I certainly hope the times are changing, because this world is in dire need of change–for the better. But what I am referring to now are some changes on my blog.

While I will still rant and rave about healthcare related injustices and stupidity, I want to add things that are a little more useful to the blog that will make it more valuable to readers.

I am going to add two more sections, and at some point, when the site is finished being redesigned and updated, there will be buttons on the masthead that will lead directly to these sections. I’m still thinking about what else I want to put into this site.

The two new sections will be Careers in Healthcare and Nursing Issues. With all the chitchat about another looming recession (can we please get rid of Bush now, before the country collapses entirely?), healthcare careers are going to be even “bigger” than before. Aside from personnel shortages in nearly every sector, healthcare is a growing and healthy industry, pardon the pun. Plus, there is so much misunderstanding about the different careers, and why shortages exist.

I also want to put nursing issues altogether in one basket, so to speak. There’s more to nursing than just the shortage; some of it good, a lot of it bad. Many of these issues of course are leading to a shortage of nurses in acute care (regardless of the silly media stories about just needing more schools), but I’d like this site to be more comprehensive in what it offers nurses who come by to visit.

So stay tuned. I’m hoping going to be starting over the weekend, at least in adding and adjusting the categories. And hopefully, I’ll get those little buttons up and running.

A very wet Easter today, and at one point, while the wind howled and the giant cedars outside my window swayed, the power flickered off. Fortunately, it came right back on again.

I haven’t seen it rain this hard in a while. But my primroses and daffodils were real troupers, and are still standing. Of course, rain is predicted all week, with some snow even… Uh, is this Easter or Christmas? I’m getting confused.

Photo courtesy of Stock.xchng.com

I know I complain a lot about spam, and it’s probably not good for my mental health. But just how many dysfunctional people are there out in the world, who have nothing better to do than torment the rest of us with relentless requests to visit their websites, so that we can see pictures of Jessica Alba (arguably one of the worst actresses ever to show her face on a celluloid screen) pick lint out of her belly button.

Or relentless requests to purchase Viagra so that our penises can grow hard as brick and mortar—even if we don’t own a penis.

Today I had 669 spams in my box. It took three tries just to download them as my computer kept timing out (I was on my laptop). Then another three or four tries to actually delete them, as once they were downloaded, it again timed out trying to send them to spam purgatory.

This is not the way to celebrate Easter, or any other day for that matter. I need to regroup in the war against spam, before it devours my computers completely.

They’re on the move, the nurses that is. Going on strike it seems.

From SF Gate:

As many as 4,000 registered nurses are expected to begin a 10-day strike this morning at eight Bay Area hospitals operated by the Sutter Health network.

This is the third action in six months against Sutter Health hospitals by nurses represented by the California Nurses Association, and today’s walkout is scheduled to be the longest. The union held two-day strikes in October and December, but nurses at some facilities were kept off their jobs longer because hospital managers said they needed to hire replacement workers for longer than two days.

The Google artist is a genius, what can I say.

I suppose for some of you, it doesn’t feel much like spring, considering there are still several feet of snow on the ground in some places–and almost cataclysmic flooding in others. Today was cold and damp and really felt like it was going to snow. The sky had that whitish look about it as well, but nothing fell from the heavens.

Anyway, happy first day of spring. My primroses and daffodils are thriving, despite a few beheadings by random deer (who have plenty to eat and just zeroed in on my flowers).

It seems that the CDC, while certainly concerned about human health, is also concerned about phama industry financial health and profits. Most of you have probably seen the new recommendation that all children get a flu shot, every year! Like kids aren’t already getting enough shots, now the CDC wants to add a yearly flu shot to the repertoire. I certainly hope that this will not become a mandatory requirement for school, as a lot of people just do not want flu shots for either themselves or their family (I am one of them).

This was an interesting opinion piece on the subject, and also points out the rather disturbing factors that figure into this equation, namely to “buy” flu shots so that the manufacturers continue to make them.

From foodconsumer.org:

The panel’s advice came roughly two weeks after the U.S. health officials at the CDC showed concerns about the efficacy of the flu vaccine that does not well-match the strains that are circulating currently in all the 50 states.

As estimated, large percentages of flu strains are not covered by the flu vaccine, meaning that vaccine’s efficacy is in doubt. And indeed, it has been observed that some people who got flu shots still came down with the illness that often causes only inconvenience.

However, Dr. Joe Bresee of the CDC’s influenza division said early “While a less-than-ideal virus match between the viruses in the vaccine and those circulating viruses can reduce vaccine effectiveness, we know from past influenza studies that the vaccine can still protect enough to make illness milder or prevent flu-related complications.”

Early this month, the CDC released news saying that 6 children died from flu complications, but the agency did not elaborate any case. Sensitive health observers took a note of this and predicted earlier that the CDC’s vaccine panel in the regular meeting this year would make their recommendations for flu vaccine in a way to cover all people.

So even though the vaccine is often less than effective, they still want to push this yet on more of the population. A lot of people do not want this vaccine, and while it would be difficult to mandate it for adults, I suppose that the CDC/pharm lobby figure that they can push up usage (and profit) by forcing it on children instead.

One very hazy area is the actual death rate from the flu. The CDC touts the magic number “36,000″ as the number of Americans who die from the flu each year, and if you ever notice, that number does not change. It remains the same whether its a bad year or a good year, and I imagine that if everyone on earth got a flu vaccine, they would still be touting that same number.

You know why? It’s not an actual number and amazing how the media never questions it. It’s a computer guesstimate. Notice that the CDC never actually posts the real number of people who die due to flu complications. That’s because the number is incredibly low, and doesn’t fit into the scare tactics of “needing” a vaccine.

If you ever take a look at their actual statistics, the CDC lumps influenza and pneumonia together. That makes the number higher. When divided up, the real casualty from flu is probably about 1 to 1.5% of these 36,000, and the rest was due to pneumonia.

But getting back to kids…this year, 22 children had died of the flu, but last year, which was a milder season, 68 children died. While it is sad that these children died, it is not a reason to force the vaccine on 59 million children, in order to avoid 22 deaths. That’s like saying that school age children shouldn’t be allowed in cars, because so many die in traffic accidents (a helluva lot more who died of the flu). Or backyard pools should be banned, because children have drowned in them ( a lot more than die of the flu)

This is perhaps the most insidious comment:

Even in the group aged 6 months to 2 years, the inoculation rate was only 20% during the 2006-2007 period, according to Reuters reporting today, a rate that has made CDC officials to show their worry last year that the pharmaceutical companies may cease producing the flu vaccine because of the low usage rate. One top official at the CDC indicated last year that even for the sake of the vaccine makers, people should go get flu shots.

So in other words, we should all get the flu vaccine just to keep the manufacturer happy? Are these people daft or what?

If someone wants to get a flu vaccine, or wants to get a child vaccinated, then fine. But making flu vaccines mandatory for anyone is way out of line, simply because of the fear that the manufacturer isn’t making a huge profit. First, how about the CDC publishing real numbers as far as death rates from the flu. That would be a start. It is amazing how the mainstream media just spits out that 36,000 number like its a mantra. Haven’t any reporters noticed that its a little weird how the number never changes?

Second, vaccine production needs an overhaul. There must be some way that the government and manufacturers can come to an agreement about the vaccine.

How self-sacrificing are you? Are you willing to follow in the footsteps of Clara Maas?

In case you are a brave soul, and want to do your part in saving the world (and earn $2000 for your trouble), you can volunteer to be bitten by a malaria carrying mosquito. And the deadliest form, no less, and all in the name of advancing science.

From enews.com:

During the next 18 months, The Seattle Biomedical Research Institute and the PATH Malaria Vaccine Initiative will be asking people in Seattle to volunteer to be exposed to the deadliest form of malaria, in order to help them test the effectiveness of more types of vaccines.

With more than 70 scientists focused only on malaria, SBRI develops one of the largest malaria research programs in the United States.

Through this experiment, scientists want to find out which vaccines should be abandoned due to ineffectiveness and which ones should be recommended as very effective.

Never fear, the volunteers will be treated as soon as signs of the parasite appear in their blood. Seattle was chosen as an optimal site because there is very little chance of the volunteers contracting malaria, other than in this experiment.

I read in another article that they already had more than enough people volunteering, and while it is highly likely that they will respond to treatment and not become gravely ill or die from malaria, there is always that slight chance. But it is slight.

Clara Maas, just in case you were wondering, was a nurse who took part in the early yellow fever experiments. During the Spanish-American War, Maass volunteered as a contract nurse for the United States Army. After finishing her second assignment with the army, Maass returned to Cuba in October 1900 to work with the Army’s Yellow Fever Commission, headed by Major Walter Reed. It was established during the post-war occupation of Cuba in order to investigate yellow fever, and one of the goals was to determine how the disease was spread. They strongly suspected the mosquitoes but weren’t sure.

Maass volunteered to be bitten by an Aedes aegypti) that had been allowed to feed on yellow fever patients, in March 1901. She contracted a mild case of the disease from which she quickly recovered. She volunteered a second time, but things didn’t go so well. The researchers were hoping that it would show that her earlier bout of yellow fever had given her immunity to the disease, but instead, she became quite ill. She died on August 24, 1901, six days after developing yellow fever.

She was 25 years old.

There wasn’t any treatment for yellow fever, or modern supportive treatment as we know it today. So I would say that Maass did put herself into a little bit more of a precarious situation that the volunteers who will contract malaria in Seattle.

Clara Maass is one of those unsung heroes that no one really knows about, and largely forgotten about until about 30 years after her death, when a memorial was placed on her grave (I believe that a nurse came across her name while doing research, and campaigned to get the memorial). The Cuban government was the first to honor Clara Maass with a stamp, issued in 1951 to commemorate the 50th anniversary of her death. A school and a hospital unit in Cuba had also been named for her.

In 1976, honoring the centennial of Clara Maass’ birth, a US postage stamp was issued. She was the first nurse to get her mug on a stamp in the U.S.

In case you’d like to read up on her.

Just as an addendum to the late, great study on STDs in teens. I notice that none of the mainstream media outlets mentioned the timing of this, given how Merck’s aggressive and ethically challenged lobbying for HPV vaccine mandates was exposed and largely failed last year. Why now? Is it because enough time has passed that people don’t remember, so it’s time to make another push for the vaccine by going through the back door, via a “scientific study.”

Also of concern is the study population itself. The survey contacted 838 women ages 14 to 19 who agreed to be tested for a sexually transmitted infection. Now, these are girls who are probably sexually active if they agreed to be tested. Do they represent the general population? Maybe, maybe not. It depends on where you’re looking, and also the age group. There are going to be a lot more 18 and 19 year old girls screwing around, as opposed to 14 year olds.

But from the very select population, the researchers estimated that 3.2 million teenagers are infected with at least one STD.

It doesn’t seem like any reporters questioned this data, or asked the CDC what else can be done aside from promoting the Merck vaccine.

Well, yeah, we already know that the United States leads the developed world in sexually transmitted infections, and also in HIV infection (as opposed to just your run of the mill twat and weenie diseases). And we also lead the developed world in rates of teenage pregnancy, abortion, and unwanted/unintended pregnancy in general, despite the fact that rates for pregnant teens have declined somewhat.

But this new CDC report is a little sketchy, and of course, the mainstream media has to present it in the most alarmist way possible. Nothing like stirring the pot in the fight for ratings, is there.

From Reuters:

WASHINGTON (Reuters) – More than one in four U.S. teen girls is infected with at least one sexually transmitted disease, and the rate is highest among blacks, the U.S. Centers for Disease Control and Prevention said on Tuesday.

An estimated 3.2 million U.S. girls ages 14 and 19 — about 26 percent of that age group — have a sexually transmitted infection such as the human papillomavirus or HPV, chlamydia, genital herpes or trichomoniasis, the CDC said.

This really isn’t at all surprising, considering that decent and informative sex ed isn’t available in schools (just say no until marriage doesn’t cut it). And after we get through the hype and canned quotes, it isn’t until much further down that we learn that HPV, which can cause genital warts and cervical cancer, was the most common infection, seen in 18% of the girls. HPV, for the vast majority of both girls and boys, is transient. You catch it, and your own body’s immune system takes care of it. There is no treatment for it and most people wouldn’t need treatment anyway. Most people in fact, never even know that they have an HPV infection. So girls who were counted at the time of the survey as having HPV may have been “cured” of it by the time theses results were published.

It says that the second most common infection was chlamydia, seen in 4% of the girls. Trichomoniasis was seen in about 3% of the girls, and 2% had Herpes simplex virus type 2–which seems kind of low. They didn’t ask about syphilis, gonorrhea or HIV infection, but the prevalence of those diseases are quite low in this age group. But without HPV in the picture, the rate of STDs that actually cause symptoms and have a treatment protocol, is only 9%.

This isn’t to downgrade the importance of HPV as having the potential to wreck havoc, but as I said, for most people who come in contact with it, HPV is benign. Some studies estimate that up to 75% of the sexually active population are exposed to at least 1 strain of HPV (there are about 100), and because HPV is so firmly entrenched in the general population, a person can have very few sexual partners and still come into contact with this virus.

But I think the main message here is the differences among ethnic/racial groups.

Forty-eight percent of black teen-age girls were infected, compared to 20 percent of whites and 20 percent of Mexican American girls. The report did not give data on the broader U.S. Hispanic population.

So why are black girls so much more likely to be infected? Well, I guess that can be the subject of a thesis, as racial disparities in healthcare are seen in all areas, whether it be breast cancer, heart disease or STDs.

What does this survey tell us? Absolutely nothing that we didn’t already know. Instead of wasting time and funds coming up with new numbers to crunch, how about doing something about the high rates of STDs in the U.S., as well as racial disparities. But I guess it’s easier to keep doing studies that conclude that we “need to do something,” rather than actually doing it.

Doing something about it means getting the new HPV vaccine, according to the CDC. And these articles read like an advertisement for it. I wouldn’t be surprised if this survey was just a scare tactic to show how many girls are infected with it, and why we are in dire need of this vaccine. Never mind that evidence is slowly creeping out that there are safety issues connected with the vaccine (deaths have been reported), and that perhaps the benefit does not equal the risk.

I would recommend the vaccine to women in developing nations, where cervical cancer is a major cause of cancer death. But in the U.S. and other industrialized nations, closer attention needs to be paid to the adverse events.

And as I said, touting a vaccine doesn’t to address the health problems that I described above. The CDC should be on the forefront advocating universal primary health care, reproductive services for both men and women, and getting some real sex ed into schools–and having it taught by someone who is trained to teach it, not the algebra teacher who isn’t quite sure what sperm is.

This post sort of continues the previous one, about violent attacks against nurses. There is an interesting new thread about on allnurses.com, about the Tao of being hit by a patient.

What I find astonishing, that in this day and age, the nurse is asking what to do about it. As though assault is still a fuzzy area, and the wonderful professional called nurse should still be wondering if it is okay for a patient (who is completely coherent and not suffering from dementia) to slap her across the face. And wondering what she should do about it.

Fortunately, most of the responses are positive, in that they are telling her to file charges against the person who hit her. Afterall, if someone slaps you in the supermarket, would you just smile and say that it’s okay? That the person who hit you is a little stressed and need to get out their aggression. What if you were working as a supermarket checker and a customer slapped you across the face, because she said you were moving too slow? Would it be okay?

Is it okay for a child/teen to smack his teacher? Does the teacher just say, “Oh, that’s okay. I know this is a rough class.”

What would your doctor do if you smacked him/her? Would the CEO of the hospital take kindly to be being whacked across the face? Or some middle-management weenie who crunches numbers all day? Would they just say that the customer is always right, even though that’s often still the message given to nurses?

If You Get Hit…

If you are working as a nurse in a clinical area, or any area, it is NEVER okay for anyone to abuse you. I don’t care about the idiocy that instructors are still dishing out, or the “customer training” that is becoming rampant in hospitals today (they think its a solution to the nursing shortage). It is not okay.

If the patient has dementia, or is otherwise not in the right mind, then it would be difficult to press charges. However, you should never again be alone with that patient and if the patient is prone to violence, the facility needs to take appropriate precautions. Do not place yourself in danger. Tell the CEO to go in and give the patient his medication, if he doesn’t think there is a need to hire on extra security.

But if anyone in their right state of mind (arguable, of course, as to who really is right in the mind) ever hits you, immediately react. I don’t care if its the Chief of Staff. Call the police and press charges. File an incident report. Don’t let anyone talk you out of it. If you don’t do it, then not only are you telling the world that nurses are somehow “different” from everyone else, and not entitled to the same protection, but it will happen again. The same person that hit you may again strike you, only next time harder. He/she may also feel free to attack someone else, since they know there are no consequences. And your hospital won’t do anything to protect its nurses.

As a human being, you have a right to a safe and stable work environment. Don’t let anyone tell you otherwise.

FYI, the person who posted this says she is a new nurse and still on orientation. That means that her schooling was insufficient, and that her instructors managed to skim over that huge white elephant sitting in the classroom–that nurses are vulnerable to physical and mental abuse. Or they delivered the old school line of thought about how the nurse should rise above that, she should report it to her charge nurse, etc. In other words, suck it up baby.

This is part of what this nurse wrote:

So, my question is this….at what point does a nurse actually look at a situation as being assaulted. If this lady slapped me across the face in the middle of the grocery store, I would have called the police.

What is that fine line? What if she bruised my face? Is that different?

I think she answered her own question, but isn’t it sad, that she thinks that because she’s a nurse, there is somehow another standard for assault. Or that a certain amount of damage needs to be done before a nurse can consider a physical attack “assault.”

It seems that’s what needed in addition to education and getting a license in the UK. A startling news release from Unison, a British nursing union, reported that one in three nurses in the UK have been attacked. Where is Rambo when you need him most?

Nurses are vulnerable to both physical and verbal attack in the U.S., but these stats are ludicrous. Why are nurses in so much danger? Do hospitals just consider violent attacks on nurses akin to vandalism–you know, that nurses are things not people, and attacking a nurse is similar to painting graffiti on the hospital wall? Do the words “increase security” ring a bell?

And then hospitals around the world wonder why no one wants to be a sweet nursey anymore.

From Unison:

04/03/08) Almost a third of UK nurses suffer frequent violence at work, according to new research.

UNISON has condemned the findings, which reveal one of the highest rates in Europe. Only in France are more nurses attacked.

The study, published in the journal Occupational Medicine, found that 29% of UK nurses had suffered frequent violent incidents at the hands of patients or their relatives.

“These statistics should make people in the UK ashamed,” said UNISON head of nursing Gail Adams.

“It is totally unacceptable for nurses to face rising levels of violence, when all they are trying to do is help and care for their patients.”

More needs to be done to protect staff, Ms Adams said.

She stressed that prevention is the key, coupled with better training and tough penalties for anyone found guilty of assault.

And she urged hospitals to review the support they offer staff, to ensure they offer good occupational health services.

“The survey shows many feel abandoned and depressed following an assault, which should not be allowed to happen.”

The researchers surveyed 39,894 nurses in 10 countries.

They found that violence had wide-reaching effects including recruitment and retention problems, increased amounts of sick leave and burnout.

Whatever happened to those dear beloved nurse angels? Hospitals would like to know, especially when faced with angels who have been unionized.

Sutter facilities in the San Francisco Bay Area may soon be faced with a strike, but it seems a little unclear what the strike is about, or how serious the infractions are.

From the MercuryNews.com:

A strike could come as soon as the middle of the month for the nurses, who are represented by the California Nurses Association. The union and management have failed to reach an agreement in contract negotiations that began in May. The dispute has already resulted in two strikes, each lasting two days, in October and December.

The nurses say the stalemate is not about salaries, but the issues of patient care, under-staffing and their health and retirement benefits. The nurses described a “hostile” bargaining attitude by Sutter Health, and expect to approve the strike vote.

In general, hospitals are not known for being benevolent employers and their attitude towards nurses is usually deplorable. Nurses are a service, not people, and its something that’s thrown in with the laundry, dietary service, and housekeeping. In fact, a nurse can double for all of those.

But in this case, I’ve seen a few differing reports about the strike, so I don’t have an opinion on it at the moment. Perhaps as the story unfolds…

I’m really surprised that this hasn’t gotten more press. I looked in Google news, and nearly all of the media outfits that picked it up are Canadian. Not one American mainstream news service other than Science Daily.

Now I realize that this study does come out of Canada, but this is really exciting stuff. Canada is a first world nation, speaks English, and conducts reputable scientific experiments. So why no interest?

From the University of Alberta:

February 28, 2008 – Edmonton – A team of researchers at the University of Alberta has discovered a gene that is able to block HIV, and in turn prevent the onset of AIDS. Stephen Barr, a molecular virologist in the Department of Medical Microbiology and Immunology, says his team has identified a gene called TRIM22 that can block HIV infection in a cell culture by preventing the assembly of the virus.

One of the greatest challenges in battling HIV is the virus’ ability to mutate and evade medications. Antiretroviral drugs introduced during the late 1990s interfere with HIV’s ability to produce new copies of itself – and though beneficial, the drugs are unable to eradicate the virus. Barr and his team have discovered a gene that could potentially do the job naturally.