F is for flashbacks, W is for weirdness

A flashback to healthcare...

"When an organization ceases to look at itself critically it no longer has the credibility it once had..."
This is a quote from a nurse.

He was speaking in the context of a hospital's Magnet Status not being held to any accountability standards. But it applies to many things, and it struck me personally tonight when I read it.

It is definitely the essence of why I left the job I did, and sums up why I don't want anything to do with corporate nursing anymore.

In fact, it sums up my non-existent exit interview. I tried to get one, but they informed me that they no longer give exit interviews. When I asked why, the human resources person could not tell me. She said she didn't know. I guess they are uninterested in improvement or change. Which was pretty obvious to me anyway, especially over the past couple of years.

Nurses don't have any protection, and physicians are rapidly figuring out what it feels like to be a nurse. It's pretty amazing and mind-blowing to find out that people who are responsible for keeping you or your family member alive- the most important job in the world as far as you're concerned- have no employment protections, no protection from retaliation or whistleblowing when they find and report a threat to patient safety, no backing to ensure that safe working conditions are provided by their employers, and so on...

Oh yeah, and I found this too...Amanda Trujillo continues her battle with the Arizona State Board of Nursing. The State Board is on a mission to destroy her. She will not be destroyed. Even if they strip her of her license, they will lose the war.

I made my first trip back to the world of the Cancer Center last Thursday night. The Survivorship Advisory Council (which includes me) had the opportunity to tour the construction site and sign the beams as the building is constructed. When I got the invitation I had a mixture of feelings. I really WANTED to tour the site, and I really WANTED to see most of the people in the group, in fact, all of them, with the exception of my former boss. But she's not my boss anymore and I really didn't give a shit what she did or thought, because she's been avoiding me for over a year and I didn't expect anything different.

I needed to do this to break the ice, to step back in and at least get a feel for things. I wasn't quite sure how it would feel. When you leave a place and there are unresolved feelings, you wonder if you're seen as the enemy. I know that I'm really not seen as the enemy as I've had an enthusiastic response and reception from everyone I've told about my new business.

But I truly felt like I might be crossing into enemy territory, just from the feeling I had from the cold reception I've had from my old boss, but she's always been like that. She did say hi to me, a very fake greeting, overly friendly, and that was the only thing she said all night.

After that she avoided my eye contact. Before I went in there I thought I might attempt a conversation, but she managed to cling onto someone else each time there was an opening and started an overly involved conversation, complete with dramatic body language and turning her back. I decided it wasn't worth it. I feel so much better, much freer being there when I'm not tied to the organization.

That was the only weirdness I experienced. Everyone else is really nice and supportive of what I'm doing, and they understand that it is a community effort. I signed the wall a couple of times, I wrote "bless the nurses" on a beam in the infusion area and I wrote an inscription on another wall in memory of a friend's wife who died from cancer.

While I was there, I also ran into one of the executives, no longer at the hospital, but is in a different branch of the same overarching organization. He greeted me as he always did, very friendly, and genuine. I quietly mentioned that I am no longer with the organization. He looked surprised, said he wishes me well in whatever I'm doing, and told me to stay in touch. I will let him know what I'm doing in the near future.

It doesn't have to be this way. The Pope is onto something...

Back to running.

Just a Thought for Cyber Monday

Not just for Christmas anymore. Let's make this last all year, and into eternity. Start by not buying anything online today, but that's the least you can do.

All of our biggest problems are caused by feeding into the greed of people who amass too much money and power. And by our silence and complacency, we allow it!

We all suffer from it here in the U.S. with our corrupt government, the system of corporate and private interest money going into lobbyists and sources of influence to tweak the system in their favor and not the people's.

It's one thing to make money or turn a profit, but when it's at the expense of millions of people's lives and well-being, that's greed. Our healthcare system is a good example of that, the insurance companies and pharmaceutical companies are perfect examples.

Even not-for-profit entities turn profits and instigate violent knee-jerk reactions to anything that might interfere with their money-making ability. Case in point: Health Care Systems. Anyone who strays outside a narrow set of lines is removed as quickly as possible by whatever means necessary, by a culture of corporate bullying that the law allows, because the law favors those with money and power.

Nurses are a readily available, exploitable source of labor easily manipulated by threats to their livelihood and licenses. Amanda Trujillo's case is one notable example, but there are many others, too numerous to track. The collusion of management, corporate culture, state-run licensing boards, and legal impediments to organized labor all contribute to an impossible situation for anyone who questions their motives or points out their hypocrisy, or worst of all, identifies a hazard to the public and tries to do the right thing to fix it.

In a conversation with a number of nurses recently, someone pointed out the analogy of a jumbo jet. If we treated airline pilots the way we run health care and nurse labor practices, any jet that took off would stand no chance of landing without crashing because there would be so many unresolved safety issues.

Make your new year's resolution something that will help all people. Resolve to make a statement, put your energy into changing the balance of power. It takes a lot of people, not just a few vocal ones. Instead of using the Internet for shopping, use it for social change. Write a letter, spread the word, don't just make people aware, motivate them to take action.

That's my $.02 for the day. Back to work...

Cheerleaders Only

I have a feeling that on Saturday at 7:30 pm I will feel like somebody shot me out of a cannon...

I am so ready to pursue my life again! It feels like the greatest gift ever, freedom!

But I have to comment on some things that are bugging me. I've allowed myself this time, until I regain my life, to blow off steam and express my anger and frustration as it surfaces. After all, aren't those human emotions? Don't human beings feel those things from time to time, especially when they've been SHIT UPON by other members of the species.

It is not healthy to hold feelings in. It is better to express them honestly. My chosen medium is by writing. I have expressed a few of my emotions out loud but somehow they came back at me via stab wounds in my back. And they were also subject to selective hearing.

I never was a cheerleader, never carried pom-poms. Couldn't do a straight cartwheel to save my life, either. I never was a girly girl either. I never fit the gender police's preferred image of a girl. Or a woman, either, when I grew up. I'm a person. Just like other people are. I believe that most persons are also human beings. At least that's what I assumed until I joined the working world.

I work my very last shift tomorrow, and it looks like I will work with fantastic people, coworkers I adore, patients I will miss. But I will not miss the cheerleaders club.

When I think about my workplace, with the exception of the majority of my coworkers, I imagine they are ready to get rid of me, too. No one in the chain of command above me said even so much as a goodbye this week. There are also a very small number of people (two to be exact) I've worked with in the past who have not bothered to answer my repeated attempts to contact them. People who claim to be caring individuals who work with many patients with serious illness, in both traditional and nontraditional health care roles. Won't even give me the time of day.

People are really afraid because I said what they think, what they wish they had the courage to say. But they are afraid. There is a pervasive atmosphere of fear.

If you disagree with ANYTHING, you have a negative attitude. Cheerleaders ONLY.

Really, I don't know why and probably never will know why the powers that be decided to shut me out of any discussion, planning or pilot programs for the very program for which I had promoted, volunteered my time, and fundraised for 5 years. Because they wouldn't even speak to me to my face. They sent a messenger to tell me they already had enough people. And this was over a year ago, before my attitude took a slide downhill into hell.

And then they avoided me for the remaining time, actual physical avoidance, despite my multiple attempts to let them know about my interest, not to mention my background, skills, and qualifications of which they were already aware from Day One.

I think it is because they only feel comfortable with a very small, select, hand-picked group of people who won't color outside the lines. Because it seems like for every project, the same people are involved. On Day One, I must have scared the shit out of some REALLY insecure person. AGAIN.

I can't help being who I am. But I shouldn't have to suppress it either. And there is a line, and if you cross that line with me, I'm not going to like it. And I'm going to say so.

Today I had lunch with a colleague who is a nurse practitioner. She brought a signed copy of Nursing Against The Odds with her. She had lunch with Suzanne Gordon, the author, at a recent conference. When she brought the book and asked me if I'd read it, I almost started to laugh.

Laughter is probably not the appropriate emotion. It would have been quite sarcastic and I suppressed it. I actually bought the book years ago, when I was a new nurse. I started reading it and it was so depressing that I had to stop reading it because I was new to the profession and it was painful to read. But after seven years of nursing I see that in the time since 2005 when the book was written, not much has changed.

I think it is very interesting what she wrote back then about Magnet, Gordon predicted that Magnet might not survive in an atmosphere of further cost cutting, and she is right. Magnet is weakening, to the point of obsolescence. No one is willing to pay for the things that Magnet requires. But then it seems like Magnet is also willing to look the other way.

Meanwhile in Arizona, Amanda is still fighting the Board of Nursing. Amanda is going through a living hell with those sick @#$%*! at the Arizona BON.

Spies, flies, and lies. Spying on people with social media, tattletales, people who listen in on conversations, people who twist reality so it fits their agenda. Then they try to shame her. Get real people. What business do they have being on the Board of Nursing, in their relentless pursuit of Amanda's license?

This is the reality of nursing folks. Nurses have no protections. If they are lucky enough to have unions, they might have minimal workplace protections, but beyond that, nurses kill one another off. The State Nursing Organizations (ANA disciples) favor management. The Board of Nursing is not there to protect nurses, it claims to be about protecting the public. Workplaces are run by companies with only the bottom line in mind. Nurses are revered only by people who have no idea what kind of slave-like conditions they are subjected to.

Nurses turn against each other by the pressure, lack of control, and hard labor they endure. Bound by their licenses, they try desperately to uphold their commitment to the patients they serve, when the organizations they work for do everything to work against them.

Not to turn the conversation back to me, because Amanda's story stands out in all it's horrifying detail. But her story reminds me, sickly, of the bullshit I experienced when a certain person tried to intimidate me over something I wrote. People with God complexes try to blow smoke and you just want to walk out of the room, because my reaction was, can we have an adult conversation here? If you're so concerned about propriety and behavior standards, then why don't you live up to them yourself?

And then we have this...

This is what mainstream nursing has become. And it is a sad fact that it will go on and continue to get worse until enough nurses are willing to put a stop to it.

I refuse to be a cheerleader. I will not shill for ANYBODY's substandard treatment of human beings in what is supposed to be a caring profession.

Which is why, once I get out of this phase of nursing, I intend to do something meaningful to support nurses who are going through similar hell, in order to help them regain their well-being in a safe atmosphere, where they can heal and move forward with their lives.

But first, I have to heal myself. Another 24 hours or so and I will truly begin...

Thankful for November

I bet you thought I was floating around in the muck at the bottom of the Arizona Canal. Wrong! I'm back! Somehow I managed to evade Sheriff Joe and his helicopters, so I didn't end up in the pink underwear-clad chain gang.

Happy November. I got home the other night after a quiet, fast flight back from Phoenix. I met some fellow ultrarunners from Washington in the airport so that helped pass the time. They were down for the Javelina Jundred, on the Pemberton Trail, my old training route. I also heard from my friend Brian who puts on the Pemberton trail 50K in February each year, and he reminded me to sign up. That sounds like a good first ultra to start with. It's only three months away but I'm pretty sure 50K won't be a problem by then. It won't be fast but it will be a start.

It's still beautiful weather here, the leaves are mostly off the trees now but there is still a lot of color everywhere.

This morning I made it over to the pool but I was exhausted. from the moment I started running in the deep water, my arms felt tired, and I was having a hard time keeping my momentum going, I couldn't stay focused. I was just plain tired. I got out after 30 minutes and started swimming, and the same thing, I bagged it after 100 meters and decided to go home. By 11:30 am I was falling asleep so I got into bed and slept until 3 pm!

I'm sure the traveling, social interactions, and energy of the past week have caught up with me. It doesn't seem to take much to wipe me out these days. Plus the stress of knowing I have to go back to work for a few more shifts. I get this knotted-up feeling in my stomach when I think about it.

I'm just going to have to tough it out until I get done. It's annoying. Why give 30 days notice when they're not even going to even replace you? I really feel like a body filling a few shifts in a factory.

I don't really know how to convey all of what I've been processing the past several days. There's so much to say, some of which I can't say yet, because the words haven't formed in my mind.

All I know is that this has seemed like the most colorful fall ever, going out in a blaze of color. All the old leaves are dropping and next spring will be a rebirth and getting my life back!

Flying home the other day, looking out the window of the airplane over pine dotted mesas dusted with snow, and bright red cliffs, the color was mind-blowing. And with the late day sun casting shadows from clouds over the wind-carved patterns in the landscape, it was psychedelic.

I was having intermittent hot flashes the whole flight, too, like I have been for the past several weeks. That's why I'm not sleeping well, I keep waking up sweating, and I have to cool off before I can go back to sleep.

I can try to describe some of what I absorbed this week. None of it surprised me, and Amanda was very much like what I imagined she might be. She's strong, she's human, she has her strong moments and weak moments, she's not perfect and she readily admits it. She easily articulates her story, her point of view, her understanding of the system, and what she feels needs to be done to change things.

Amanda Trujillo is a real person. She's genuine, passionate, down to earth...she's real. She has the best of intentions. Her story is even more important. What her story shows is the cruel nature of the system and how it beats you down.

That they've censored it in the Arizona nursing schools- nursing schools are not allowed to talk about it with students. That shows you that nursing education is not really about educating people to become good nurses, it shows that they want to produce more factory workers, who will just acquiesce to the executives, say yes, and become good little Stepford Nurses and stab each other in the back when one of them shows a spark of creativity or intellect.

Amanda talked about nurses being authentic, about the practice of nursing allowing you to be who you are. But the system works against us, it wants us to function like robots in a factory.

It's easy to see how the system has skewered her, has engaged in total character assassination, has taken away her well-being and health in just about every way possible, and she's still standing. She's still raising her daughter through this ordeal, and her daughter has suffered too. She's a bright kid and has a future that I hope will not be impacted negatively from this mess. She is fortunate to have a strong mother as a role model, but she's also seen firsthand at a young age how the system can destroy people.

The Arizona Board of Nursing, which I wouldn't trust any further than Sheriff Joe, and Banner Health, have used their power and financial resources to effectively destroy Amanda's reputation and future employment prospects, at least for now. I think that impact will subside and Amanda will move far beyond this, she has everything it takes to succeed, except for the financial resources. And that is a problem that can always be overcome.

The thing that resonated with me personally about our conversation, of all things, was something she said toward the end. She said the exact words that I have said to myself so many times I can't even count, in that searching for existential meaning in all of this mess, in all the pain we go through.

I am paraphrasing here, as these are my own words: "Why was I put here on this planet, when I don't seem to fit anywhere? Is this some cruel joke? Why am I here? Where is my place in this world?" But Amanda asks the same types of questions.

I told her what I learned a long time ago, that when you're different you have to carve your own path, the system will not allow you to exist. It will eat you alive, destroy you in the cruelest of ways. It takes a lot of strength and belief in oneself to overcome the psychological warfare that the world imposes on you. And it takes the support of other people besides what you have in yourself.

Unfortunately a handful of other nurses have engaged in backstabbing Amanda, instead of realizing that there is a lot more positive than negative, or seeing through the ugly smear that the powerful interests paid for their attorneys to dig up, twist and put on display for the world to see. The world of nursing is losing huge potential to move forward by banishing her and it's a sadly transparent display of their shortcomings and shortsightedness to censor any discussion of her case in the schools.

Every time we allow a nurse to be hurt, we hurt ourselves. At the same time nurses wait with daggers for someone else, they are really stabbing themselves.

Amanda and I both like this song because it's something that helps us through those rough days.

For me, by going into nursing after trying academia all those years ago, I gave the system another chance. But eventually it let me down again. I need to get out in order to survive.

On my way back to my car on the shuttle from the Denver airport, I got a Facebook message from another nurse I work with. She said she had worked in my area that day and someone told her that I had quit for good. She asked if that was true. I wrote back and said, yes, it's true, in another two weeks I'll be gone.

I'm counting the hours.

Seeking Peace at the Grassroots

I've retreated to the woman cave for the evening.

Today was a weird day, I didn't have energy for anything physical. I don't know what was wrong. I was tired, and I felt like I needed more sleep. I did get up early and started writing by 6:15, and didn't stop until after 10:30. Then I took Iris out for a quick run, as Isabelle did not want to go despite my offer to take her to Starbucks. It was getting warm.

After I brought Iris home I went back out intending to do 10 miles but I didn't feel like it was going to happen. I got to the Power Trail and was dragging my butt. So I turned around and came home. I decided a nap might be a better idea. I didn't feel ready to take a nap though, so I ate lunch and read a few articles out of my literature review and then played with the girls.

I finally got into bed around 3:30 pm and slept until 5:30. Then Dennis came home and I wanted to go for a run, but I still didn't feel like running. So I went out and walked. I needed to think, anyway, so I thought a walk would be perfect for getting into my thoughts. Unfortunately I couldn't get a peaceful moment. I walked through the neighborhood, past the Mormon church and to the schoolyard, and there was noise everywhere.

The most obnoxious of which was the ice cream truck. I can't believe those things still exist. They are so loud and annoying, playing that tune, whatever it is, over and over. I could hear it from blocks away. And finally when I got about a mile from my house, I could hear it again, it followed me! Aaargh! Then there were a lot of kids playing in the streets, on bikes and skateboards. School is out so it's much more lively in our neighborhood. I finally decided to just go home because I wasn't getting the quiet I needed in order to lose myself in my thoughts.


The flowers are going crazy in the garden. All the purples bloomed first and now the oranges and pinks are coming out.



I'm pleased that the words have been pouring out of me. I was looking at the grass and thinking about the concept of grassroots. It's what fuels my passion. I so believe in the power of people, that it can be harnessed to create good, to improve things for other people in ways that big organizations and institutions don't accomplish.


That's why I like Pearl Izumi, and being part of what they call their grassroots team, of runners in the community who can talk to other runners, being more in touch than having only elite runners represent them. To ordinary runners, it can be intimidating to approach an elite runner, no matter how down to earth that person is. I was just thinking of Scott Jurek at Runners' Roost a few weeks ago and how some of the people at the gathering acted like he had some kind of magic aura surrounding him, that he wasn't really REAL, but he was the friendliest, most approachable guy you could imagine. Another human being. Same flesh.

Being a nurse, you come to understand how other people are really made of the same flesh. They hate to be poked by needles, hate invasive procedures, have the same fears for themselves, their health, their families, and are afraid of the things they don't understand. They can be taught, explained to, communicated with, and their anxieties relieved to varying extents. Every single person, regardless of where they stand on the socioeconomic ladder, is made of the same flesh. It is my sincerest belief that all people need the same thing, to be treated with the same care and respect, and that no one deserves better or worse treatment because of where they came from, what they have or don't have as far as things, money, or talents, or what they look like.

So before I depart from this topic of nursing, that I've beating into the ground both on and off this blog, I want my readers understand where I'm headed. I have plenty to say about nursing and I'm saying it all the time now, in a different place from here. I just feel that there are things that need to be said here, to wrap up that topic, to illustrate what drives me and why, and how it relates to running for me.

I feel that a grassroots approach is needed to transform nursing as a profession, and my project off this blog right now is focused on working toward that. There are a lot of people working on it besides me, but my piece of it is a personal writing project. Nurses are hurting everywhere and need advocacy for their own survival. Nurses spend all their time advocating for patients under conditions that are far from ideal or even helpful for providing effective patient care, so nurses need advocates for themselves. Otherwise I think much of the profession is doomed to obsolescence.

If you're not familiar with Amanda Trujillo, she is a nurse in Arizona who was fired over her attempts to advocate for a patient. She is still fighting the Arizona Board of Nursing. Arizona is a backward state in many ways, I know that from living there myself. It's a fascinating, but sad and frustrating story. She's paid a huge personal price for her refusal to back down and continues to stand up for what she believes is right. If you click on her name above you can go to her blog and find out more about her story. I want to share an excerpt from what she says, she so inspires me. I've used this piece with permission from Amanda, so I thank her again. I believe in my heart that she will end up on the right side of history. Amanda advocates for a grassroots approach to changing nursing.

"The most important thing….I’ve learned…is to never stop talking, never stop putting your passion and ideas out there—-Never let your voice, your heart, be silenced. The moment it happens happens you are invisible to the profession–both its present and future. With each nurse who is rendered silent we lose a shade of color from the color pallete that is our profession, we become less of an art... and we become grayer…..we lose the possibilities for greatness and influence and growth, we lose out on someone’s gifts and their own unique light. With every nurse who chooses to succumb to silence we lose what could be the next great leader, the next great theorist, another potential role model….you make change by staying loud and finding a way to contribute your own gifts in your own special way, and I will debat until my last breath anyone who tells me "There is a right time and place to do it." It's BS, sorry. If there was a rule book I didn't see Martin Luther King flashing it around or Cesar Chavez recommending it to everyone during his movement either. They relied on their dreams and what they had in their spirit. ….For me, its writing…and once I get into a new home with my daughter and get settled—it will be continuing my volunteer work as a nurse, writing my nurse memoir, working with the state legislature to enact a law to protect nurses in Arizona from retaliation, and advancing NAASA–the advocacy org I want to make into a non profit. Though I have fires to put out and much going on right now I have determined what my contribution and legacy will be to Nursing and how I will have made my profession a little bit better. What I will not allow is for a profit and politically driven healthcare system to render me inept or irrelevant. I have too much love and too much passion for nursing to ever EVER allow Banner Health or any BON to do that to me or my spirit." --Amanda Trujillo

When organizations and institutions get too big and powerful, they impede progress. They get unwieldy and awkward. They become too complex, and too divided into hierarchical levels to serve at the human level. This interferes with their ability to impact individual lives in an effective way. It's part of the political and economic landscape we live in. That's not to say it's okay or forgivable to operate this way in the context of the present time. It's just the reality of what we live with now. It needs change. I intend to do whatever I can to work toward that change, in my own piece of things. Nothing changes if you keep your mouth shut. People need to be more vocal and assertive, and put more energy and force into getting their needs met. The people at the tops of organizations are human too. Same flesh.

I am hopeful that someday we will move away from the tendency to form huge conglomerates, monopolies and mergers and return control to people and their communities, for the human beings who have to live in this world. I don't know if that's too idealistic, or if it's ruined beyond change at least in my lifetime, but there has to be a breaking point.

Running is a human endeavor. It reminds you of your own strengths, weaknesses, potential, and limitations. It takes away all the crap that the outside world piles on top of us every single day. We can sweat it out and it flies off into the breeze. Running is one way of keeping yourself grounded and sane in the crazy world we live in, that takes us so far away from the human animals we are.

I think it's important to have a constant reminder of the fact that you're an animal occupying this planet, with other animals. Dogs are great for that, they make us more human, and the more we can be like them, the better off we are.


The girls are my companions, they like to go in and out the door while I work out here.

Iris has the evildoer look on her face, but she's sworn to secrecy.


I want to thank the readers of this blog for staying with me through my tangents from running. I hope I've been able to show you how, in my eyes, it's all related.