Blogging has taken a back seat, the reason being some repetitive strain/tendinitis in my right arm. It gets better and then worse. No surprise that it gets worse when I forget to rest it more. So since I type so much for work, and am trying to get an “outside regular work” project done, I’ve slacked off on blogging.

I am trying to use my left arm/hand more, but I am a righty, so this does really rain on my parade. In my yoga class, I am trying to figure out how to modify some of the poses, so I don’t put too much pressure on my arm. It has felt better the past two days…so hopefully this will pass.

But sitting by the computer and typing if I don’t have to be is really not the best thing for it. Maybe I’ll try some short posts, and see how that goes while it heals.

A love letter to nurses. And not a sweet sappy nauseating tribute to the “angels of mercy” kind of thing.

Dana Jennings, an editor at the New York Times and a former prostate cancer patient, has written a nice opinion piece called “In Praise of Nurses.” In it, he recounts his experiences as a patient, beginning from when he was a child all the way up to his bout of prostate cancer. Unfortunately, he has had a few health problems which necessitated hospital admissions and care. Fortunately, he was cared for by competent and professional nurses.

It is nice to see this sort of article, in that he offers praise to the nurses who provided his care, without the usual idiotic sugar coated rhetoric. It’s not sentimental, but simply shows the vital role that nurses played in his care.

He appreciated it. He remembers them even if he doesn’t recall their names.

Thank you, Dana! Happy New Year!

Doesn’t that look cool? So binary.

The first day of a new year is always filled with such hope and promise. A brand new, fresh baby year–just bursting over with so many possibilities.  But as far as healthcare in the US goes, these past 2 years were filled to the brim with wasted opportunities.  The situation is worsening, as far as I’m concerned. After dealing with my mother, as I mentioned in November, I could see first hand at just how broken this system is.

The nursing home/rehab where my mother was kept her longer than usual because after talking to me, I think they smelled lawsuit. So instead of throwing her out the door and leaving her in the parking lot of her condo building, they waited until we had finalized placement in assisted living.

The assisted living where we placed her is very nice, but also expensive. Aside from her social security, we are counting on two other sources of funding, which will cover the costs. If it doesn’t come through, and she is still unable to live her own, then she will have to go to a cheaper facility. Not so nice, but then, equality is not what this country is about when it comes to healthcare.

But getting back to the more general issues, Obama had a golden opportunity to do something and failed badly at it. The bill that was finally pushed through is anemic, and while it does put some brakes on an insurance industry gone out of control, it does absolutely nothing to curtail spending. And maybe that’s intentional–afterall, healthcare is for the most part a profit making machine.  Healthy people, streamlining the system, and smart choices don’t make money.

For example, while Michele Obama is talking about child obesity and going through all the motions, her husband is busy promoting fat. Yes, that’s right. Not him personally, but he is the president, and supposedly should know what’s going on.

Dairy Management, a marketing creation of the United States Department of Agriculture, is heavily involved in getting people to eat more high fat cheese. Yes, the US government telling people to lose weight but at the same time spending millions in taxpayer money to support and increase the consumption of high fat cheese. Cute.

From the NY Times:

Americans now eat an average of 33 pounds of cheese a year, nearly triple the 1970 rate. Cheese has become the largest source of saturated fat; an ounce of many cheeses contains as much saturated fat as a glass of whole milk.

When Michelle Obama implored restaurateurs in September to help fight obesity, she cited the proliferation of cheeseburgers and macaroni and cheese. “I want to challenge every restaurant to offer healthy menu options,” she told the National Restaurant Association’s annual meeting.

But in a series of confidential agreements approved by agriculture secretaries in both the Bush and Obama administrations, Dairy Management has worked with restaurants to expand their menus with cheese-laden products.

Consider the Taco Bell steak quesadilla, with cheddar, pepper jack, mozzarella and a creamy sauce. “The item used an average of eight times more cheese than other items on their menu,” the Agriculture Department said in a report, extolling Dairy Management’s work — without mentioning that the quesadilla has more than three-quarters of the daily recommended level of saturated fat and sodium.

Dairy Management, whose annual budget approaches $140 million, is largely financed by a government-mandated fee on the dairy industry. But it also receives several million dollars a year from the Agriculture Department, which appoints some of its board members, approves its marketing campaigns and major contracts and periodically reports to Congress on its work.

Isn’t great to know how serious the Obama administration is about healthcare reform?

So on that note, happy new year, and stay healthy.

So, with less than 48 hours left to 2010, what’s the verdict? Good year or bad year, as far as healthcare and all that goes with it?

In my mind, its definitely a mixed bag. A very mixed bag.

Some good news is that the Center for Safety battled Monsanto (the evil empire) in the U.S. Supreme Court – and were victorious in maintaining the ban on the planting and sale of GMO alfalfa. They also won another major lawsuit against USDA, Monsanto, and a number of other biotech companies this August, which halted the sale of GMO sugar beets.

The bad news is that our healthcare system is still a mess. Nothing has changed for the better. It’s gotten more expensive, and care has not improved.

Oh, and our esteemed Surgeon General, Regina Benjamin, has finally issued her first report. And guess what she wasted taxpayer money on–drum roll….the dangers of cigarette smoking. Like lady, don’t you know that the Surgeon General issued that same report 40 or 50 years ago. But to be fair, Dr. Regina took the opportunity to sensationalize it a bit, and publicly state that even smoking one cigarette can kill someone with underlying heart disease. Or was it one puff on one cigarette?

Is the woman so disengaged from life that she can’t find a public health issue to beat her drum to? Smoking is unhealthy, but we’ve been there, done that. It is an ongoing issue, and with so many other public health issues to choose from, it is incredulous that this woman will drag out a topic that has been studied to death (pardon the pun). She has taken the office of the Surgeon General to a new low and she is clearly not suited for the job.

What can we expect in 2011? I’ll be back with my predictions…

Merry Christmas All! And yes, I am being so politically incorrect by actually saying those two words.

But you know, it is Christmas tomorrow and tonight is Christmas Eve. Santa is coming. It is not “Happy Holidays” or “Season’s Greetings.” it is Christmas.

Trying to be politically correct because of the perceived offense to those who don’t celebrate Christmas just adds the generification of holidays. It’s bad enough that we see Christmas supplies appearing in stores in September, mixed together with Halloween and Thanksgiving. The holidays aren’t even given a chance to breathe and stand on their own.

If you celebrate the Solstice, then say “happy Solstice.” If you celebrate Hannukah, the say “Happy Hannukah.” Ditto for Kwanzaa, or any other holiday that happens to fall around this time. I won’t be offended if someone wishes me a greeting for a holiday I don’t celebrate. I think it is very kind of them, and I will wish them the same.

So Merry Christmas! And I hope you’ve all been good boys and girls.

And special thanks to all of the nurses, doctors, and other healthcare personnel who are working on Christmas. I hated having to work on holidays, even though it was time and a half pay. But thank you for being there, for as all of us in healthcare know, its a 24/7 job that doesn’t take time out for holidays, weekends and birthdays.

Not sure how I missed this story considering that I used to work at this hospital.

D.C. hospital fires 11 nurses, 5 staffers for snowstorm absences

The Washington Hospital Center, which I believe is the largest facility in the area, fired several nurses because they were unable to show up at work during one of the worst–if not the worst–snowstorms in the city’s history. Strange how most of the nurses that were canned have seniority and have been there a while. What a nice way of getting rid of the best paid people and those that might come around begging for a pension sooner rather than later.

In a letter sent to the staff on Friday, hospital President Harry J. Rider sought to quell rumors that hundreds of people had been fired. He said he expects fewer than 20 people will be dismissed.

“Sadly, we did experience some issue with associates who did not show the same commitment as most of their co-workers to the community, our patients and their fellow associates. They are the few who turned away from their scheduled shifts and who tried — and are still trying — to turn the focus on themselves rather than the thousands of Washington Hospital Center workers who fulfilled their commitment to their patients and colleagues, and made it to work,” he wrote.

I wonder if Henry and his other peons managed to make it into work during the snowstorm, and show their “commitment” to the hospital. Did management make it in?

If they hospital was really committed to its staff and patients, they would have made an effort to help nurses get into work. Send out army humvees if need be, but get the nurses to work. Or offer to pay them to come in ahead of the snowstorm, and give them a place to stay. It works both ways, Henry. Nurses are committed to their jobs, but they are not about to kill themselves trying to make it to work, or abandon their children (I guess that Henry never thought of that either–that schools and daycare were closed, so what should nurses do with their kids–not that he’d think to offer daycare at the hospital’s expense).

On one forum, some nurses were saying that their hospitals expected them to come in ahead of time if a storm or something was anticipated. They didn’t get paid for their time, and they could stay in an empty patient room, or stay in a hotel at their own expense. And baah baah baah, most nurses just follow like sheep.

Well I hope all of these fired nurses suit the crap out of the WHC, and in another article, it says that the nurses have voted to become part of a larger union. Yay!

Happy Veteran’s Day to all vets out there. And in keeping with the theme of this blog, I will specifically acknowledge healthcare workers who have served in the military.

Nurses became a formal part of the military following the Spanish-American War, after about 1500 civilian nurses had been contracted to serve in Hawaii, Cuba, Puerto Rico, Guam and the Philippines, as well as to the Hospital Ship Relief.

The Army Reorganization Act of 1920 gave nurses a little more status–and granted military nurses the status of officers with “relative rank” from second lieutenant to major (but not full rights and privileges). It wasn’t until after WW II that nurses were given permanent commissioned officer status.

An addendum to the story of my mother…well, they operated on her hip on Monday afternoon. She had also received a blood transfusion because she was a little anemic. I spoke with a friend of hers last night and he told me that she wasn’t eating, and still had an IV in. I also spoke with her PCP, who said that depending on how she was doing, she would be discharged to rehab on Thurs or Friday.

Well, my favorite caseworker called me this am to tell me that my mother was being discharged from the hospital today and going to rehab. She was her usual abrupt pseudo-friendly self. I can’t tell if she’s just overworked/underpaid (the usual drill) or if she really just hates her job. Maybe a combination. She couldn’t answer any questions, of course.

I’m at least glad that they waited for her anesthesia to wear off before discharging her. On one hand, its good to get out of the hospital asap, so you don’t catch something there. And a somewhat debilitated old woman, who just had surgery, is a likely candidate for the infection of the day. But on the other, it doesn’t sound like she is ready to go out into the world yet. I would think they would keep her at least one more day, just to make sure she is eating and drinking, and everything stable.

But as the world turns…of course we don’t need healthcare reform. Everything is just so peachy cool as is.

Grrr….

Should be everyone’s worse nightmare, but in all fairness, some places are better than in others.

Florida, and in particular South Florida on the Atlantic side, is probably not one of the best places to either be a patient or to be an employee.  The pay sucks, unions are almost non-existent, the work force transient (there’s always an enormous number of travel jobs available in Florida), and basically, it shows.

No, I haven’t done a survey or scientific study, but many of the hospital horror stories take place in Florida. Nurses on forums report the often pitiful wages paid to them, and the severe under staffing. And although I worked in Florida quite a long time ago, I felt like I had gone back in time 20 years.  I briefly worked on staff and then through the registry/per diem, and it was an overall nightmarish experience.

But now, I guess I am aiming on one facility in particular. My mother fell and broke her hip, and I have to deal with an assortment of people, ranging from nice and helpful to total incompetent morons. We can start with someone from the county sheriff dept, who didn’t know where Seattle was and thought that I could just get in my car and drive right over. He didn’t seem to understand the distance from California to Florida either. And this is someone who is an officer of the law?

Next, the hospital operator was a total moron, who kept transferring me to arbitrary voice mails and fax machines.  The floor nurses were okay, although they could have been more helpful. I realize that they are probably extremely short staffed, and don’t have time to chat with me, and probably wish that I would just come in and take care of my mother. When I spoke with my mother, before she had surgery, she was trying to get a nurse to come because she had to use the bathroom. And nobody had bothered at first to help her with her hearing aids. They assumed she was demented because she couldn’t hear them.

The ER nurse had asked for my permission to do surgery because my mother is “demented.” Granted, my mother has a lot of mental problems, and she can drive you up the wall, but demented she’s not. I told the ER nurse that I would give my permission, but that the women was dehydrated, had been traumatized, did not have her hearing aids–and that does not add up to dementia.

The best one was this moron nurse caseworker (yes, she is a moron) who called me from the hospital and was trying to talk in that silly “nurse talk” like I have an IQ of 10.  Uh, I don’t think so. She wanted to know if I was the one who would help my mother make a decision on where to go for rehab. I told her that she might first try by asking my mother if she has a preference, or maybe doing something really radical like asking her primary care physician?

We already established that I live 3,000 miles away, so why would she think that I would be familiar with rehab in their area? Or does she think that I spend my spare time reading up on rehab in Florida. She seemed a little surprised by my answer–like it never occurred to her to ask the patient, or doctor.

Anyway, that’s my rant for today. My stepfather died in this hospital, and the ICU nurse that I spoke with right before he died was about as intelligent as the nurse case worker described above.  I’m not impressed with the place, and again, I imagine that the employees are overworked and poorly paid. The caseworker couldn’t wait to push me off the phone. Nice customer service.

October is one of my favorite months–except for this year, as its been so rainy. Then again, I’ve hardly been at home to really get too soaked. Have been orbiting around–first in Milan, then Vancouver, and more happy trails are lined up. I love Halloween, all that orange and black.

Notice, orange and black, not pink. No breast cancer “awareness” month for me. No frilly pink idiocy, pink ribbons pinned on my shirt, and doling out money to pink items that I don’t need or want, or have no idea if even one cent is going to breast cancer causes. Or if it is, exactly what cause and what will it be spent on.

In honor of Pepto Bismol month, the New York Times has a review of two breast cancer related books. Very appropriately, the title of the review is called Breast Cancer Tales: The Inspirational vs. the Actual.

The inspirational is a sweet memoir by Nancy Brinker, founder of Susan G Komen for the Cure, and really the person who is ultimately responsible for not only breast cancer awareness, but for turning breast cancer awareness into a combination circus and industry.

The other book, rips into the pinky sweet movement by “taking issue with the “she-ro” of the breast cancer movement — an idealized patient who is assertive and boundlessly optimistic, and remains feminine and sexy despite the depredations of disease and treatment. This paragon often uses a diagnosis of breast cancer as a catalyst for a personal transformation; she begins to “take time for me,” discovers “what’s important in life” and comes out of the experience a changed and better person.”

I have to give Brinker credit for bringing attention to a “women’s” issue at a time when women’s issues were pretty well ignored–other than the ever ongoing battle of abortion.  But I think Komen has evolved into a business, and the final straw was their partnership with Kentucky Fried Chicken–selling junk food in pink buckets. If you’re an advocate for breast cancer patients–then you have to draw the line somewhere. And that line is advocating food which can directly lead to a huge number of health problems and indirectly lead to cancer–including that of the breast.

At any rate, the only advocacy group that I really see working towards prevention is the Breast Cancer Action, and I mean real prevention, like taking on corporations, industry, regulatory bodies (like our friends at the FDA). They also have a fantastic “Think before you buy Pink” campaign which seeks to educate the consumer about pink buying and what you need to know.

So I continue to ignore pink. Instead, I am enjoying the reds, yellows, golds, of the fall season. And the orange and black of Halloween.

Time to take cover from the pink onslaught which begins today.

What pink onslaught, you ask? Why Breast Cancer Awareness month, when the world turns into one sickening shade of pink.

In fact, the pink has now crept out beyond October, and the rest of the year is becoming sporadically dotted with pink.

I can’t stand it. I think it is overdone, and quite honestly, I think its time to move on.Plus the pink propaganda can also be deceiving–a lot people buy pink stuff thinking they are helping a worthy cause, but instead, are just contributing to some company’s bottom line. None of the money spent on the pink frou frou may be going to breast cancer research, for example, as the pink items are notorious for omitting any information that tells you where the money is going, what percentage of the purchase price is going to research, etc. And thus far, almost none of the big “pink groups” has done anything to try to reign in the fraud.

There is an interesting article in the LA Times about downside of the so-called awareness campaigns. This  is what I found very disturbing:

“If it’s not broken, I don’t think we should try and fix it,” said spokeswoman Laurie Casaday, senior manager of corporate affairs in oncology for drug maker AstraZeneca, National Breast Cancer Awareness Month’s founding sponsor.

The campaign’s website states that the organization remains “dedicated to educating and empowering women to take charge of their own breast health by practicing regular self-exams to identify any changes, scheduling regular visits and annual mammograms with their healthcare provider, adhering to prescribed treatment and knowing the facts about recurrence.”

Other campaign literature highlights the stories of women who believe their lives were saved by a screening test. But the unsettling reality is that many of these lives were never actually threatened, says Gayle A. Sulik, author of “Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health.”

Sulik says the problems of over-diagnosis and over-treatment are rarely discussed in ads, promotional literature or advocacy messages. Neither of those terms appears anywhere on the websites for National Breast Cancer Awareness Month or Susan G. Komen for the Cure, the oldest and largest breast cancer advocacy group.

But note, nothing is said about real prevention in the campaign’s mission. Overdiagnosis aside, there is not one peep about preventing the disease to begin with. Mammography is not prevention, it is a screening tool and a diagnostic tool. It can only tell you what’s there. Taking charge of your health goes beyond a visit to the doctor or looking for lumps. You want to prevent the lumps, but real prevention involves taking on powerful industries–the kind who make junk food, pesticides, toxic household cleaners, the chemicals that go into cosmetics and toiletries, etc.

It means taking on the FDA and forcing them to do their job. It means a lot of things that the major advocacy groups don’t want to talk about.  And women themselves, I think, prefer to think that all they have to do is wear pink ribbons, and breast cancer will be cured. Many do not want to be inconvenienced by having to exercise, or lose weight, or give up happy hour every day, or their breakfast donuts.

Anyway, this is the only post I am going to make about pink, unless there is something else really juicy in the news. Otherwise, I plan to ignore it. I will not buy anything pink colored, or even wear pink. That’s my political statement!

I have long been opposed to this idiotic system of licensing nurses (and other healthcare professionals) state by state. There is one national licensing exam, and therefore, there should be one national nursing license.

The system as it exists now, allows individuals who have lost a license in one state, who are considered incompetent or even dangerous, to simply pack-up and move across state borders.

From the LATimes:

Because there is no federal licensing of nurses, each state sets its own standards on punishable behavior.

In general, states can discipline a nurse based solely on the actions taken by another state. But they vary widely in how quickly — or harshly — they act on this information, according to interviews with regulators in 14 states.

Under the law in Virginia and Louisiana, for instance, officials must immediately suspend nurses’ licenses for serious misconduct in another state. Nurses are barred from practicing unless they successfully appeal.

Missouri, on the other hand, must personally serve all accused nurses with written charges and offer hearings to contest them. If nurses can’t be found, their licenses remain clear and they are free to continue practicing, said Lori Scheidt, executive director of Missouri’s nursing board.

Delays in several states left Craig Smart free to practice. In 2000, he surrendered his license in Florida after testing positive for cocaine and flunking a treatment program. It took eight years for five other states in which he was licensed to respond to Florida’s action. California was the last to revoke his license, in 2008, after he had practiced here for several years, apparently without incident.

Even when states share borders, they sometimes fail to heed each other’s disciplinary actions. At least 10 nurses, for example, hold clear licenses in Massachusetts despite being disciplined next door in Rhode Island, including suspensions for drug thefts and violence.

Nurse Karen Rheuame’s Rhode Island license was suspended in 2007 after she was arrested on suspicion of assaulting a woman in a wheelchair in a hospital emergency room and trying to steal her pocketbook, according to state disciplinary records. She also had numerous other convictions and, records show, had once brought two beers to work, which she explained to her boss were for “the ride home.”

But she’s free to practice in Massachusetts. A health department official there said regulators are reviewing Rheuame’s case and others to see if action is warranted, but they haven’t received any complaints about the nurses in Massachusetts.

A unified national system would eliminate this. But of course, state Boards of Nursing would be reduced in size and number. They basically exist to keep this inefficient and dangerous system alive, and as we can see, they are totally inept in doing their job. Having dealt with the Board of Nursing in Washington state, regarding renewing a license, I can vouch for the lack of professionalism and total self-importance seen at least in this state. It took a threat to the governor’s office and other state regulatory agencies, for them to refund money owed to me for licensing fees.

State agencies would need to exist, but in a smaller form, and with less power (and yes, the BOR does not want to get off its power trip). Forcing a nurse to be licensed in each state is simply a means of revenue–it supports an unnecessary BOR, and allows incompetent/dangerous nurses to continue working.

Nurses, listen up. Christine O’Donnell, the new rising star of the Republican party, or is it the Tea Party, has the solution to STDs, teenage pregnancy, and unwanted pregnancies in general. She believes that you can just tell the world to “STOP HAVING SEX.”

And they will listen.

I think she is the new messiah. Or she thinks so. Maybe you can get her to come give lectures at the local nursing and medical schools, because this advice is just so easy. I mean, who would have thought that these major issued can be solved with just three words.

So the next time a patient asks about birth control, or AIDS–just tell them the three magic words and then end the conversation. And if need be, then send them to see Christine O’Donnell.

As in, where is she?

throughout the entire debate on healthcare reform, she has been notoriously silent. I will admit, that I don’t read the news every day, and in fact, try to avoid it, but I did a search and I really can’t find anything about her. Not only with healthcare reform, but giving an opinion on anything.

What is her focus? What is her platform?

The surgeon is supposed to have a bully pulpit, and is supposed to be a vocal advocate of something related to health. But it seems that Dr. Benjamin is of the opinion that her post is meant to be invisible.

Now more than ever, the Obama administration could use some help in advocating for the healthcare reform bill. But I guess that Dr. Benjamin thinks silence is golden. Maybe she thinks that she is supposed to spend her time behind a desk and be neither seen nor heard?

Yesterday I posted about a new addition to the nurses health study, and put out the word, as requested, to recruit more victims..uh subjects for the study.

Now, there is nothing really wrong with the study, except that the data is used to make sweeping conclusions and statements about health. In my opinion, many of the questions are highly flawed in that they don’t allow you to answer correctly. In the questionnaire on diet and supplements, for example, they asked about your intake of fruits and veggies. They have a note in the margin that says..

Please try to average your seasonal use of foods over the entire year. For example, if a food such as cantaloupe is eaten 4 times a week during the approximate 3 months that it is in season, then the average use would be once per week.

Are they kidding or what? But yes, that’s what it said on the questionnaire. As if eating peaches a few times a week when they are in season and then not eating them all winter is the same thing as eating one peach a week all year round. So in other words, the nutrients and fiber that you get from a peach sort of paces itself, just a like a timed release capsule.

Now if that isn’t dumb enough, do I really know how many cups of blueberries I eat a week? I don’t measure them out, I just eat them. How many apricots do I eat in a week?

The only way to keep an accurate account is to have a food diary. But this is to be done from memory.

In some part of this particular questionaire, you also cannot specifically say that you don’t eat a certain food, ever. They give you a choice of “never or less than once per month.” That is not the same as never eating it.

In a few questions, they don’t even give you that.  For example, they ask “How often do you eat toasted breads, bagel or English muffin (e.g., slice or 1 half bagel)?”

There is no way to answer that you don’t eat toast, bagels or English muffins. The “least” answer is less than once a week.

Also omitted are very crucial questions pertaining to the type of food you eat. They ask about adding sugar to beverages, but don’t really ask about the consumption of sugar laden–yes, there are questions about eating cakes, cookies, etc, but it really doesn’t give a full picture. They also don’t ask about the amount of processed foods eaten, about foods containing questionable additives, organic foods, amount of raw food eaten, etc.  If the produce you eat is fresh vs. frozen vs. canned.

The questions about breads, cereals, etc, do not allow you to say that you eat whole wheat pasta, for example. Or sweet potatoes as opposed to regular potatoes. The list of vegetables and fruits  they ask about is pathetically small, and at the end, they allow you to add in any other “important” foods. Three to be exact. Wow, generous.

They ask about eggs, but nowhere can you enter if you eat free range/organic eggs. You can’t say that you absolutely eat no processed meats whatsoever. Or do not drink soda, diet or otherwise.  They list soy products, such as burgers, miso, tempeh, etc, in the vegetable section. I realize that soy is a vegetable, but many people eat it as a main dish, as in soy burgers and hot dogs. They really should split it up–soy as vegetable like edame, and put soy main dishes in a separate category. Ideally, they should really have a separate list for people who eat no meat at all, because it is impossible to answer this questionaire accurately if you happen to adhere to a vegetarian or vegan diet.

Anyway, this questionnaire is really sad, and it is frightening that they are pulling data out of it and drawing conclusions about diet and health. There is so much missing from it, and it relies totally on memory…oh, and idiocy like pro-rating your peach intake.

That was just to draw your attention–it’s not as bad as that. But if you, meaning nurses, are interested in participating in a study–here’s your chance. And its not just any study, its the latest phase of the hallowed Nurses health Study. Yes, that Nurses Study.

If you sense a bit of sarcasm in my tone, well, you’re right. I have very mixed feelings about the results that pop out of this study periodically, being that I have been a participant for 20 years. The methodology is somewhat questionable, as are many studies that rely almost solely on self report. This is especially true of the NHS, which relies on self reported questionnaires that ask questions that are near impossible to answer correctly. Plus, the data they collect has a lot of omissions in it that I think could really affect their results.

Self-reported questionnaires can be useful and accurate if they are focused on one narrow subject, such as side effects from a specific medication, or if yoga has relieved back pain.  But the questions they ask are epic in nature and require things like remembering how many peaches you eat a week, how many hours you stand at work per day…now, unless you are closely monitoring diet/exercise/patterns of daily life, at best, this is something you will only approximate.

Anyway, I’ll discuss it more tomorrow, but I just wanted to make the announcement, in case any nurse is interested in signing on.

For the new cohort,they are enrolling 100,000 or more female RNs and LPNs between 22 and 45 years old (born after January 1, 1965). The new study will be entirely web-based, as roughly half of Nurses’ Health Study II is already. To learn more and to join, nurses should visit www.nhs3.org

No, fortunately, there are people left with working brains. The shooting incident at Johns Hopkins Medical Center was tragic and certainly, terrifying for employees and visitors alike, but precautions have to be reasonable.

Nurses have long been at the receiving end of violence, as they are a vulnerable group due to the nature of the job. This time a physician was shot, which is a more unusual case.

Hospital security often sucks big time, to put it bluntly. Parking garages are often poorly monitored, if monitored at all, security is slow to come when called, security staff is often spread very thin, and there is often just a general lack of standard safety features such as good lighting at night in garages and walkways around the facility. In addition, nurses have often been discouraged from reporting incidents, or even threatened if they do so.  Accusing patients of violence does not make for good PR or customer service.

So in a way, this incident has helped bring to light that violence is a way of life for healthcare workers and that is an area in dire need of improvement. But metal detectors is not the answer since most violence does not involve guns. In fact, it may involve equipment that is already inside the building–a chair thrown at a nurse, for example. Or just being hit, bitten, punched, kicked…

Hospitals need more security and to get rid of the stigma of reporting a crime. Nurse and other staff need to be supported, not criminalized. Disruptive patients, family members, and other visitors need to be shown the door.

From the Baltimore Sun:

While Hopkins has long focused on safety at its sprawling medical campus in crime-plagued East Baltimore, the hospital does not require patients or visitors to pass through metal detectors, as Americans must do now at airports, courthouses and many federal buildings.

With a weekly stream of 80,000 patients and visitors, imposing such security restrictions is “impossible,” Hopkins officials say — and security experts agree. Even as violent incidents appear to be on the upswing at hospitals, they need to remain welcoming places, experts say.

Can you imagine metal detectors in a large hospital like Hopkins? It would take hours just to get inside the building.  As I said, it is fortunate that people are thinking with their brains for a change of pace.

Apparently, the National Nurse movement is alive and well, and still trying to push through an Office of the National Nurse. While all of the arguments for it are well and good, the bottom line is–is this something that we really need to be spending money on?

What many people don’t realize is that there is already a Chief Nurse Officer of the Public Health Service. Just expand this role a little, and you’ve got a national nurse. Make this nurse a little more visible. The bill that the National Nurse advocates are trying to get pushed through lists all of the responsibilities that the new National Nurse would have. But in reality, none of them are new, or require the formation of a whole new office.

In fact, some of it is really a little naive. I wrote up an article about this a few years ago, and one of the people I spoke with was–shall I say–quite unrealistic in what she thought that a nurse was going to accomplish. She kept repeating to me the rhetoric of how nurses are the most trusted profession, and how people listen to nurses (ummm…then why are they so abused in the workplace and so powerless), and so on. But that doesn’t translate to everyone dropping what they’re doing to come and listen to a nurse speak. Or that they will pay more attention to head honcho nurse than the Surgeon General.

Duties- The National Nurse shall carry out the following:

• `(1) Provide leadership and coordination of Public Health Service nursing professional affairs for the Office of the Surgeon General and other agencies of the Public Health Service, including providing representation for the Government of the United States at the Global Forum for Government Chief Nursing and Midwifery Officers and serving as a member of the Federal Nursing Service Council.

• `(2) Represent the Surgeon General and the agencies of Public Health Service in communications with groups and societies concerned with nursing issues at the local, State, national, and international levels.

• `(3) Provide guidance and advice to the Surgeon General and the Nurse Professional Advisory Committee on matters such as standards, recruitment, retention, readiness, and career development of nurses employed by and contracted with agencies of the Public Health Service.

• `(4) Conduct media campaigns and make personal appearances for purposes of paragraphs (5) through (7).

• `(5) Provide guidance and leadership for activities to promote the public health, including encouraging nurses and other health professionals to be volunteers and developing projects that educate the public about and engage the public in prevention practices to achieve better health.

• `(6) Provide guidance and leadership to encourage nurses to become nurse educators.

• `(7) Provide guidance and leadership for activities that will increase public safety and emergency preparedness.

Is there anything on this list that requires a whole new office to be set up? No. Is there anything on this list that the current CNO of the public health service can’t do? No.

Plus there are a lot of vague statements, like number 7. What kind of guidance, exactly, is the National Nurse going to provide? Go around and check up on all of the state and local public health departments? What those places need are more funding and manpower, not a National Nurse “giving guidance.”

Number 6 is not only naive, it is downright silly. Do they really think that “words of wisdom” from the nurse in the sky are going to convince nurses to become educators? That the only problem in convincing nurses to go into teaching is the “lack of guidance”  or “leadership?”

It sounds all nice and good in a document, but in reality, RNs with a 2 year degree from a community college can make more money than an educator with a PhD.  Bottom line is that nurses are not becoming educators because they can make more money (a lot more money) working in other areas of nursing. You need at least a master’s degree to teach, and a PhD if you hope to get a tenured position. Higher degrees cost money, and if you’re going to invest in education, then there are many more opportunities awaiting–for much better pay, that are a lot more interesting, that allow more independence and career advancement, and lack the headache of academia.

So unless the National Nurse is going to work some magic and substantially increase the pay of nursing instructors, nurses are not going to drop what they’re doing and run off to teach school–just because the National Nurse offers them “guidance.” All of this stuff sounds so nice and proper on paper, but in reality, its just silly talk.

If we didn’t already have a CNO in the public health service, then I would say we should consider the National Nurse. But all that needs to be done is expand the current CNOs role a little bit, and let him/her become more visible. That would involve minimal spending, and could easily be put into place.

On yesterday’s theme, about shortage vs. surplus, one thing we don’t need is money spent on more scholarships and funding to increase nurses. There are more than enough nurses, if only hospitals would hire them and improve working conditions.

We don’t need to waste money on trying to push more nurses through school. One major reason is that people will jump at the chance to take the funding, whether they really want to be a nurse or not, because they’ve “heard” that nursing is a recession proof career and plus they’ll get to go to school for free.

So Obama, you’ve got the wrong idea and you’re talking to the wrong people. This constant nonsense about the nursing shortage when nurses can’t find jobs is really getting old. How about using all that scholarship funding to to help fix the broken system? There’s a nursing shortage because hospitals aren’t hiring and working conditions suck–not because nurses are in short supply.

President proposes nurse scholarships

AACN Applauds the President’s FY 2010 Budget Request

President Proposes to Increase Funding for Nurse Loan Repayment and Scholarship Programs from $37 Million to $125 Million

WASHINGTON, DC, May 7, 2009 – Today, President Obama released his FY 2010 Department of Health and Human Services Budget that provided specific details on the funding levels he has proposed for nursing education and research programs. The American Association of Colleges of Nursing (AACN) is thrilled that the Administration provided $263 million for the Nursing Workforce Development Programs (Title VIII of the Public Health Service Act) and $144 million for the National Institute of Nursing Research (NINR).

The proposed funding for Title VIII programs represents a 54% increase over the FY 2009 level of $171.03 million. The greatest increase was awarded to the Nurse Loan Repayment and Scholarship Programs, which received $125 million, a 238% increase over last year’s funding level. The Nurse Faculty Loan Program received $16 million, a 39% increase over the FY 2009 level of $11.5 million.

“President Obama is a true champion for nursing. This proposed funding allocation marks a historical point for nursing education, recruitment, and retention,” said AACN President Fay Raines. “If the President’s request passes Congress, it would be the highest allocation these programs have received since created in 1964. AACN will work diligently with our top nursing advocates in the House and Senate to see this funding level enacted.”

The President’s request would offer significant relief to help alleviate the 11-year national nursing shortage that is projected to grow in the coming years. According to the U.S. Bureau of Labor Statistics (BLS), nursing is the nation’s top profession in terms of projected job growth with more than 587,000 new nursing positions being created through 2016. The demand for nurses will continue to grow as the baby boomer population ages, experienced nurses retire, and the need for primary and specialty health care intensifies. BLS projects that more than one million new and replacement nurses will be needed by 2016.

AACN is also pleased that the President’s budget proposes a 1.4% increase for NINR over last year’s funding level. Moreover, the President’s budget outlined that the NINR will receive $36 million in funding from the American Recovery and Reinvestment Act that would potentially bring the total for FY 2010 to $180 million.

“This substantial investment in nursing education and research signals a strong commitment to ensuring the availability of quality nursing care to all Americans,” said Dr. Raines. “AACN looks forward to working with members of the nursing community to secure these funding levels and will continue to work to advance nursing’s role in the national discussion about patient-centered healthcare reform.”

Here they are, happy grads, ready to go on the unemployment line, where most new graduate nurses are ending up these days.

As many nurses and wanna-be nurses have realized, the late great nursing shortage has virtually vanished. In its place has come a shortage of jobs. So what the…?

To reiterate, as most of us intimately acquainted with healthcare know, there was never really a shortage of nurses, as in living breathing bodies with an RN degree. Rather, nurses were leaving hospitals and healthcare altogether for greener pastures. Hospitals claimed to be interested in hiring more staff, and the drum roll was on to open more nursing programs, shorten the programs currently in existence (to push out fresh new grads sooner), or to break down the barriers to hiring foreign workers.

The idea, as many guessed, would be to flood the field with warm bodies, so that for every nurse who quit, another was waiting to take his/her place. Thus, the perpetual revolving door.

And now, with the current economic status quo, hospitals have jumped full force into the “poor me/financial woes” bit, and have frozen hiring, laid off workers–the whole 9 yards and then some.

To be fair, many facilities were facing financial problems before the great bust, but many were not. And many, as we know, dished out exorbitant executive bonuses at the same time workers were being slapped with their pink notices. And the economic situation was a prime excuse not to hire on more nurses and other staff, and just “make do.” Who needs nurses, aides and housekeepers when you’ve got suits and stockholders to keep happy and smiling?

Here is an excerpt from an interesting story that appeared online at AJN, and it is the epitome of what many nurses are now facing:

Although patient acuity and nurse skill level are considered in making shift assignments, certain situations can’t be predicted or planned for. An extra workload will always negatively affect the nurse and the patient. In the best of circumstances, the nurse won’t get lunch or breaks and the nonessential elements of patient care, such as baths and linen changes, will be skipped. The busier the assignment, the more likely that something critical will be missed. (For more on this, see the Muse, RN’s blog post, Nurse-Staffing Ratios: Nurse’s Perspective.)

I heard her say, “An extra patient shouldn’t make any difference in the standard procedure for passing medications.”

Does anything more need to be said? It would be just karma if that nurse manager ever became ill or in an accident, and she was that “extra” patient that the nurse got stuck with. And then faced the consequence.