Nursing Homes in Massachusetts

Nursing Homes in Massachusetts

McDonough allowed to testify in Sudbury sexual assault case - Framingham, MA

A Sudbury nursing home resident who said she was sexually assaulted by an employee of the home more than a year ago will be allowed to testify at his trial, a judge ruled today.

Ruby McDonough will be allowed to testify against Kofi Agana in his Framingham District Court trial on Jan. 12, Judge Robert Greco said.

McDonough has been diagnosed with expressive aphasia, a condition that makes it difficult for her to communicate verbally or through writing.

McDonough had previously been ruled incompetent to testify by a Framingham District Court judge, but the state Supreme Judicial Court made a ruling that the judge erred by not allowing her to have an aide assist in her testimony.

McDonough, through her lawyer Wendy Murphy, was seeking to have that incompetence ruling overturned. Greco did not specifically overturn the ruling because he said the ruling did not make a judgement about her mental capacity. He said it was a ruling on her ability to testify.

After the ruling, a visibly happy McDonough gave a thumbs up to Murphy.

"The fact that she's being allowed to testify is the same as saying she is competent,'' said Murphy. "She's so happy."

Greco said McDonough will be able to testify with some accommodations, such as yes or no questions and being allowed to take a longer time than usual to answer questions. However, he did not rule how much an expert will be allowed to assist in the testimony.



Read more: Ruby McDonough allowed to testify in Sudbury sexual assault case - Framingham, MA - The MetroWest Daily News http://www.metrowestdailynews.com/archive/x298229494/Ruby-McDonough-allowed-to-testify-in-Sudbury-sexual-assault-case#ixzz1Ew1R6RFaRuby McDonough allowed to testify in Sudbury sexual assault case - Framingham, MA - The MetroWest Daily News

Elder abuse and neglect complaints are on the rise in Massachusetts

BOSTON — Complaints of elder abuse and neglect have risen statewide in recent years while resources to investigate them have failed to keep pace.

Case workers investigated about 16,000 reports of elder abuse or neglect in the year ending June 30, 2009, the most recent statistics available. The data cover people 60 and older in private living environments.

“It could be the economy. It could be any number of reasons,” said Deborah Fogarty, director of protective services for the state Executive Office of Elder Affairs. “We have a rapidly growing population of people who are 60 and over.”

Only when an extreme case of neglect is alleged, as in the case of a 68-year-old Hanover man charged this week with allowing his 93-year-old father to live in squalor, does elder abuse attract widespread attention.

Prosecutors say John T. Hallinan, 68, left his father duct-taped to a chair while he went to work. Police found the elderly man lying in a diaper on the floor in excrement, with sores on his feet.

Hallinan has been charged with assault and battery on a disabled person over 60.

Massachusetts law defines elder abuse as physical, emotional and sexual abuse, caretaker neglect, self-neglect and financial exploitation of a person 60 or older.

There are 22 regional agencies in Massachusetts in charge of investigating cases of elder abuse, and they have a total of 179 case workers assigned to investigate complaints.

After someone files a report of abuse, it is screened by a supervisor at one of the local protective service agencies to determine whether it is covered by the elder abuse law. Cases then are assigned to three priority levels from emergency to routine response.

Emergency cases call for contacting the alleged victim within five hours and visiting within 24 hours. Routine responses involve a home visit within five days.

Protective service agencies can assist elders with medical, legal, psychological, financial and housing assistance. In extreme cases of abuse, they refer cases to local district attorneys.

But investigations can come to an end if the senior refuses to answer the door or declines assistance.

“Self-determination is one of the underlying philosophies,” Fogarty said. “If an elder has the capacity to make decisions and declines an investigation, they have that right.”

Educating members of the community on how to spot signs of elder abuse is a priority of the state and local agencies, Fogarty said. A housekeeper visiting the Hanover residence reported the alleged abuse Aug. 23 after finding the 93-year-old man bound to a chair with duct tape.

Agencies held public events around the state in June to commemorate World Elder Abuse Awareness Day. They also have worked with local banks and trained employees to spot signs of financial exploitation, such as seniors withdrawing large sums of money frequently.


Elder abuse and neglect complaints are on the rise in Massachusetts - Fall River, MA - The Herald News

Massachusetts Ombudsman and State Agencies.

http://www.ltcombudsman.org/ombudsman/massachusetts NORC - Locate an Ombudsman and State Agencies.

COMMONWEALTH vs. LIFE CARE CENTERS OF AMERICA, INC.

COMMONWEALTH vs. LIFE CARE CENTERS OF AMERICA, INC.

Opinion 2010

MA Court rules LIFE CARE CENTERS OF AMERICA can't be tried criminally

The Highest Court in Massachusetts in 2010 concluded that a corporation could not be convicted of involuntary manslaughter, based on a theory of corporate criminal liability established by aggregating the knowledge and actions of multiple employees that were at worst merely negligent (i.e., a nursing home employee's removal, from a patient's medical chart, of a doctor's order that the patient wear a security bracelet; the knowledge of various employees that the patient was supposed to wear a security bracelet and tended to attempt to leave the nursing home; the knowledge of a nursing supervisor that the security bracelet order had been removed from the patient's chart and her failure to have the order reentered on the chart; and the failure of a substitute nurse to check that the patient was wearing the security bracelet), in the absence of evidence that at least one employee acted, or failed to act, with the requisite mental state of wanton or reckless conduct.
This court concluded that a corporation could not be convicted of neglect of a resident of a long-term care facility, in violation of G. L. c. 265, § 38, based on a theory of corporate criminal liability established by aggregating the knowledge and actions of multiple employees that were at worst merely negligent, in the absence of evidence that at least one employee committed abuse, mistreatment, or neglect while acting with the requisite mental state of knowing and wilful conduct.
LIFE CARE CENTERS OF AMERICA, INC., COMMONWEALTH vs., 456 Mass. 826

Life Care Center faced manslaughter charges in Massachusetts

Acton, Mass. — There are a few facts almost everyone agrees on surrounding the death of Julia McCauley.

On the morning of Aug. 17, 2004, McCauley, 74, rolled her wheelchair unattended out the front door of the Life Care Center of Acton, where she had been a resident for five years, and tumbled down a flight of stairs. She died a short time later.

McCauley, who had approached the doors of the 1 Great Road facility before, was not wearing a doctor-prescribed WanderGuard bracelet designed to set off an alarm and lock the doors if McCauley got too close to the exit.

But that’s where the common ground ends for Life Care Center officials and Attorney General Martha Coakley.

Coakley’s office believes that McCauley’s death could have been avoided had she been wearing her electronic bracelet and that the nursing home’s parent company, Life Care Centers of America, is culpable.

But Life Care Center officials deny any wrongdoing and argue that McCauley’s death, though a tragedy, was an unfortunate accident in a long-term care facility striving to provide the best possible care.

Life Care officials also argue prosecuting the corporation could also cause a backlash against nursing homes, hospitals and other health care facilities where accidents inevitably occur.

The corporation is charged with manslaughter and neglect of a long-term care facility resident. The trial begins March 9 at Middlesex Superior Court.

“We think it’s an important case,” said Harry Pierre, a spokesman for Coakley’s office. “Our lawyers are prepared to prosecute the case.”

If convicted, the Tennessee-based corporation could face fines of up to $6,000.

But Life Care officials said they are confident heading into next week’s trial.

“Julia McCauley was a beloved member of our community and a part of our family. At the end of the day, her death was an accident, not a crime,” said Rob Alderman, Life Care’s director of public relations. “We are looking forward very much to having our good name cleared.”

Life Care operates more than 200 facilities in 28 states, including several that have come under scrutiny in the past.

In 2005, the company paid $2.5 million to resolve allegations of billing Medicaid and Medicare for services that were never provided or were useless to the residents of a Lawrenceville, Ga., facility.

And the Acton facility has been the target of state and federal fines in the past.

The facility was fined $2,112 in the fall of 2005 and $11,147 in December 2006 for various deficiencies found during routine state checks.

In July 2007, state and federal regulators imposed fines totaling more than $164,000 for deficiencies that jeopardized residents’ safety. But the fines were rescinded after a more extensive investigation.

Alderman said the Acton home has addressed all the deficiencies found in the state inspections, which has improved the facility.

“The question is do we get up every single day and decide to make the facility better than it was the day before, and that’s the case in Acton,” he said. “Acton is absolutely on top of it. It’s a great place to be.”

The case against Life Care Center is possibly one of only two instances where the commonwealth has charged a corporation with manslaughter.

In August 2007, the commonwealth charged the company that supplied epoxy used in the Big Dig with manslaughter after a Jamaica Plain woman was killed when a ceiling panel in the Interstate 90 Connector Tunnel fell on her car. That case was settled last December.

Coakley also held a press conference last week to announce her support for legislation to increase the maximum fine for a corporation convicted of manslaughter from $1,000 to $250,000.

The $1,000 fine was enacted in 1819 and needed to be updated, Coakley said in the Feb. 26 press conference.

If the Legislature approves the change in law, it would not apply retroactively to the Life Care case.

But Alderman questioned the timing Coakley’s press conference, a week and a half before the start of the trial.

“The timing was rather odd for this announcement with the upcoming trial,” said Alderman. “We believe the people of the great commonwealth have to ask themselves the question ‘What’s motivating the attorney general and who stands to benefit from the case?’”

Pierre denied any connection in the timing of Coakley’s announcement and the start of the Life Care trial.

“I can say there’s no correlation between when the case is starting and our announcement,” he said. “We felt the law needed updating and we felt this was a good place to start.”

Life Care Center faces manslaughter trial date - Acton, MA - The Beacon

Prisons vs Nursing Homes

prisons vs Nursing Homes

Hippa Form for Medical Records - Free Download

Down load free Hippa form to get your Nursing Home Records
Hippa Form Medical Records

Proposals to curb nursing home abuse faltering in Kentucky

Two proposals aimed at preventing and investigating abuse of nursing home patients appear to be dead or stalled in the ongoing state legislative session, according to their sponsors.

In Kentucky, nursing home deaths from neglect and abuse often aren't criminally prosecuted because the coroner isn't called to investigate. But a bill that would require Kentucky nursing homes to report all deaths to the local coroner will not go forward this session because of opposition, its sponsor said.

Rep. Tom Burch, D-Louisville, said he won't call House Bill 69 for a vote in his House Health and Welfare Committee, citing opposition from the nursing home industry and budget concerns from the state's chief medical examiner, Tracey Corey.

Corey has said she would need to hire three medical examiners and support staff to handle the additional death investigations that could result from calling coroners after each nursing home death.

Burch said he tried to compromise with nursing home industry leaders with no success

Read more: http://www.kentucky.com/2011/02/19/1641282/proposals-to-curb-nursing-home.html#ixzz1EVESwRGiProposals to curb nursing home abuse faltering in Frankfort | Voiceless & Vulnerable: Nursing Home Abuse | Kentucky.com

Hippa Form

Authorization for Use of Protected Health Information (Hippa Release) Page 1 of 2

Name of Hospital/Doctor: _________________________________________________

Hospital/Doctor Address: ______________________________________________________

Patient Name: Phone Number:

Date of Birth: Patient Record # (or SS #):

Address:

1. I authorize the above medical facility to disclose my health information specific to the following date or time period: To .

2. Name and address of individual or entity authorized to receive my health information:

3. The purpose for which disclosure is to be made: for use in a legal proceeding.

4. Information to be disclosed (check all applicable):

__Abstract __History and Physical Exam __Operative Report
__Admission Summary __Consultation __Laboratory Report
__Pathology Report __Radiology Reports
__EKG __Emergency Dept. Record __Discharge Summary
__ Entire Medical Record __Other:____________

5. To the extent applicable, I understand that my medical record may contain information that is considered sensitive under law. My check marks below indicate that I do not permit information of this time, if it exists, to be released. I understand that if I do not check the box, the above medical provider will release such information about me if it exists, including all healthcare information inclusive of alcohol, drug abuse, HIV testing, psychiatric notes, venereal disease and/or other sensitive related information.

__HIV/AIDS infection __Sexually TransmittedDiseases
__Mental/Psychiatric Health __Treatment for Alcohol And/or Drug Abuse

6. I understand that my records are protected under the federal privacy laws and regulations and under the general laws of the state of Massachusetts, and cannot be disclosed without by written consent except as otherwise specifically provided by law.

7. I understand that if the persons or entities that receive the information is not a healthcare provider or health plan covered by federal privacy regulations, the information described above may be disclosed and is no longer protected by those regulations. Therefore I release the above Hospital, Doctor or healthcare facility, its employees and my physicians from all liability arising from this disclosure of my health information.

8. It is my understanding that this authorization will expire 90 days from the day signed below. I understand that I may revoke this authorization by notifying, in writing, at any time. I understand that any previously disclosed information would not be subject to my revocation request.





Page 2 of 2

9. I understand that I may refuse to sign this authorization and that my refusal to sign will not affect my ability to obtain treatment, payment for my eligibility for benefits, unless otherwise described in the space provided here_________________________________


I UNDERSTAND THERE IS A PROCESSING FEE AND A COPYING COST

This form must be completed in full before signing.



________________________________ _______ ___________________________
(or Legal Representative) Date


____________________________ _____________________
Print Name of Legal Representative Relationship to Patient
(if applicable)

Guide to Nursing Home Care

http://www.mass.gov/Eeohhs2/docs/dph/quality/hcq_circular_letters/dhcq_nursing_home_brochure.pdf

Death of nursing home liability bill

Mississippi -

Just like last year, legislation that would have required nursing homes to carry a minimum $500,000 in liability insurance died.

Just like last year, the Mississippi HealthCare Association argued that legislation mandating minimum liability insurance for the state's nursing homes, personal care homes and assisted living facilities was unnecessary.

But unlike last year, the legislation that would have made the nursing homes carry such insurance died in the House rather than the Senate. In 2010, the legislation sailed through the House only to die in the Senate Insurance Committee.

But this year, the bill passed the House Insurance Committee by unanimous vote only to die in the full House. A number of House members who supported the measure in 2010 voted against it this year. Go figure.

The legislation would have required non-government nursing homes to carry the same $500,000 in liability coverage that government nursing homes carry. Nursing homes owned by county hospitals or other entities covered by the State Tort Claims Board are covered for legal claims up to the statutory cap of $500,000 if a jury finds that a patient has been abused, neglected or otherwise sufficiently harmed in a covered facility.

Yet a number of private nursing homes in Mississippi do not carry liability insurance sufficient to cover claims up to the statutory cap.

Some carry so-called "eroding" policies that take the nursing home's legal fees and other court costs out of the available liability insurance before a victim is compensated.

Is that fair to vulnerable patients in those private facilities? Is it fair for them to have paid taxes or have families paying taxes that subsidize the public nursing homes' tort claim coverage while the laws allow private nursing homes to be uninsured or underinsured for the very same offenses against the elderly? No.

My sisters and I had to make the painful decision to place our late parents in the care of such facilities here in Mississippi. My folks were fortunate. The people we paid to care for them when we could no longer care for them treated them with respect and compassion. That's the way it is in most of Mississippi's nursing homes, but surely not in all of them.

Nursing home abuse happens in Mississippi like it happens in the rest of the country - physical abuse, sexual abuse and financial abuse. There are some 16,000 Mississippians in Mississippi's skilled nursing facilities and that number will increase exponentially as 78 million Baby Boomers age.

In the tort reform fight, Mississippi lawmakers capped tort liability damages at $500,000.

Again, the minimum nursing home liability insurance that lawmakers are rejecting requires non-government nursing homes to carry the same $500,000 in liability coverage that government nursing homes carry under the Tort Claims Act.

But it seems that some Mississippi nursing homes don't carry enough liability insurance even to cover those damage caps if a vulnerable elderly person is injured, mistreated or abused while in their care.

The pure logic of lawmakers rejecting that legislation evades me.

The nursing homes and the insurance companies got the "tort reform" caps they sought. Now, the elderly deserve some accountability from those same entities.

Strange that we require liability insurance for cars but not nursing homes. Are our cars more valuable than our mothers and fathers?



Death of nursing home liability bill an insult to patients | clarionledger.com | The Clarion-Ledger

Fall Prevention and accidents FTAG 323

F323
§483.25(h) Accidents.
The facility must ensure that –
(1) The resident environment remains as free from accident hazards as is possible; and
(2) Each resident receives adequate supervision and assistance devices to prevent accidents.

42 CFR 483.25(II) (1) AND (2) ACCIDENTS AND SUPERVISION
The intent of this requirement is to ensure the facility provides an environment that is free from accident hazards over which the facility has control and provides supervision and assistive devices to each resident to prevent avoidable accidents. This includes:
• Identifying hazard(s) and risk(s);
• Evaluating and analyzing hazard(s) and risk(s);

• Implementing interventions to reduce hazard(s) and risk(s); and
• Monitoring for effectiveness and modifying interventions when necessary.

Definitions are provided to clarify terms related to providing supervision and other interventions to prevent accidents.
• “Avoidable Accident” means that an accident occurred because the
facility failed to:
- Identify environmental hazards and individual resident risk of an accident, including the need for supervision; and/or
- Evaluate/analyze the hazards and risks; and/or
- Implement interventions, including adequate supervision, consistent with a resident’s needs, goals, plan of care, and current standards of practice in order to reduce the risk of an accident; and/or
- Monitor the effectiveness of the interventions and modify the interventions as necessary, in accordance with current standards of practice.
“Unavoidable Accident” means that an accident occurred despite
facility efforts to:
- Identify environmental hazards and individual resident risk of an accident, including the need for supervision; and
- Evaluate/analyze the hazards and risks; and
- Implement interventions, including adequate supervision, consistent with the resident’s needs, goals, plan of care, and current standards of practice in order to reduce the risk of an accident; and
- Monitor the effectiveness of the interventions and modify the interventions as necessary, in accordance with current standards of practice.

• “Assistance Device” or “Assistive Device” refers to any item (e.g., fixtures such
as handrails, grab bars, and devices/equipment such as transfer lifts, canes, and wheelchairs, etc.) that is used by, or in the care of a resident to promote, supplement, or enhance the resident’s function and/or safety.
• “Hazards” refer to elements of the resident environment that have the potential to cause injury or illness.
o “Hazards over which the facility has control” are those hazards in the resident environment where reasonable efforts by the facility could influence the risk for resulting injury or illness.
o “Free of accident hazards as is possible” refers to being free of accident hazards over which the facility has control.
• “Resident environment” includes the physical surroundings to which the resident has access (e.g., room, unit, common use areas, and facility grounds, etc.).
• “Risk” refers to any external factor or characteristic of an individual resident that influences the likelihood of an accident.
• “Supervision/Adequate Supervision” refers to an intervention and means of mitigating the risk of an accident. Facilities are obligated to provide adequate supervision to prevent accidents. Adequate supervision is defined by the type and frequency of supervision, based on the individual resident’s assessed needs and identified hazards in the resident environment. Adequate supervision may vary from resident to resident and from time to time for the same resident.

Numerous and varied accident hazards exist in everyday life. The frailty of some residents increases their vulnerability to hazards in the resident environment and can result in life threatening injuries. It is important that all facility staff understand the facility’s responsibility, as well as their own, to ensure the safest environment possible for residents.
The facility is responsible for providing care to residents in a manner that helps promote quality of life. This includes respecting residents’ rights to privacy, dignity and self determination, and their right to make choices about significant aspects of their life in the facility.
For various reasons, residents are exposed to some potential for harm. Although hazards should not be ignored, there are varying degrees of potential for harm. It is reasonable to accept some risks as a trade off for the potential benefits, such as maintaining dignity, self-determination, and control over one’s daily life. The facility’s challenge is to balance protecting the resident’s right to make choices and the facility’s responsibility to comply with all regulations.
The responsibility to respect a resident’s choices is balanced by considering the potential impact of these choices on other individuals and on the facility’s obligation to protect the residents from harm. The facility has a responsibility to educate a resident, family, and staff regarding significant risks related to a resident’s choices. Incorporating a resident’s choices into the plan of care can help the facility balance interventions to reduce the risk of an accident, while honoring the resident’s autonomy.
Consent by resident or responsible party alone does not relieve the provider of its responsibility to assure the health, safety, and welfare of its residents, including protecting them from avoidable accidents. While Federal regulations affirm the resident’s right to participate in care planning and to refuse treatment, the regulations do not create the right for a resident, legal surrogate, or representative to demand the facility
use specific medical interventions or treatments that the facility deems inappropriate. The regulations hold the facility ultimately accountable for the resident’s care and safety. Verbal consent or signed consent forms do not eliminate a facility’s responsibility to protect a resident from an avoidable accident.
An effective way for the facility to avoid accidents is to commit to safety and implement systems that address resident risk and environmental hazards to minimize the likelihood of accidents.2, 3 A facility with a commitment to safety:
• Acknowledges the high-risk nature of its population and setting;
• Develops a reporting system that does not place blame on the staff member for reporting resident risks and environmental hazards;
• Involves all staff in helping identify solutions to ensure a safe resident environment
• Directs resources to address safety concerns; and
• Demonstrates a commitment to safety at all levels of the organization. A SYSTEMS APPROACH
Establishing and utilizing a systematic approach to resident safety helps facilities comply with the regulations at 42 CFR §483.25(h)(1) and (2). Processes in a facility’s system approach may include:
• Identification of hazards, including inadequate supervision, and a resident’s risks of potentially avoidable accidents in the resident environment;
• Evaluation and analysis of hazards and risks;
• Implementation of interventions, including adequate supervision and assistive devices, to reduce individual risks related to hazards in the environment; and
• Monitoring for effectiveness and modification of interventions when necessary.

For nurses, it’s a constant dash to respond to alarms

For nurses, it’s a constant dash to respond to alarms
By Liz Kowalczyk
Globe Staff / February 13, 2011
E-mail this article To: Invalid E-mail address Add a personal message:(80 character limit) Your E-mail: Invalid E-mail address Sending your articleYour article has been sent.
E-mail|Print|Reprints|Comments (2)Text size – + Logan’s cardiac monitor flashed a red crisis alarm and broadcast a fast, high-pitched beeping, a piercing sound that reached his nurse, Tammy Dillon, in the hallway.

Logan was fine. His pumping legs had triggered the crisis alarm again.

The red alarm is the most urgent, meant to alert nurses to a dangerously slow or fast heart rate, abnormal heart rhythm, or low blood oxygen level. But on this morning in the 42-bed cardiac unit at Children’s Hospital Boston, infants and preschoolers activated red alarms by eating, burping, and cutting and pasting paper for an arts and crafts project.

All morning long, nurses heard — and responded to — constant beeping, dinging, and chiming; some kind of alarm sounded at least every minute.

Nurses know that a large percent of patient monitor alarms are false — triggered by movement, a poor connection, or some other factor — but they still must listen carefully to each one and react quickly in case a patient really requires immediate medical attention. Given the almost overwhelming number of alarms going off, nurses, doctors, and health care leaders are concerned about staff in hospitals across the United States becoming desensitized to the noise, a phenomenon called alarm fatigue.

“Children move a lot, and that creates lots of false alarms,’’ said Dillon, a nurse at Children’s since 1996. But “if you have an alarm that is real, a sick child goes down very fast. You never want to be the person responsible for a delay in care.’’

In the case of Logan Narolis of Williamstown, N.Y. — who had surgery at Children’s for a heart defect — the movement of his legs interrupted the oxygen level signal on his monitor.

Children’s is working with engineers at MIT to develop more sophisticated monitors that better identify true crises, with fewer false alerts.

On another morning at nearby Beth Israel Deaconess Medical Center, the 10 nurses caring for 35 patients on Clinical Center 7 responded to all manner of warnings — abnormal heart rate alarms, arrhythmia alarms, bed and chair alarms warning that fragile patients might be getting up, patient call bells, intravenous medication pump alarms, and emergency alarms in patient rooms.

Each has its own unique noise, speed, and pitch — the most urgent are, by design, the most annoying — differences barely discernible to visitors but second nature for nurses. The most serious alarms also scroll across signs in hallways or are sent to nurses’ pagers.

Nurse Sylvia LaRocca was caring for a patient whose cardiac monitor blared a low-heart-rate alarm every few minutes — each time pulling LaRocca away from other patients and into the woman’s room. In every instance, the patient was fine, alert, and breathing well. The hospital’s monitors are programmed to set off an alarm when a patient’s heart rate falls below 40 beats per minute. Doctors had lowered the limit on this patient’s monitor to 34, but her slower-than-normal heart, which dipped down to 31, was still triggering the alarm. Now doctors were debating whether to lower the parameters again.

“You have to respond to the alarm, you have to do it,’’ LaRocca said. “But there are some days when you feel you’re just running from alarm to alarm. It can be exasperating.’’

Dr. Julius Yang, medical director for the unit, said it’s a dilemma. Doctors could risk the patient’s safety if they made her monitor less sensitive, but if they don’t, they run the risk of desensitizing the nurses.

“I worry about alarm fatigue quite a bit,’’ he said. “The problem is, when is real real?’’

For nurses, it’s a constant dash to respond to alarms - The Boston Globe