On Power, Nursing, and Sunsets: A Long Overdue Rant!!

"My job is ________ (insert true purpose), not to be a cog in the wheel!"

Okay, so as a nurse, I would fill in the blank with patient advocacy.

Why THIS rant, and why NOW?

It's been quite the week, or several...

Recent events have reminded me of why I left traditional healthcare setting to become a nurse entrepreneur and do the work I am passionate about.

One is the Harvey Weinstein scandal and all of the related accusations that have followed.

Another is the latest revelation of an eye surgeon physically assaulting a nurse in the operating room, in Cedars-Sinai Medical Center in West Hollywood.

Still another is hearing someone's account of going through the wringer just to get a diagnosis and chance at treatment of her metastatic cancer.

And another is being almost done with my book, and after toning down my passion and enthusiasm so as not to be perceived as angry, I was told I need to put some teeth back in the book by my most honest critic, which I gladly did. (Why can't women be angry? We certainly deserve to be. Those are valid feelings. We don't have to shut up because it makes somebody uncomfortable.)

And finally, today I received yet another e-mail from a nursing organization offering a continuing education module, sponsored by a drug company, about pancreatic cancer.

What do all these things have in common?

They all have to do with a power gradient and how the powerful can push, shove, elbow, sneak, and bludgeon their way to maintaining the status quo.

Hearing about the surgeon assaulting the nurse, according to the allegations, the surgeon was barely slapped on the wrist, while the nurse was bullied by the powers that be, reducing her hours, moving her to a different floor, and not being taken seriously. It doesn't matter that it was not sexual assault. Harvey Weinstein used his power to manipulate, threaten, and ruin the careers of women who did not acquiesce to his demands. Nurses are seen as an expense in the healthcare system, expected to stay quiet, cooperative, and inexpensive. Surgeons, on the other hand, are revered as money makers. In a healthcare system that values profit over patient outcomes, this is what you get.

And if a patient is emotionally needy, scared, and anxious, maybe even a bit dramatic, the doctors avoid her, push her out of the way, write notes to each other about her, and try to push her off onto someone else. Instead of seeing her for where she is and what she's facing, and considering what might be driving her behavior, the doctors are focusing on the behavior and seeing the patient as the problem.

To top it off, I saw this email about continuing nursing education on pancreatic cancer. I like to keep up with the latest in cancer treatment, and I opened the email to read the information inside. I skimmed over it, finding very little useful information, and when I reached the bottom, there it was, sponsored by Celgene.

Just another one of those mind-numbing continuing education opportunities that continue to focus more on the characteristics of the disease and treatments themselves, rather than on helping the patient heal and regain quality of living. Once again, there was plenty of material about the common symptoms and disease characteristics, but at the end , a few crumbs were thrown in the direction of mentioning quality of life, without any substance or real attempt to help nurses develop new tools or skills to make a difference for patients where they exist in their own lives.

And this is the problem in nursing- because nurses are an expense, expendable, and an afterthought, we are thrown a few crumbs by the big powerful drug companies, who make it easy for us to digest what they want us to parrot to the patients, to keep them coming back for more. Meanwhile, the qualities of creativity and intellectual curiosity are removed from nurse education. Who wants to be creative or investigate new ideas when they've been on their feet for 13 hours?

Being a cog in the big wheel of profit-driven healthcare is what is expected of nurses. Even if we get assaulted on the job. And it's happening more frequently. We're speaking out.

It's very frustrating to the powerful to not get their way.

Before I forget, watching Roy Moore's horse's ass ride off into the sunset- his defeat was delightful. It was a wonderful occasion to appreciate a Hanukkah present for this nonobservant JEW. You schmuck. And your evil wife.

I love sunsets, don't you?

Dogs Smell Like Popcorn, Let's Keep It That Way

It's been a while since I've posted a good rant. One is overdue.

I have written before about my aversion to things that stink, like perfumes, colognes, and all the other overly scented crap that people put on their bodies trying to smell like a, I'm not sure, anything other than a human being. Note number two, which is exactly how it smells to me...way at the top of the list, of Fifteen random facts about me.

When you come near me, I can smell you. If you're on the trail and you run by, I can smell you then too. You've already fouled my air, albeit temporarily. At least you didn't physically contact me with that crap, and it will eventually dissipate in the wind.

If you want to stink up your own space, that's fine. You probably can't even smell yourself because you've overloaded your scent receptors.

But don't put it on my dog!!

People stink. If they would just allow themselves to smell like human beings without trying to cover something up- what, I'm not sure, but whatever odor comes from body cannot possibly be as offensive or obtrusive as something you buy and put on yourself for the scent.

It drives me absolutely insane when I want to inhale the perfectly intoxicating puppy scent of my little girl, her popcorn scented feet and all, sometimes she smells like maple syrup, sometimes like popcorn, sometimes like dog food farts. But all of these are preferable than the scent of some human who patted her on the head and in doing so, wiped their scent onto my dog's fur, and I can't get rid of it.

If I wanted to smell YOU on my dog, I would send her over to visit you, to take showers with you, while you soap her up and shampoo her with your disgusting fragrances, your deodorants, your dryer sheets, your sprays and lotions and detergents and who knows what else you smear in, on, and around your body and home.

Yesterday I was at the vet and this bozo in front of me checking out at the front desk came over and without asking, started patting Velcro on her head. I could smell the wafting stench when he reached for her and I pulled back. Instead of respecting that I didn't want him to touch her, instead, he moved closer, as if SHE had moved away. "It's okay, I'm just going to pet you, you're so cute."

No, dude. I moved back to keep your foul fragrance off of my dog so she doesn't have to suffer through it and I don't either. We'll both have to deal with that smell until I can find some way to get it off of her. And that shit stinks! The oils in that crap don't come off easily with soap and water, and I don't want to torture my puppy with a bath just so I can breathe!

This guy needs to go back to kindergarten and learn not to touch strange dogs and to keep his hands to himself.

I think I might have to make some kind of a service dog-looking vest with a sign on it that says, please do not touch me without asking my mom if you pass the scent test.

That's another pet peeve of mine (love the pun), when you go to the vet and one of the staff has something stinky on them and it stays on your dog. Fortunately yesterday they were scent-free as far as I could tell.

At the vet it's always a crapshoot. Usually it's one of the vet techs and I need to ask them to please wash their hands because they have some holy hell awful flowery smelling garbage on that lingers for days on your puppy's ears or somewhere, not what you want to smell when you want a face full of puppy.

And I'm not the only one... here and here and here.

My dear friends, I might love you very much and tolerate your fragrance, but I can't take it anymore. If you want to come see Velcro, please, as much as I love you, don't assume I want her to smell like you.

What about you? Do you find some scents offensive and what do you do about it, or do you suffer in silence?

POWDER Trips: A Rant

Been running into a lot of powder lately. Makes me want to cough, gag, hack. Go out for some fresh air.

Seems like everywhere lately, I get powdered.

I'm not a skier even though I live in Colorado and I'm not talking about the lightweight white stuff that falls from the sky four months out of the year. Nope.

I'm talking about some arrogant pasty bastards.

Pompous Old White Dudes Explaining Righteously. The mansplainers.

What the hell is it about men now in their 60s and older who seem to think they have a special mission to keep the world on track, working like it always has, in their favor, and when someone bends the rules and does something different, they can't deal with it? Especially if that someone happens to be a woman.

Look here dudes, if you happen to be white and reading this, and thinking, "That B****, how dare she lump me into a category with a bunch of fuddy duddies and dinosaurs? I don't think like that!"

Maybe you don't, but you probably unconsciously, deep down, have adopted or inherited some vestiges of white male privilege so just be aware. You can handle it. Breathe. Now read on...

When I was in graduate school, back in the last century, ancient times, I can remember how it felt, being a woman in a doctoral program in science, and having no role models or mentors of my own gender. I wasn't the only female grad student in my program, but at the time there were absolutely ZERO women on the faculty in my department. In fact, they hired the very first female tenure-track faculty member the year I graduated.

When I brought my ideas to several faculty members to try to get my graduate committee together, I was told by the other female students definitely not to go to the one dude who was known as a pervert and had been known to have multiple affairs with students over the years. Which I later found out was true one day, when was out on a run and I caught him hiking down the trail, holding hands with one of the undergrad students in the department!! EEK!

But the one statement that sticks with me all these years later was the fairly young at the time (40ish) professor who told me point blank, "Your ideas have no place in our discipline."

F*** You very much, sir, so glad your pompous arrogant ideas have no place in the modern world and that people have evolved over the last 27 years since you said that to me, to accept those ideas as second nature.

That was in the late 80s, the very end of the heyday of complete and total male dominion over natural resources in academia.

In my graduate program I had all men on my committee, I managed to find four of them who didn't cling quite as tightly to the ideas of dominionistic types. Not that I still didn't struggle with sexism in many blatant and subtle ways. But I managed to get out of there with a Ph.D. and I'm still moving forward.

Bizarre ideas and all. Such bizarre ideas I have, along with others of my ilk. Let's look at some of them...

In graduate school, that physiology and social psychology might actually have anything in common that was worth studying. That qualitiative research might have any value in producing real world-applicable results.

In education, that we would hold everyone to the same standard, not having a separate standard for wrestlers and football players. Or that a lesbian administrator at a university could actually function at her job and even hire women faculty without having an ulterior motive to drive the men out and take over the campus with some Amazonistic agenda.

In healthcare or anywhere, that we could treat people with compassion and sensitivity in our workplaces. That we could stop skewing and screwing the balance of economic resources across all people. That we could do a better job with taking care of patients than rushing them through an auto industry-designed assembly line with understaffed, unsupported and unappreciated nurses.

In cancer care specifically, that we could clean up the mess we leave behind as healthcare workers and physicians treating people with potentially life-threatening disease for which we give potentially life-threatening at worst, quality of life-diminishing and traumatizing at best, treatments. And in business.

I have been noticing this in many aspects of what I'm doing, now that I've crossed over to the dark side into the domain of the corporate and business world, still firmly held by POWDER. They are so sure they know how to do everything exactly the way they know is right. They don't know a damn thing about you or your business, but they want to sell their consulting services to you and tell you how you should market things to potential customers, even though they wouldn't know the first thing about what those customers might be concerned about, value, or want.

Or if a vendor wants to sell you their product, even if it's based on shoddy science and questionable claims, that if you reject them, they have to tell you how inhumane you are and question how you could possibly work with cancer patients. It doesn't matter if the vendor has unverifiable credentials or approaches you in a creepy and unprofessional way that immediately gives you the red flag to investigate them further...

I hope people who are non-white, non-Christian, non-male, non-straight, non-linear, non-robotic, non-upper middle class, non-dominant culture brainwashed don't have to deal with this crap much longer. It might be this way the rest of my working life, but damn I plan to keep doing something to change it until I turn up in a ditch off the side of the road with my stiff, running shoe-clad feet in the air. By my own doing, not by being ambushed by some coal-rolling, truck-swerving, gun-toting jerk high on POWDER.

Thanks for indulging me. As a certain poetic genius* once said, "Haters back off!"

*Miranda Sings, a girl.

Quality of Life...

I haven't really been in the mood for writing lately. I've been surprisingly together since Iris is gone, but I do miss her. I realize every day that there is some habit that I've acquired just because of her, that I no longer need to continue. It's really strange as I keep discovering all the ways she affected our lives and how many things we did for her.

I haven't been overly motivated but I am slowly getting things done, chipping away at a long list of tasks that I need to stay on...I have a new student working with me, which helps to keep me on my toes.

Since we skipped our vacation and stuck around I got a few things organized. I got some bookshelves for the woman cave that I've been needing: I had piles of stuff everywhere.

Running-wise, nothing, but I have been getting out for lots of miles on my feet, did over 60 this past week. This is the view I see now. I've been pushing Isabelle around in the cart. Her arthritis in her right hip is really bothering her. We give her Rimadyl but it just doesn't seem to be enough these days, so what I want to do is try giving her some marijuana-laced dog treats. I ordered some and we should have them by early this coming week. They have the active compound that might help her without much THC, so it shouldn't be psychoactive. I'm hoping that that helps her enough to make her more comfortable.

We've been trying to keep her busy, trips to Dairy Queen for pup cones, Starbucks for pup cups, and so on.

If that doesn't work I will call the pet palliative care service because they might be able to help us figure out ways to make the house and her everyday activities more comfortable for her.

We're talking about a 14 year old dog who still enjoys some things, like eating, watching squirrels, howling at us when we come home, and sitting in the grass in the yard letting the breeze blow in her hair, I just want her to be as comfortable as possible and not be bored or depressed, especially after losing her lifetime companion a few weeks ago.

Last night I walked to the bookstore just to get some miles on my feet while Dennis went to watch a Broncos game with his friend Mark. I got some bedtime reading for Isabelle: I needed some Selp-Helf. The new book by Miranda Sings. I can TOTALLY relate to her doing her character. I am a loyal Mirfanda.

Last week we were going a little stir crazy and we decided to have a garage sale. That was an interesting study in human nature. No need to go to Walmart, you can just bring it to your house. I think next year on my birthday maybe I need to run from garage sale to garage sale instead of going to Walmart.

Grief is so unpredictable. You don't know how you're going to respond. I have been amazingly tear-free. I keep thinking that maybe one of these days it's going to hit me, but maybe it won't hit me until Isabelle's gone. I don't know.

I feel like Iris's time was done, she was such a great dog. Nobody had a personality like that. As I walk through the neighborhood, it amazes me how many people knew Iris around here. Not just on our block, but for a good mile radius from the house, so many people knew us from walking and running her. The entire Starbucks staff. And many of the customers too. She lit up the room and commanded all the attention. She was like a bright light that you couldn't look away from. A true soulmate.

I was thinking about maybe taking Isabelle to a 5K in pushing her in the cart and see how I feel about being around runners. Local short road races don't get me motivated because I have so little interest in them. If anything I can just do the miles on my feet and just so that I'll be able to tolerate it when I get back to doing some ultras.

I do have my work cut out for me as far as work goes because I need to finish the content for this online service. One thing I can say is that work still brings me an incredible amount of joy. I don't know how many people get to have that feeling where they do their work and feel so good about it. How do I describe it other than this warm feeling that spreads and takes over your entire being. It feels so satisfying, purpose-driven and right.

I can't even describe it any other way, I know never felt that way as an oncology nurse in the hospital because of all the little mindless tasks that had nothing to do with taking care of patients and helping them make their lives better. I knew that I was helping people and I felt good about that but it was nothing like this.

Which reminds me, I keep seeing all these articles in medical newsletters talking about how cancer survivorship care plans are not really helping people and they're causing more anxiety. Well, DUH!!! I could've told you that because all you're doing is telling people all the things they need to watch out for, in terms of cancer recurrence, and the thing that people are most anxious about is a cancer recurrence.

The follow-up screenings are important, but you have to show people what they can actually do, in terms of actions you can take to help yourself feel better, live better, and enjoy life more. But that's the stuff that the medical profession doesn't help with or know how to do or convey. They're not trained to do that.

It's okay if doctors don't know everything, but they need to acknowledge that their patients need something that they can't provide, so they need to stop being fuddy-duddies and start admitting that they don't know it all, because there are things that exist outside of their scope. They need to open their eyes, learn about other options for their patients, and start referring people to those services.

Basically what the medical establishment doesn't get, is that after you clearcut, burn, and salt the earth, you have to restore it somehow to bring it back to life. You can bring out all the chainsaws you want, but if you don't plant the seeds afterward and nurture the seedlings, you'll never have a forest again.

They're starting to catch on, but they don't have a way to act fast enough. They're tripped up by their own rigidity, dogma, and bureaucracy. And need I mention, profit interests? Not only that, but doctors are pathetically overworked, overstressed, and undersupported. And it's only getting worse as they've become employees of the big corporate health systems.

That's been one of the biggest frustrations for me, I pretty much have to ignore people in the medical profession, which is unfortunate because I'd love to work with them if they could just acknowledge that what I could bring to their patients would actually be very helpful. But, of course, when healthcare is really just about money, anything that helps their patients spend less money on healthcare is actually in competition with them. It's unfortunate that healthcare is the misnomer that it is.

People just don't trust science or medicine the way they used to, because there is so much corruption and greed on all levels. Just like our political and legal systems.

I didn't mean for this to launch into a rant. I'm thinking about the cancer stuff and how it takes years for the medical establishment to change anything they do. There's a lot of talk now about the inadequacy of cancer survivorship effforts but by the time they change anything from the current practice, I'm going to be retired or close to it. Meanwhile, there are people suffering and the medical people have little to offer them.

And on my way to the bookstore last night I was walking past the A & W and there was a sign that said, "Now hiring talented individuals starting at nine dollars an hour". They also had the same sign over by the dumpsters in back so it makes me wonder. Sad.

Bedtime reading for Isabelle.

The Pre-Nurses' Week Cancer Rant

Yesterday I had lunch with Wheaties Boy's mother-in-law, Faustine. I admire this woman in so many ways. We have a lot of interests in common, obviously health and fitness, but also cancer and healing. She has been a massage therapist for years, doing medical massage and has worked with many people with cancer.  She is also the epitome of vibrant and healthy aging. And gorgeous, she literally glows. 

We talked about my business ideas and where I'm moving with my online service development. We discussed the important components of empowering people to improve their own well-being after diagnosis and treatment for a serious illness, and moving beyond the sticking points. One of the things that I'm passionate about is getting people the answers to their questions that can't be addressed in a short doctor appointment, but not having to stress themselves financially in order to get the help they need. 

Medicine is becoming more of a product and not a service, and doctors are being squeezed for time and production...getting the patients in and out, and those short appointments don't leave room for explanation, education, or personalized attention. The rushed encounters-yes, they literally are referred to as "encounters" in the popular electronic health records...don't leave docs much time to have meaningful discussions with patients or teach them the finer points to empower them to manage their health.

Nurses can and often do fill many of the gaps in information and explanation, but they are under similar time and documentation constraints and in the rushed corporate health care environment, many of the details slip through the cracks as the robotic expectations of the organization for which they work supercede the desire to sit, educate, and empower.

This patient empowerment is a huge unaddressed need, especially in the time period after they get done with cancer treatment. Patients feel lost and abandoned in that transition from cancer patient to...not sure what they are afterward. Called survivors, they don't always feel like they survived. There are patronizing references made to what they feel after treatment. "The new normal" is one of those that makes me grind my teeth at night. 

Feeling like crap with nowhere to turn is not normal. It's not fair or humane to tell them, "well, we treated you for cancer, we poisoned you, burned you and cut out parts, so now you're supposed to go through life tired, sick and debilitated. Get used to it. It's your new normal." 

Not cool. 

People deserve to get information and help in restoring their health, in terms they can understand, and in ways that they can apply to their own lives. They need to do much of the work themselves, because only they can determine where they want to end up in terms of quality of life. But they need guidance, support, and attention getting there after enduring the rigors of cancer treatment and all of the associated emotional, social, financial, spiritual, psychological, and physical invasions in their lives. 

As Faustine and I discussed our ideas and experiences, I thought about my trip to Arizona, where I'll be talking with my dad and stepmom about what day are going through right now, trying to manage my dad's upheaval with chemo and all the fatigue that has stripped away his normal energetic life. Between naps and blood transfusions, he is able to carry on with some of the activities he enjoys, but I had to explain to him why it was not a good idea for him to call his personal trainer to come over for a workout the day after his blood transfusion...which is exactly what he did before I happened to call and catch him in this error that could have resulted in quite an unfavorable outcome. 

He's being treated at a world-renowned cancer facility yet no one explained to him why being severely anemic is not a good condition from which to exercise. Why? Because in medicine, they often don't think to ask about the daily habits of patients, their lifestyles, or what their normal activities are. And my dad doesn't have an education in exercise physiology or health care. They neither have time, nor the thought process in place to do so. It's just not how medicine thinks. 

Even if by chance someone did explain something to him, there is not adequate time for them to assess his full understanding of what they taught him. There is no time for "teach-back" or a way to ensure that the message they tried to convey was received, absorbed, and understood.

So it's just by chance that my dad as a cancer patient happens to have a daughter who is an oncology nurse and told him that not having enough oxygen in your blood to feed important organs like your heart and brain during exercise could result in you having a heart attack or passing out and falling and injuring yourself. And stopped him before it happened. 

People are not being given the attention they need and doctors are not referring them to appropriate resources for help, for their individual lifestyle needs. It happens during treatment and after completion of treatment. And that is what I want to address in a way that is affordable, accessible, understandable, and useful. 

Yet I can't get doctors to give me the time of day to let me explain them how I can help their patients. They're "too busy". So I go directly to the patients themselves. That's okay, but it would be much better if the doctors were aware of this service and could let their patients know. Sad reflection on the state of health care, isn't it? 

You can't make an addict stop the addictive behavior until they want to. You can't change dysfunction from within the system. So I do it from the outside. Meanwhile the doctors will continue to be unaware of these resources available to their patients. And they will do a disservice to their patients by omitting that important information that makes a difference in their healing and quality of life. 

Which is why I've been saying all along, health care is neither health nor care. 

We can do better. And I am. 

End of rant. 

Random Late Winter Thought Rants

Tomorrow at 4:03 pm it is solstice. I am so glad. I have decided to use it as my motivation to get my butt back in gear. I woke up this morning at 4:20, but fully able to breathe. I didn't wake up once with a coughing fit. First time in probably a week and a half.

Today is my dad's birthday, he's 73 and going strong. Some underlying health issues pop up to haunt him every so often, mostly just reminders when it's time to get that follow-up check, but he's been fortunate, and he does take good care of himself in general.

Life and death have been on my mind this week as I have been writing a bit about those topics and just read Atul Gawande's book Being Mortal. Good read, by the way. If people would accept death as a part of life and not fear it so damn much, they might take better care of themselves on this side of the grass. Then we might not have such crazy out of control health care costs. We won't even get started on the relationship of fear of death to religion. But I could get going on a soapbox on all of these...

A former patient and now friend passed away this past Wednesday after dealing with a type of cancer for several years. He was one of my favorites. He was a musician, and was always warm and friendly and had such good energy. I know he suffered a lot in private, all the years of treatment and the ups and downs from that were hard on him. I've come to know his wife well as we've spent many morning conversations stopped along the Power Trail while I was running and she was walking her dog. I had been thinking of them a couple of weeks ago and then I got sick, and then just found out he's gone. I am glad he no longer has to suffer a medical experiment, but it's really sad when people who are such gifts to humanity get removed from our presence prematurely.

My thoughts have not been on running so much, which is good, but I am starting to feel kind of stiff and rusty. My back has not 100% recovered from the massive sneeze attack from earlier this week. It's getting there though.

The donut run idea was received enthusiastically by a number of people in the running club, so it looks like my crazy idea might take off. We have to wait for Dunkin Donuts to open in Windsor, and that might not be until after my birthday. Maybe next year, but we'll see.

So what is it with the newest male fashion statement, the unkempt, long, thick scraggly beard? I'm sorry to any of my readers who have one, but I can't handle it. Maybe it's a reliving of childhood trauma when I lived back east and I used to see those Hasidic Jews in the cities, wearing those long beards and the crazy long sideburns, and their black hats. They always freaked me out as a small child.

But I think my beard aversion has more to do with the number of men I've observed dropping food in their beards and seemed to be unaware. I wonder how long things live in that rat's nest. And then when I see these guys who are runners and I think of all the sweat and gels and snot and all the other unsavory things that happen during an ultra...I just can't get past it.

"Lumbersexual" or Duck Dynasty, hipster fad or spare refrigerator, it's freaking me out and I'm already way over it. Can't we go back to something less obvious, like tattoos and nipple piercings? At least we get a break from looking at those in the winter.

Beards, beards, go away.
Store your food some other way.

This too shall pass. For now, my advice is, if you must, please Trim It.

And this concludes my sleep-deprived, pre-solstice rant. And yes, the title of this post says late winter. Spring starts January 1st.

Deconstructing Construction, and a Mini-Rant

This morning I drove down to Loveland before daybreak to meet a former coworker to run around the lakes with her. The lakes are where I love to run in the fall. We were supposed to meet at 6:30 am and I left the house a little early to get there. I wanted to be there early, she's a new runner and she was nervous about running with me, and she had never been there before so I wanted to make sure I was there in case she had trouble finding me.

Well every damn back road between Fort Collins and Loveland that I usually take to get down there was blocked off for construction. I swear, every time I turned to make a detour, my alternate route was blocked by another road project. After driving twice as far and out of my way several times, I was pissed. Why do they always do this? They can't just do construction on one little part of the road, they have to do it on multiple nearby intersections, so the only logical detours are also under construction. Some bonehead planned that one. We seem to have an ongoing problem with that in this area. Hmmm.

I don't have a lot of patience for traffic anyway, I'm sort of like TOWANDA! I'm older and have more insurance, so get the hell outta my way, get your thumbs out of your ass, put your foot on the gas pedal, point your car in the direction you want to go, get off the phone, quit texting, smoking, eating, putting on your makeup, yakking at the person next to you or on your Bluetooth gadget, and drive with a F@#$ing purpose!

Yesterday I had to go somewhere on an errand at 3:30 pm. It took 5 changes of the light at Horsetooth and Timberline before I could turn right. It wasn't even rush hour. It's not even a big city. But Timberline road is under construction right now, on both the north and south ends of town. It also happens to travel through the part of town with the most growth. Hello traffic engineers?! Hello?!! It took me 25 minutes to go somewhere that normally takes 10 minutes.

It's funny, Fort Collins was named one of the safest driving cities by some insurance company, probably because no one files claims with them. But Fort Collins, is AWFUL in some respects when it comes to traffic, no matter what they say about it being a great place to live. There are so many slow damn drivers, people who drive, as I like to say, "with their thumbs up their asses".

Slow drivers especially make me absolutely nutty. And it's true that slow drivers are worse because they cause accidents, because people get pissed off and then try to get around them and end up crashing into something. I try not to do that, though, I usually just cuss them out under my breath and make snide remarks about their level of consciousness and lack of intelligence.

But I'm launching into a rant, and I don't feel like going there, so I'll save it for another time. Maybe.

Anyway, I ended up driving way around Boyd Lake and down Madison, around to Highway 34, and then up Rocky Mountain Avenue with all the roundabouts by the hospital there. By the time I got there, I was late and hoping Laura wasn't lost. She wasn't. She was sitting in the parking lot waiting. And I was pretty much on time, less than 10 minutes late.

There was a foggy sky and the sun didn't peek over the clouds until close to 7 am. As we came around the north end of the lakes and started on the trail section, we saw this line of pelicans perched on a pipe that extends into the lake.

As we got closer, a heron joined them, first tiptoeing his way onto the pipe, as if he wasn't sure if the pelicans would accept him.

He got bold and sat down in line with the pelicans.

After making himself comfortable, and us watching from the shore, we took off. The entire east side of the lakes were bulldozed and broken up into muddy swaths and there were fences lined up alongside the original road. A subdivision was going in that extended from Houts Reservoir to the end of Equalizer Lake.

My peaceful loop was being encroached upon by suburbia! Can't leave any open space unaccounted for, can they? I was afraid it was over. My favorite place to train in peace for long road ultras, destroyed.

Laura and I followed the path to the original road, jumping over chunks of mud and rocks torn up by the heavy equipment. We ran down the east side road and caught the bridge to the south end, which was intact. The construction was all the way down to the existing houses.

We rounded the corner by the big cottonwood tree and finished the loop, then we cut across the trail between the lakes for a pit stop at the portapotty.

While I waited for her, I noticed this sign on the barricade. Temporary. What a relief. At least the loop will still be here, but I am afraid of what the increased density will bring. Of course the condos were built a few years ago on the other side of the lake and that has never affected foot traffic around the lakes much, and I usually run on weekdays anyway. Oh, the benefits of having an obesified populace...damn, I'm in a snarky mood today. I am hoping they won't pave the entire loop, though.

After that we ran backward and caught the ditch road and followed it west. As we were running, I recognized a runner I had met just last Monday at the half marathon, we'd been standing in line together before the race and got to talking. We stopped, I introduced her to Laura, and we talked. Then Laura and I took off, and we soon turned around to limit our run to an hour and a half.

It was so nice to see Laura. She started running about a year ago and when we worked together, she was frustrated that she had gained weight when she had her last baby a few years ago, I think her youngest daughter is 3 now. She dropped some weight, started running, and now she is very fit and seems happy with her newfound passion of running. She wants to do an ultra. Her son ran cross country and track in high school and was a very good athlete. I'm pretty sure he got his running talent from her.

After I drove back to Fort Collins, on I-25, which I would have taken in the first place if I'd known about traffic hell, I got home, took a shower, and went over to Starbucks to meet a fellow nurse, who is in graduate school and working in oncology, to discuss the state of health care in general, our career ambitions, and solve the world's problems pertaining to health care and delivery of cancer services.

Progress is what it is. I guess they call it progress, even though it can be so destructive. Construction is destruction, on the one hand, but it also means growth for the area, economic growth, which is what I need to keep my business viable into the future. So I have to deconstruct it, and deal with the fact that there might be a bit more pavement on my old half dirt loop out there. As long as they leave the view of the mountains, I'm okay.

After our talk, I went out and distributed some flyers for my upcoming bimonthly exercise & cancer support group that I'm starting at Raintree Athletic Club in October. And picked up some crack at Runner's Roost- the chocolate cherry Clif Shot kind of crack, to have for my race. The high octane stuff.

It definitely feels like fall, yesterday I considered turning on the heat! But I didn't. It got down to 62 degrees in the house. Finally, I am not being kept awake hot flashing. Such a relief!

I'm not looking forward to ice, but I have a feeling winter will come early this year. It feels like it's about 3 weeks ahead of schedule. But for the next few weeks, I can enjoy the changing colors and all the other things that make it my favorite season.

Redneck Holiday

It's Isabelle's birthday and I doubled her age in miles. Poor Isabelle. She has to share her birthday on the day after the worst holiday that exists, as far as she's concerned. She shakes in terror the whole night before, every year, thanks to the almost universal (in this country) whims of dumbass redneck hicks who use what little intelligence they have to blow firecrackers out their asses on the day of July 4th and for several days before and after.

Have I told you how much I hate fireworks? I don't mind organized fireworks displays that are put on at public parks for large crowds of people. But the stray ones in town, and for the stupid people who set them off in fire-prone areas, I'm gonna kick your ass, mothafuckas!

Yes I'm labeling people today, because I am sick and tired of these ignorant selfish yahoos who have no concern that their behavior is inhumane to creatures who share the earth with them. Darwin Award candidates. I always hope they blow their fucking hands off. It pisses me off that I have to give my dogs sedatives for them to get through the night on July 4th.

I did a little over 26 miles today, super easy in 4:45, started at 10 am and finished around 3 pm. It was 75 degrees when I started and 93 when I finished. I ran a consistent pace throughout and felt good, especially in the heat. I did four 6+mile out & backs running around Warren Lake. I used the house as an aid station so I didn't carry too much, but I did fill my ice bandana and wrapped it around my neck the last two times.

I took the last two days off, my right hip flexors are not happy after my 30 miler at Horsetooth a week ago. I remember now that it was within the first mile as I started running downhill, before I was really warmed up, I felt a sharp sudden pain in one spot on the front of my right hip, but it went away after a few steps and didn't bother me the rest of the run. I was probably tight and strained the muscle there. I didn't feel it again until the next day, and it's just been an annoyance all week.

I iced and took a couple of days off, and everything felt fine today in the first 20 miles, by the end I could feel the sore spot again, and I iced when I got home. It was fine when I was running, it hurts when I put pressure on the spot with my hand. I had planned to run the Firecracker 5K on the 4th of July but slept in until 8 am, which was a better option. Speed and hills are what will aggravate this, so I'll take the opportunity to rest up for a while.

I think it needs a bit more time and more stretching and ice once things settle down. Next week will be an easy week for me, I might just stay on the bike since it's my low mileage week anyway. Then I have a week before I leave for Badwater. The time at Badwater usually doesn't involve much running at all when you're on medical. I will time it with my running schedule as a break.

I am so looking forward to this trip. I don't know if it's just the thought of being alone and isolated in my car from here to Las Vegas and having the time to think, or not think, or the memory of the dry hot wind baking me as I keep the AC off and the windows down, or what.

I had to go to Target the other day for a few things and I was having Las Vegas flashbacks while I was in there. I think it's because the only time I go to those stores is when I'm getting ready for a race, and it was hot, and there's this cheap plastic smell in those stores that also remind me of Las Vegas. All I know is that I'm looking forward to it. I also look forward to the grounding feeling again of being with my peeps...

There's also the visit to Sushi Koma. I'm looking forward to that too.

I'm glad July 4th is over. I'll be really glad when people run out of fireworks so we don't have to listen to that noise and the girls won't be scared. What is it about firecrackers that is such a thrill? Do we all have to be a bunch of stupid rednecks like Duck Dynasty and Honey Boo-Boo? What has happened to pride in human potential? July 4th makes me think we've entirely dumbed ourselves down to big, fat, selfish, ignorant stubs. RAH-RAH USA. God bless Murrica. Oh but we're good Christians, see, we're waving our big fat red white and blue cross with stars and stripes on it.

It's my flag too. Don't hijack it with your religion. I don't share your fervor. Oh, by the way, when you try to get into heaven, you might think twice about waving that USA flag at the pearly gates. I don't think any divine being could be too happy with what the stars and stripes represents these days, the leaders of this country completely self-interested and tone-deaf to the needs of the people who reside there...

Last night there were a bunch of dweebs sitting out in the adjacent street setting off fireworks, sitting in lawn chairs right on the curb, with 4 adults drinking cans of beer and three little kids who were going out in the street to light them, and there were a couple of dogs too. I have never seen these people before, they were sitting next to a truck, I think they were visiting someone in the neighborhood. But I was walking by and I was creeped out first of all by the scene, but even more so by one of the creepy men leering at me as I walked by on the opposite side of the street.

First of all setting off fireworks in town is illegal. And it's a fire hazard, even though this year we've had more moisture, there's still dry grass everywhere. Of course no one pays attention to those common sense things, except for the people who have pets and are disturbed by the emotional response of their pets to the noise. These fireworks boneheads are likely the same people who think it's okay to open carry guns in restaurants and stores. No empathy for other human beings, or animals. I always wish they'd do us all a favor with their guns and shoot their own heads off by accident and win the Darwin Award.

I'm hoping I get to catch up on some sleep tonight with calm Buffaloes.

Obesification: A Suicide Mission

Kevin Pho's blogpost on the proportion of executive and administrative salaries in our sick health care system, along with the VA scandal, got me fired up again.

Conservatives and liberals alike are mad as hell...oh, the outrage.The light on the VA scandal made public the problems of power and corruption, mistreatment of employees and whistleblowers. Again. The shameful treatment of veterans whom the agency was supposed to be helping. Again.

Obama knew about this problem when he took office. The problem was already there when Bush was in office. Obama caused it by promoting big government. Bush caused it by starting wars we couldn't pay for. It’s the Republicans. It’s the Democrats. It’s Bush. It’s Obama. It’s Fox News. It’s MSNBC.

STFU.

It's us, all of us. We have our voices, we have our votes, most of us have two legs, two arms, two hands, a mouth, and a brain. We can be cognizant of our world and act in it. Use the damn resources you've got instead of sitting on your fat ass texting.

When you look at problems such as the VA’s actions that do come to light, it’s really just another day, another dollar, another power broker. Bullies and greed run the show. The government has acted no differently than private industry or nonprofits.

Apparently it’s okay to bully people who point out injustices, or who criticize the status quo, no matter what sector you work in. Wouldn’t want someone to have an independent thought. Talk out of one side of the mouth about providing value for the patient, while stealing value blind?

The value they talk about is only about how well it serves the interests at the top.

We approved it, yes we did.

Is it because we are working ourselves to death, doing the jobs of two or more people, working longer hours with less pay, fewer benefits, and less compassion than ever before? Auto-piloting through our jam-packed workdays, stacked together into a blur. Stuck in our self-imposed commutes, bound to our inflated mortgages, reliant on our vehicles, ruled by our electronic gadgets.

Whose fault is that?

We were complicit in underfunding public education, we didn’t provide physical or health education that prepares kids to be healthy, informed and functionally literate adults. We succumbed to our reliance on processed, fast, convenience foods laden with sugar, simple carbohydrates and salt to seduce our tastebuds, drain our wallets, and addict our minds.

We approved of the behavior of executives and those with power who run public, private, and so-called not-for-profit companies, corporations, agencies and health care systems, who siphon off financial resources into their own pockets, personally risking little as they have a golden parachute to back them up.

Where’s the golden parachute for the rest of us? What if we are all forced to jump into thin air, and no one will rescue us. We’re being taken by gravity, and no one will be there to pick up the pieces when we go SPLAT!

Instead, we think our golden parachute is the next weight loss drug, the next diabetes drug, or the next New York Times Bestseller Diet Fad.

Will we not stop until every single citizen of this country is impoverished, obese and Type II diabetic?

Eventually there will be a breaking point where the people will no longer have the resources to passively support this system. We’ll be too old, sick, fat, exhausted, and poor. Only when we’re dead will we cease to support the system.

Except for the unfortunate recipients of our stupid genes, if we passed them along to the next generation. But the way things are going, they won’t have to suffer as long as we do.

They won't live as long.

On Banning Bossy

It's snowing today and I'm catching up on some of the thoughts that I placed on the back burner all week.

There's been a lot of hype about the "Ban Bossy" campaign in the news lately, and the talk is all over the map. I was thinking about the Ban Bossy campaign in regards to health care, especially nursing, since nurses are notoriously "bossy", or at least referred to as such.

I can even remember being a nursing student and talking with a physician about a patient during my clinicals. He told me, "You nurses are all alike: bossy". He was joking, and it was actually meant in a complimentary way, because he took my idea seriously. But in general, I think the "bossy" label is stuck to nurses like superglue.

Leadership means you help raise all ships. You encourage people to be their best. But the corporate world's aims are at odds with this. Maximizing profits and cutting costs does not encourage people to be their best. Nurses working short-staffed become short-tempered, even if they aren't "bossy" to begin with.

Managers find ways to cut staff, undermining people's efforts and encouraging backstabbing among peers to get people to leave, especially those who might question (threaten) the wisdom of their decisions.

There is a large gap between true leadership and bossy in nursing. There are so few real leaders, who help people to improve. Of course there are always the constructs of improvement or success to contend with. In the corporate world, they mean profits. And the way health care is reforming, with the conglomeration model, it's getting worse. It's a human factory, both on the patients' and staff's sides of the coin.

There's no time for real leadership activity when your staff are out there running themselves into the ground, and when your management duties require you to attend time-consuming meetings for additional propaganda "training", learning how to script your words to obscure the newly merged organization's pursuit of the bottom line despite it's carefully and expensively crafted mission statement.

The other thing management has to do in the new health care model is worry about numbers. Scores on every possible measure you could imagine. Patient satisfaction, readmissions, meaningful use, those are only a few of the newly coined terms that fly around in the hallowed hallways of the muckety-mucks in health care.

Bean counters and consulting firms are the gods, they are prioritized over staff who carry out the drudge work. The most valued players in the organization are the consultants who show shaky-handed executives how to navigate the new world of health care and preserve their well-paid spots backed up by golden parachutes.

You can either stuff your feelings and toe the line or get out. Simple as that. It doesn't matter how good you are with people, or how skilled you are as a leader. Doesn't matter if you're a good nurse with the patients. You have to keep your mouth shut and nod your head.

Yesterday I was in the parking lot of the grocery store and ran into a former colleague from the hospital. I liked working with him, and he was good at his job. He apparently didn't know I left. I asked him how things were going, and he replied, "still hanging in, coming up on 17 years. What else are you gonna do?"

I said, "I got out". He looked surprised, he obviously didn't know.

"What are you doing now?"

I told him about starting my business. It was like someone pulled the curtain back. I could see the amazement in his face, it was something he never even considered for himself. He had resigned himself to being stuck in that job and employer forever, according to his slumped shoulders and lowered head.

An old friend of mine was in the hospital across the country after having a complicated laparoscopic hysterectomy, and they kept her for just 23 hours post-surgery. It wasn't a simple procedure, the surgery took a few hours longer than they had anticipated. Still, they discharged her according to the insurance company's coverage and the original plan.

She was sharing a room with another patient whose behavior was not conducive to my friend's healing. Not only did my friend realize, in her post-anesthesia and poorly controlled pain -induced fog, that the nurses were understaffed and working their butts off, and unable to stay on top of her pain, but she saw other things too.

My friend noted the behavior of some people to milk the system. She noted that the family of an elderly person with dementia were trying to get the doctor to keep the woman there when there was nothing justifying her hospitalization.

The family probably just needed respite, and we don't do a good enough job providing resources for people who are caregivers. As the population ages we need to be able to provide these resources, but the system is busy cranking out dollars and minimizing costs, so the extra care and the services that are less profitable get cut, and people suffer.

When organizations are so focused on profit, bossy becomes the rule. Bossy in the sense of bullying and controlling. It's top down, hierarchical, and domineering. Those with poor people skills get ahead in these organizations. Time will tell how the new health care model pans out for the recipients (dare I say victims?) of it's excesses of profiteering. I predict we'll soon be circling the drain.

I'm not a fan of "Obamacare", because it is truly flawed. I never thought I'd hear myself using the derisive term "Obamacare" but I'm oh so skeptical, and not for the same reasons that conservatives use to bash it.

Insurance companies and health care executives are benefitting, but we have yet to see how much the people who were formerly uninsured benefit. Personally I think we need health care for all in a single payer system.

So in my opinion, banning bossy is a lot more complex than the effect of labeling on people's ambitions. I think we need to start by banning our love affair with power and greed.

That's my $.02.

March: In Like A Buffalo

It's snowing. Again. Polar vortex, you and I need to have a serious discussion. I'm in a ranting sort of mood.

I am postponing my 40 miler until tomorrow, which will give me a chance to finish working on my presentation for next Wednesday. Plus the fact that I woke up to 16 degrees and a slick layer of ice on everything. Again. Tomorrow promises to be somewhat better, a little warmer and no snow, so I'm waiting.

This was an all-around weird week! The earth must have been slightly off it's orbit around the sun, or the moon was doing something weird. I felt off, in every way.

Every afternoon this week I needed a 2 or 3 hour nap. That's after sleeping at least 8 hours. I haven't even been running much, I averaged roughly 6 miles each day this week, saving it up for my long run. I ran the same route all week, too, and finally the lake is almost free of ice except for in this one corner.

Each day this week, it smelled like spring. The birds were singing in the morning. The snow was melting. Some little green tulip leaves were popping up out of the ground in the back yard.

Wednesday I gave into an ice cream craving after 2 months without the nasty stuff. It probably has been my favorite food forever, at least up there among the top 3 with sushi and green chile. But this time I noticed I felt horrible the day after eating it. Thursday I woke up hungry, had no energy all day. It was the sugar and I think I am done with sugar. I've had so much more energy since I quit eating crap at the beginning of January.

I could not understand why I was craving carbs so badly. Last week I did bump up my mileage, but I ate plenty. So then I got my answer, sorry for the TMI but this is how it is. After not having a menstrual period for 5 months, I thought I was done. I had my physical with the doctor last week and told her that, and we were talking about how I'm probably done. You are considered to be officially in menopause when you have not had a period for one year. So I was really hoping another 7 months would go by undisturbed.

Well as of this week, I got to start over with that year. Sucks! I am so ready for this to be done. I really hope this is the last one. At least it wasn't triggered by a race, like it has been for the past few years. But it would explain my general state of irritability, impatience, and carbohydrate cravings, not to mention the state of my face which broke out randomly about a week ago. I became the RPB again. Dammit.

Then Friday I took my Cancer Exercise Trainer exam. I passed, so now I have that certification and I am finally done with the studying part and can move forward in my business.

Consistent with the earth being off it's orbit, I had a briefly gut-wrenching experience. I went out to Greeley to take the test at Aims Community College, and I sat through the exam, which was much easier than I expected. I got done in an hour and 15 minutes and they allow you 3 hours.

I've taken a lot of these computer exams lately so I sort of know the drill, you finish the exam and submit it, and a little window pops up on the screen that asks, "Are you sure?" and you click yes. And then another little window pops up again and asks, "Are you sure?" and you wish there was a "yes, dammit" button, but you click yes.

And then you wait as it thinks for a while, and then it displays the results on the screen. I passed. It showed my score and how I did on the different sections of the exam. Sometimes they'll have a little survey at the end that they want you to complete. So I sat there and waited while the computer did it's mind crunching thing, and it took a long time. L-O-N-G time. Suddenly this little box came up on the screen that said, "Critical error. Contact test administrator".

Eeek!

So I went out of the room to find the people at the front desk, and they couldn't find my score report. I was thinking, oh shit, they lost it, what if I'll have to do this all over again! But the guy called the test company, and after waiting on the phone for a good ten minutes, he finally got connected to someone. Who then put him on hold and transferred him to another geek, with another forever wait.

Finally they walked him through whatever he needed to do and they recovered my data and I got my score report and I was done. Whew!

It's been this hurdle sitting there ahead of me, so one more thing checked off the list. Now I can concentrate on the good stuff, the marketing, contacting physicians, and the last bits of paperwork and legal stuff before I can really move forward. There's a lot to do, but I want to do it right, and I'm not going to rush through it.

I've been trying not to multitask. It feels great to focus on one thing at a time. I will eventually get back to some multitasking, but it feels good to not put pressure on myself to remember everything. I make my list and get through it, but I'm not running around crazy, trying to stay on top of six things at once. Or twenty-five at once, like when I was working as a nurse-bot.

Speaking of nursing, something really cool has happened, or is about to happen. Finally, nurses portrayed as the human beings and professionals that we are. I hope the American public sees it and starts to wake up. Not just waking up to what nurses do and endure, but also to the reality of health care and that along with all the pressures of the job, professionals in health care are not treated very well by their employers in the current profit-focused model of sick care delivery.

This nursing movie trailer. Please see the movie when it comes out. It looks to be released around Nurses Week, early May, amid the usual consternation and heartburn that the weeklong "event" causes nurses. At least this year, something in our favor.

So now that I've bitched out all my frustration of the week, I am going to move on and do something productive today. One thing.

Off to the woman cave...

I'm Tired of It. Let's Start Fixing It: A Rant and Call to Action.

I've done my share of bitching about health care and nursing. I am getting tired of it. The nursing profession needs a total overhaul. And there needs to be a solution. I don't necessarily have the answers, or any good ones, but I know where I'd like to start, so I'll offer a few suggestions here and maybe it will light a spark, if not a fire, under someone. I'm already on fire but I can't do it alone.

So what CAN we do about it?

We need to change the big money in politics, that will be the only thing that really changes things in the direction of the common good.

But barring that, the nursing profession needs an organization that is comprised of direct patient care nurses, free from the corruption of the executive, administrative and too-high-in-higher-education classes that taint the entire system.

Like that's really going to happen anytime soon? Shya...

Nursing needs representation and advocacy from a group that backs them with financial and legal resources, given the reality of the current political climate. Here are a few ideas. They're not anything new, plenty of other people have suggested many of these things. But there's been little momentum. These all have the potential to be fleshed out, they are projects for anyone willing and able to take them on.

Unfortunately, money seems to be the only thing that makes these big guns sit up and take notice, so we have to start figuring out ways to hit them in the wallet.

Patients don't have a lot of choice in going to different hospitals under their insurance plans. But if they see something they don't like, they can complain to their insurance companies, to Boards of hospitals, to consumer advocacy groups, their local newspapers (which doesn't always work if the hospital is a big advertiser), they can talk to anyone who will listen.

Social media is a powerful network. If people see things they don't like when they visit the hospital, such as nurses being too busy to really care for them, then they can complain to management, but what works even better? Post something on the hospital's Facebook page. Tweet it. The hospital isn't going to want visible complaints in the public domain. It's embarrassing.

People need to flex their consumer muscles. It takes a grassroots effort, people talking to each other on the street. Consumer advocacy groups can help with this. If there isn't a consumer advocacy group to help with this, then perhaps one needs to be started.

A grassroots organization would ideally be free from the influence of those who are only in it to enrich and benefit themselves, such as health care executives, and the people high up in higher ed, such as university administrators. We need to stop serving their money and ego interests. They serve on public boards to build their resumes from ceiling to floor, in search of ever higher paying jobs with perks. They are bought by the industries that stand to benefit, the bankers and textbook manufacturers who are lobbying the state legislators and Congress to win favor for their "products".

Remember the sticker shock you were in when you lined up to buy your books in the university bookstore, as we did when I was in college, before the age of the Internet? Same thing now, but those books, software, and other products are bought online. Still expensive as hell. Someone is making a profit off of students. Student loan companies and textbook companies...

Don't get me wrong, I'm not anti-education. I think it's crucial to the future of nursing. But nurses need to be able to use their education to benefit the patients, and to enable their own professional growth in ways that benefit patients, the profession, and nurses themselves, not to inflate some artificial construct designed by self-interested administrators for the purpose of marketing for profit to line their own pockets.

Not to allow some university president to make a huge salary while delivering little to no educational, financial, or career benefit to the student for the exorbitant cost of a degree that puts them in mortgage-level debt before they even have their first job.

We need to disband the ANA and it's Magnet subsidiary, they do nothing except serve themselves. Read their statement of purpose, it is vague... they claim to be at the forefront of health care reform, yet what are they doing for working nurses? They don't even serve all nurses, as they claim. They do little to protect nurses from their big corporate employers taking advantage of them with incrementally unsafe staffing levels, for example.

They are basically using extortion to force nurses to get degrees that they might not even need, threatening them with losing their jobs. Why should a nurse with a bachelor's degree in another discipline be forced to get a BSN? Aren't there just a few courses they could take to make up the difference?

Furthermore, nursing schools keep nursing students in the dark, they show them very few examples of the wide variety of jobs nurses will be qualified to do once they graduate and get a few years of patient care experience. They prevent students from doing clinical rotations in areas like ambulatory care or with nursing entrepreneurs, areas that are the future of health care. Instead, they worry about how many Foley catheters the students can place, learning sterile technique, or starting IVs. All of which nurses will learn much more readily on the job, as needed.

Higher ed has devised some excuses for why it's necessary to take more than just a few classes to "measure up". Does experience count for anything? Is this evidence-based practice? Where is the evidence that a few classes would bring a bachelor's degree-holding experienced nurse up to speed instead of forcing them to spend gazillions of dollars on school for which they are not even reimbursed or compensated?

How can you make the argument that a nurse needs a BSN when you're giving her or him such a busy patient load that all they get to do is rush through assessments, pass meds and chart. If they even have time for that. When all else fails the nurse is forced to do the documentation above all to protect their license and their employer, even if she or he didn't have time to do anything to help a patient.

And if anything goes wrong the employer is going to blame the nurse. You tell me a BSN is going to make a difference under those conditions? Nurses don't even have time to THINK. There isn't a real need for higher education if you're forcing them to function like robots. Nurses get more education so they can get OUT of patient care. Why? Because those 12 hour shifts and running your ass off day after day multitasking like a maniac is EXHAUSTING. Once they cross over to the "dark side" of management, those BSNs and MSNs do little for direct patient care.

Most organizations and Boards of Nursing are made up of the same people, the executives, administrative types, from higher ed or corporate industry. Get rid of these influences on the nursing profession and replace them with real, hard working advocates for real, hard working nurses.

We need to get away from the profit-centered secret mission of these health care institutions. Everyone knows they are in it for the profit, but they will swear on their gold-plated executive suite graves that they are for patients, customer service, health care, and safety. We ALL know that is BULL.

NAASA is an organization that is the brainchild of Amanda Trujillo, it has chapters in several states and membership is free. It's grassroots. This is where we need to be directing our efforts, to take back the profession before it is destroyed and the human-focused art of nursing is lost.

It might not be THE answer, but it is a start. Until grassroots organizations like this one become large enough to exert influence and have a voice, they won't be very effective. But one thing is for sure: the corporate world is scared. They don't like dissent, they don't like anything that calls them on the carpet. Hell, even little old me, I managed to scare the pants off a few people before I left my job. I wasn't even trying to. All I did was point out what I saw. I said some words.

When middle and upper management of these hospitals have the guts to speak to our faces and tell us the truth about why they blew off the most qualified, creative candidate for a project or job in favor of an established yes man,

when nurse managers admit their collusion in encouraging coworkers to backstab each other,

when administrators and management actually fund and complete projects that benefit patient and workplace safety when JCAHO isn't looking,

when executives have the cojones to admit that it's all about them, their profits and bonuses, their ability to double dip when they get fired by getting a severance package from the old place and starting a new overpaid corporate job all at once, and getting to keep the status quo of their gold-plated lifestyles, not even feeling a dent in their lifestyle or budget, while the institution is cutting direct patient caregivers left and right,

when they can at least admit the truth about those things...

Well, that is never going to happen unless enough people point it out, verbalize it, make noise, and stomp their feet until the earth shakes.

And that is precisely what a grassroots movement is going to have to do before it can make any forward progress. We need to stomp our feet, shake the earth, raise a few points on the Richter scale. We need to shine light on the greed, waste and incompetence that keeps us as slaves to the corporate healthcare machine.

People already know it, but they haven't been adequately motivated to do anything about it. They need to find their voices, overcome their fears, and realize that things are only going to get worse until we do something about it. How uncomfortable do you want to be? How uncomfortable are you willing to be before you do something?

The system has screwed the people in so many ways, aren't you tired of it yet? Do you enjoy being taken advantage of? Do you enjoy working yourself dead?

If you do, then go right ahead and keep your head buried in the sand, wake up and see your reflection in the mirror and be so proud of what you have accomplished for your fellow human beings today: setting them back just a little further, enabling the corporate assault culture that wages physical and psychological warfare against those who work in the trenches, and ultimately, the patients.

Spin Doctors Come to Jesus and the Mystery Body Fluid

So the past two days have been interesting...must I elaborate?

I will. Tuesday I met with three different friends at three different times of the day, and the conversation each time was partially about my future plans. I really need to get on a different track, and I'm taking small steps but haven't been able to focus on what IT is. I'll get there.

Tuesday night I got slapped in the face by my own dose of reality, my own Come to Jesus. I went running with Wheaties Boy, and we were about 7 miles into the run, going at an easy 9 minute pace and the hamstring had held up well, when suddenly....

A pine cone appeared under my feet and I rolled my right ankle on it, and after a few four letter words and stopping to check the damage, things seemed okay. I iced my hamstring when I got home, I could feel it at the end of the run. Then in bed I could not get comfortable. My right hip, front, side, and back muscles at the level of my iliac crest were screaming, I had pain shooting down my leg, and I tossed and turned all night, sleeping poorly.

As I was lying there awake, I realized it was dumb of me to go running, I should not be running at all right now. I should be sticking to the bike and the pool. The hamstring needs a certain level of rest and rehab first, and I have not given it that. The universe was saying, don't run now.

And the other thing I realized was that when I twisted my ankle, I must have thrown my pelvis, hip, back, SI joint, and whatever other movable parts there are back there out of alignment, because everything hurt, and I was cracking and popping in all sorts of weird ways that I hadn't been before the run.

So I plan to get in the pool and try to loosen up my back and on vacation I will have a non-training agenda.

You know you're ready for a vacation when you see things in a flat light. Today I barely made it through the work day, I was simply not having any fun at all. Your mind is forced to be there but it wants to be somewhere else.

My mind kept coming back to my back- how sore it was, how my entire lower half feels twisted, and both hamstrings hurt. I just wanted to find someone to walk on my back, shake my legs and crack my SI joint back into it's proper position.

But even more than that, one of the nurses I like and work with often told me today she gave notice. She's moving out of state and she's looking for a completely different job. She doesn't even have a job lined up yet, but she'll have no problem. We've been talking about changes for a while, so I'm happy for her, and truthfully, I envy her. She's been a nurse for the same amount of time I have been.

But she's 20 years younger than me and has the world in front of her, and I envied her freedom and that she is getting out and moving on. I have the ability to do the same thing, with more at stake, as I'm in a different place in my life. There's a big difference between 30 and 50, for a lot of reasons. But sacrificing your happiness and sacrificing being true to yourself are not healthy options, and I'm paying for that now, and have been for some time.

Nursing is such a dead end job. Working directly with patients at the bedside, chairside, in a hospital setting is the worst. There's something wrong with a profession that burns so many of it's members out in 7 years or less. There's plenty of lateral opportunity but you can't really stay in the same workplace and move up or into more fulfilling jobs. Unless you're one of the few who enjoy torturing themselves with management duties, and/or being a yes man. Becoming a nurse practitioner might look appealing on the surface, but they are going to be forced into getting more and more education, the value of which is not looking too favorable. And then there's always the glut that happens after the big sell job by the diploma mill.

If I felt like my own skill set was valued, I might feel differently, but I don't. Sick care, not creativity, original thought or innovation, is the only thing that drives the health care industry in the hospital setting. It's nothing more than a factory. It's all about the bottom line, all about the bucks, not at all about the people who serve and are served. The spoils go to the yes men who can recite the scripts, or scripture. Corporate culture is more like a religious cult.

It's been an interesting time. Seems like every time I turn around someone else is leaving. And this week the muckety-mucks are freaking out because they got a big dose of reality after a survey that showed staff satisfaction has plummeted into the gutter. Literally, turned inside out. But how could they even be a little surprised?

What kinds of things are going on in the world of health care? What has health care reform brought us? Hospitals are merging, as we did. They are switching over computer systems, like we did. Mergers and big changes result in everything turned upside down, a gazillion people at all levels of the organization leaving for other places, and staffing levels are reduced, like we did. At the same time these organizations claim to be making the work environment efficient and lean, they spend huge sums of money on expensive consulting firms and wasteful, ineffective training programs, the hypocrisy of which is not lost on even the most menial of workers.

All this is happening in health care nationally at the same time. And here, they also chose to do it that way, in a short time frame, using those methods. No one said they had to do it that way, or all at once, or by carrying a big stick. It's easy to call the shots from your penthouse, when you don't have to live the day to day reality of it. It's a systemic problem, and we can blame it on our own apathetic response to our current system of allowing legislators to run amok with power and money.

So as far as getting slapped in the face with the reality of screwing up royally, that's what happens, when companies take on too much, too soon, and throw thousands of people's lives into a tailspin. Can't blame the people who had no say in the matter, the powerless peons. Given an opportunity to speak out in a survey, they will speak, because it's their only way to be heard. Those way up high, far away, have no one to blame but themselves when they hear the message they don't want to hear. They are now suffering from a big butt bite and all I can do is give them a rabies vaccine.

The spin is entertaining, if not sad. How many ways can you twist the reality of a clear message that you have fucked up into something that avoids taking full responsibility? Let's see how many ways it's possible to script a message into a yes-man digestible version to be distributed to trickle down to the masses. No matter how you spin it, it's not the fault of anyone but the people who have the power to initiate the changes. As in, those who make the six and seven figure salaries and never get their hands dirty. But many people below pay for it, out of their hides, every single day.

So that's my work hangover-induced rant. To add a twist on my otherwise doldrum-like day, I did have a little surprise to spice things up.

Early this afternoon I was sitting at the computer doing my charting, and I looked down at my pants. There was a quarter sized stain, with starfish-like extensions, dried on the front of my thigh. It was a brownish-green color. No one had puked on me, and I couldn't figure out where it came from. The only thing I could think of, and what it resembled most, was that someone had coughed up a big ol' loogie and hacked it on the front of my pants. They would have had to be low to the ground to do that, though. I haven't had to deal with much in the way of lung cookies since my ICU days. I suppose there are some things to be missed if one ever leaves the nursing profession...

I freaked out for a minute, in my own quiet way, and then went to the sink, wiped it off with some water and alcohol wipes, and it was gone.

Those pants are definitely getting washed separately tonight...