The Fallout Continues...

Tonight I did a radio show on breast cancer awareness month and pinkification of October. It was fun, especially when I was scheduled for a 30 minute show and the host suddenly, a few seconds before we started, saw something that erroneously told her we were on for 60 minutes. I was fine with that, I had plenty of material and I could talk forever about these topics. We slowed everything down to stretch it out, and then suddenly, 5 minutes before the 30 minute mark, someone tapped on the door to tell her the show was only 30 minutes, so she let me get my last words in and I scrambled to say all of the important points in the last 3 minutes or so. Crazy, but fun anyway.

After the show we talked for a little while casually about health care and I mentioned my challenges in getting my business off the ground. One of the biggest assumptions I made at the beginning was about how I'd market my services. I thought doctors would be interested in what I was doing and welcome it. Well, getting to talk to a doctor face to face has only happened enough times to count on one hand, and most of those were by accident when I ran into them in town somewhere by chance, like in the grocery store.

The way I see it is, I have this great service that would be so good for their patients, but I can't even get 5 minutes of their time to talk with them about it. They just don't prioritize that, it's a different way of operating than they are used to, and now with fierce competition in town, everyone is protecting their own turf and profits. They see anything outside of what they do as competition.

The host of the radio show, who works in health care herself, told me that a doctor she knows thinks physicians are slow as snails to adopt anything new, she said on the order of 17 years (about as long as a new drug patent used to last before the generic could be marketed).

We are still being inundated with Ebola everything, and I have read some highly astute observations from people at the direct care levels of health care, physicians, nurses, infection control specialists, and techs on the state of health care in this country. Many of the things I have discussed in past blogposts with regard to patient safety and how nurses are treated in the workplace and when they raise concerns about safety issues in the workplace have surfaced in the Texas Presbyterian flap.

I also read with interest this article about how things are being handled at the Biocontainment Unit at the University of Nebraska medical center, one of the hospitals where Ebola cases are treated and they have a solid and effective plan in place for their workers to prevent transmission of the disease. If you go to page 2 they talk about breaking shifts into four hour blocks when dealing with the extreme conditions of having to work in hazmat gear, and on page four, they discuss how they pay attention to the needs of the caregivers.

Some of the things they do could be applied in general, such as allowing time for breaks, to eat and drink and use the bathroom, having behavioral specialists to help people deal with the stresses of working. If you're not in health care, you might think, what? Of course you need to take breaks and eat, drink, and go to the bathroom. If you are a nurse, you're thinking, what a novel common sense approach, and you're already googling on U of N Medical Center to see if they have any open positions on their employment site. You're thinking, hell yes I'll work with those patients in a space suit if it means I get to pee and eat every four hours!

Just think what we could accomplish if safety was our top priority. We'd have to slow down, and maybe take care of the needs of the employees who are taking care of patients. And then maybe we could have zero hospital acquired infections, and instead of thousands of medical errors they would be as rare as Ebola in the U.S.

Why is it that in health care, when we should be staffed by smart people making good decisions because we are relying on them to take good care of our health when we are sick and dependent on them, that it turns out we are at the mercy of irresponsible, detached, myopic decision-making at the highest levels of the organization which trickle down to the front line workers being abused and working under inhumane conditions?

The other thing I noticed was that under the CDC new guidelines, which they released after a bunch of health care workers (namely nurses) made A LOT OF NOISE about the inadequacy of the first few messes they sent out...the new guidelines clearly state that management and leadership (ha- see my blogpost from a few days ago) are responsible for seeing that the guidelines are implemented and followed. Read: Five Pillars of Safety and I quote:

Five Pillars of Safety

CDC reminds all employers and healthcare workers that PPE is only one aspect of infection control and providing safe care to patients with Ebola. Other aspects include five pillars of safety:
•Facility leadership has responsibility to provide resources and support for implementation of effective prevention precautions. Management should maintain a culture of worker safety in which appropriate PPE is available and correctly maintained, and workers are provided with appropriate training.
•Designated on-site Ebola site manager responsible for oversight of implementing precautions for healthcare personnel and patient safety in the healthcare facility.
•Clear, standardized procedures where facilities choose one of two options and have a back-up plan in case supplies are not available.
•Trained healthcare personnel: facilities need to ensure all healthcare providers practice numerous times to make sure they understand how to appropriately use the equipment.
•Oversight of practices are critical to ensuring that implementation protocols are done accurately, and any error in putting on or taking off PPE is identified in real-time, corrected and addressed, in case potential exposure occurred.


A culture of worker safety. Hmm. And what culture is that? It's the one that is greatly exaggerated by most corporate leadership accounts. If something interferes with the bottom line, there will be a workaround. Somehow...

And somehow...University of Nebraska seems to get it, but that safety culture needs to expand throughout the health care system in this country, and profit-centered models of health care are not going to welcome it.

Certainly that culture was nonexistent at Texas Presbyterian, where they couldn't figure out that their PPE was inadequate or spend the money to transport a patient to where someone knew how to take care of him...yet they had plenty of money to hire an expensive PR firm to tell them how to handle their image after their disastrous mistakes that repelled patients to the point where their hospital is nearly empty now.

The culture at Texas Presbyterian, the same one that has administrators telling nurses not to go to the media or they'll be fired, the same one that resulted in one nurse blowing the whistle and we know she'll never be able to go back to working for that hospital again because of the retaliation she will face. Lawyer or not, the hostility directed at her after speaking the truth will make it impossible for her to carry out her duties, as they'll be watching her every step and finding ways to harass her until they get rid of her.

This is the reality of health care, folks. And it needs to change. If you're not in health care, this is what goes on behind the scenes when you or your family member is being "taken care of". This is what the nurses endure. This is what physicians are forced to work with, administrators who are unresponsive to their needs too.

This is what I've been screaming about so passionately for a long time, and finally we have a crisis that has brought these issues directly to the surface. And a lot of organizations are going to deny that they do business this way, and defend their own practices with lawyers, PR tactics, and doing whatever they feel they can get away with. "We're not like Texas Presbyterian" will be the cry of protest. But right now, every one of these organizations is scrambling to give the impression that they are prepared and trying to minimize their expenses to protect their profit. Some are more prepared than others, but the culture is what needs to change across the board.

This is health care in the U.S. naked.

Do you care yet?

Is Ebola the Cure?

Ebola is shouting at us, but is anyone listening?

This morning I read what perhaps makes the most sense of any of the volumes of material that have come out in the media over the past two weeks since Ebola hit our shores.

I'd like to elaborate on some of the points the author makes and add my own.

Ebola might actually be the cure, if we would just pay attention and listen to what it is telling us about how we run things in this country.

I see Ebola as an opportunity to get things back on track. Will we have the vision and leadership to do this?The way we’ve been operating for so long, my fear is, we do, but we’ve forgotten where to find it. We need to put our ears to the ground to listen.

First, we have gross misallocation of resources in this country. The huge portion of our GDP that we spend on health care is largely wasted, we’re not getting our money’s worth.

We don’t value preventative care or good health.

We have media looking to make a buck off mass hysteria. They stir the pot to the point where it bubbles over to one side or the other, parroting stupidity and spewing hate. Each side is convinced the other side has a conspiracy to destroy those with whom they disagree. Look at the trolls who follow any online article.

We have greedy, profit-centered institutions guide our health care system, looking only to make a buck off our sickness, with lip service to something called wellness.

Companies manufacture more new products every day to make us sicker, from foods to chemicals to sedentary entertainment gadgets.

Specialty-trained health care providers looking to make a buck off the few patients they hang onto when avoiding joining the big guns give advice to patients they don’t really have the expertise to provide, and the patients themselves are not health literate or able to critically think enough to know the difference.

Health care itself is dysfunctional in that there is no communication between the levels of hierarchy that have been created. Nurses, who spend the most time with patients, know the most about the patient. Physicians know how to treat the patient, but do they listen the nurses? Administrators are concerned only with protecting the bottom line of their own little turf, don’t listen to the physicians, and friction develops between the layers.

Meanwhile, the money gets funneled to duplication of efforts and waste. No one at the top of the heap listens to the muffled cries of those at the bottom, those who see reality on the ground.

We have a political system that has completely failed us through inaction and servitude only to the wealthiest entities who feed it. Only self-interest and greed guide our career politicians. There is no coordinated effort in our government to look out for the best interest of the people. Those who seek election think it’s optional to take facts and scientific evidence seriously. If it interferes with profit, who needs it?

Not only have we failed to fund public health, we’ve been failing to fund education, transportation, and other public resources. Look for more crises in these sectors in the near future.

We’ve forgotten how to communicate with respect, how to listen, how to think critically. All of the issues that Ebola has brought into sharp focus should be seen, but we don’t have any leaders who are seeing.

We’re going to face more crises of this magnitude the longer we allow our country to operate in this dysfunction. We need true leadership, an end to the greedy, profit-obsessed way of operating, and a re-focus on the needs of our greatest assets: people.

Leadership is just another word for...

Yes. As in yes men.

One of the things you see in organizations is the habit of naming certain people as part of the LEADERSHIP. They LOVE the L word. They love to hear themselves say it.

They emphasize to everyone that THEY are the designated leadership team. That gives them privilege, they get to sit in on meetings and are privy to additional layers of company secrets that the underlings are not. They also get to escape accountability as a perk. They get to blame other people for failure, but leaders stay clean. 

The moment anyone DOES try to hold them accountable though, they hide behind the other big L: Lawyers.

Leadership has become simply another word for yes man.

What we needed in the face of the Ebola problem, as in so many other events, was a leader. Solid decisive action. We did not get that. We got buddies of the President appointed out of political favor instead.

You won't hear me criticize Obama very often. I don't usually mind when people do, though, because I don't mind other people having opinions that differ from my own, and I don't need to be right.

As long as it's not some troll spewing mindless racist hate or parroting abject stupidity, I just let it be. I have my own political views and I'm not afraid to say I tend to lean very much toward the left most of the time. But I also think it's important to remember that we are talking about public health and safety, and Ebola doesn't care if you're a Republican, Democrat, or Purple. Nurses don't refuse to take a patient based on their political affiliation. We're all human beings and we're all affected by this.

That said, I am very disappointed in Obama for this appointment of a so-called "Ebola Czar." This guy has no health care or public health experience whatsoever. He's an attorney and works with big business, and therefore has no clue about the things that frontline health care workers do or deem important.

We have a problem in this country and it's lack of true leadership. True leadership is not the fake kind taught at Harvard Business School. Look at the people in Congress, for example. They won't even act on minor issues because it's midterm election season. Where are their priorities? They certainly are not with the people of this country. They prioritize their own reelection so they can continue to prey on the well-funded palms that feed them, the ones who got their money by preying on the public.

We need to string them up by the part of their anatomy that is most sensitive to pain and say, you need to act. Quit protecting your own turf and do what we're paying you to do. Remember we are still paying them, in terms of benefits like health care and retirement, and it's out of our taxes, which we pay disproportionately more of than their rich buddies. The perks from lobbyists and guarantees of golden parachutes are much more lucrative, and as long as they keep it so, the people are screwed.

Career politicians are not leaders, just like the so-called leaders of corporations. Self-interest. Greed. Power. Those are the things that motivate these people. As long as they are safe, comfortable, and profitable, they won't do a damn thing to change.

This is what happens in corporations. I can remember working in the hospital and there would be these "leadership" meetings that always consisted of roughly half the unit staff, while the other half stayed and worked. All of the so-called leaders were in their positions due to length of time they'd been there or the fact that they were the biggest kissasses, and/or the most toxic people on the unit.

This is an aside, but I couldn't help thinking, when I saw what happened to Nina Pham, the first U.S. nurse diagnosed with Ebola in Texas, that she must have somehow drawn the short straw on assignments that day. Or maybe she volunteered for the challenge. I can remember the nasty charge nurse I had to deal with in ICU who would always give me the most distasteful assignments that she'd never give to her buddies. When I was a new nurse, I used to ask for more challenging assignments, but what usually happened was I got the patients no one else wanted. Had Ebola come to the unit I worked in, I probably would have been the one given the Ebola patient without adequate protection.

Who knows what they discussed in those meetings, I was never invited. I was one of those dangerous people who questioned things and might actually think for myself. I stayed and took care of patients while they "led" in the conference room. They never communicated to the rest of us what was discussed in those meetings. Occasionally we'd ask them to, and they'd pretend they would do it, but they never actually got around to it.

There were always a lot of leaders relative to the non-leaders. It was more of a secret club than anything. You'd have to somehow demonstrate your loyalty to the system before you could be granted admission. And just how you did that, was never made clear. There was never a book of rules, or a playbook that was shared with everyone. That's how you keep the underlings in line. People who want to do things and take action are not the ones who are valued in these organizations. It is the sheep who stay, are promoted, and kept.

Do a shitty job, keep your clique in place, and get rid of anyone who thinks critically or has ideas? Get promoted to an executive position, created just for you.

Take action on a patient safety issue? You're fired. We don't want the world to know that we really don't value patient safety, that it interferes with the bottom line.

Business schools and law schools don't produce leaders. Actually most schools don't. They provide didactic knowledge, but it's not applied to any real world situation very well, if at all. Experience and demonstrated decisive action do. That's one reason why we've always valued military service when people ran for president.

I am not sure that the military is any better of an organization but it certainly does provide opportunities to demonstrate leadership. With all the changes in the military I am not sure that it provides what it used to. But I do know that in my health care experience, I have seen the establishment frat boy culture completely diss a newcomer with military experience and common sense, when they could have learned and gained from his ideas.

The frat club of business school-educated "leaders" knows how to work the system to eliminate any common sense or true efficiency from the system. They pretend to implement systemic changes which really only serve their bottom line, and usually result in inefficiencies for the people who do the real front line work.

Some have called for an office of a National Nurse, another ball that has been dropped in our pathetic Congress. If there had been a national nurse (not to mention a Surgeon General and adequate funding) in place prior to the Ebola incident, perhaps we could have avoided this mess.

What's it gonna take? Well first, we have a midterm election coming up. You can start by voting for people who have demonstrated competent leadership. A newcomer, preferably, not an incumbent. We can make sure that anyone running for President who gets as far as the primary is thoroughly examined by the public to look for true leadership ability and experience, not a career politician.

And we need to insist, like National Nurses United has demonstrated so well, on our voices being heard, our recommendations being implemented and taken seriously, and not backing down to the fear tactics currently used in the corporate playbook that result in voices acting in the public's best interest being threatened and squelched.

The one nurse from Texas who blew the whistle and went to the media? She is a hero. She is risking her livelihood but she is protecting the public, and that's more important. She will find work, perhaps not in a corporate health care system, but someplace where she can do meaningful work.

We have got to stop allowing these business school educated, incompetent people to run our health system. We need people who know the health care landscape, who have experience, boots on the ground, and know how to take action in a crisis.

You wouldn't allow the CEO to run a code, would you? Why should they run the hospital at all?

Health care and public health are not a business. Stop running it like one.

A Day Late...

And a dollar short...yeah, that's the understatement of the year thanks to the CDC and a few other entities who could have been on top of things.

On Wednesday I listened in on the teleconference held by National Nurses United on the topic of Ebola. I want to share some of the details of that webcast with you, because I think it's important for the public to get a picture of what is going on in health care from a health care provider's perspective, and how it could affect your health if you were to end up as a patient in a medical facility, regardless of what you come in to that facility for.

It's important to think about this, instead of listening to all the media hype, because they are great at scaring large segments of the public, and if you read the comment sections on any online news story, which I advise against, you will immediately see a list of diatribes from anti-Obama, anti-government, anti-everything psychotic rants that do nothing but finger the political party with which they disagree and blame them for this. The truth is much broader than that and it's a failure on many levels.

The fact is, you are highly unlikely to come in contact with Ebola in your usual everyday life. But I also want you to understand the magnitude of the problem because for those very few instances where there is an actual case of Ebola, it is a problem, the way it's been dealt with so far by hospital administrators and the government. And this needs to change.

I want you to understand that if you are admitted to a hospital for kidney stones, for example, and your nurses or doctors have been caring for a patient with Ebola, and have not followed proper procedures, your health could be at risk.

That said, nurses and doctors are human beings and they work for entities known as health care organizations aka hospitals and those hospitals have certain policies and procedures that they mandate the staff to follow when interacting with patients everywhere from signing admission paperwork to ordering meals to handwashing, not to mention handling isolation patients with highly contagious and deadly diseases.

The NNU teleconference started with statements from nurses stating their hospitals were unprepared, from all over the country. There were a few statements from nurses from other countries.

There was also the story of a Florida nurse who was "suspended indefinitely" for seeking her own information directly from the CDC, because her hospital did not provide the information.

The CDC did not act fast enough when it was known that there was a case of Ebola. The health care workers did not have the training or proper protection and for 3 days took care of the patient with less than adequate protection, even though the CDC's information on their website was dated June 2013 so we already knew that Ebola was a class 4 pathogen. The virus can live for up to 7 weeks outside the human body, so the disinfection process is much more intensive and specific than for many other pathogens.

The fact that hospital acquired infections from organisms much less dangerous and virulent than Ebola are epidemic in our health care system, even according to the CDC itself, to the tune of 1.7 million per year! and chronic understaffing of health care workers- from nurses to housekeepers, results in staff who are working being more likely to be rushed, pay less attention to detail, with more mistakes made, and important things missed.

Why the CDC did not immediately arrive in Texas is not known. Why did it take 3 days before the nurses caring for the first Ebola patient had barely adequate protection? Why did the administrators at the hospital allow the nurses working with Duncan to take care of other patients? Why did they not demand a visit from authorities to give them clear and immediate direction in handling this case? There are dozens of unanswered questions from the whole incident from the time Duncan arrived at the hospital the first time.

Where are the administrators of the Texas Presbyterian Hospital now? They are silent (CYA) hiding behind their lawyers, and of course bracing for legal action. They are no doubt formulating their defenses and not 100% concerned with health care at this point. After all, as a human being, you can only do so much. Here is the statement from the nurses at that hospital.

Why did the CDC tell the second nurse that it was okay for her to get on a plane? She should not have but she did seek their guidance. And that is what they told her. Two wrongs don't make a right. She should have used her own judgment in not getting on plane, but the CDC also should not have advised her to get on plane.

The plane that carried her from Cleveland was decontaminated. How many passengers could be exposed, probably few at the early stage of the disease but we all know that planes are filthy and not cleaned between flights, so there is a huge potential safety hazard to the public which the airline industry should be addressing now. Do we actually know how Ebola is spread at different points in the disease? What is the viral load at the beginning of symptoms as opposed to when the patient is extremely ill or dead? How are the virus particles spread- through the air? Or only by direct contact as they were saying. In the teleconference one of the scientists said that she was now changing her mind about how the virus might be spread, and it's possible that it could be airborne. We just don't know for sure yet.

So many pictures have surfaced in the news of workers wearing hazmat suits to transport patients and decontaminate. So why were the nurses not given this protection? The hazmat suits are Level 4 HazMat gear which is recommended for Ebola, Marburg, and several other types of extremely contagious pathogens. A secured area is required that will contain a method of decontaminating and removing the protective suits, the hazardous waste is handled in a completely different manner than most red bag waste in hospitals, and the rooms are cleaned and disinfected in an entirely different way than even most standard isolation rooms. Transporting and disposing of the waste (through incineration) requires another detailed and meticulous process. This is far beyond what is needed for meningitis, flu, TB, and other commonly encountered diseases in the U.S.

Employees who will be involved in any part of the process, from nurses to housekeepers to facilities and waste management people, will now have to be trained in flawless execution of these procedures. That costs money and takes time.

According to National Nurses United, it's a public policy failure, a result of long term underfunding of public health. The CDC’s budget for Public Health Emergency Preparedness fell from $1.1 billion in 2006 to $698 million in 2010 to $585 million last year. From 2008 to 2013, local health departments lost 48,300 jobs to layoffs and attrition, or about 15 percent. “Those job losses absolutely eroded the capabilities that would be needed if we had to deal with Ebola,” source: The CDC's funding had been cut in half over the past 6 years. Now we have a crisis.

Off the subject, but relevant, is the fact that so many public agencies have been underfunded. Take public education, for example. Eventually those chickens will come home to roost too. If the comment sections of any of the online news outlets are any indication, people have already lost the ability to think logically and critically, they just parrot the words of politically motivated hate spew.

National Nurses United is bargaining for adequate staffing, protection, and training. The ANA (American Nurses Association) has been much quieter, have not taken a strong and vocal stance. Nurses were the ones who made noise about it while the CDC and Texas hospital administrators, and administrators of hospitals all over the country were dragging their feet. We all know that if administrators had to go see a patient with Ebola you can bet they'd have the highest quality hazmat suits ever but with the workers they try to do it on the cheap. All about the bottom line.

Nurses are concerned with care and protection for patients and workers. Nurses will save your ass. In a pinch, count on a nurse.

There is a whistleblower hotline 1-888-381-4585 to call if your hospital is not taking adequate precautions. For more information ebolaprevention@nationalnursesunited.org

The NNU says they will be not silenced and will not stop, will not back down to leadership or threats. Policymakers (Congress) are not helping, they need to take action. People and the public trust nurses, and for good reason. We are the ones screaming about this louder than anyone, and have acted to make changes in health care. (Except for maybe the news media, who have blown this all into a scare crisis to boost their own bottom lines.)

If you are a nurse or health care worker in a place that accepts patients from the public (urgent care, hospital, ER) and your employer has not yet come up with any sort of plan to address potential cases of Ebola and shared at least the relevant information with you, then you ought to be looking for a new job, and at the very least, blowing the whistle. There is nothing wrong with opening your mouth. You might save lives. Too many nurses have been silent about safety issues in situations far less deadly than this one. It's time to stop that submission to power and threats, and do what you know is right.

So if any heads should roll, let's start with the director of the CDC, the Texas hospital administrators, the administrators at the Florida hospital, and any other people who tried to suppress the actions of nurses who were acting in the interest of public health.

And if Congress does not act, their heads too. Election year or not, they better do something. We have a problem in this country, and it is our elected officials' addiction to power and money.

The bottom line is, there are a lot more important things than profit. If we would start valuing those things, like public health, and education, in a spirit of compassion and respect for our fellow human beings, it would go a long way toward solving so many of these crises before they even become crises.

Curse The Nurse: Not Gonna Fly

The chickens came home to roost. The old knee-jerk response out of the administrative playbook, blame the nurse, it's the nurse's fault, is not going to work anymore. Playing the game I call Curse the Nurse.

National Nurses United had the cojones to address the situation head on, instead of the pathetic response from the American Nurses Association. No wonder no one joins the ANA. They don't do a damn thing for nurses, they are part of the problem.

Just a few brief thoughts here as I am busy today with other things, and I want to attend the teleconference being hosted by National Nurses United about the Ebola issue.

Playing Curse the Nurse: It's a problem that happens from the lowest levels of management to the highest levels of national agencies. If you as a nurse let your manager know that there is not enough working equipment on the unit, they are likely to say, "Well, what are YOU going to do about it?" (implied: in between caring for 4 or more patients)

From a foot-dragging response to concerns about patient safety on the unit that could easily be fixed with an inexpensive solution, to passive-aggressive spying tactics and manipulation of coworkers to skew employee reviews, to playing dumb "I don't recall having that conversation", management plays this game flawlessly. They get away with it.

And as the CDC has shown us, it's a convenient tactic at any level of the health care industry. Blame the nurse for all the problems. Blame the people with little power and few resources for the missteps of those who hold all the power and all the resources.

Blame the nurse for breaching a virtually nonexistent, and at best, totally inadequate protocol. Tell other nurses, when your mistake is discovered, that they'll be fired if they say a word to the media.

Profit-mongering, covering your ass, and playing these big business games are unacceptable in healthcare. When it comes to public safety and patient safety, nurses don't operate like that. We are there for the patients first. No big executive bully is going to tell us we can't go to the media or we'll be fired. Being fired is better. Who wants to work for scumbags like that?

Provide the right equipment and training, quit screwing around and counting your beans, and take people's lives seriously.

The truth comes out. Oops.

Here is my friend Andrew Lopez on the issue.

There are additional public health issues coming to light as we discover that a second health care worker in Dallas has Ebola, and may have flown on a commercial flight with 130 other passengers. There are the issues of flying & travel, e.g. surfaces in airplanes, poor hygienic practices of staff who easily cross-contaminate the public: flight attendants, airline companies, restaurant workers, hotel housekeeping staff.

But we aren't even there yet. What I am hoping is the silver lining, in this Ebola outbreak, whether it is contained at a handful of cases or becomes something larger, is that the public will be made aware of just how dangerous a big-business profit model is to their health and safety.

I'll have more to say later.

The Big Picture

There's a lot going on in the world right now and I was thinking yesterday about all of it, trying to put it all in perspective. I really need to get back to running posts, and I will.

I don't mean to sound negative here, because I spend my days now doing work that I feel is important and valuable to real people, and I live in a beautiful place and environment, and things are generally good in my life. I am fortunate to be where I am at the moment, and I enjoy it.

The things I see and read on a daily basis are so disturbing that I have to put it out of my mind in some way, and I think that's true for most people who pay attention to things, care about things, and live with this onslaught of information about insanity in the world. This whole Ebola thing really gets to me for some reason, and I think it's just the images of government and health officials flapping their arms and wringing their hands and looking so indecisive and lost as to how to handle it.

There is so much distrust of government and authority that the efforts to educate the public with health information are often wasted. People don't listen to sources they don't trust. The anti-vaccination movement is one example, but over the past week, look at Ebola and the information coming out of the CDC, all of the things we try to teach people about taking care of themselves and preventing cancer and chronic disease, so much of it is not being listened to.

I was writing a piece for the local paper yesterday on breast cancer and I mentioned prevention, like exercise, eating right, managing stress. These are things basic to decent health, for prevention of any disease. And so many people don't even have a grip on those basic things. We are a society hurtling toward self-destruction by our own self-neglect.

Do people have an underlying death wish? Do they really think it's a comfortable way to go, by self-inflicted obesity, septic and bloated to 500 pounds from a diabetic foot wound and hooked up to a ventilator with families surrounding them praying for a miracle? I've seen this more times than you could imagine. I can still remember the smells. Should we provide guns to these people instead? It certainly would be cheaper.

I think there is such an atmosphere of distrust here in the US because of our divided government and everyone's self-interest at the top, the focus on profit. Think about it, we are trying to prevent a disease epidemic, whether it's flu or measles or Ebola, and some for-profit hospitals are so cheap they don't even provide adequate protective materials for their staff like gloves and gowns.

The spokespeople at the tops of government or worldwide agencies are often viewed as shills for an already distrusted government, and those suspicions turn out to be right. So that just strengthens the case for distrust of agency information, and promotes more reliance on untested, unscientific sources such as the so-called health gurus who claim there is a natural cure for everything if you take the right supplements (a multi-billion dollar industry), you can cure cancer with a daily kale and wheatgrass smoothie, people who still believe childhood measles vaccines cause autism, and it goes on.

What if they came up with a vaccine for Ebola? Or a vaccine for breast cancer?

All over the world there is so much unrest, I think it has always been this way but there was less ability to follow it and draw attention to it due to the Internet and technology. Having those mouthpieces available like social media, makes it more attractive to rebels to get attention and be seen by the world, bringing attention to their cause. People are always going to have their attention grabbed by the extreme, so these groups resort to the extreme and show it on video over Instagram or Facebook.

There are the very rich countries and the very poor countries, and the US can definitely take the blame for it's role in creating a good bit of it. But a country that is seen as a world leader, or was once seen as one, has serious problems at home within it's own people. Poverty, wealth disparities, greed, corruption in all levels of government, capitalism taken to the extreme that it robs the people of resources that would make their lives so much better, all of the things that the US always claimed to be above, those are all spreading like an epidemic and there is no leadership to correct these things.

I have always been politically left-leaning and socially liberal, but these days I find myself understanding more about why the people on the right feel the way they do, and the anti-government sentiments they express are often valid, even if they don't follow the same logic to get to those that I would. I hear the right wing complain bitterly about Harry Reid and Nancy Pelosi and when you listen to them talk, the criticisms are warranted. I recently heard an interview with Nancy Pelosi that was absolutely nauseating, I wanted to kick her out on her ass. There are so few Democrats I view as being above the fray that I can't say I support the party at all.

Not to say that John Boehner and others are any better. The Republicans have their own full lineup of bozos just waiting to embarrass themselves and the rest of us in the upcoming 2016 primary election. Between now and then none of the politicians on either side will do a thing because it's an election year, or we're coming up on an election, so they do even less than they do regularly. The government does not at all represent the people, and here we are, the taxpayers, paying their salaries, benefits, healthcare, and all they do is act in the interest of the corporations and wealthy individuals who don't pay their fair share of taxes.

There must be a playbook somewhere that instructs the people who are groomed for so-called leadership positions: in government, finance, industry, professional sports, that teaches them how to be liars and slimebags, how to steal the public blind, and the language of corporatespeak or leaderspeak. Maybe it comes from Harvard business school or there's some kind of a secret club.

Not only are these things happening at top levels of government, but it goes all the way down to communities and local agencies. Corporate speak and lies, everywhere.

There are days when I think we would all be better off if a giant meteor hit the earth like a reset button. That would cure all of our problems! I am so glad I don't have kids because I would hate for them to be left in this world. I don't know how parents these days are preparing their kids for the kind of world they have inherited.

I look at my niece who is 17 and a senior in high school, and she's so smart and talented and I think the future of the world rests with her and kids like her. I hope they have the tools to confront it. I hope it doesn't hurt them too much to care.

What Color is Your Crisis Part 2

I got my wish on my previous post. Here, an intelligent voice discusses the issues surrounding the public health crisis of Ebola.

Thanks to National Nurses United to have someone speak sensibly about some of the issues facing the health care system that contribute to problems like the current one.

I did want to say one thing more, to clarify, that nurse informaticists are becoming an important force in developing EHRs (electronic health records) but when nurses at the bedside are not directly included and listened to, we run into problems. And the administration who is responsible for spending money on EHRs needs to be listening to the input of nurses.

Again, representation on boards and better understanding on the part of executives regarding the day to day work of nurses would go a long way toward improvement. It's a rare event for a person in a suit to follow a nurse all day to see what actually happens. We desperately need this to happen. Stay tuned...

What Color is Your Crisis?

Pretty freaking amazing. Now the news media are going batshit over the Ebola story. What I find interesting is that none of the administrators of the hospital in Texas have come forward to talk about their own culpability in the "systems errors" that have been blamed for the discharge and re-admission of the patient with Ebola.

You'd think it was Ebola Awareness Month instead of Breast Cancer Exploitation Month. Instead of the Pink Scourge, now it's Purple and Yellow.

Yup, the so-called health care world is going to hell in a handbasket, and none of the people at the top can take any responsibility. No one seems to hold them accountable. They do make the big bucks.

Point the fingers: at the nurses, the doctors, the computers, the "systems". But who makes the systems? Someone has to. They don't create themselves. Someone has to make the decisions to follow certain protocols and set things up the way they are. Someone is benefitting from things being the way they are.

Well eventually the Ebola scare will pass, just like AIDS and HIV freaked everyone out at the beginning until they understood how to control it and contain it.

I watched this short little interview on MSNBC with the head of the Texas Nurses Association and I had to comment. It was just too much for me to keep my mouth shut. Watch the whole thing but especially the end part when they interview the Executive Director of the TNA.

I wrote this in the Joy Reid Facebook page. I haven't heard a response, but then I don't expect to. The media wants sensational stories, not reality.

"In your interview with the head of the Texas Nursing Association I could not help but notice that this woman hemmed and hawed but refused to address the real issues in health care that threaten public health. The rushed environment, chronic understaffing, and the second class citizen status of nurses all contribute to these “systems” errors, to which she kept referring.

Nurse informaticists’ concerns are not listened to when they are working on these EHRs but even worse, most nurse informaticists are not currently working at the bedside and are unable to see what is happening NOW.

Furthermore, nurses are silenced and their jobs are threatened for raising concerns about safety issues, they are treated like second class citizens in health care, they are not represented on boards, those who do the front line work of taking care of patients are not the ones whose ideas are tapped for making common sense developments of EHRs, the workflow is separate for nurses because doctors don’t want to be bothered reading nursing notes even though they contain lifesaving information.

What about the failure of administrators and executives to be held accountable for "systems" failures? Isn’t that why we pay them the big bucks? Shouldn’t they have a duty to protect the public from faulty “systems”?

The head of the TNA sounded like she had no clue about what really goes on in the hospital setting. I would like to see the press interview a nurse who could really tell it like it is. The ANA nationally has a tiny fraction of our country’s 3 million nurses as members because they simply don’t represent real working nurses’ interests."


Yup. We've got ourselves an epidemic on our hands, but it ain't pink, purple or yellow. It's black and navy suits. Hiding out behind their "systems".

They need a good disinfectant. Like, sunshine.

The real crisis is the failure to hold any of these suits accountable for their actions that harm public health.