Nurses Week Takeaways from DC Part I: Politics and Nursing

It’s Nurses’ Week again.

I'm going to write two posts of Takeaways from the Nurses Take DC rally in Washington in April. There's so much I want to say, I can't fit it in a single post.

For the first post, I want to go back to Pam Robbins’ presentation in DC, Ascend to Political Nurse Advocacy, because she pointed out so many important considerations for engaging all nurses in our cause. I am paraphrasing many of the statements she made and adding my interpretations here.

I’ve talked about some of these points in my book, Navigating the C, in regard to my experiences in healthcare, in an oncology nursing context, but it applies universally to all nurses, and all of healthcare. In my second post of Takeaways, I am going to incorporate some of what I said in my book along with the points I made in my speech in DC.

First, FEAR
Pam talked about fear being the biggest thing that holds nurses back. Part of it is the antiquated, unenlightened approach to thinking about gender and the roles we have associated with gender in the past. It’s time to discard those ways of thinking and be people. Yes, we have differences and that makes things interesting, but we are all first human beings.

Nurses MUST stop being martyrs and stop shortchanging ourselves with self-deprecation. If we want to be leaders we must overcome these fears, placing more value and believing in ourselves. Too many nurses are terrified they will lose their jobs for speaking up.

And I can tell you from personal experience, they will do everything they can, no matter how ridiculous and petty, to get rid of you do if you do. But if we don’t speak up, it means our patients’ safety is forever compromised. We cannot afford to risk their lives.

Nurses need to articulate our value to the public by getting out there, speaking to journalists, being interviewed, being visible on social media. We need to speak up in our professional organizations, who should also be involved in such matters, as unhappy nurses will not be as productive or influential in their careers.

Every professional specialty organization, such as AACN, ENA, ONS, AORN and so on, needs to take a stand WITH their nurses, instead of siding with those who will take advantage of nurses. The power gradient against nurses increases when our professional organizations do things that don’t truly help us. They may talk a good game but it is important for nurses to look closely at the policies they come up with.

That is why Nurses Take DC has offered similar but better legislation that works in nurses’ best interest. Working nurses should be in control, have more control, and right now, many professional organizations do not want to yield that. They mostly support industry interests and will back the administration’s interest over staff nurses. All you have to do is attend a nursing conference and you will see the disproportionate influence of pharmaceutical and hospital industry funding.

The fear extends beyond the workplace to participating and speaking within these organizations, too. Recently, I found it interesting that when I posted my reply to a post about the nursing shortage on the discussion forum of my professional organization, I only received one public reply. But I received several private replies from people, which tells me the level of fear is pervasive, to the point of not wanting to speak out even on these specialized forums.

If you’re one of the many (maybe majority still?) of nurses who say, I can’t lose my job, my livelihood depends on it, I have a family, a mortgage, my kids, or I’m a single parent, here is what YOU need to do.

• In the workplace, form a coalition of nurses so you stand together when you approach management with an issue. Don’t leave each other alone- have each other’s backs.
• You don’t have to necessarily be vocal in your workplace, either- you can be a nurse constituent and contact your legislators with your concern. Your employer won’t know about that.
• There’s Flo’s Whistle, and anonymous reporting tool for unsafe staffing conditions in an easy to use app.
• You can also become active in contributing and leading as a nurse in your community.

Here are some other practical interpretations I got from Pam’s presentation at Nurses Take DC.

Nursing Culture and Education
We need to start educating nursing students in both policy and taking political action. That is a tall order and a giant shift in the nursing school curriculum. Unfortunately, the abusive culture of nursing often starts in nursing school. Instructors exert their control over students and show them the ropes of the eat their young culture. Nurses need leadership skills and we need to start learning these early on in our careers.

Nurses can be, and have been, awful to each other. Nurses get so little recognition and expressions of appreciation. When there’s so little to go around, they fight over it, like a scarce resource, like dogs fighting over a bone. They feel constantly abused and taken for granted, and this feels like another reminder of just how insignificant they feel. It sounds like middle school all over again, and in many ways, it is. Stop it. Don’t be nasty. Grow up, act like mature adults. This applies just as much, if not more, to management. Leaders need to set examples, not be part of the problem.

Public Perception
Nurses need to learn how to stand up for themselves, to have a voice in their workplaces and in their communities, to be visible, audible, and persistent. The public does not have a realistic perception of what nurses do, how important we are, and our potential for stepping up our influence in public policy.

The Robert Wood Johnson Foundation published a report in 2010 based on Gallup opinion leaders polls conducted in 2009. Pam discussed some of the findings:

• While opinion leaders nurses are the most trusted profession, the same opinion leaders perceive nurses as having little influence over healthcare reform in the near future.
• Nurses are not perceived as important decision makers or revenue generators, and that we do not have a single (unified) voice on national issues.
• The public views nurses as functional doers rather than thoughtful strategists. We need leadership skills, and we need to start early.

Paternalism in Healthcare
Healthcare is not all about medicine and physicians. Nurses are the ones who keep patients safe and alive, during times when the doctor is not there, which is over 99% of the time. Really. If the doctor is there for 5 minutes a day when the patient is in the hospital, that’s only about 0.3% of the time! So nurses are watching you 99.7% of the time. And nurses check the doctor’s written orders to make sure that everything is appropriate and safe for the patient, and we correct them if they are wrong!

I really think we need to start changing the language around healthcare workplace relationships between physicians and nurses- doctors writing “orders” still sounds so paternalistic, as if they are ordering us around, like we are their handmaidens.

Doctors write a medical treatment plan, and nurses have a nursing care plan, so it should be referred to as something more egalitarian, that can be established mutually in the interest of the patient’s safety. They can’t exist without each other, and they are important, I would even say that without nursing care, patients would be in trouble if they only had the medical treatment. Because nursing care will keep you going even in the absence of medical treatment.

Politics
In our politically divisive times, we also need to make the case that this is not about being pro-union or anti-union, Republican or Democrat, red/blue or purple state- but it’s about issues that affect everyone.

One thing that I add is that nurses wouldn’t think of refusing care to someone because they believe differently or have a different political affiliation, we accept everyone as our patients and give them equal care. This issue is beyond political divisions. Every single person is a potential patient.

And every one of us are, also.

Apathy and Democracy are Incompatible
We live in a democracy, but few of us take full advantage of the power it affords us. As citizens, we have the right to vote and make our voices heard, yet only a small percentage of the voting-eligible public votes! Only a miniscule proportion ever get involved in the legislative process.

If you saw something being done to your patient that would cause them harm, you wouldn’t hesitate to stop it and speak up on behalf of the patient. But when it comes to our country, and public health, safety, and well-being, few nurses use their advocacy skills.

If nurses would think of our country as their patient, insist on only the highest quality care being given, and protect the public from harm, we would make great strides.

Takeaways-What we need to do
1. Lose your fear. It’s power in numbers, and by banding together, you can help each other deliver a stronger message. When a colleague expresses a need to change things, don’t treat them as if they were radioactive. Instead, get behind them, support them, and bring others on board.

2. Don’t downplay the achievements of your colleagues, don’t put them or yourself down. When someone is recognized for an achievement, it’s common for backstabbing, envy, and resentment to well up among those who feel even more diminished if one of their colleagues is being publicly honored. When we raise the profile of nursing through one of our colleagues’ work, we lift all nurses’ profiles.

3. Stop making it about political affiliations. This is about everyone, we are all potential patients. This is about the public’s best interest, all of us.

4. Nursing education must start preparing nurses with skills on political advocacy, negotiation, and articulating the value of our profession to the public. If we can get the public to understand what we do, and articulate that clearly, we can show that healthcare is not all about medicine and physicians, the holistic approach to nursing care is what moves patients away from illness and toward wellness.

5. Research by nurses should hold equal status to medical research. You can give all the medicine you want, but unless there is someone there to make sure they are being cared for safely and that medicine is administered properly, all the medicine in the world won’t save a life. It’s not all about medicine and physicians. Nurses are the ones who keep patients safe and alive, during the times when the doctor is not there (which is most of the time).

6. Look at the different nurse staffing bills in front of Congress. Both the ANA and Nurses Take DC bills are based on evidence, but unless you have regulation with staffing ratios in writing that holds the employers accountable, you have nothing. We must hold our employers, as well as our professional organizations, to account and transparency.

While they are similar in many ways, note the ANA’s bills (S. 2446 and H.R. 5052) do not include a mandate for employers to commit to a staffing plan for their employees, in writing. The Nurses Take DC bills (S. 1063 and H.R. 2392) do have such a mandate, with proposed ratios in different clinical areas. Employers would not be able to avoid the staffing plan mandate. This protects both nurses and patients.

For more information about the Nurses Take DC movement, visit http://nursestakedc.com

The next post will be about takeaways from my speech at Nurses Take DC.

photo credit: Andrew Lopez

(Note: a variation of this post was recently published in Oncology Nursing News)

The Catch-Up

It's been way too long since I've been on this blog. Sorry, readers. I have been so busy since the book came out, I can hardly keep up with myself. I'll write a quick post and then I want to post two long overdue running posts- one from this year's Human Powered Brewery Tour in February, and another from my Urban Adventure Birthday Run this year in March.

Today is Saturday and other than those two events I just mentioned, it is my first real day off from working since January. I am hoping to have more space for living life as of this month, because I overbooked myself the past three. A lot going on in my life and sometimes it's just like that when you're self-employed. I wish I could clone myself, hire a person to do my social media and other stuff for me, but I can't.

I'm not going into a lot of detail but I'll do the bad news first, the local running community lost another runner to cancer this past week. Kirsten was only 45 and is the mother of young twin girls. She ran her first ultra a few years back, and then about two years ago she was diagnosed with Stage Four cancer, and now she's gone. She was a great runner, fun to be around, and had a lot of energy and a great sense of humor. Her service is on Monday and I'm going. It's rocked the running community hard. I hope her family gets a ton of support, it seems like they are.

April has been such a tough month for deaths. Seems like I go to a lot of funerals in April. Just an observation. Personally, if I were able to choose when to die, I think I'd choose November. That's when it's getting cold and dark and gray, and there's a long winter ahead. But not too many of us get to choose. I hate that I'll be visiting Kirsten at the cemetery, that's where I visit a lot of people I've known.

The good news is that I have had a lot of projects going as a result of my book and my programs. We're doing a pilot group, actually two of them, of my Cancer Harbors program with a local nonprofit. We got a grant from the State Department of Health to do it. And I'm doing some continuing education course development with another company. And I've been contacted by other people as far away as Australia to collaborate of various cancer-related projects. And I've had half a dozen podcast interviews. I'm waiting for all of them to be put up online, they should all be up this spring.

The book sales are going fairly well, though I wish I had more time to focus on marketing it. I do what I can.

I've been running more consistently. I have been building up my miles, though not all of it has been running. I'm trying to build up the running time now. It's getting there. I am running a 24 hour fun run near Palmer Lake in two weeks. I don't expect any great performance, it would be nice if I could exceed what I did at Across the Years. If the weather cooperates, that will help, because running in the foothills at 8000 feet elevation in the spring is like playing Russian Roulette.

The girls are growing up into big grown up girls. They are 18 months old now, and running 5-8 miles most days. They still have their puppy quirks, but are growing out of most of the real troublemaking. We still have some chewing issues, Velcro likes to chew on anything that isn't a flat surface. She steals things off the counters too. And Gypsy is a little sassy thing. They make our lives so much fun.

I am excited because I was invited to speak on the U.S. Capitol steps at the Nurses Take DC rally for safe staffing. I'll be going to DC later this month for that. There should be around 1000 nurses or more. There is a chance I might get to meet Bernie Sanders and/or Elizabeth Warren personally. If I do, I'm getting a selfie and posting it here!

Next week I am taking a couple of days off to do my own personal retreat in the mountains, a mid-week spa weekend. I hope to get caught up on some personal writing and relaxation time. It's been a long time since I've been able to do that.

Tomorrow I'm hoping to get a good 20 mile run in, and that should be the last long run before Palmer Lake. And then I have no plans except for Across the Years, I'll have to find something to fill in the gaps between now and then.

That's about all I have for you now. I really, seriously, do want to get back to writing more frequently. With more running, I'll have more adventures to share. Happy spring, and thanks for sticking with me!

The Best Things in Life...

Are friends.

Followed by running, writing, and dogs, though not necessarily in that order. They all rank high up there on my list.

When you have any combination of them, it's pretty hard to beat.

Today I met with Libby James, a longtime writing and running friend in Fort Collins. We used to both write a monthly running column in the local paper along with our writer/artist friend Tom Riggs. We have a lot in common, mainly writing and running, but Libby is much more prolific than I am when it comes to writing.

She has published several books, I am not sure how many but she's written about running, and a number of other topics and genres, like historical fiction- her latest work. She's a great writer and that's not even the tip of the iceberg as far as her life stories. She happens to be a multiple-time age group world record holder at running, too.

I've always been inspired in running by the older runners who keep going, into their 70s, 80s, and even beyond. Libby falls squarely in that category although I wouldn't even try to categorize her. She's a lively, focused, interesting, and talented human being who has contributed great things to the world, including her offspring.

I met her at her house and we took off for a few laps around the cemetery, which happens to be one of our favorite places to run, another thing we share. Then we came back to her house where she made tea and we sat and talked books and plotted schemes around our favorite topics.

I got a peek at her latest book which hooked me within the first page, and I plan to read it as soon as I catch my breath around here. She's been at this a lot longer than I have been, and actually has her own shelf of local authors' books, she created a small lending library. I'm excited to be adding Navigating the C to her collection.

On our run around the cemetery we talked about our friend Morgan whom we lost last January. I felt like she was listening. After our run I kept seeing the name "Morgan" everywhere, like the directional sign near the university pointing to Morgan Library, and bright lime green colored objects, which was her favorite color. I realized the last time I saw Libby was last spring at Morgan's memorial. I've been intending to get together with her and the book kept taking over all my thoughts and plans.

We talked about how important it is to take the time to get together, these connections and conversations are so important, more important than the many distractions in everyday life.

I started this morning missing Donut Friday because I was up in the middle of the night, unable to sleep. Maybe it was just being excited because before bedtime I found out that my books were being overnighted from Amazon in time for my book signing this Sunday. They have been super slow on production and last week when I checked, they told me I wouldn't receive them until January 31 or February 1. My book signing is on the 28th, and I ordered them on the 10th, with expedited shipping.

But they came through for me. (I've actually been very impressed with almost everything they do at Amazon around the book creation process.) When I arrived home from Libby's, the books were waiting for me!!

And I always have plenty of help with the boxes.

It was one of the best mornings I've had in quite some time (would have been 100% perfect if I'd made Donut Friday!). Ready to start getting this book out there to see the light of day in the world. I have more to say about that, in a future blogpost. For now, you can find Navigating the C: A Nurse Charts the Course for Cancer Survivorship Care, on Amazon.

The Big Launch

Just a quick post for now, the big news is, I am now an author. I announced the release of my book, Navigating the C: A Nurse Charts the Course for Cancer Survivorship Care, yesterday. It's sort of a slow leak, I've let small numbers of people know and I'm still in the process of spreading the word through next Tuesday, then I will begin beating the bushes to let everyone I can possibly reach know about it.

I don't even know if I feel like writing about the process. It's been a learning curve, sometimes exhilarating and sometimes exasperating, like when you find out your books that you carefully pre-ordered to arrive in time for your first book signing event are delayed in production because they are backed up from the holidays! (it's almost February!!) and they might not arrive in time!!

AAARRGH!

Anyway I am just really glad to be at a place where I can start working on something different. The marketing aspect of this is a learning curve too. But I look forward to it.

Since I got back from Across the Years, I was sick for two weeks with some kind of upper respiratory crud, not sure if you could say it was the flu. I did have a slight fever- 99.8 is what I got, and I felt like crap, and even this week I'm not quite 100%. I only ran twice this week, Donut Friday and bagel Saturday, 3 and 5 1/2 miles respectively. No donuts for me, but I did have a bagel today. Not a very good plan for someone who wants to lose 20 pounds. But I pretty much wrote this week off since I've been so busy and it was cold. I am such a cold weather wimp!

I also planned my birthday run this year, which will be a taco theme. I plan to hit at least 4 or 5 different taco joints on my 54 km or so run on my birthday. I'll end up at the Rio, for the margaritas. I have been so much better since the new year about avoiding beer and margaritas, which were my downfall. I blame it partially on the Trump effect, but I am finding I enjoy a cup of tea in the evening too. Not quite as much as a strong margarita, but I am determined to lose this spare tire.

The thing I did do this past week was to get together with my boxing instructor, Alyssa, and she made up a program for me to build my upper body, mostly, but a little bit of power for my legs too, to prepare for doing longer runs again. I need to get back in gear next week and start working out again, and moving.

I guess in a way this year is about starting over and renewal. I'm switching gears from writing the book, looking for opportunities to reach out and speak and get the word out, I'm involved in a few different exciting pilot projects of my own work and of some other people. My girls are growing up and they are running with me, not as demanding as they were as puppies, and I'm already looking at some travel plans like Washington DC and Las Vegas for various endeavors- more about that later- not running-related, but I will share eventually.

I did sign up for a marathon (Revel Rockies) and I'm considering a second one (Leading Ladies- did that one in 2014). And I'm keeping my eyes peeled for an ultra opportunity or two, maybe a 50 and a 100 mile or 24 hour run, we'll see. I do plan to run the 48 hour at ATY at the end of this year. And I am having fun with my running buddies, Fridays and Saturdays.

I hope to blog a lot more frequently, run a lot more, and sell some books...more about the book soon.

photo credit: Pixabay

Greetings from Strong Badia

Strong Bad, who lives in Strong Badia, is my hero. I sort of like his Teen Girl Squad too, I used to use them to tease my brother about my niece Jenny when she was in high school. If you're unfamiliar with these characters, you MUST check out THIS.

It's been a while since I blogged here. This year I wrote a book.

There's something about writing a book that sucks the desire to write much else out of you. At least it was that way for me. I couldn't think about writing much of anything, I was so focused on the content of the book. There simply was nothing left. Between that and having two puppies, going through training, spaying, daily walks, cleaning up after them, replacing everything they destroyed, and we're not done yet...with the madness of having two high energy baby Aussies at the same time, I sometimes wonder how I did it.

But the pups kept me in line and I got through the book, and the editor has it now. We are doing revisions. I expect it will be out late this fall. Here's the cover design, ignore the Latin from the template, this was just a rough draft.

It's about healthcare, the stuff I have ranted about on this blog and in other places, except less of a rant than about solutions and how those solutions are needed to improve the cancer patient experience, making it less traumatic and disjointed. In other words, people in healthcare need to clean up after themselves, the mess they make when treating people for cancer doesn't clean up itself. I'll have plenty more to say about the book later, and if you want to know more, feel free to go to my website and sign up for the updates where you can subscribe to get more information, bottom of the home page.

This summer I was supposed to help out at Badwater again but I ran out of time at the last minute finishing the manuscript and I promised the editor I would have it done by a certain date and she had arranged child care so she could work on it, and it took me longer than expected, so I ended up not going to Badwater. Slightly disappointing, yes, but then, it took a pretty good arm twisting to make me go back there, after claiming my retirement status.

I went to Scottsdale to hang out with my Dad while my stepmom went away for a much needed spa weekend, and he's been taking boxing classes. He has Parkinson's. If you've been to this blog before, you know he was being treated for a type of chronic leukemia a few years back. He's been in remission with that but almost as soon as he finished chemo, he was diagnosed with Parkinson's.

But my dad doesn't get stopped by much, and he has been doing everything he can to keep himself functioning well despite the symptoms he experiences, naturally from the disease and from the medication, which is not the easiest stuff to tolerate. He started taking boxing classes, specifically for people with Parkinson's, and he is also taking singing lessons, because the voice is affected by Parkinson's, and tap dancing lessons! He is fortunate to live in proximity to the Muhammad Ali Parkinson Center in Phoenix, and there are all sorts of great activity and support networks there.

He continues to work out with his personal trainer and goes to physical therapy too. He is busy and active, and that is the best thing anyone can do. I'm really proud of him. It's been difficult to watch this unfold but not as hard as it is to live with it yourself or for a spouse to live with it. Hence the spa weekend.

When I was visiting, I went to his boxing class and watched him. Seeing those men in his class work out was very inspiring, but I also was inspired by the workout itself. The strength, core, cardio, it all looked like a great workout, and I took karate lessons for a short time as a kid and loved it. When I got home, I looked up boxing and thought I'd try it myself. I took a class at Title boxing and I felt like I found the holy grail.

I have been having so much trouble motivating myself to work out on my own. I've never had this problem of self-motivation or discipline until now. I've struggled all summer, wanting to get back into running, and lose the 20 pounds I gained, and start doing some cross training, but I couldn't get myself to do it. The weekly donut runs were about all I was doing regularly. So now I'm taking several boxing classes each week, and so far all I can tell is that my abs are extremely sore. It is a good cardio workout though. I'm starting to feel a little smoother in the technique, but I'm naturally pretty uncoordinated, so every time we have to do a series of more than 5 punches, I struggle remembering the sequence, but I just keep throwing punches and that seems to work, for now.

I'm not running a lot, but I did do a 27 miler last week and it was the first ultradistance run I've done in a long time. I still plan on doing the There Goes the Sun 12 hour run next month in Arvada. And I did sign up for the 24 hour at Across the Years, just for fun, to run with my ultra buddy Sasquatch, a.k.a. Dale Perry, who has quite the interesting comeback story going on. There should be a good-sized Colorado contingent there to make it a fun party.

I've been staying busy with the community cancer programs I've been working on, things start to get busier for me in the fall. And there's a lot of marketing work to do on the book. So between that and puppies, who are going to be a year old soon, and need to start running, I have my hands full. And writing, of course. Now that I have the bandwidth to write my own blogposts for fun again, it's nice to be back.

I'll be filling you in over the next few months with details on life, the book, returning to running, and boxing with puppies. I didn't even rant about politics yet, either, but who needs any more of that when you've got an overload of outrageousness in the news everyday!

Enjoy what's left of summer, if you're on the top part of the planet, and I'll be back before long. Until then, I'll be in Strong Badia. Thanks for reading!