I guess the University of Washington Medical Center got slammed by all the bad press concerning the recent Seattle marathon. In an update article, they “apologized” for the misunderstanding.

UW Medicine spokeswoman Tina Mankowski said comments made by race announcers and promotion surrounding the Sunday event may have created a mistaken impression. She wanted to make it clear that only money given in addition to race fees — which cost up to $120 — goes to the UW Medical Center Patient & Family Housing Fund. The UW also is the primary event sponsor.

“Judging from the e-mails we are getting today, it was not clear to a number of people in the community, and we apologize for that,” Mankowski said. “Moving forward, it will be very well spelled out for people. I don’t think there’s any question about that.”

It’s a little late for apologies. Why didn’t they nip it in the bud, and correct it immediately. The promotion began months before the event, so they certainly had their chance.

Dozens of readers contacted The Times on Monday. Many were upset. “The Seattle Marathon is clearly misleading people with regard to the extent of its charitable contributions,” wrote one. “Why is the City of Seattle closing streets when the purpose is to line the pockets of the organizers?” wrote another.

Good question. While a marathon doesn’t have to necessarily be for charity, certainly, the high fees charged to enter this one as well as the high fees paid to the organizers does make it seem rather murky–plus the “misunderstanding” about it being for charity. And closing off streets, sending traffic through an obstacle of detours, and inconveniencing the majority of residents not participating in the marathon may be acceptable if a huge portion of the money was going to benefit a good and local cause–but instead, it seems that the primary reason for holding it was to pay the organizers.

And here’s another tidbit in this article that is rather interesting, and certainly suggests that the Seattle marathon may be an expert in “misunderstandings.”

Meanwhile, officials at the previous beneficiary of the marathon said Monday that they had involved a lawyer after they became concerned about the small amount of money — also about 1 percent — that they received from the event.

Attorney Paul Carpenter said he worked pro bono for the then-named Candlelighters Childhood Cancer Foundation of Puget Sound, which was the beneficiary of the Seattle Marathon for four years ending 2005. He asked marathon officials for an audit of all four years but they refused, he said. The Candlelighters couldn’t afford to pursue litigation, he said.

Kokes said the marathon association was happy — and remains happy — for the Candlelighters to conduct an audit, but it would have to be at the Candlelighters’ expense, something that organization had balked at.

Yeah, they balked at it before they are a small charity and prefer to put their donations to good use, and not pay for an audit. And since he knows that the group can’t afford litigation, this Kokes guy can mouth off all he wants, making it seem that they are willing to fully cooperate. If he had nothing to hide, then he would open up his books.

I hope no one signs up next year for the Seattle marathon.

Yesterday a bunch of diehard Seattlites huffed and puffed and participated in 37th annual Seattle Marathon. As the thousands of hopefuls lined up (many just hopeful that they could complete it), the announcer said: Remember, you are running to benefit UW Medical Center patient housing today.

In other words, these folks assumed that the hefty$95 for the half-marathon and $120 for the full marathon was going to support the UW Medical Center. That this was a charity event, much the way buyers picking up pink trinkets during October’s breast cancer month thought that their money was all going for a charity.

Well guys, think carefully before you fork over money for the 2008 38th marathon—unless, of course, you just want to pay for the privilege of running through the streets of Seattle. From the Seattle Times:

What many runners may not have realized was that not one cent of their race-entry fee — which costs up to $95 for the half-marathon and $120 for the full marathon — is destined for charity. Only money that runners decided to donate on top of their entry fees will go to charity.

Last year that amounted to only $12,000 — 1 percent of revenue — at an event that now pulls in more than $1 million annually.

The Seattle Marathon Web site plays up the charity connection, with a logo at the top that says “To benefit UW Medical Center Patient & Family Housing Fund.”

The Web site also states prominently that the marathon “is organized and run by volunteers in the community.”

While race organizers do rely on thousands of volunteers, the Seattle Marathon Association’s 2006 tax returns show that the association paid $330,000 in compensation to employees and organizers — triple the $110,000 it paid two years earlier.

So out of $1 million that the Marathon, less than 1% went to charity. Nice, huh. In addition to the compensation, the article gives more of a breakdown for the remainder of the money:

Aside from compensation, expenses included awards and medals ($198,000); supplies ($171,000); printing and publication ($62,000); fees and permits ($37,000); and advertising ($36,000).

Uh, $198,000 for awards and medals??? What were they giving away, diamond encrusted trophies? That figure seems a bit inflated and I wonder whose pocket got lined with that. Supplies for close to $200,000? What kind of supplies do you need for a marathon, to the tune of $171,000.

I hope that they are audited, and that people who paid the entry fee because they were falsely led to believe that it was going to charity sue them.

On the other hand, the article has a nice comparison between Seattle and Portland’s marathons.

Portland
Runners: 12,000

Entry fee: $90 ($150 to register the day before)

Revenue: $1.2 million

Paid to workers: Directors, $28,000; professional fundraising fees, $40,000; accounting fees, $3,600

Entry-fee money paid to charity: $200,000

Seattle
Runners: 11,000 to 12,000

Entry fee: Up to $120

Revenue: $1.1 million

Paid to workers: $330,000 in compensation to employees and organizers

Entry-fee money paid to charity: $0

What is wrong with this picture? My advice is if you live in this area of the country, and want to participate in a city marathon and have your entry fee go to charity, head to Portland. Do not allow yourself to be ripped off by the Seattle con artists, which is basically what this amounts to.

Early Teen Sex May Not Be a Path to Delinquency, Study Shows

An interesting editorial today in the NYTimes about the high costs of healthcare.

Yeah, I know, we’ve heard this before, but they’ve taken an interesting spin on some of the issues. And I should say, issues that really spell it out.

Does It Matter? If citizens of an extremely wealthy nation like the United States want to spend more on health care and less on a third car, a new computer or a vacation home, what’s wrong with that? By some measures, Americans are getting good value. Studies by reputable economists have concluded that spending on such advanced treatments as cardiac drugs, devices and surgery; neonatal care for low-birth-weight infants; and mental health drugs have more than paid for themselves by extending lives and improving their quality.

But if health care spending continues on its same trajectory, the United States will reach the point — probably several decades from now — where every penny of the annual increase in gross domestic product would have to go for health care. There would be less and less money for other things, like education, environmental protection, scientific research and national security, that may be equally or more important to the well-being of society.

A real man should have a real penis–here it is…

So said the email in my box, and on Thanksgiving Day no less. Well, I didn’t see a penis enclosed in that email. Liars!

But considering the inordinate number of emails that I get box in my regular box and blog comments, about the plight of men with a small penis, I have to wonder if there really is something going on. Is there a small penis epidemic raging in the U.S. and even worldwide? Is it some deadly plague that is silently creeping up on us and insidiously shrinking the male penis to microscopic measurements?

Hmmm….

I thought this was really nice, and really puts thankfulness in a very nice perspective.

It is from Dr. Bob Hoffman, Co-founder The Masters Circle

If you woke up this morning with more health than illness, you are more blessed than the million that will not survive this week.

If you have never experienced the danger of battle, the loneliness of imprisonment, the agony of torture, or the pangs of starvation, you are ahead of 500 million people in the world.

If you can attend a religious meeting without fear of harassment, arrest, torture, or death, you are more blessed than 3 billion people in the world.

If you have a refrigerator, clothes on your back, a roof overhead and a place to sleep, you are richer than 75% of the world.

If you have money in the bank or in your wallet and spare change in a dish someplace, you are among the top 8% of the world’s wealthy.

If you hold up your head with a smile on your face and are thankful, you are blessed because the majority can, but most do not.

If you can hold somebody’s hand, hug them or even touch them on the shoulder, you are blessed because you can offer God’s healing touch.

If you can read this message, you just received a double blessing in that someone was thinking of you, and furthermore, you are more blessed than over 2 billion people in the world who cannot read at all.

Have a great day, count your blessings, and pass this along to remind everyone else how blessed they are as well.

As we celebrate Thanksgiving, let us remind ourselves of all we have to be grateful for … our health, our families, our work, the freedoms we take for granted and the opportunity to make a difference in the world while we create a happy and fulfilling lifestyle for ourselves and others.

You live among the top few percent of all of the world’s people. Feel your power and be thankful. Instead of stressing, see how good you already have it, and appreciate the unlimited potential you have to make it even better.

Choose to be grateful when life treats you well and graceful when it doesn’t. Make this year’s Thanksgiving a time for you to really feel blessed and then do whatever you can to become infectious and spread that blessing around.

Remember that the purpose of this important holiday is to be thankful, as compared to just being full.

I give thanks this morning that there were only 52 spams in my comment box, as compared to 145 yesterday. Maybe even spammers take time off their harassing the public and celebrate a holiday. I give thanks that it is not raining today, although the trade-off that it is very cold (for Seattle–I know, it’s wimpy weather for those of you getting snowed in today).

Another gem from Google, in honor of Thanksgiving.

Did you know that prehistoric scorpions were over 8 feet tall? Well, now you know.

Check out Boing Boing. They do have the weirdest stuff on that site.

That’s of course if they walked upright. Since they crawl around on fours, I would imagine that they were about the size of alligators. Nice, huh?

Imagine getting bitten by a poisonous one. That would be about equal to have a quart of venom released into your body. I doubt the local ER could do anything, except if it’s an ER doc like George Clooney. Or a saint like Dr. Welby.

This is an interesting thread on allnurses.com, that flies in the face of the usual “we need more nurses,” whimpering. One nurse started the thread by writing about how her hospital is cutting back on the use of travelers and that there is obvious “wage-fixing” in the area. How’s that for trying to entice nurses to work at your facility, or making an effort to “reduce” the shortage.

I will say it again- there are too many nurses in this country. Too many nurses being churned out every six months from ABC Community College. Hospitals count on nurses getting burned out and leaving after 2- 3 years. Then they can bring in another group of new grads and pay them several dollars less than they are paying you.

Sounds like a clear notion of what is really going on. There are almost 3 million RNs in the U.S., and new grads are churned out every six months from community colleges and BSN programs. The idea is that if enough new grads are pushed into the profession, then wages can be lowered because it will become a seller’s market. Too many nurses grabbing for the same miserable jobs.

Of course, the spinning heads don’t realize that has already happened. Back in the early-mid 1990s, when they were laying off nurses and it was virtually impossible for a new grad to get a job, nurses didn’t sit around and clamor for the jobs available. Or take cuts in pay. Or take impossible patient loads. They left the profession entirely, or entered non-hospital positions.

As most nurses know, sometimes you’re faced with some really…umm…uncomfortable situations that can really test your nerves. Some situations can really be a challenge to one’s ethics.

That said, there was an article in Nurse.com about how to deal with “moral distress.” Interesting terminology, but fair enough, it is an issue. However, the examples they gave are just so lame. There are so many real and pressing issues that can cause real “moral distress” in any nurse with half a conscience, so I have no idea how they came up with these watered down silly scenarios.

Story #1

Rick is a nurse at a health clinic that provides vaccines required for school entry to eligible children at no charge. However, his agency does not provide additional vaccines that recently have been recommended by the Centers for Disease Control and Prevention for free as well, including rotavirus and human papillomavirus.

Rick is frustrated because he cannot reconcile his belief that the policy is a barrier to his responsibility to care for the health needs of the public. He also experiences feelings of anxiety and anger because of a policy that conflicts with his beliefs about professional practice and the commitment he made to protect the health of the public. He questions whether he made the right career choice.

Is this really a case for severe moral distress? The guy works in a clinic that provides school entry vaccines for children free of charge. Repeat, it supplies required vaccines that children need to attend school. Rotavirus and HPV are not required for school entry. There are other places that people can go to obtain those vaccines if they want them. So what is Rick’s problem? That he can’t provide everyone who enters his clinic with every kind of healthcare need and desire? Is that a moral dilemma?

Doesn’t he think that what he’s doing helps a lot of people? Is it an all or nothing proposition? The guy sounds a little mentally unstable to me.

Story #2

Sue is a staff nurse in an orthopedic unit. The nurse/patient ratio is adequate for the level of patient acuity, but Sue believes multitasking and assisting agency staff prevent her from delivering the level of care she expects from herself and the standard of care she perceives her patients deserve. She feels guilty that sometimes an hour passes before she can respond to a patient’s request. Sue also experiences feelings of frustration, anxiety, and anger because of this recurring situation, which conflicts with her beliefs about professional practice. Sue’s sensitivity to patient vulnerability and the trust that patients place in her contribute to her distress.

Sue begins to question her effectiveness as a nurse, and because Sue is dissatisfied with her work situation, she contemplates a transfer to another unit.

Well Sue, join the club. And in this case, most nurses would not question their effectiveness as a nurse (unless, of course, they are endowed with the martyr/angel of mercy complex), but would question the staffing and the practices of the facility. Again, this is a silly scenario because there is no moral distress here, just poor staffing practices. And Sue shouldn’t be questioning her competence–she should be demanding better staffing and more help; or working to organize/unionize the facility so that patient care improves.

What is it with these nursing articles? Why are they so afraid of speaking on a level that is meaningful to readers? Why not give real examples of hard choices and situations that nurses are in, rather than this silly drivel?

From the NY Times:

A new, unusually virulent form of a virus that can cause colds and other respiratory infections has caused 10 deaths in the last 18 months, federal health officials said. The new virus, Ad14 (for adenovirus serotype 14), has caused at least 140 illnesses in New York, Oregon, Texas and Washington, according to a report from the Centers for Disease Control and Prevention. The illness made headlines in Texas in September, when a so-called boot camp flu sickened hundreds at Lackland Air Force Base in San Antonio. A 19-year-old trainee died.

I’m actually surprised that this hasn’t made more news until now. Usually killer bugs splash across the headlines with news of their exploits. Well, this can be a trial run for when the great flu pandemic hits. Let’s see if they can supply healthcare workers with the proper safety gear.

The United States is a leader in….drum roll…

Well, take a guess.

Okay, I’ll give you a hint. It’s stuff that you can get from having sex. It’s also stuff that happens when people aren’t being properly educated, and there is no comprehensive primary care network of healthcare.

See what we have to show for ourselves, from the Seattle PI

Just in case you happen to be interested in becoming a nurse, or are a nurse looking for a new job….and happen to live in Seattle or want to live here….

Tomorrow is the job fair!!!

Another great sliver of Google art.

There are a lot of nurse veterans in the country, and I thought I’d take this opportunity to point out some interesting and not so pleasant facts about military nursing.

Male and minority nurses have been basically ignored as non-entities by the military, and even in times of severe need, their services were not accepted. During WW II, when the need for nurses was so severe that a nursing draft was passed (yes, Pres Roosevelt signed it into law and the only reason nurses weren’t drafted was that the war in Europe ended), male nurses were not permitted to work as such, and minorities were either severely restricted or in some branches of the military, not permitted at all.

While the restrictions and quotas on female minority nurses were lifted after WW II, male nurses were still drafted and treated as your ordinary grunt. Is that absurd or what? There are plenty of men who can pick up guns and go blast someone’s head off, but skilled caregivers are at a premium and desperately needed by the military. Since male nurses are only a small group anyway, one would think that allowing them to work as nurses would not seriously deplete the ranks of soldiers.

But as daft as it may seem, it wasn’t until Vietnam that this changed.

Just when you thought that it was safe to go outside….

The plague. Like, isn’t that from the middle ages, when the plague swept across Central Asia and Europe and is believed to have killed about 75 million people before calling it a day? Actually, 75 million was just the toll for one year.

* 1000 38 million
* 1100 48 million
* 1200 59 million
* 1300 70 million
* 1347 75 million
* 1352 50 million

However, the bubonic plague has not been wiped off the face of the earth, and is found in many countries including the United States. Yes, gasp, we have the plague right here at home. It’s not very common, but it is endemic in the southwest.

An average of 10-15 cases per year have been reported in the U.S. during the last few decades. One of the largest animal foci of the plague worldwide is found west of the 100th parallel, in states such as New Mexico, Arizona, Colorado, Utah, and California. Only one case of imported plague has been reported since 1926, and in 2006, 13 human plague cases were reported in the United States, the most since 1994. Not a good trend, if you ask me.

I remember reading a while ago that because the plague is quite uncommon in the U.S., your chance of getting a correct diagnosis is not very good. At least, not before it kills you. In fact, you are far more likely to get a correct diagnosis in Vietnam, where they see far more cases, and changes of survival are far greater.

From Medical News Today:

Eric York, a 37 year old wildlife biologist who worked at the Grand Canyon National Park who was found dead at his home on the South Rim of the Canyon in Arizona on November 2nd, probably died of the plague caught while carrying out an autopsy on a mountain lion that had probably died of the disease a week earlier.

Plague, due to the bacterium Yersinia pestis, was confirmed as the likely cause of death following preliminary laboratory tests at the Arizona Department of Health Services (ADHS) and the Centers for Disease Control and Prevention (CDC).

York had been treated at a local clinic for flu like symptoms that started three days after he did the autopsy, but nothing more serious than that was diagnosed at the time. When he was found dead health officials suspected either plague or hantavirus that causes a type of hemorrhagic fever, and immediately tracked down 49 people who had been in recent contact with him so they could have aggressive antibiotic treatment. None of them has become ill.

This article had promise, I thought. Finally, a story in the standard media that was actually going to say something different. Afterall, read this line:

An investigation into the shortage of nurses begins in nursing school.

I thought, finally, exposure of the archaic methods, the lack of meaningful and real life information, the crazed power hungry quadruple PhD professors who last touched a patient during the Korean War….and surely the article would discuss the high attrition rates, how many students are entering nursing because they’re told its a “good profession” with a lot of “opportunity,” but have no idea that they are actually going to have to wipe a sick old man’s butt or watch a 10 year old puke up blood…

WRONG! The article is one of those experiments that tries to see just how low the public IQ is.

From WMTW.com:

Anyone who has been treated in a hospital knows that nurses can make all the difference. But what they might no know is that routine surgeries have a 31 percent greater risk of the patient dying if they’re admitted to a hospital with a shortage of nurses, according to research done in 2002.

Dr. Sue Sepples has been a nurse at Maine Medical Center for 11 years. She said MMC is not facing a nursing crisis, as so many other hospitals are.

According to Sepples, who also heads the nursing program at the University of Southern Maine, there were roughly 1100 job openings in Maine hospitals for nurses in 2005. That same year, she said, about 600 people received nursing degrees from Maine undergraduate programs, leaving a 500-person gap. She added that in the previous year, another 600 qualified applicants were turned away from nursing programs because there simply weren’t enough spots in school due to a lack of teachers.

Now here’s where you step back and blink, and wonder what you’ve just read. Or if you read it correctly. Or if this is some secret mind twister that a sinister covert agency put into place to see how quickly people can be driven senseless.

So let’s see, according to Sepples, there were 1100 nursing vacancies in the state of Maine in 2005. When 600 new nurses graduated, all of them went to work in Maine, and that reduced the shortage to 500. So in 2006, one would assume that another 600 nurses graduated, they would have a 100 nurse surplus. And did yet another 600 graduate in 2007? That would leave Maine with a 700 nurse surplus, since, according to Sepples, all nurses who graduate apparently stay right in Maine, and no one seems to quit their job.

And why was there even a 1100 nurse vacancy rate to begin with? By the logic of this article, Maine should have been overdosed with nurses in 2005.

Did the person writing this article ask any questions, like, do all nurses who graduate stay in Maine? Do all stay in nursing? Do all go to work as hospital nurses? What’s the attrition rate in the work force? How many nurses left nursing or their jobs at the time these new grads entered the field?

And so on. But this article goes on just to be a mishmash of quips about mannequins used in training, and random quotes from people. Put it this way, if there was a contest for the poorest quality mainstream articles about the nursing shortage, this would be a top contender for first prize.

There’s a video that goes with this majestic piece of journalism, but done’t hold your breath expecting anything new or exciting. Same old, same old.

Is it a holiday? Well, not really. But it is my mother’s birthday, so I just thought I’d mention it.

My brother and I usually meet in Florida for my mother’s birthday, but we didn’t make it this year. It just crept up so quickly this year.

Anyway, my mother had a nicer cake than this one, but I don’t have a picture of it so this one will have to do.

Photo courtesy of a href=”http://www.sxc.hu”>Stock.xchng.com<

No, it seems. I don’t know if this applies to nurses in general, but it seems that at least the nurses and nursing students posting on allnurses.com are not about to sacrifice themselves for the “public good.” Whatever that means.

Backtrack…someone posted the classic hypothetic scenario. The bird flu finally manages to mutate, causes the long awaited pandemic, with a fatality rate of 60% and with 80% of the cases in the 0-40 year old age range.

You, as the devoted nurse, must face the following situation: Hospitals are overwhelmed and staffing is at about 50%. The Government orders all nurses to work (and I’m assuming, although the poster didn’t say, all doctors as well). There is not enough Personal Protection Equipment (N95 masks, gloves, goggles, tamiflu, vax, etc).

Home quarantines become common, your family is quarantined and supplies are running low (stuff like food). However, Big Brother aka the feds, promise that you will be “taken care of” if you are a good nurse and report to work.

So would you go to work?

The scenario does sound like the real situation, should a pandemic ever occur. Since healthcare workers are readily treated like throwaway items, hospitals and government have not invested in making sure that there are sufficient amounts of Personal Protection Equipment. So if you are a good nurse and enter the hospital, you better be ready to sacrifice yourself.

I didn’t read all of the comments, but the majority would not go in. Or would only go in if they were able to attend to their family first. But most were highly skeptical of a government promise to be taken care of….I mean, without protection, does that mean the government will pay your funeral expenses? Put lilies on your grave?

One person made an excellent point, and one that any of our pandemic planners should take to heart:

“Pandemic or not, my family comes first. Sorry, but its not my problem that they have not invested enough money for PPE, staff and research; nor, should I risk my life trying to accomodate their mistakes.”

The poster also pointed out that we are not likely to see politicians or any other high level officials rolling up their sleeves and exposing themselves to patients stricken with a deadly disease, without being able to protect themselves.

You can read the full thread on allnurses.com

It is a conundrum because someone has to care for the sick. And I’m sure that nurses and other healthcare workers wouldn’t mind coming in, if they truly were going to be “taken care of.” Paid extra, have food and other supplies delivered to their families, and given the top of the line protection against contracting the virus from patients. But gone are the days when the nurse is supposed to lay herself on the altar and try to be a martyr.

I had an interesting conversation a few years ago about coming into work during a disaster. A nurse, who I will call Marcy, was talking about her friend who worked during one of the hurricanes that hit the Atlantic coast during the 1980s. I think it may have been Hugo. She said that her friend went into work, rather than evacuate. The hospital she was working at was damaged, as was her home. Because she was at work and couldn’t leave, she had no time to even attempt to secure her home.

I said that the nurse was crazy. Marcy got a stiff lip and said that her friend was a “devoted nurse” and should be commended. I said that the hospital, being in harm’s way, should have evacuated their patients. There was quite a bit of warning for the hurricane, and hospitals do have the option of evacuating patients. They should not expect staff to risk their lives coming into work, or to willingly stay over and do shift after shift. What they did was put everyone at risk.

It is an interesting conundrum, nevertheless.

Tonight’s the night when we get our precious hour restored. That is, if you’re into the game of moving clocks which unfortunately, most of us have to play along if we expect to keep our jobs. On the bright side, just think…a whole extra hour to sleep. Unless of course you’re working the night shift, and you get stuck with an added hour.

Clock picture courtesy of Stock.xchng

How did it get to be November 3 already? I mean, did someone just fast forward the clocks while I wasn’t looking?

It’s funny, because I was interviewing a nurse this morning for an article (yes, on a Saturday), and she mentioned something about night shift. I remembered very clearly how time does most certainly slow down when you are working nights. One night shift minute is equal to at least 90 seconds, although it stretches to about 300 seconds between 3am and 5am. An overall 8 hour night shift is equal to about a 24 shift day shift.

Time does slow down.

However, when I would like it slow down, such as when a deadline is looming, it speeds up. There are only 10 minutes in the hour. Or even less.

November is going to be an extremely busy month for me, and so I’ve been both anticipating it and dreading it. A lot of great exciting things going on, but still, very busy. And then at the beginning of December, two more conferences. I’m not complaining, but they couldn’t have been planned for worse times. I wish they were taking place right now, so I could get them out of the way and clear the deck, so to speak.