Vanderbilt Nurse On Trial: Will The Outcome Adversely Change Healthcare?

NOTE To The Reader:

This matter has been previously addressed in an entry dated January 28, 2019, headlined as “Vanderbilt University Medical Center Corruption.”

The subject of concern is a complex one, with many “moving parts” which most news-reporting organizations have not mentioned, nor will they. (That’s a whole ‘nother “ball of wax.”) In this entry, I will attempt to enumerate some of those important-yet-unreported situations, scenarios, their corollaries, and relationships, in order to give a more full understanding to the readers.

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One CRITICALLY IMPORTANT MATTER is the as-yet-unreported problem in which CMS found that VUMC had 100% TOTAL responsibility for the failure that led to the patient’s death.

Yet this trial is apparently completely overlooking that matter, and the critical unitarily integrated legal principle of “respondeat superior.”

As written in the journal Proc (Bayl Univ Med Cent). 2010 Jul; 23(3): 313–315., which appears online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900989/, in the article “Responsibility for the acts of others,” by Russell G. Thornton, JD:

“Respondeat superior embodies the general rule that an employer is responsible for the negligent acts or omissions of its employees. Under respondeat superior an employer is liable for the negligent act or omission of any employee acting within the course and scope of his employment (1). This is a purely dependent or vicarious theory of liability, meaning a finding of liability is not based on any improper action by the employer. The fact that the employer may have acted reasonably in hiring, training, supervising, and retaining the employee is irrelevant and does not provide a basis on which the employer can avoid liability for the acts of employees (1). The underlying premise of respondeat superior is that the cost of torts committed in the conduct of a business enterprise should be borne by that enterprise as a cost of doing business (2).

“An employer can also be directly liable for the negligence of its employees. This means that some negligent act or omission of the employer was a cause of, allowed, or led to the negligence of the employee, thereby causing injury to the claimant. This direct or independent liability of the employer generally arises from a claim that it negligently hired, trained, supervised, or retained the employee in question (13). These claims can also involve allegations that proper policies and procedures were not implemented or enforced and that those failures caused the injury at issue (13).

“If a member of your group acts negligently, you must expect there will be a direct liability claim for negligent hiring, training, supervision, or retention of that person. In my experience it is rare that the employee at issue in one of these claims is a longstanding, well-qualified, well-experienced, still-employed exemplary employee that simply made a mistake. More often than not, the employee involved was not very good to begin with, had been talked to before about competency-related issues, and was subsequently let go for similar reasons within 12 months or so of the incident at issue.

“The assertion of a claim against an employee also means that employee’s past experience and performance are relevant. As such, the hiring, training, supervision, and retention of that employee are relevant and discoverable. For this reason, it is imperative that problematic employees not be retained. It is also important that any concerns about employees are quickly and properly addressed and that these steps are noted in that employee’s file.”

The RN undoubtedly made a horrible mistake, a sloppy, lazy one, even, as some have previously noted.

However… the matter turns not on her carelessness, or sloppy work, per se, inasmuch as it OVERLOOKS the CMS findings of FAULT with VUMC, which agency attempted to coverup their doings and activities, by FAILING to report the matter to the appropriate regulatory agencies, State and Federal.

Further, while the RN’s admitted mistakes resulted in a death, it has NEVER been the practice of ANY law enforcement agency to prosecute any practitioner for such careless work, however “negligent” it may be.

Such matters have historically been handled by civil courts, not criminal, and by licensing and/or professional boards of practice.

At first, the TBON (TN Board Of Nursing) did NOT revoke, nor suspend (as best as I recall) her RN license… BUT! After the Davidson County DA obtained a criminal indictment, TBON reversed and rescinded their previous ruling, and revoked her RN license to practice.

Meanwhile… VUMC got off SCOT-FREE.

Not even a 10¢ fine.

VUMC was NOT punished. They only received a threat of what was essentially “fix this NOW, or else we’ll pull the plug.”

WHERE is the JUSTICE in that!?!?

Again, this is NOT to exonerate her sloppy, even careless work, but to illustrate that historically, such matters have NEVER been criminal, only civil, because there was NO MALICE involved.

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Nurses, and the healthcare professions in general, will undoubtedly be watching the State of Tennessee’s criminal lawsuit against RaDonda Vaught, of Bethpage, TN (an unincorporated community in Sumner County, Zip Code 37022), with bated breath.

The outcome of the trial-by-jury case against her in Davidson County Superior Court in Nashville could affect the very future of the Nursing profession, and healthcare delivery in general, on a broad national scale.

The “long and short” of the matter is, that

No Smoking, No Joking: Alabama’s Medical Marijuana Law Examined

Flowering bud (female) of the Cannabis Sativa plant, aka “marijuana”

There are 49 other states to which Alabama could turn to examine what works, and what does not, and could emulate the best of the best.

But, Alabama’s gonna’ Alabama, regardless of who, or what party’s in office.

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Alabama patient advocates may have celebrated following “Guvnah Memaw’s” signature on the “Darren Wesley ‘Ato’ Hall Compassion Act” sponsored by Republican State Senator Dr. Tim Melson, MD (District 1).

But now, reality is about to set in.

The law, like so many others, is a fiasco. Citizens should rejoice the legislature cannot figure out how to connive and wheedle a gambling scheme to benefit themselves, or their “Big Mule” cronies.

Superficially, the “compassion act” sounds good.

That’s where it stops.

The law leaves patients high and dry when it comes to protecting them, and:

• Allows them to be fired without recourse, denied UC benefits, and denied Worker’s Comp benefits “regardless of the individual’s impairment or lack of impairment resulting from the use of medical cannabis.” {page 15, line 20, §20-2A-6(a)(10)} {page 16, line 13, §20-2A-6(a)(11)(c)}

But then, patient abandonment & neglect is Alabama’s forte.

• Allows DHR to remove children from a patient’s household, and states that the agency shall not be prohibited from “considering a parent or caretaker’s use of medical cannabis as a factor for determining the welfare of a child.” {page 16, line 19, §20-2A-6(a)(11)(d)}

• Penalizes diversion much more harshly than trafficking <500lbs of marijuana – 2 to 20 years vs 5 years + $50,000 fine, respectively. {Section 13A-12-231(1)(a)&(b)}

• Automatically suspends the driver’s license of “any person who is recommended a daily dosage of medical cannabis that exceeds 75 mg… regardless of whether he or she holds a valid medical cannabis card.” {page 99, line 9, Section 6}

• Taxes collected, over and above the board’s operating expenses, less 10%, will go to… The General Fund. {page 22, line 18, §20-2A-10(3)(c)}

No surprise there. It’s Alabama’s slush fund.

• Has an even number of voting board members (12), assuring deadlock on

RNs Being Begged to Work in COVID-19 States With Little PPE. Trade Money for Your Life?

COVID-19 novel Coronavirus is no laughing matter, and is rapidly overwhelming hospitals nationwide, especially in New York City, which has become the practical epicenter of the global pandemic in the United States.

In response, physicians are being requested to come out of retirement to assist states where the effects of the almost instantaneous demand for licensed healthcare professionals are being experienced the worst. Some for love, others for money.

And, as one might expect, Registered Nurses are in great demand as well, the shortage of which is being keenly and acutely felt. As a result, Travel Nurse agencies are placing calls nation-wide for RNs to assist in localities hardest hit, which include Washington state, California, and New York City.

The compensation packages which are being offered in response are nothing less than eye-popping, with almost “stupid money” being paid for RNs to work – however briefly – in hospitals where needs exist.

An unexpected problem has arisen, however, and that is an acute shortage of Personal Protective Equipment (PPE), which includes gowns, gloves, nose/mouth masks (especially N95 respirators), and eye shields. If the healthcare providers do NOT have the proper equipment to care for patients, their lives will be placed at risk, as well.

In essence, one is being asked to risk their life for money – and unnecessarily. Already, there are widely circulated national news reports of some staff in some facilities reusing such PPE, which is designed for ONE USE ONLY, which is also required by law and/or regulation for the health and safety of staff and patients.

Examples of how, and where they’re being recruited (including internationally), and the compensation packages include:

Which Are The Best & Worst States For Registered Nurses?

Like most segments of the economy, the nursing industry is in a state of significant transition under the weight of major socioeconomic dynamics — from the aging U.S. population to the student-loan crisis to concerns about the future of key entitlement programs. But such concerns are not unique among recent graduates, regardless of industry.

More specific to nursing professionals are the various day-to-day demands placed on them, such as mandatory overtime, overstaffing, unionization and allegations of systemic disrespect. Despite those challenges, however, aspiring nurses have much to look forward to upon certification. Nursing occupations are some of the most lucrative careers with the lowest unemployment rates in the U.S. In fact, the industry is expected to grow at more than double the rate of the average occupation through 2024.

With such bright projections, WalletHub’s analysts took stock of the nursing industry to help registered nurses, particularly the newly minted of the bunch, lay down roots in areas that are conducive to both personal and professional success. We did so by comparing the 50 states and the District of Columbia across 18 key metrics that collectively speak to the nursing-job opportunities in each market. Below, you can check out our findings, expert commentary on the state of the nursing industry as well as the methodology we used to conduct this report.

Remembering Alabama OB-GYN Dr. Larry Stutts, MD, DVM

“Men more frequently require to be reminded than informed.”

-Samuel Johnson (1709-1784), Rambler #2 (March 24, 1750)

Dr. Larry Stutts, MD, DVM was elected as a Republican to Alabama State Senate District 6 in 2014 by a 70-vote margin. His 36-year-old patient Rose Church, RN died 10 days after giving birth in 1998 because he refused to order a $5 test, and sent her home from the hospital early.

After narrowly winning election in 2014 by 70 votes in Alabama State Senate District 6, Dr. Larry Stutts, MD, DVM, a Republican, immediately wrote a bill (SB289) to repeal Code of Alabama Title 27-48-2, commonly known as “Rose’s Law,” which unanimously passed the House & Senate and become law in 1999.

“Rose’s Law” was written in response to the death of Stutts’ patient, Rose Church, a 36-year-old Registered Nurse, who died of a heart attack 10 days after giving birth to a girl in 1998 at Helen Keller Hospital in Sheffield. A simple $5 test could have saved her life, but Stutts refused to order the test, and sent her home early.

“Roses Law” gave women in Alabama a legal right to remain in hospital for 48 hours after a normal live birth, 96 hours if the birth was Cesarean or presented a complication, and required health insurers in Alabama to pay for the stay.

Stutts’ bill (SB289) would have repealed “Rose’s Law,” and would have also repealed a State law requiring physicians to

Which are the BEST & WORST States for Nursing Practice?

The nursing industry – like most segments of the economy – is in a state of significant transition under the weight of major overarching socioeconomic dynamics, from the aging U.S. population and the Affordable Care Act to the student loan crisis and concerns about the future of key entitlement programs. It’s therefore understandable if recent nursing school grads aren’t sure where to turn once they receive their diploma.

That concern is not unique among recent graduates, regardless of industry, but both the magnitude of the issue – the nursing industry is expected to grow far faster than the average occupation through 2022 – and the various day-to-day demands placed on nursing professionals – from overstaffing and mandatory overtime to unionization and allegations of systematic disrespect – are indeed profession-specific. With that in mind, WalletHub decided to take stock of the nursing industry in order to help nurses, particularly the newly minted of the bunch, lay down roots in areas that are conducive to both personal and professional success.

We compared the 50 states and the District of Columbia in terms of 15 key metrics that collectively speak to the job opportunities that exist for nurses in each market, how much competition there is for each position, differences in the workplace environment, and projections for the future. You can check out our findings as well as

Male Nurses Earn More Than Female Nurses

This issue raises some very interesting questions. First, because men are a minority in Nursing, is it justifiable for them to earn more than those, who as a group, dominate the profession?

Or, is parity genuinely or truly parity?

Should men and women earn the same amount of money if they do the exact same kind of work?

Or, are there accountable differences in the pay which justify the difference, however slight – and is very slight.

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Male Nurses Make More Money

• February 25, 2013, 1:17 PM

ByBen Casselman

Men now comprise 10% of all Nurses in the United States, up from 3% several years ago. / Getty Images

Hospital patients are more likely than ever to see a male nurse at their bedside — and odds are he earns more than the female nurse down the hall. Men made up close to 10% of all registered nurses in 2011, according to a new Census report released today. That may not sound like much, but it’s up from less than 3% in 1970 and less than 8% in 2000.

It’s no mystery what is drawing men into nursing. Male-dominated professions such as construction and manufacturing hemorrhaged jobs during the recession and have been slow to rebound during the recovery. The health-care sector, meanwhile, actually added jobs during the recession and has continued to grow since. All told, health-care employment is up by

Alabama’s useless anti-texting while driving law

Alabama‘s politician’s have demonstrated, once again, their individual & collective incompetence.

In an effort that could only be described as hopeful, the fools on Montgomery’s Goat Hill passed

Nursing Salary Survey reports Western Nurses earn more

One category of expert nurses this survey omitted – perhaps purposely – was Certified Registered Nurse Anesthetists.

As a group, they have consistently earned six-figure salaries, typically upwards of $125,000/year.

Among Advanced Practice Nurses, CRNAs have continually earned significantly more than the average APN.

In fact, according to a salary survey report performed in 2005 by LocumTenens.com, CRNA respondents reported income ranging from $90,000-$250,000, with 63% reported earning between $110,000-$170,000/year.

The average salaries reported were: 2008-$163,467 / 2009-$169,043 / 2010-$166,833.

And, in 2011, the average reported salary for CRNAs in that survey was $168,998.

Research published by the American Association of Nurse Anesthetists in AANA Journal, April 2008, indicated that the median range for CRNA faculty – academic and clinical – earned between $120,000 and $140,000.

So, as you read the following items, please bear that in mind.

In the Occupational Outlook Handbook published by the Bureau of Labor Statistics, the overall average salary for Registered Nurses in 2010 was $64,690 per year, or $31.10 per hour. The job outlook (forecast) for 2010-2020 is that need is expected to grow 26% (Faster than average). According to the BLS, there were 2,737,400 Registered Nurses in 2010.

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Among Nurses, NPs and Those in the West Earn the Most

Jennifer Garcia

Authors and Disclosures
Journalist
Jennifer Garcia
Jennifer Garcia is a freelance writer for Medscape.
Disclosure: Jennifer Garcia has disclosed no relevant financial relationships.

May 11, 2012 — Nurse practitioners are the top earners among nurses, according to the Physicians Practice 2012 Staff Salary Survey . The survey reports salary averages from 1268 respondents, including nurse practitioners, registered nurses, and nurse managers. Salary information from other staff members such as physician assistants, medical records clerks, medical assistants, front desk staff, billing managers, and medical billers was also included in the survey.

Physicians Practice collected data during the fourth quarter of 2011, and

Where the Jobs Are: Is the Nursing Job Market a mixed bag?

Eminent nursing researcher & scholar Dr. Peter Buerhaus, PhD, RN, FAAN has made a career studying Nurses, and suggests that the jobs picture for new nurse grads is good, and that they may be facing one of the best job markets in decades.

A 2009 study he conducted found that, “Registered nurse (RN) employment has increased during the current recession, and we may soon see an end to the decade-long nurse shortage. This would give hospitals welcome relief and an opportunity to strengthen the nurse workforce by addressing issues associated with an increasingly older and foreign-born workforce. The recent increase in employment is also improving projections of the future supply of RNs, yet large shortages are still expected in the next decade. Until nursing education capacity is increased, future imbalances in the nurse labor market will be unavoidable.”

A 2004 study of his said that, “Wage increases, relatively high national unemployment, and widespread private-sector initiatives aimed at increasing the number of people who become nurses has resulted in a second straight year of strong employment growth among registered nurses (RNs). In 2003, older women and, to a lesser extent, foreign-born RNs accounted for a large share of employment growth. We also observe unusually large employment growth from two new demographic groups: younger people, particularly women in their early thirties, and men. Yet, despite the increase in employment of nearly 185,000 hospital RNs since 2001, the evidence suggests that the current nurse shortage has not been eliminated.”

Most recently, research he worked upon which was published in the December 2011 issue of Health Affairs found that “because of this surge in the number of young people entering nursing during the past decade, the nurse workforce is projected to grow faster during the next two decades than previously anticipated.”

In essence, “...the nurse workforce is now expected to grow at roughly the same rate as the population through 2030.”

They also cautioned however, “that the dynamics of the nursing workforce are more complex than sheer numbers.”

Lead researcher and RAND health economist David Auerbach said, “Instead of worrying about a decline, we are now growing the supply of nurses.”

Here’s something very interesting, however.

In that same issue of Health Affairs, a survey conducted by Christine Kovner of New York University examined the low “mobility” of new RNs. The most striking finding was that

Here’s Encouragement

Have you ever wanted to read someone’s email, letters, text messages or eavesdrop on telephone calls or conversations?

If you’re honest, there has to be at least one time in your life in which the above has been true for you. However, as we mature, we realize that eavesdropping is nothing more than an effort to control, and that in many cases, we have little or no control over many – if not most – events and people in our lives. Certainly, we have no control over others’ thoughts or actions.

Eavesdropping on communication is and remains a hallmark of international espionage, and constitutes the basis and bulk of many international relationships. Eavesdropping on communications is not done among friends. It only accompanies enemies.

Acknowledging that fact is but one reason why love is so good. It is mutually reciprocated and wholly voluntary. Relationships of all type in life – business and personal – are made better by voluntary cooperation and the mutual respect and honesty that naturally accompanies it.

Unfortunately however, not all are so empowered by love. And unfortunately, that spills over into other areas of their lives – most notably even in business. For example, how can one perform at maximal efficiency and capacity if their personal life is in disarray or turmoil? For the healthy person, it’s not possible.

Recently, a dear friend of mine lost a job. We became friends during our tenure with each other as professional colleagues. After it had occurred to me that things probably weren’t as they seemed, I wrote a letter as a source of encouragement. It is my hope that this note may be a source of encouragement for you dear reader, as well.

It occurred to me that the “rationale” given for

Researchers: Nursing Shortage end may be in sight

The end may be in sight for the  highly-documented Nursing shortage.

Why and how?

According to renown Nursing workforce researcher Dr. Peter I. Buerhaus of Vanderbilt University, and two others in a recent investigation published in the December issue of Health Affairs, there may soon an easing – if not an end – in sight for the Nursing Shortage.

The research makes one obvious statement – that

Registered Nurse job aboard private Mediterranean Yacht

How would you like to be an Registered Nurse based out of London, work aboard a Private Yacht traveling the Mediterranean earning a tax-free salary, paid housing, health insurance and flight?

If you’re a female – sorry guys – here’s your chance!

Salary, based upon current rate of exchange, is $57, 283/year with a one year contract.

More details and application below…

I am saddened

This evening, I have been weeping.

Yes, I – a full-grown man – have shed very sorrowful tears upon learning of the untimely death of a long-time college friend and colleague.

My friend Jeffrey Rosado died this evening. Apparently, while dining at

Rhode Island Nurses May Strike; Short Term Contracts Available

Registered Nurses to provide Patient Care during a possible labor dispute in Rhode Island, which is also a participating state in the Nurse Licensure Compact.

The pay rate for this short term assignment is

New Registered Nurse Grads Face Tough Job Market

For the first time in many years, new Registered Nurse graduates face a contracted job market, and may face tough employment prospects, adding to an already dismal national economic portrait.

Researchers such as Vanderbilt University’s Dr. Peter Buerhaus, PhD, RN, FAAN, the U.S. Bureau of Labor Statistics (BLS) and others have warned about the impending Nursing shortage. However, because of the poor overall economic conditions of the United States, many experienced RNs have foregone retirement, and or have come out of semi-retirement or translated part-time and PRN jobs into full-time status and have therefore made many hospitals flush with Nurses.

Previously, many experienced Nurses would have taken PRN (Latin for “pro re nata,” meaning “as needed”) or part-time positions, working anywhere from one shift every two weeks, 12 hours weekly, or in some cases no more than 24 hours weekly at most. Most Nurses are hospital-based employees, and work 12-hour shifts, and a typical full-time work week for Nurses is three, 12-hour shifts in a 7-day (one week) period.

Nursing has been, and continues to be a predominately female-populated profession, so the indicator of hospitals flush with Nurses is indeed a fascinating observation on at least two accounts. It speaks volumes about dire national economic conditions because women have found themselves in the unenviable position of having to work, and in many cases being their family’s primary breadwinner.

In an article published by Alabama & New Jersey’s State Nurses Association, Dr. Buerhaus shared his perspective on “The Short and Long-term Outlook for Registered Nurses in the US.” He wrote in part “that once the jobs recovery begins and RN’s spouses return to work, many currently employed RNs could leave the workforce.”

He noted further that while RNs’ employment prospects continue to be… To read more, click here.

A Brief History of… Me

On occasion, we all possess some tendency toward voyeurism – not necessarily of the unhealthy kind. That is, on occasion, our own innate sense of curiosity is aroused within us and motivates us to see, read or hear things that are not intended specifically for us. While at times harmless, it can be deleterious – though this is not one such occasion.

What you’re about to read is… my e-mail.

I had been motivated to write a letter of introduction to a friend of a friend, and… well, read on!

Registered Nurse jobs in Bermuda

Having received information about this job, and others with the same hospital system, and having spoken with the recruiter, I wanted to share this opportunity with others.

These jobs REQUIRE A THREE YEAR CONTRACT.

Salary in Bermuda is TAX FREE, and the American Dollar and British Pound Sterling are used interchangeably.
Department: Nursing and Nursing Support Facility: King Edward Memorial Hospital (Acute Care Facility)
Department: CRITICAL CARE P. AD.
Schedule: Full time
Shift: Days/Evenings/Nights
Hours: 1820 (hours per year)
Contact Information: Contact: Glenda Daniels
Email: Glenda.Daniels@BermudaHospitals.bm

Address:
Job Details: Bachelor’s of Science
BLS Cerification
RN Required
1 year of experience required

Registered Nursing jobs in Alabama, staff

I received this message in e-mail and wanted to pass it along to others whom may be interested.

Wishing you all the best!

Good News! California’s Nurse:Patient Ratio Law Saves Lives!

Extra! Extra!

Read all about it!

Should that, or

“Told ‘ya so!”

be the cry?

California and her residents, often maligned within and without, on occasion do come up with some good ideas.

Here’s one of the better ones.

Is there a Doctor (of Nursing) in the house?

I recollect one day, several years ago, at a then-small, rural community/junior college where I began my higher education, while walking across a parking lot, that I greeted an administrator whom I saw.

“Hello, Dr. Gudger!,” I cheerily greeted him.

“Good morning!,” came his reply.

Just then, another student, unknown to me or Dr. Gudger, called out, “Doctor! Oh, doctor! I have a question about my mama’s ...”

“I’m sorry I can’t help you. I’m not that kind of doctor,” replied Dr. Gudger, as he turned and looked the student in the eye.

At the time, I thought it rather odd, then quickly considered that the fellow – likely from a very rural and poor background – was there to obtain an education. And so in part, he was schooled that day.

However, interesting stories aside, as healthcare goes, our nation is experiencing a significantly decreasing interest in rural healthcare practice, as well as family practice, followed by internal medicine.

Now, I realize that some would pooh-pooh lawyers and blame law suits (everybody hates lawyers… until they need one), claiming that sue-happy folk are to blame for the problems. However, while law suits may have a role – albeit an insignificant one – insurance companies are probably more to blame for increased costs of healthcare and rationing the delivery of health related services.

It’s really rather easy to understand: Anytime anyone gets in between you and the checkout stand, you’re gonna’ pay more. From a fiscal perspective, that’s essentially what happens.

Now, while I could drone on and on about the hows and whys that the insurance industry is (in my opinion) corrupt (the federal government has also bailed them out, along with banks – which, along with stock brokerage houses enjoy an incestuous fiscal orgy), and has corrupted whatever thing their hand touches, I shall confine my remarks toward the more germane and problematic topic at hand, which is the shortage of healthcare delivery to rural areas, and among the poor.

NCLEX Nurse Entrance Exam Gets Tougher

Studies continue to demonstrate that among all professions (jobs for which one has specific higher education, must be licensed often at a state level, and typically has continuing education requirements), Nurses continue to be held in highest esteem. And, rightfully so.

Nursing is not just hand holding and bedpan emptying, although there is a component of that in almost every nursing assignment.

Now Nursing Students will become even more challenged – as right they should. Increasing burdens call for increasing competency, and hardly anyone could disagree with “raising the bar” for entrance just a wee bit higher… particularly when your life depends upon it!

More than enough

I have a confession to make.

I recognize that I must confess to… well, I must confess to… to… to…

Not being exactly sure about how to proceed, I suppose it might be wise to be honest.

On occasion throughout my life, I have periodically engaged in