gooseylucy (anonymous) says...

I agree with you Kathy!! Why is Admin. trying to make our community hospital a "Mayo" or a magnet hospital? It just doesn't sound feasible to me. Especially in these financial times!

And even LPN's are employed in magnet hospitals. So that really doesn't make any sense. There are several magnet status hospital right in our area and they employ and hire LPN's. Hmmm, just doesn't make sense at all.

Come on Emporia & Lyon County speak up!!

November 20, 2009 at 3 p.m. ( permalink | suggest removal )

goodoleboy (anonymous) says...

Newman doe not see the forest through the trees. The reason they have to make these cuts is because more and more people are avoiding the place and heading out of town, they will continue to slit own throats, they don't have a clue.

November 20, 2009 at 3:55 p.m. ( permalink | suggest removal )

spectator (anonymous) says...

Yes, Kathy, they are. The latest hiree with horsepower is from the Mayo Clinic and has indicated she wants to make nhrc another Mayo. The hospital has already tried 3 times I know of to make it an all-RN facility and I agree this is ridiculous. Some of the best caregivers I've met are *lowly* aides, LPNs or CMAs. The more time spent in the classroom will shorten the amount of time a new nurse has in actually taking care of the patient as a person as opposed to a number. Just because you have 1/2 of the alphabet behind your name does not mean you know squat about being a nurse. We've all met people who are 'book smart' who couldn't pour water out of a shoe even if the directions were printed on the bottom. Letters are good but are worthless without common sense.

November 20, 2009 at 7:14 p.m. ( permalink | suggest removal )

jayhawkers1 (anonymous) says...

Again our local hospital makes the news..apparently this time with a Chief Nursing Officer with multiple letters after her name trying to make a name for herself. Is one person allowed to make all these drastic changes? Isn't there a hospital board that most certainly should have some control here? Some of the best nurses at the hospital are LPN's. Are their years of service and experience all of a sudden worth nothing because of some master plan by a person that came here from somewhere else? Is she not aware of the nursing shortage? Or does she not care because she has no vested interest in our community? In the recent past the hospital hired agency RN's from all over the country at a huge cost to our struggling hospital. This will happen again if she is allowed to continue her quest. Or how about paying thousand's in big bonuses just to have these nurses go back to their own communities after their time runs out. That is smart too. Hopefully someone will be able to stop her before it is too late.

November 21, 2009 at 1:27 a.m. ( permalink | suggest removal )

knute (anonymous) says...

The peons in the trenches make newman's function in spite of itself.

November 21, 2009 at 12:04 p.m. ( permalink | suggest removal )

USNretired (anonymous) says...

Almost every organization functions better with a mix of experience and training. Those without training should be encouraged and rewarded to seek credentials and to keep them current, because they often posses the potential to become the most valuable cogs in the machine. Passion is not enough over the long run and those that have the passion deserve to be developed, not denigrated and replaced. The top dogs need the training, and to be vetted by their peers, but are just bean counters if they are without the passion and experience. Keep the LPNs but pay for their development. Grow them into the leadership positions.

November 21, 2009 at 5:47 p.m. ( permalink | suggest removal )

wildcatnurse (anonymous) says...

YY4U and USNretired-
I know and have worked with many LPN's that have no desire to be an RN or BSN. Some nurses prefer bedside care, not paper pushing and management. BSN is just that........Bull S*&^ Nurse. People who only want to sit behind the desk and get all the credit for the hard work the RNs, LPNs, and CNAs do.
Also, it is not that simple to just "enroll in school for a few hours each week". Do you realize how hard it has become to even get into nursing school? There aren't enough teachers and class sizes are small. Compound that with schools that want all their teachers to have a Masters Degree and it's just ridiculous.
Tell me how a new BSN is a better nurse than a 15-year LPN. Tell me how a small community hospital can afford to go all BSN? It can't. NRH is drowning and about to die and no one in the community seems to care.
To all of the truly amazing LPN's at NRH, I am so very sorry. I am sorry the new management doesn't realize what you mean to Newman's. I am sorry the old management that is still left doesn't have the guts to stand up to the new guy/girl. It's sad.
To the new DON, you are in Emporia,Kansas.....not Rochester. If it's a Mayo clinic you want, you are more than welcome to go back. I'm sure they will be happy to have you and your small-minded views back. You do not belong in a small-town, community hospital.
Okay....I think I'm done.

November 21, 2009 at 10:35 p.m. ( permalink | suggest removal )

gooseylucy (anonymous) says...

YY4U, you need to get more information before spouting off and showing your ignorance!! There is nothing wrong with an LPN wanting to stay an LPN. They are a valued part of nursing. And we're not talking about a "few hours" of education.

To go from LPN to RN you are talking about at least 3 years of education. Most of which happens during daytime hours. How does that work around most peoples schedules?? How much $$ does that cost?? In these financial times, how can you afford it??

Many of our hospital LPN's are within 5-10 years of retirement. So going back to school just does not make sense. Not only that, but after going thru 3 more years of school, you almost always lose your current shift and or unit that you work on. Yeah, they will stick you on whatever shift and whatever unit that they want to. Now tell me again, why should they go back to school?

Plus, in case you haven't heard, diploma RN's will be the next ones to go. Yeah, they want them to go back to school too! So now you're talking even more education, time and $$.

Sounds like a plan to me. (A bad one that is.)

November 22, 2009 at 10:12 a.m. ( permalink | suggest removal )

spectator (anonymous) says...

yy, i can't help but feel that your posts reflect that you're a letter-behind-the-name snob. Explain exactly how an ALL RN ETC ETC ETC staff, which includes the added cost to me, the patient, will benefit everyone other than the braggers who want this overly qualified staff. Furthermore, why would an RN ETC ETC ETC want to stay at nmch when the larger, more solvent institutions can, and will, pay for all of those letters after the name? While YOU are coming up with "BS excuses", would you also explain why an RN ETC ETC ETC is better qualified to empty my bedpan, helps me walk in the hall or changes my bed linen? And why do you feel obligated to force your what's best for me has to be the best for you attitude down our throats? I'm glad you like going to classes. Are you one of those book-smart yet can't pour p***out of your boot with the directions on the bottom people? You mention "a bunch of lazy loudmouths who are really quite unpleasant to be around." You are portraying yourself as bitter and "really quite unpleasant to be around." One more thing. OK, you beat the odds. Good for you, I'm happy it worked for you. Now get your nose out of the clouds- I really wouldn't want you to drown the next time it rains.

November 22, 2009 at 11:43 a.m. ( permalink | suggest removal )

USNretired (anonymous) says...

If Newman really wants specific training, then why don't they hold the training? I got 1st responder and EMT quals way back when via night classes paid for by the EMS and FD when I was stationed in SC. I would like to see Newmanendure, as I was born at Newman when my grandma worked there in 1958. I am G6PD and I am sure someone's education paid off in the fact I am still around, working hard and contributing to society.

November 22, 2009 at 12:03 p.m. ( permalink | suggest removal )

oh4theluvof (anonymous) says...

One of the biggest problems that nurses here in Emporia face, is the attempt at monopolizing their education that is being done by ESU and NRH collaborating. They won't acknowledge course credits from FHTC's LPN program for a nurse to expand on their degree, so I am doubtful about their willingness to accept credits from an online source. NRH wants to switch to all RN because that's the only degree that they offer and they are the only school in town that offers it. This is a bad idea in a community that needs a variety of educational levels to not only be available, but to also be usable right here. It is yet another example of the Emporia's-high-and-mighties failing to grasp just where we are in the scheme of the nation and that they too, are just Emporians. On second thought, maybe they do realize that, and in their quest for notability in the world, they are willing to sabotage the lives of anyone under them. Either way, this isn't good.

November 22, 2009 at 3:14 p.m. ( permalink | suggest removal )

jayhawkers1 (anonymous) says...

YY4U, I have no problem with education. It is obviously a daily event in most nurses lives. They continually experience and learn. What your talking about is former education, which is not the goal of many people that have a life to live in addition to working. Chronic education seekers sometimes have nothing but that. They reassure themselves that they are "better" and "smarter" because of those extra letters tacked onto their name. That is not necessarily true or correct no matter how many people you want to quote. Are you perhaps trying to defend your snobbish attitude and disrespect for different people and their goals and aspirations just because you are so "educated"?? Yes and it seems like you DO know how to pour piss out of a boot.

November 22, 2009 at 3:54 p.m. ( permalink | suggest removal )

jayhawkers1 (anonymous) says...

YY4U, correction on my previous comment..I meant "formal education", not "former education". A highly educated person such as you you would probably pick out that small mistake in a moment...and have some more quotes ready to share with us.

November 22, 2009 at 4:23 p.m. ( permalink | suggest removal )

spectator (anonymous) says...

Apparently, yy, your immense education taught you to do both. Or was it from trial and error? jayhawkers1 is so nice; chronic education seeker is so much more politically correct that professional student. I'm going to bow out now because I want to test this squat or sit idea that has been bestowed upon me by what certainly must be an all-knowing god.

November 22, 2009 at 5:48 p.m. ( permalink | suggest removal )

admireed (anonymous) says...

YY... truth hurts

November 22, 2009 at 8:46 p.m. ( permalink | suggest removal )

jayhawkers1 (anonymous) says...

"Alright, I asked for it. So I tried to give some advice to people who obviously were going to be looking for different work because they didn't have what it takes to keep their miserable job as a poop tray dumper." Are you just plain ignorant or did it take years of "education" to make you so superior and condescending?? What a fake you are.

November 22, 2009 at 8:53 p.m. ( permalink | suggest removal )

barefootin (anonymous) says...

not everyone has a desire to advance to the next level. moving up the ladder wont make anyone more competent or more open minded. ask someone who has spent decades working at the same level of nursing if they would do it over again if given a chance. i ve known plenty who are content with working below the r. n. level, it doesnt mean they are ignorant or unmotivated simply like what they have in life. i bet the booger eating cna that moves up to r n level will be a loudmouth-booger eating r. n. excuse the punctuation problem i have, i m using the broken keyboard again.

November 22, 2009 at 10:31 p.m. ( permalink | suggest removal )

barefootin (anonymous) says...

spectator, squatting worked better for me when i used the neighbors yard instead of mine-give it a try

November 22, 2009 at 10:36 p.m. ( permalink | suggest removal )

barefootin (anonymous) says...

i went to the allnursing link you provided and one thing popped out, by 2010, there will be a projected 213,000 shortfall of nurses, when that happens, will there still be a demand for r n only when there is that much of a shortage, it sounds like there will be a demand for any type of nurse, not just rn

November 22, 2009 at 10:47 p.m. ( permalink | suggest removal )

spectator (anonymous) says...

barefooten, squat, squirt, sit or point, it's all good and not really the trick yy thinks it is. I agree that the nurse shortage will be here in 2010, no doubt. The fact that an all RN ETC ETC staff will increase costs remains too. And is it honestly, truly the best route for nrhc to go when it's usually in the red?

yy, You have yet to explain to me why the higher paid RN ETC ETC ETC is better qualified to empty my bedpan [ a poop tray dumper - your terminology, not mine ], help me walk in the hall or change my bed linen than an aide or LPN. In addition, considering your beginning statement "I thought [etc]" It impresses me that your thought processes consist of nothing more than how superior you are above and beyond everyone else. "poop tray dumper" and "booger eater in a flowery shirt" - it must be terrible to be as perfect as you in this imperfect world.

November 22, 2009 at 11:33 p.m. ( permalink | suggest removal )

holding (anonymous) says...

After reading all the comments I felt a need to share my thoughts as well. So, here goes. Everyone of us will need a nurse one day...when that day arrives I hope the nurses you have look at you with kind eyes, concern in their voice, a willingness to help, and knowledge to know how to provide that help. I bet you don't mind what letter is after their name if you are being taken care of appropriately. Nursing is a unique profession. We see people at their most vulnerable. We enter into a realm that even their families may never share. We are a ladder. We provide one step of that ladder or several depending on their needs. Birth,Sickness,Death....a nurse is there through all. There are so many areas for nurses:Obstetrics,Surgical,Telemetry,ER....and as a nurse you choose where your skills work best. It is impossible to know 100% of all the skills but it is very possible to know where to find the one who does. That is a team and good nurses work as a team. You do not learn everything it takes to be a good nurse in school, alot is learned on the job, through work and the various situations you have to deal with. I do not want to discredit any person who achieves a BSN or any other "letter" behind their name. That is something to be proud of, but do not use this to take away from the ones who have worked hard and are fine,caring nurses and are happy and proud of this fact. Professionalism is something one CHOOSES to embrace and there are many that have been to school many years and have yet to achieve this. To YY4U- (How bold of you to consider yourself too wise for others):
"If I can stop one heart from breaking,I shall not live in vain;
If I can ease one life the aching,Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain."
Emily Dickinson

November 23, 2009 at 8:34 a.m. ( permalink | suggest removal )

gooseylucy (anonymous) says...

Higher education is fine, if that's what you want to do. Many people are perfectly happy right where they are. And there's nothing wrong with that. And both RN's & LPN's, have to do continuing education to maintain their license. And they also get on-the-job training any time there is new technology. So esentially they are always being educated!!

Just imagine if all the floor scrubbers, became fry guys. Then who's gonna scrub the floors?? Nursing is the same way. The 3 levels work great together!! They each have their own responsibilities and job functions. It works well for the patient, as they get the right kind of worker for whatever their care calls for. It also works well for the hospital, as they don't have to pay RN BSN salaries for a "poop dumper" etc.

Does anyone else remember the saying, "Too many chiefs and not enough indians."? That's all we are trying to say here. You need chiefs AND indians. And thank God there are people out there that are willing to be the indians!!!

November 23, 2009 at 8:52 a.m. ( permalink | suggest removal )

holding (anonymous) says...

I hope above all hopes that YY4U is NOT a nurse. I am sure you would not be able to take care of a patient w/o first categorizing them to see if they deserve YOUR WISE views.

November 23, 2009 at 10:57 a.m. ( permalink | suggest removal )

Anywhere (anonymous) says...

Its not that simple to just go back to school or take a few hours to advance your degree. May LPNs as well as others have to work to support themselves and families. Also the necessary classes and schooling are not that available here. When people are treated as these nurses are being treated they won't come here for healthcare and their familes and friends may not either. The hospital and Doctors will end up loosing. Believe me its not that far to Topeka and Wichita and they employee LPNs!!

November 23, 2009 at 11:09 a.m. ( permalink | suggest removal )

mrobvious (anonymous) says...

YY4U, I have to wonder, with all of your years of education, how much nursing or medical training have you had? How much real world experience have you had in the hospital as an employee?

With all your talk of "booger eating morons" and "poop tray dumpers", how many nurses do you actually know? Personally, I've known several. My mother went to nursing school when I was a child, so I grew up with her classmates who all worked hard to get their LPN, or Licensed Practical Nurse. Some of them then worked further to gain their RN, or Registered Nurse. My wife took a different route and earned her BSN, Bachelor of Science Nursing degree. All of the nurses I've known, despite their level of education and despite the various letters behind their names, have had to do the same work, take care of the same patients, empty the same bedpans.

Letters do not make a difference in the person. I've known LPN's that I would rather have care for me than BSN's or RN's. It boils down to the persons themselves. If an LPN is rude or ignorant, studying to become Registered will simply make them a more educated rude and ignorant person. Getting a college degree will only make them a highly educated, deeper in debt rude and ignorant person.

I have nothing against trying to better one's self. I love to learn as much as I can. Sadly, I can't afford to even take online courses, so I have to educate myself. Still, I don't think less of those don't try to continue with their schooling. Life is sometimes a better teacher than any college professor could be.

November 23, 2009 at 11:16 a.m. ( permalink | suggest removal )

gooseylucy (anonymous) says...

YY, Your analogy doesn't really apply to this situation. Or your logic is skewed. Here's how I see it.

If you had a leaky roof, or a furnace not working or a broken window, here is what most people would do. (Now keep in mind, this is what people ON A BUDGET would do.) Which we all know the hospital is on a strict budget, or should be.

If you had been doing regular preventive maintenance, this may not have been a problem in the begining. (Or in other words, taken care of the good staff you already had.)

Or you could have read a good home improvement book and made the repairs yourself. (Or equate this with LPN's & RN's getting continuing eduction, which they already do.) And I would think you would like this option, as you are such an educated person. This option also saves you a lot of $$.

Or you could hire a handyman to fix these problems, thereby saving yourself $$. (Once again this represents using all 3 levels of nursing staff, at a significant cost savings.)

Or you could hire a "professional", to fix the above problems. (This represents using all RN BSN staff.) Now this option fixes your problems, but also costs you lots of $$.

Therefore, it would make sense to use one of the first three options, WHEN YOU ARE ON A BUDGET. Yeah, you may prefer to use the last option, but it is very expensive. And I do agree all of the options needs education, which you seem to be very fond of. However, we are talking about a small community hospital here, not Mayo Clinic. We have a budget and need to "live within our means". If you don't agree, that's fine, just hope you have "the means" to get yourself to Mayo the next time you need care.

November 23, 2009 at 11:44 a.m. ( permalink | suggest removal )

gooseylucy (anonymous) says...

YY, Once again you show your ignorance, as it relates to healthcare. The hospital already has a few student nurses that work as CNA's. However, most of the student nurses are not even from Emporia. They drive in from surrounding areas to attend school and a lot of them work in their hometown. That's why when they graduate, they don't come to NRH to work. They either go back to their hometown OR they go to the bigger cities where they can make more $$.

That's another reason why NRH should take better care of the "bottom feeders". Because the elite, educated BSN RN's do not want to work here. Or maybe they are just snobs, like you and they don't want to "mingle with the booger pickers".

November 23, 2009 at 3:54 p.m. ( permalink | suggest removal )

barefootin (anonymous) says...

yy, i got to hand it to you for putting up a big argument and thanks for upgrading the booger eating-poop dumpers to career bottom feeders.
the mayo clinic is a very good facility-been there- they attract patients for all over the country, maybe the hospital has grand ideas of improving so much they will pull patients from outside emporia.

November 23, 2009 at 6:58 p.m. ( permalink | suggest removal )

jayhawkers1 (anonymous) says...

YY4UHave you by any chance migrated south and being employed by NRH as the CNO?? :-|

November 24, 2009 at 7:12 a.m. ( permalink | suggest removal )

spectator (anonymous) says...

yy, your posts went from being extremely "educated" to abusive to acting the playful and thought-provoking and, finally, back to reference to the unimportant nurse. You have maintained a level of snobbery and pettiness throughout. Heaven forbid, I would bet that should you require the attention of one of the "booger eaters, poop dumpers or bottom feeders" or whatever your education decides to label them next, he or she would display professionalism, integrity and your care would be more than adequate even if your yy name and comments were displayed on your chart. You might claim you did all this simply to promote discussion but but I sincerely doubt that. Suggestion: print this article and the posts and use a Hi-Liter to make yours obvious. Eventually you'll require the services of a "booger eater, poop dumper or bottom feeder" nurse. Hand it over and identify yourseld as the author of the Hi-Lited areas. Chances are you will STILL get the care you require. That's called "ethics". You'll likely cover that next semester.

November 24, 2009 at 11:31 a.m. ( permalink | suggest removal )

spectator (anonymous) says...

yy, your posts indicate that you are already at the top. Which leaves the rest of us with the same ole view as we attempt to climb up. OK, yy, you've convinced me, now explain where I find the time and money to advance myself at the portals of a neverending pursuit of knowledge and, dare I even hope, to be on the same level as yourself. (Got that article and the posts, including your last one, the disclaimer, printed out yet?)

November 24, 2009 at 5:36 p.m. ( permalink | suggest removal )

CRAZE (anonymous) says...

Ask a patient about the care they receive from a LPN and I bet they will tell you it is just as good or better than a RN The multiple time I have been a patient at NRH a LPN has cared for me and they take special time out for the patient. Losing LPN's means losing a lot of patient care.

November 24, 2009 at 8:15 p.m. ( permalink | suggest removal )

barefootin (anonymous) says...

lets remember that with the internets popularity, there are alot of online courses that may not be accredited. before paying out for something online, check the credentials first and most community colleges and universities are the best way to go for online classes. k-state is one that is good at trying to meet the needs of the non-traditional student and smaller colleges like allen county and hutchinson community college offer medical courses. some of the small ones will also let you take gen ed classes with them and then transfer the credits over to esu saving you money for gen eds towards an esu degree. some will also let high school kids start taking classes to carry over to a college degree. paying for the class and books arent the main expenses of a class, taking time off working, paying a sitter, and transportation can be barriers to on campus classes. i dont think taking an online course in a medical field is as good as taking the class on campus, there is alot better learning involved in being in a class, but for those who do well at learning online thats good. oh yeah, and dont forget, taking classes and working means there is less time to cook meals at home meaning paying for high priced fast food while your in the class.

November 24, 2009 at 10:57 p.m. ( permalink | suggest removal )

biscuitboy (anonymous) says...

YY4U

Hey ole buddy. You kinda opened up a hornets nest on this one didn't you. :-)

I would be hard pressed to find an incident ever where advancing ones education ever caused them harm. But for those content to stay on the bottom rung...don't complain about others stepping on your head as they climb above you.

Having said that I would also add that NRH acting like it can be another Mayo Clinic makes me question just exactly how much all those brainiacs running the show up there really learned with their educations. As mentioned by one poster earlier.....my guess is this change has more to do with feeding the education programs at ESU and NRH than it does with improving health care.

November 25, 2009 at 8:12 a.m. ( permalink | suggest removal )

biscuitboy (anonymous) says...

NRH is in the unique position to be able to profit off of teaching you the skills you need to meet the requirements they demand of you. Pretty neat trick huh?

November 25, 2009 at 8:19 a.m. ( permalink | suggest removal )

gooseylucy (anonymous) says...

YY, In many cases going back to school is just not feasible. Especially if you only take a class here and there. Close to 1/2 of the LPN's at NRH are within 2-8 years of retirement. It makes absolutely no sense for them to go back to school. It would cost them more than they could make back. Many of the younger LPN's have already left the hospital, to go work in some of the bigger hospitals in the area. (Where they continue to hire and value the work ethics of LPN's.)

And the Admin of NRH have repeatedly told the remaining LPN's that they would be replaced thru attrition. (This was also put in writing.) However, they seem to have gone back on their word on this. As they are currently forcing them into other non-nursing positions. Or they are giving them all of the On Calls, in an attempt to force them out. That doesn't sound like attrition to me.

I suppose you'll come back with, they should go back to school just to improve themselves or increase their knowledge. That's all well, fine and good. But in these bad financial times, money or the lack thereof speaks the loudest. Knowledge doesn't always put food on the table, work does!!

November 25, 2009 at 8:46 a.m. ( permalink | suggest removal )

nmse_s (anonymous) says...

I would like to say I have a BSN in nursing and I am very proud of that. It was a huge hurdle for me jump over and it took a lot time/energy. I chose to pursue this profession at the BSN level because the majority of nursing programs across the country are BSN not diploma. The program here is very good and the instructors are some of the best I've seen at their profession. From what I know the LPN program is a great program as well and am sure their instructors are just as great. Could their be better colaboration between the two programs (especially if a LPN decides to switch to BSN) of course there could be and should be.

I'm not sure why the new DON wants an all RN staffing; considering Stormon Vail is a Magnet Status hospital with LPN staffing. I do know this... you will see the good the bad and the ugly with BSN, RN, and LPN. I've learned a great deal from LPN's and truly appreciate what some of them have done to help me learn. I've also learned a great deal from RN's (diploma prepared) and appreciate them as well (you can't beat learning from experience). Yes you don't need BSN behind your name to make you a better nurse....but WILDCAT, BSN-prepared nurses are not just sitting behind a desk, pencil-pushing. We are on the floor as well working along side the LPN's and RN's, learning from their valuable experience. In 10 or so years it'll be the RN's who are Bachelor's prepared that will be taking care of you (the diploma prepared RN's will be retiring in these next 10 years). I hope you learn to appreciate the BSN nurse as well.

The all RN staffing at NRH not only de-values the wonderful work of our LPN's but it can also damage the program at FHTC. I hope something changes and soon before more damage is done.

November 25, 2009 at 8:54 a.m. ( permalink | suggest removal )

jayhawkers1 (anonymous) says...

YY4U.....no one is objecting or denying that continuing education is wrong or bad for you..YY4U has been downright rude in his presentations. He is trying to deny this by pretending that he, or she was trying to inspire us all to recognize the value of education. But none of us are buying that weak explanation. I recognize a boorish, superior attitude when I observe it. Biscuitboy, I agree with you about NRH providing education that is needed to support their nurses. What a plan! As for you YY4U, you need to acquire some human decency and respect for the rest of us peons and whatever career we choose. Hope you get advanced to whatever you deserve.
"I have really enjoyed picking on you guys", is one of your idiotic statements that was not appreciated by any of us.

November 25, 2009 at 4:49 p.m. ( permalink | suggest removal )