is tomorrow. It is almost 30 years since the first published document about AIDS appeared in MMWR in 1981, a short little article about 5 gay men with strange problems afflicting their immune system. Of course, it was not the first time this strange syndrome had appeared, but the first time it appeared in the scientific literature. Thus, June 1981 has been marked as the beginning of the AIDS epidemic.

According to UNAIDS estimates, there are now 33.2 million people living with HIV, including 2.5 million children. During 2007 some 2.5 million people became newly infected with the virus. Around half of all people who become infected with HIV do so before they are 25 and are killed by AIDS before they are 35.

But as we get ready to mark World AIDS day, some experts are saying that the epidemic is overblown

Interesting article and some points to consider. The different viewpoints are all valid, but it all adds up to the same thing--money. How should we best be using scarce resources?

One good use of money would be to increase salaries of nurses and physicians in developing nations so that these people have some incentive to stay and work in their homelands. While brain drain is talked about, nothing seems to be done about it.

According to a new Gallup poll, nurses are the bastion of respect and honesty. Those babes in white are to trusted above anyone else.

PRINCETON, NJ — For the seventh straight year, nurses enjoy top public accolades in Gallup’s annual Honesty and Ethics of professions survey. Eighty-four percent of Americans call their honesty and ethical standards either “high” or “very high.”

This year’s results are based on a Nov. 7-9 USA Today/Gallup poll rating the honesty and ethics of workers in 21 different professions.

Nurses have topped Gallup’s Honesty and Ethics ranking every year but one since they were added to the list in 1999. The exception is 2001, when firefighters were included on the list on a one-time basis, shortly after the Sept. 11 terrorist attacks. (Firefighters earned a record-high 90% honesty and ethics rating in that survey.

It is nice to be so trusted, but where does trust get you? Trust without respect is meaningless, particularly in the workplace. Patients often treat nurses like they are the “hired help,” like the nurse was their private servant.  And they treat nurses like they are the upper class and nurses are lowly working class drudge.  And of course, some nurses reinforce that image by not sticking up for themselves, and demonstrate to the patient that they are nothing more than servant labor–by grabbing a mop instead of calling housekeeping, or washing down the shower!

Administration also has little respect for nurses–I don’t know how many nurses talk about punching a time clock. Gee, we’re supposed to be professionals and instead, playing Laverne and Shirley? At least factory workers tend to be union members, which is more than I can say for nurses.

But in the words of Aretha Franklin:

R-E-S-P-E-C-T

Find out what it means to me.

R-E-S-P-E-C-T

Nurses need to add that word to their vocabulary, and demand it.

Does Google have the coolest and most talented artist in the world, or what? Just looking at this picture is enough to give thanks.

This was another ditty that I’ve had hidden in my draft file for several months, and unfortunately, I don’t know what happened to the link. But it amused me, to think that educating oneself to work as a nurse suddenly became as indelible as skin color. Or ethnic background. Or eye color (although contact lenses have changed that).

Is a nurse always a nurse? Is it something that hangs around your neck like a ball and chain no matter what else you do in life?

Apparently, even if you scrub yourself with Chlorax and steel wool, and incinerate your license, and drop your nursing gear into a crater on Mars, you are still a nurse. First and foremost.

Nurses may add JD, MBA, or EdD to their names, but while they may not work in a clinical setting, they are still nurses.

“Whether working with computers in nursing, in forensic investigations, as a pharmaceutical sales representative, or as a quality assurance coordinator, each nurse brings something special, something compassionate, some healing touch to someone, somewhere,” she says.

I think that the person who wrote is one of the starry eyed beings who thinks nurses are angels of mercy, and getting an RN license is akin to a pair of silvery winger.  You’re still a nurse first and foremost, no matter what else you do? Please, spare me the sentiment before I start feeling  queasy.

If a nurse returns to school and becomes an MD (I know, sacrilegious), does he/she still consider himself/herself a “nurse first and foremost?” Or a physician? I think the answer to that is obvious.

If a nurse becomes an expert sculptor and opens a pottery studio, does she apply the “healing touch” to all of those vases and urns? Does she tell her customers that she’s really a nurse underneath those clay stained hands, and just dabbling in pottery? And is making pottery for the healing experience?

Yes, you can see where this is going. What is it with nurses, that they must cling to these adages. Take the case of Clara Barton. She is widely considered to be a nurse, especially among nurses who proudly add her names to the ranks of the historical nurse elite. And they will bristle if you tell them otherwise.

But truth be known, Clara Barton was a school teacher. Then a patent clerk. And when she took her wagon full of supplies out onto the battlefield, she had no training as a nurse and did so out of frustration. She saw supplies sitting in Washington DC, while soldiers were dying a few miles away. So Barton being a strong minded woman took it upon herself to bring those supplies out to where they were needed, and ended up assisting in the battlefield. But when the war ended, so did Barton’s “nursing career.” She spent the next several years locating missing soldiers, and then established the American Red Cross.

So now, Barton is an interesting case. She had 2 careers before her stint as a nurse, which was by far the shortest career of all. So should we say that Barton was first and foremost a teacher? Wasn’t she still a teacher then, when she headed off to madness and mayhem in the war zone? Or still a patent clerk? Or do those jobs not count?

She lived for almost 91 years and spent 3 of them doing her “angel of the battlefield” stint. And if there hadn’t been a war, it is highly unlikely that Barton ever would have ministered to the sick and injured. She was a teacher–founded her own school, the first woman to hold a clerkship in the patent office, and then the bulk of her life was dedicated to the Red Cross. She was also involved in the women’s suffrage movement, and the early civil rights movement for black Americans.

But first and foremost, Barton is a nurse?

If someone spends five years working as an accountant, then becomes a nurse and works in the field for 2 years, and then goes on to become an English teacher for the next 25 years, is “nurse” the shining moment of her life? The height of her identity, the pinnacle moment?

You know what I think. What do you all think? Does nursing override everything you’ve done before and afterwards, like indelible ink?

I have a number of articles that I have sitting and fermenting in my draft box…some of them beginning to near retirement age. But with the election, and then spooning more work on my plate, and then revamping my website (yes, my official memo about that is coming), and then updating Windows this weekend–well, poor blog. Gets ignored and left out. Plus there’s my other blog (www.moneyfaithandchocolate.com) that is really being ignored, and I have great plans to start yet another blog.

This is an interesting little story from the NY Times about scrubs. It’s a short piece and designed primarily for reader input. It asks the interesting question:

Should hospital scrubs be worn in public places?

That’s one of the questions asked by my Well column this week, which looks at the role clothing may play in the spread of germs by health workers. The issue of scrubs on the subway and other public places has been raised often by readers of the Well blog.

“I cringe every time I see a medical professional on the subway in their scrubs, which is a regular occurrence,” writes reader A.K.

I don’t think wearing soiled scrub clothes poses a threat to public health, unless you work in a level 4 biosafety lab, or just emerged from a cholera unit. My problem with scrubs is that they have lost their purpose.

When I first started working in NICU, the hospital supplied the scrubs. You wore them, then dumped them in the laundry bin, where they were washed with hospital detergent. Then it came about that alot of hospitals required nurses to wear their own scrubs. So these scrub clothes were worn into work, ie, like outside in the street, then worn in the unit, and then worn home. And who knows how many times they were worn before washing? The only place that maintained a strict protocol on scrub clothes was the OR. Fortunately…

Scrubs are now commonly worn by nurses all over the hospital. There’s nothing wrong with that, except the scrubs that they are wearing in places that are supposed to be a little ultra clean (aside from the OR) are no better than a regular uniform. Like the NICU. Shouldn’t nurses, doctors, etc, be wearing scrubs that never leave the hospital? That are washed in the hospital after one use, and washed with whatever disinfectants that are used to clean hospital laundry? Doesn’t that make sense?

With all of the excitement over the election, and my usually hectic schedule (I finally sent my last two change of address cards–never mind that I moved 11 months ago), this entry sort of got pushed to the back of the pile. But a reader contacted me and asked me to read an article she had written, and to comment on it. And if I liked it, to please mention it on my blog.

Well, I do. It is a great article about those little details of nursing that most of the “experts” like to omit. It zooms right in on what the problems are in nursing, the real problems. And in looking at these real problems, it is impossible to just shrug the shoulders and say, “Well, we can solve the nursing crisis if only we offer more scholarships.” Or “Let’s try to get more minorities/men/three headed elves into nursing.” Or “We just need to turn out new nurses faster, and once we mass produce them, we’ll glue them into place on the job.”

You can read her whole article at Right Here! But here’s the first paragraph–and you can see why I like it so much…

Why Are Nurses Still so Underpaid?

The Mission-Critical Sticky Factors in Nursing

The nursing shortage is a veneer for other nursing-specific problems that really go under-reported. We tend not to hear about them because they lay bare a few disappointing truths about nursing often only known by insiders.

• First, nursing salaries stink—period.
• Second, nurses as a whole are uninspired when it comes to furthering their education or moving up the “healthcare ladder.” The rest of the world thinks it’s a novel idea, but nurses think little about it.
• Third, the nursing shortage doesn’t get any better when you try and put new nurses into the pipeline simply because it’s an open-ended model—as fast as you drop some new into the stack a slew of very experienced – the real valuable human resources – go tumbling merrily out the back side, relieved to be free and onto OTHER CAREERS, OTHER upward ladders.

These are huge factors in the nursing profession in one way or another and each poses a real world “sticky” problem.

Healthcare is  still a priority for President-elect Obama (ooooh, doesn’t that sound wonderful), but getting the economy going is the number one priority. Still, it does sound like there is going to be a push for healthcare reform, and soon.

No one has taken any polls or surveys, as far as I can tell, but I am curious if healthcare professionals tended to vote more Dem or Repub, or if they were just all over the place.  Of course, the election was skewed somewhat by the presence of Sarah Palin–she was one of the greatest boons to the Democratic party.  Just the thought of her being the vice president to a 72 year old president whose had cancer 4 times….but I digress.

It would be interesting to hear the views of healthcare professionals weigh in on this, especially as the new administration moves forward.  But I am curious if the respective healthcare plans played any part in votes cast by doctors, nurses, technicians, pharmacists, etc.

And Yes We Did!

Congratulations to the new president and vice president of the United States. Now is the time for change, especially in healthcare. May the day come when no one in this country will be forced to declare bankruptcy because of medical bills; may the day come when no one in this country will be forced to forgo necessary medical care because they can’t afford it/their insurance won’t pay for it/they can’t get insurance.

One of the oddest points in a very odd and nasty presidential campaign (and sorry if I offend, but the bulk of nastiness has been spouting from the lips of the McCain/Palin campsite), is the attack on science. Granted, I know that Sarah Palin has been quoted as believing that humans and dinosaurs walked the earth together only 6,000 years ago, and wants creationism taught in schools. I haven’t investigated whether or not she actually said that–about the dinosaurs–but that philosophy has been attributed to her.

But Palin, who has tried to make herself seem like an “everymom” and constantly derides the evils of the intellectual elite, appears to be profoundly ignorant of science and scientific research in general. Granted, John McCain has promised to increase funding for cancer research, so I don’t know if he shares Palin’s overall disdain or ignorance of the subject. But it is worrisome, if the duo is elected, to have someone sitting in the VPs chair, who thinks that scientific research on fruit flies is being done because of an overwhelming interest in the personal lives of the little critters.

From the Chicago Tribune:

In an election that has been fought on an astoundingly low cultural and intellectual level, with both candidates pretending that tax cuts can go like peaches and cream with the staggering new levels of federal deficit, and paltry charges being traded in petty ways, and with Joe the Plumber becoming the emblematic stupidity of the campaign, it didn’t seem possible that things could go any lower or get any dumber. But they did when, at a speech in Pittsburgh, Republican vice presidential candidate Sarah Palin denounced wasteful expenditure on fruit-fly research, adding for good xenophobic and anti-elitist measure that some of this research took place “in Paris, France,” and winding up with a folksy, “I kid you not.”

I supposed that stating that the location of this research was supposed to emphasize how silly it was, that sharing data and working together with scientists living in friendly nations is somehow bad. Or makes the research spending worse than it actually is.

But what is ironic is that Palin has been touting the virtues of small town America, and how wonderful these places are. But I guess its okay if the farmers living in these small towns and rural areas, ie, the real America, have their crops devastated by fruit flies. Yes, fruit flies are one of the most destructive critters to agriculture, and the maligned research was studying that very issue. But even it was explained to her, I doubt that she’d get the message. She clearly stated during the VP debate that knowing the causes of global warming was not necessary in order to stop it and reverse it. So I guess that studying fruit flies to try to control their destructive behavior is a silly endeavor. Just control them, stop them, fix it. Who needs to do research? Just get a can of Raid and “spray, baby, spray.”

The second part of her ridiculous statement has to do with genetics. Scientists have been using fruit flies for over 100 years to study genetics, and much of our knowledge stems from–ahem–fruit fly research.

It was in 1933 that Thomas Hunt Morgan won a Nobel Prize for showing that genes are passed on by way of chromosomes. The experimental creature that he employed in the making of this great discovery was the Drosophila melanogaster, or fruit fly. Scientists of various sorts continue to find it a very useful resource, since it can be easily and plentifully “cultured” in a laboratory, has a very short generation time, and displays a great variety of mutation.

This makes it useful in studying disease, and since Gov. Palin was in Pittsburgh to talk about her signature “issue” of disability and special needs, she might even have had some researcher tell her that there is a Drosophila-based center for research into autism at the University of North Carolina. The fruit fly can also be a menace to American agriculture, so any financing of research into its habits and mutations is money well-spent. It’s especially ridiculous and unfortunate that the governor chose to make such a fool of herself in Pittsburgh, a great city that remade itself after the decline of coal and steel into a center of high-tech medical research.

I rest my case. As I said, McCain has said that he will restore funding to NIH for cancer research. I read his plan for cancer care, and it plainly states that. But as for other scientific research, well, I don’t know where he stands. He hasn’t said anything about the fruit flies, nor has he jumped in to smooth over Palin’s inane comment about it or clearly state that scientific research is a priority.  Or explained how important fruit fly research is to farmers the world over, including those that live in those cute little pockets of real America, and no matter how “Pro-American” they are, their crops will still be destroyed by fruit flies run amock.

I fear that if McCain/Palin are elected, scientific research will take a hit, or at least they will make an attempt to curtail funding. Afterall, McCain did say that initially, all govt spending will be frozen, other than defense, veterans, and “vital programs.” What constitutes vital, I’m not sure, but it sort of contradicts his pledge for cancer research funding, and certainly doesn’t paint a rosy outlookfor other research.  And that is something that should be of concern to all of us.