, the race that real runners fear” —when the phone rang. It was Eileen’s nephew. Suddenly, I had no fear of what I would take on at 5 a.m.

The next morning, with my wife at my side, I completed my first-ever half-marathon, raising more than $4,000 for the newly established Eileen Bowden Memorial Scholarship. Little did I know it was the beginning of a journey to create a permanently endowed scholarship for students interested in pursuing a career in school nursing.

The following year, I was once again training to run in San Francisco to raise more funds for the scholarship when Tom Grant contacted me. Tom is Eileen’s brother-in-law. In 2010, he, too, was not a runner. However, inspired by my efforts, he had begun training for New Jersey’s Long Branch Half Marathon, which coincides with the New Jersey Marathon, and was calling to ask if I would help him replicate what I had done to raise awareness and funds. Not only did I say yes, I asked if I could run with him. I can’t begin to tell you what an honor it was to run by his side and cross the finish line together in his first-ever half-marathon.

To run a half-marathon (13.1 miles), you need all the help you can get!
Before running New Jersey's 2010 Long Branch Half Marathon together,
Tom Grant, brother of Eileen Bowden, and Ken Dion pose for the camera with
an energy product designed to help them make it across the finish line.

A highlight of making the trip to New Jersey was having the opportunity to stay with Tom and his wife Rosemary, Eileen’s other sister. And if the kindness they showed me was not enough, I had the honor of spending the evening with Betty Bowden, Eileen’s mother. We stayed up until late in the evening, sharing stories about the joys and sorrows we experienced as nurses. Mostly, the joys!

Eileen was the epitome of what nursing is all about. She was active in her community. She chose to work as a school nurse to assure health and health education for the future of our country. The single mother of an adopted daughter, she was a daughter, a sister, a friend. She was also a member of the Honor Society of Nursing, Sigma Theta Tau International.

So, on the fifth anniversary of Eileen Bowden’s passing, I would like to dedicate this Nurses Week blog post to her and others like her who have made the ultimate sacrifice in the service of others.

On behalf of all those you have touched—especially this nurse—thank you, Eileen!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Choices

What an amazing time we live in! I was sitting in a chair in the sky, enjoying a cold refreshing beverage and watching the evening news—live—while traveling at 500 mph, when two separate human-interest stories piqued my interest.

The first, about the rise of heroin use in the United States, featured two mothers, both of whom shared stories about their children’s experiences with the drug. Sadly, the child of one of them had died. The other mother then talked about her son, a popular high-school athlete who had overdosed. Now in his mid-20s, he suffers from severe mental and physical disabilities, while both he and his family struggle to cope with the activities of daily living and long hours of therapy. His prognosis is fair, at best, and he will never return to his former level of ability.

Jenny Bonner/iStock/Thinkstock

Another young man, featured later in the program, had just entered high school when his father, then in his mid-40s, was diagnosed with incurable cancer. The son, not particularly athletic but motivated by devotion to his father, vowed to win the state championship in wrestling, in his weight class. For three years, he began each day at 6:30, lifting weights, and spent the rest of the day doing nothing but health-promoting activities. He achieved his goal, won the state title and, at the end of the championship match, saw his opponent congratulate his father and give him a huge hug.

These seemingly unrelated stories caused me to pause and ask myself: Is it possible that, if the resources expended on the young man who suffered from a heroin overdose had been directed toward finding a cure for the cancer contracted by the second young man’s father, might the father’s prognosis have improved?

Health care science and technology are advancing at a mind-boggling rate, while the ethics and laws guiding the use of newly discovered science fall further and further behind. My question to you is this: If health care is a right, what responsibilities go with that right? In the face of limited resources, do we deny health care to individuals who make poor health choices when the care involved is directly related to those poor choices? What do you think?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sgima Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

The provider side of big data

We have entered the age of “Big Data.” I’m not certain how this age differs from the Information Age, but a statement by Dan Ariely, James B. Duke Professor of Psychology and Behavioral Economics at Duke University’s Fuqua School of Business and director of Duke’s Center for Advanced Hindsight, provides an interesting perspective: “Big Data is like teenage sex: everyone talks about it, no one really knows how to do it, and everyone thinks everyone else is doing it, so everyone claims they are doing it.”

So, if we are in the prepubescent stage of health care informatics, what does the future hold?

allanswart/iStock/Thinkstock

The focus of big-data analytics today is on what I like to refer to as “patient-side data.” Investments being made to analyze patient-side data, evidenced by IBM’s recent agreement to implement natural language processing (NLP) in Cerner’s electronic medical record (EMR), are staggering. These data analyses run the gamut from genomic deconstruction for the purpose of individualized chemotherapy intervention to population-based trending of indicators beyond imagination. If these analyses result in actionable information, which I have no doubt they will, the actions required will not take place in a vacuum. More data is needed if these new discoveries are to reach their full potential.

I am a believer in Occam’s razor, a principle of parsimony. To paraphrase, the solution with the least number of variables is usually the one that should be employed. The Synergy Model, just one such parsimonious exemplar, provides a framework that may help us think about the other side of the big-data coin—“provider-side data.” The Synergy Model tells us that both patient and provider have specific characteristics which, when aligned, optimize patient outcomes.

We’re just beginning to scratch the surface in capturing and interpreting patient-side data, but we’re even further behind the curve when it comes to the provider side of the equation. Not long ago, the most we knew about members of our staffs is that they had licenses and could fog mirrors. With the advent of learning management systems (LMS), we can now track employee education. However, this remains a highly compliance-driven function. 

With the advent of the EMR, we’ll be able to aggregate provider-patient interaction data, such as the number of specific procedures completed by a practitioner. Data like this can be used for purposes such as credentialing and certification—in other words, quantitative data generated to support compliance-driven activities. Will the holy grail of improved patient outcomes be found in the check boxes of an EMR or the compliance report of an LMS? I think not.

Just as patient characteristics described by the Synergy Model relate to data found in the patient narrative, so too provider characteristics relate to data found in the provider narrative. Whether the professional narrative be found in the EMR (through documentation of patient interactions) or the professional’s development record (a narrative resource as rich as the patient's narrative), they are equally important in influencing patient outcome.

So, as we mature in the age of big data, what will the role of provider-side data be? Will it be purely regulatory, or will it begin to capture today the qualitative provider-side data we need to influence patient outcomes in the future?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Hacked!

If you are reading this blog, you are being hacked! It is virtually impossible to live in modern society without creating a digital footprint. From cookies implanted in your browser from every website you visit to every credit-card transaction you make to every text, tweet, post, and email, you are being digitally deconstructed. The digital footprint you are creating is not only being followed, it is being backtracked to predict future behavior, as evidenced by Apple’s acquisition of Topsy.

The upside of being followed is that you are offered things based on your preferences, from coupons to returns on Internet searches. The more information you are willing to share with vendors, the more they are willing to pay you through various rewards and loyalty programs. Many of the rewards seem enticing but, as Grandma said, “Nothing in this life is free,” and, in this case, the cost is the dark side of the digital life.

We have all come to ignore pop-up ads. However, in their time, they achieved their goal. They manipulated our behavior and generated revenue for search engines through pay-per-click programs designed to drive traffic to specific vendors. Our “free” searches were then used to drive ads to us, which put us at risk for having our behavior manipulated. And if media or government used those searches to manipulate our behavior, frightening scenarios could be imagined.

As disconcerting as those scenarios might be, equally alarming is the hacking we have seen played out in recent months. From monitoring of electronic communications to credit-card hacks spawned out of Eastern Europe, which, by the way, is not a new phenomenon. (See “‘Dark Market’ Takedown.”) There is a very dark side to our digital lives. Your life is being hacked, and you are an active participant in the process. You didn’t think that reward or email account was really free, did ya?

As part of “Building a better planet,” IBM has tasked its supercomputer, “Watson,” to analyze treatment and practice patterns of oncology practitioners with regard to outcomes. Additionally, these efforts include use of genomic analysis for development of targeted chemotherapy intervention. At this point, we are, whether we like to think about it this way or not, being genetically modified by the computers we have created. Presumably, given time, those same computers will have the ability to predict the future, just as they did with relative certainty in the consumer-behavior model. Do you really want to know how long you are going to live? Do you want other people to know that? And what about the ability to manipulate it? Off to the scary dark side we go!

As we genetically engineer and reengineer the planet, we are also making great strides in biomechanical engineering. We have seen the quality of life of veterans returning from conflict improve, due to advanced prosthetics. Cochlear implants have enabled the deaf to hear. Implantable defibrillators have saved countless lives. Envisioning a future enabled by implanted technologies, politicians have dazzled us with stories of implanted devices that warn of an impending heart attack by sending an email to the owner’s cellphone and calling EMS. Sadly, as promising as this technology is—and it’s within reach—it, too, comes with a dark side.

All of these auspicious medical devices share a common element—a microcomputer. Taking the next step and actually embedding computers in our bodies has done great good. However, computers, by definition, can be hacked.

The preceding thought brings a frightening new possibility to the phrase “having your life hacked.” If you thought having to replace your credit cards because you shopped somewhere was an inconvenience, it’s a really bad day when your implanted defibrillator gets hacked!

So, I have two questions for you: Are we ready for the first time this happens? And what do you think the reaction and fallout will be?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.