Proceed Until Apprehended – Zero is Possible

Angela Green, PhD, RN, CPHQ, FAAN

This past week I attended the Children’s Hospitals’ Solutions for Patient Safety (SPS) National Learning Session. This is my favorite meeting.  The content is always fabulous.  Being surrounded by and learning from 500+ colleagues committed to eliminating serious harm in children’s hospitals is even more fabulous.  I arrive excited.  I leave inspired.

This time feels different. In the kickoff, we see our network data. This time, Anne Lyren, our SPS Clinical Director, led us to see it in a different way: the long stretches of time many are achieving with no harm on outcomes such as pressure injuries, central line associated bloodstream infections and unplanned extubations.  We saw it there in front of us – zero is possible.  Zero is possible.

Zero harm is not a new idea. That it is possible might just be. I am back home now, grateful for the experience, the learning, the people, and a future where zero is possible.  I believe in zero.


Proceed Until Apprehended – Sacred Trust

Angela Green, PhD, RN, CPHQ, FAAN

As part of a leadership development program this week, we were asked to think about the most meaningful work related recognition we have received. My direct patient care roles are ancient history by now – over 15 years ago. As I reflected, I felt fortunate to have numerous examples of meaningful recognition to consider across the years.  Yet I found myself drawn back in time to a NICU more than 20 years ago and a beautiful baby girl who died of sepsis after a long stay in our unit.  I was a nurse practitioner at the time; I had taken care of her a lot and knew her parents well.  I was there the day she died, part of the team trying to save her life until it was clear that we could not.  I don’t remember if I carried her to her parents to hold in a private room after her death. But I do remember this – when they were ready to go, her parents asked for me.  They wanted me to be the one that took her from them.  With tears running down all of our faces, they handed her to me and I carried her back to the unit.  In that most sacred moment, they trusted me. I’ve thought of this so many times in the days since. I remember their faces.  I remember their hope, I remember their pain. I remember their beautiful baby.  I’m not sure that I’ve learned all the lessons I need to learn from this yet. But one thing I do know, parents trust us with what is most precious to them, their children. That trust is sacred.  I will earn that trust.

The Relentless School Nurse: The Text Message No Parent Wants to Get – An Active Shooter is at School

The Relentless School Nurse: The Text Message No Parent Wants to Get – An Active Shooter is at School
— Read on

Sharing The Relentless School Nurse: Parenting with High ACEs – Voices of Lived Expertise — The Relentless School

Christine “Cissy” White is leading a movement to make sure that parents with high Adverse Childhood Experiences (ACEs) scores have the resources and support they need to end the trend of generational trauma that so many have inherited and unknowingly passed on to their children. The voice of the parent is first and foremost in […]

via The Relentless School Nurse: Parenting with High ACEs – Voices of Lived Expertise — The Relentless School Nurse

Proceed Until Apprehended – Changing the Story for Women and Girls

Angela Green, PhD, RN, CPHQ, FAAN

A few years ago, as part of my Robert Wood Johnson Foundation Executive Nurse Fellows work, colleagues and I hosted a summit, Changing the Story for Women and Girls in Arkansas. This was in response to data that revealed that Arkansas was the state with the poorest outcomes for women and girls along numerous dimensions including health, education and economic outcomes.  The summit generated an action plan and amazing women and men moved the action plan forward.  I am so proud of that work. However, as I’ve processed the events of this week, the Christine Blasey Ford testimony, the Brett Kavanaugh testimony, the news coverage and social media threads, I’ve wondered why sexual assault did not come up, particularly given that nationally 1 in 5 women will be raped and 1 in 3 women will experience some form of contact sexual violence in their lifetimes ( It is likely because our scope was along world peace dimensions.  But from the vantage of hindsight, I wonder if it was because our work was before the #MeToo movement? I wonder if it was because we thought we were further along than that? That while the outcomes we were focused on were poor, the lives of women and girls meant more than that?  I wonder if it was because the shroud of silence and shame was still too strong? Those questions will remain unanswered, but the truth is, without impacting the epidemic of sexual assault, we will not change the story for woman and girls anywhere.  This week, however, marks a new beginning.  While the shroud of silence and shame is not gone, it is ripped. Countless numbers of courageous woman have come forward telling their stories. The epidemic nature of sexual assault is no longer hidden from public view.  Now is the time to change this story.

Proceed Until Apprehended: SEC Game Day

Angela Green, PhD, RN, CPHQ, FAAN

I must start with a disclaimer. I am an intense Southeastern Conference (SEC) football fan.  Or to be more accurate, I am an intense Auburn Tigers fan.  I have “tied for second favorite teams”:  the Arkansas Razorbacks and LSU Tigers.  I really like the Georgia Bulldogs.  I live in Florida. I’ve spent most of my life in Alabama and Arkansas. When I woke up Saturday (9/22/18) morning, Alabama (notice, not on my list of favorite teams), Georgia, LSU and Auburn were all ranked in the top 10. Mississippi State and Texas A&M are in the top 20. Football is amazing in the SEC.

If you look at the states with SEC schools, there is a troubling pattern. Outcomes for children are not amazing. The Kids Count Data Book (https://datacenter, ranks states based upon the well-being of children. The overall ranking includes economic, education, health, and family and community outcomes.  When you look at the states with SEC schools, our position is reversed: we are at the bottom.  For overall ranking, Alabama, Arkansas, Louisiana, Texas and Mississippi are in the bottom 10. Florida, Georgia, Kentucky, South Carolina, and Tennessee are in the bottom 20. Only Missouri is not in the bottom 20.

This is not the first time I’ve wondered this and it won’t be the last. What if? What if we used some of the energy (and money) spent on football in the SEC and aimed it straight at the well-being of children?  What if we studied and debated educational opportunities and health outcomes for children in these states with the fervor that we discuss who will be the starting quarterback for Alabama?  What if we decide that it is not okay to have the top ranked football teams and the lowest ranked outcomes for children? I dream of the day.

While I am dreaming, I commit to doing. I will vote for candidates who champion children.  I will partner with colleagues in children’s hospitals to make healthcare better for children in these states. I will champion gun violence prevention.  Will you dream with me?  Will you act with me?