Transcript of my speech from Nurses Take DC 2018

I am honored to have been asked to speak here today, thanks to the Nurses Take DC organizers for the invitation. I want to make this short but not sweet. There is no sugar coating why we’re here. I want to suggest some ways to kill two birds with one stone in our own communities- back home, wherever we all came from.  We can solve the nursing shortage AND create safe staffing for patients by living up to our values around nursing care. But first, I want to tell you a story.

When I left my hospital job they didn’t give exit interviews. They didn’t care what their nurses thought of working there- what experiences led to their leaving- or how they might have done better to retain that nurse. There’s a lot of talk coming from above about shortages and retention, but no action. You’d think they’d want to find out how to keep us around- right?  How can you expect to retain employees if you don’t find out why they are leaving? 

Well I finally got my exit interview. Six months after I left, completely by chance, I ran into my old CEO- I was coming out from my mammogram- and ran into him in the hallway at that exact moment. I grabbed his ear (so to speak) and we went out in the parking lot and that’s where I had my exit interview.

I had to explain to him the difference between a leader and a ringleader. Because that’s what management was at the hospital- ringleaders. And you know some of our professional organizations use that same style of leadership. They have so little respect for us, value nurses so little, that we are just another production unit… it’s such an inconvenience that we cost money to train and replace. Gets in the way of profit. 

When leaders don’t act in our interest, and their actions don’t match their words, it’s time to get new leaders!!

These hospitals are built with mortar mixed with blood, flesh, sweat and tears, even lives, of patients, and also nurses and physicians. (If you don’t believe me- watch Dr. Pam Wible’s documentary- Do No Harm- about physician suicides- but physicians aren’t the only healthcare professionals who kill themselves.) We work ourselves to bone-deep exhaustion while executives sit in their suites, dining at nice restaurants and playing golf at 5-star resorts at their ACHE meetings. They have second homes, while we get second jobs to make ends meet since our nursing job doesn’t earn us a comfortable living.

They ask us to be responsible for the lives and safety of our patients, and document everything so they won’t get penalized, while we can’t even go to the bathroom, eat lunch, or finish two nurses’ work in one 12-hour shift. Every time we are understaffed, we are doing the work of two nurses. Or more.

They have no idea what they are asking of us. Have you ever had an executive shadow you for an entire shift? Have you ever tried asking them to?

So…The million dollar question is NOT, “Thank you sir, may I have another?”

It is, “How do we solve this mess?”

I don’t know why so many nurses sit behind the nurses’ station whining about work but never do anything about it. I know I’m preaching to the choir here. The point is, we have to do more. Let’s make nursing a career worth keeping!

So here’s what I want each of you to do, myself included.

I want you to go back to where you came from and convince at least one of your colleagues to get off their butt and do something about safe staffing- grow a pair, say something, step out of their comfort zone and take a risk. Then…

I challenge each of you to have three conversations this year, out of your comfort zone. I want you to talk with that nurse colleague, and a physician, and with someone in administration, preferably an executive. I want you to find common ground with them as a human being and have a conversation. Break the ice by asking them, what is the most difficult part of your job…  Let them know you’re interested in what they have to say. And then… creatively propose a way to start solving the problem of safe staffing. Together. Follow through. Commit.

When we have those conversations, there are a few points I want you to take away, remember, and use.

1.     There is a difference between safe staffing to avoid sentinel events and staffing that is adequate to improve a patient’s health after being hospitalized or being treated in a healthcare facility.

2.     Today’s nursing jobs are not the equivalent of a regular desk job. They shouldn’t be compensated like a desk job. Hour for hour, we put in a lot more work and have a lot more responsibility than your average paper pusher. It beats us up, physically, emotionally, spiritually. 36 ≠ 40! Think about that.

3.     Nurses need to be able to do our jobs without sacrificing our physical or mental well-being. We need to see that we’re not stuck forever with only lateral options for career moves. We need to know that by advancing ourselves, we don’t have to sacrifice our integrity.

4.     Keep your intellectual curiosity alive- don’t rely on dumbed-down, pharmaceutical and hospital industry-funded continuing education for all your career needs. They won’t help you go above and beyond. Strive to grow personally, strive to grow beyond the scripted, measured, limited status quo that keeps us stuck.

We hear a lot about VALUE-based care these days, it’s one of those favorite buzzwords that the scripted bots of the healthcare industry love to hear rolling off their tongues. But healthcare won’t be successful unless those who deliver the care have human qualities to care. And exhausted, burned out, chronically understaffed nurses can’t care. Let’s start using value and care as verbs instead of nouns. How about if we VALUE nurses so we can CARE?

But most important of all- let's get back to value- each of us should think about what we value. We’re here for patient safety. We can’t live our values if we’re not authentic. When we know who we are, what we value, and why, we are grounded, and are less likely to be swept away by the strongest gust. 

If you take nothing else away from this rally, resolve to define your values around your work. Why did you become a nurse in the first place? What’s your number one priority as a nurse? Live and work in accordance with those values. Encourage your fellow nurses to do the same.  Moral distress is not good for your health, or your patients’!

Patients and nurses alike, each of us only gets one life for sure. Let’s make sure each of us can live it fully.  Thank you.

Evolution of a Runner and Thoughts on Life and Death

Monday was solstice and I made a commitment to myself to get moving. So far this week I have been successful. Lifting, doing my abs and core work, my hip strengthening exercises, and running and walking. My neighbor has helped, she's been off work after hand and wrist surgery so she can't do her usual yoga, and we decided to walk while she is unable to do her routine, which helps me get out the door.

It's been cold and I haven't been running a lot, I did an hour on Monday and a little over a half hour each on Tuesday and today. I will try for an hour of running tomorrow even though it's supposed to be super cold. But Christmas and any big holiday have always been my favorite times to run because traffic tends to be light, people tend to be in a decent mood, at least less likely to run you over. I'm sure that will all change on the 26th when the shopping frenzy resumes.

I was thinking a bit about how I've evolved as a runner. For me it has never been a straight line, I have gone back and forth with being competitive and non-competitive, being highly driven and laid back. I love to run and I am thinking about finding some fun adventures to do in the coming year, though they won't be about racing or being competitive. I am ready to explore some trails and places I've been wanting to go but my specialized training for roads and my ankle problems never allowed me to put much effort into it. I have some new running partners who are also on-foot adventurers, and one of them is as much a photo freak as I am, and I find myself looking forward to their company.

Tomorrow is Christmas. We are taking it easy, having one friend over and that's it. I made tortilla soup and I got some stuff for quesadillas, and baked some cookies. After two tries on the cookies I finally did it right. I don't know why but cooking in the kitchen has been disastrous this week, I attribute it to the lack of a kitchen supervisor watching me. Isabelle took over Iris's position, and she was getting good at it. But now it's just me. Cooking is not nearly as much fun without Buffaloes.

We got Isabelle's ashes back last night. Dennis cried as he walked in the house with her, having picked her ashes up on his way home from work. A little turquoise box. It's almost an affront to fourteen years of companionship. But that's the way they do it, and now we have them both back.

It's so strange to receive the remains of your dog, the whole, wiggly, soft, furry, loving, interacting, communicating, responsive creature, in the form of a little cheesy-looking box in baby turquoise blue with a little pawprint charm attached to it, with some fake flowers to top it off. Now Iris and Isabelle are both home for Christmas, sitting together on top of the dresser, next to the hedgehog and bone pillow they each loved.

I remember how Iris and Isabelle used to run and could go forever, running circles around us, covering ten times the distance we did. Then they gradually slowed down, going from running Dennis's pace to my pace, to slower than me, then just walking, and in Isabelle's case, barely walking, until she could only go places being pushed in the cart.

I miss my girls, but I wouldn't have wanted to prolong either of their lives beyond where they both ended. I wouldn't have subjected Iris to being reliant on medications to prevent her from having seizures until she got so bad that she herniated, and I wouldn't have wanted Bella to keep losing her balance, falling, not being able to get up without help, losing bowel and bladder control, and living with the pain in her joints.

I know I'll keep moving as long as I can. I just hope that by the time I am unable to move forward on my own feet, that I or someone will be able to help me end my life when I feel like there's no reason to live. I hope by then we have more progressive laws that allow for that to happen for humans.

Death is a part of life and we're all going to die someday so we might as well accept our mortality and live each day the best that we can. If more people would not avoid thinking about and discussing death, and learn to face it as a normal part of what happens in our lives, and deal with the reality of it, we would be so much better off.

We would live our lives better, take better care of ourselves and each other, spend so much less on medical interventions, and we would finally expand palliative care to be a major part of medicine and health care. Instead of treating people as diseases, we could treat them as people who need help either healing or being made more comfortable.

The days are getting longer, and that means more daylight to enjoy each day. Only one more week until spring. Full speed ahead!

Groundhog Sees A Shadow

I don't care what Punxsatawney Phil says, it's spring.

Over the last week things have improved considerably in many ways. The sun has made an appearance more often, for one thing. I started supplementing with vitamin D and while I can't tell a difference yet, just knowing that there is something really wrong and it's an easy, though slow, drawn out fix, getting my vitamin D level above 11 will surely help things.

My back is still sore most of the time, but I'm able to move better and with less pain. Friday I went out on the Spring Creek trail with some of the running club runners and did about 20 minutes of running before I had to stop. I walked back, and got about 4 miles in. Since then, each day I have walked 6 miles a day, some with the girls, then more on my own.

Saturday I added some very easy yoga stretches, and on Sunday I threw about 20 minutes of running in to my walk, here and there, a few minutes at a time, and that seemed to be okay, and the next day it didn't seem to make things worse.

So I will continue that. Maybe I can build up by adding more running into my walks. I've been plowing through the drudgery of some necessary tasks for work, which will be done by next Monday and then I can move back to the good stuff.

What really has me excited is my new project, Fighting Dinosaurs. It will be launched sometime this spring, I have no date set yet, but I'm working on it. It's going to be a blog about...you guessed it...nursing and healthcare. It will be very different from this blog, though. I'll keep you posted, or you can check back at the URL.

Also, the book Empowered Nurses will be released March 2 and I have a chapter in it, so be on the lookout for that one. I'm being interviewed this Friday and that will be on the book's website when it is released.

Finally, on the running front...I spoke with my friend Bob Becker in Florida yesterday and he is applying for Badwater. He's already run the race twice, we actually met for the first time in both of our rookie years, 2008. If he gets in, he is planning to do a double, to celebrate his 70th birthday. I am going to crew him on the return part of his trip. So I have a running purpose again. It all helps my overall outlook. Now I need the weather to cooperate!

Spring, Hook, Line & Sinker

So far this spring sucks! We're already 9 days into it, and I am going to absolutely lose my mind if we don't start getting some consistent sunshine, enough to at least melt the ice off the sidewalks.

It's slicker than snot out there, and the Great Antarctic Ice Sheet is back, thicker than ever, filling the street up over the curb, with big fat chunks that have solidified to the point of making the sidewalk ice rinks ankle twisting hazards too. It's crazy. I can handle the cold, I can handle the snow, but ice and continued gray skies drive me bonkers!! I can't go out to run or even walk. That's how bad it is.

Yesterday was the most halfway decent day we've had so far, we did get sunshine, with a cold wind, but it was just enough to melt things to the point where they didn't evaporate and overnight it froze again and a light dusting of snow fell, just enough to coat everything in a fine layer of ice.

Then this morning I tried to step out the door to the woman cave, just to go out and turn the heat on before I started working, and two steps out the door I almost fell on my ass on the patio- the entire surfaces outside-concrete patio, gravel path, snow-covered yard, and flagstone leading to the steps of the woman cave- were an ice skating rink.

I went back in and had to put on my Yak Trax just to walk across the freaking yard!

Plus it's cold, and gray. No sunshine. The sun did seem to be trying to come through the clouds for a brief time today, but never quite happened. It hit maybe 25 degrees.

And of course the girls don't understand that I can't walk them in these conditions. I would be okay if I had my Yak Trax or Microspikes on, but the girls wouldn't be safe. They are older and it would be too easy for them to twist something or fall on the ice. Not worth it. So Iris has been pouting on the couch all day, in between brief games of hedgehog toss.

Wednesday was the only day I went out all week to run, so far. I might get out this weekend, but honestly, I don't care right now. I met Cat at the fire station on Wednesday morning and we ran 9 miles on the icy bike path, in the freezing cold. I wouldn't have gone if she hadn't called me. I have been an absolute slug all week. The weather is definitely affecting my moods and motivation.

I texted Wheaties Boy to see if he could go for a run this weekend, but he's off to Florida to run the 2/3 Goofy Challenge, as a pacer in the Disney Marathon, Maybe next week we can do a few miles.

Meanwhile, my fitness takes another slide. I am just not in the mental place to sit on the bike and pedal. That's just where I am. I don't care.

This past week I had an interesting conversation with someone I used to work with, about healthcare and nursing leadership. He quit and moved on about a year after I did, and it was excellent validation to hear that the same things really do occur at all levels of an organization and hear echoes of the same sentiments I've had, about the need for professional nursing reform, about the profession dropping the ball when it came to health care reform, the failure of any overarching organization to support nurses, the higher education scam in nursing, and the inability of different players in the organization to communicate with each other at all, in any language, of business, medicine, nursing, or whatever.

It also reinforced the point that I needed to hear, which was, that good, strong leaders help to nurture people and their ideas and bring them along, but if you're in an organization that has leadership who fail to recognize or value the potential of their people, you are sunk, and you might as well get out.

I've been working on an idea recently that has to do with blogging, and this blog will not change much from what it does now, but I am seriously considering taking my health care vents and rants to a separate blog with a completely separate agenda. That blog would have a different character from this blog. When I do it I will announce it, and I hope that readers will check out the new one.

After over a year away from the corporate world, I'm still so passionate about changing the nursing profession, and I hear it from so many other people, the same thing, from nurses all over the world, and nurses need an outlet for their voices to be heard, because they aren't being heard in the workplace or by any organization that even slightly supports nursing. For all my snarling and bitching, I do have some ideas on how things could be changed. Lots of other people do too, and those ideas need to get out there in a visible way.

Otherwise it's just like being at work, everyone puts on a happy face for the powers-that-be and for the patients, but behind the nurses' station they're bitching and moaning and miserable. You can't make change within these entrenched institutions so it needs to be done from outside. So it's time to get the ball rolling. Stay tuned.

And stay warm.

Wrong Way

Physical activity needs to come first.

That's just one of a few of my thoughts on health care as we enter this new year under our still-newly implemented health care reform system. I think we're headed in the wrong direction, even though we do desperately need to reform the way we do health care in this country. As a nurse and health coach I see firsthand what's wrong with our approaches, in people's everyday lives.

I just spent some time writing a chapter in a book on nurse empowerment, and the topic of my chapter had much to say about nursing leadership in the current climate of health care. Then I read a couple of articles this morning, both of which echo what I have been saying and observing for so long, that we are going about things the wrong way by trying to do "health care reform" by approaching health care the same old ways, by the top-down, paternalistic, medically-reliant model.

The opinion piece I read this morning asks who really is pushing health care reform along in this country, but the author asks it from a physician's viewpoint, steeped in the medical model. I have a different take on it from a nurse's perspective. Here is my reply so you don't have to wade through the comments:

"Coming from a nursing perspective I see many of the same problems in the health care system. RNs are currently being used as waitstaff and should instead be utilized to the fullest extent of their skills and training. If the entire health care system would rely on a less hierarchical system and use a care-based model, holistic in nature much like nurses are trained, with medicine as a part of the approach but not the guiding approach, we could make great strides in health outcomes. The medical model has a blind spot and physicians do not usually see or understand the value that nurses bring to health and care. We could make your lives so much easier if we would all work together to provide education, coaching, and reinforcement for patients, especially in regards to education in the community and from a very young age in the public schools (huge political and legislative hurdles notwithstanding). The current corporate model of profit should not be directing health care as it is unsustainable, and the current top-down model of medicine guiding health care is also unsustainable if we ever hope to put a dent in the growing costs of early onset chronic disease, or health care waste and costs throughout the lifespan."

And then I was doing some further reading, and stumbled across this blogpost, which really spoke to me, not just because exercise and oncology are my primary areas of professional interest, but also, because of the problems with our health care system, namely the way in which health care reform has been implemented to benefit the profit margin of certain segments of the industry which do not directly serve public health or care.

If you haven't been around the running scene for several decades, you might not remember former U.S. marathon champion Ken Martin, but he ran a 2:09 back in the day. Now he is an exercise-oncology research advocate and post-stem cell transplant cancer survivor. He writes an excellent blog on physical activity and cancer. Here is a quote from the blogpost.

"If patients are willing to have their bodies ravaged by surgery, radiation, and chemotherapy, all of which can decrease physical function, then it shouldn’t be too much to do 30 minutes of walking a day, however one wants to carve that time up, as a part of cancer treatment plans or at least as a part of survivorship care planning. With better planning prior to first treatment maybe exercise can improve cancer treatments and reduce treatment side effects, including cancer related fatigue, which appears to be more debilitating than we thought." -Ken Martin

If you don't know how to plan an exercise program, and you make it either too challenging or not challenging enough, you will not get the benefits, because you either will give up, or you won't be working hard enough to be effective. Current guidelines on exercise state that you should do at least the effort level of a brisk walk for 150 minutes a week, or 30 minutes a day 5 days a week, it doesn't really matter how you split that up as long as you do it.

There is ample evidence of the health benefits of this type of exercise, however, in order to improve fitness beyond basic health maintenance, it is necessary to do more than this, in terms of how hard, how often, and how long. When a client comes to me frustrated because they have been able to do 150 minutes a week but feel they haven't accomplished the fit, hard body like they hoped, I explain it takes much more than that to achieve the fit, hard body.

Evidence suggests that certain types of cancer, such as colon cancer, are better addressed by at least 6 hours of this level of exercise weekly. That may be because the health of the GI tract depends on adequate motility, and exercise helps to "keep things moving", but there are lots of other reasons this could be the case, I won't even attempt to make assumptions.

The point is, if you want to exercise but know very little about how to plan an exercise program, and especially if you've had some sort of chronic disease or cancer diagnosis, it's important to work with a coach who can help you determine what you need, what is appropriate for you and a realistic starting point for you. It takes time, patience, and persistence to achieve the benefits, but you will.

When you think about how much health care costs and how much pain and suffering you go through as a result of chronic disease, why wouldn't you want to make the investment in yourself before these things occur? Either you will prevent the illness from occurring altogether, or if you happen to be unfortunate enough to be diagnosed with cancer or another illness, by being physically fit you will likely reduce the overall amount and length of medical interventions such as medications, chemo, surgeries, tests, labs, and imaging that will you need, which reduces the cost, too.

Nursing takes a holistic approach to health, and that's where I'm coming from as a health coach with a nursing background. I look at all of the things that affect our overall well-being. Physical activity is one of them, and I believe a huge part. It's not everything, but it is an essential piece of the puzzle, linked to all of the other pieces holding us together. It takes time and a little money to incorporate health behavior changes and reap the fitness benefits, but it takes a lot less time and only a tiny fraction of the cost, for example, of complications of diabetes, or cancer treatment and associated recovery.

The other point is, we are going about things the wrong way. The corporate profit and power approach is killing us. There is nothing wrong with making a profit, or with being in business, but it cannot come at the expense of public health and our fellow human beings. That is simply unsustainable.

Gut Feelings and Decisions

I have hit a point of burnout and I need a break from racing. So I will do that and put my energy into adventure type runs as I go into this coming year.

I'm not talking commercially-run adventure races that are so popular. I mean my own personal homegrown low-key on a whim exploration adventures. At the current moment no races appeal to me. I can't even get myself to sign up for the Pemberton 50K.

I am lucky right now to get myself to do a daily workout at all. I have been more consistent the past two weeks, I am doing something each day, but I have been struggling mentally with it. Each day it becomes a challenge to get my butt out the door, even for an hour. And if I don't get out the door, it's a challenge to get my butt on the bike. And I can't even fathom going over to the pool.

Yesterday I received an email from Pearl Izumi reminding me and all the others on the promotional team that they are taking applications for next year. I have made an executive decision not to apply for 2015. I really don't want to feel obligated to attend races or events this coming year. And I am ready for a break. I just want to run when and where I want to run, without feeling like I have to represent something. It was fun and I love their products, but it doesn't make sense for me to do something when my heart isn't in it, so I will relinquish that and let someone else have the opportunity. I need a physical and mental break from all of it.

My heart right now is in developing my business further and in writing. I haven't been doing very frequent blogposts because I've been putting a substantial amount of energy into a separate writing project. I suppose that's where my energy from running has gone. It's okay.

This blog is approaching a quarter million pageviews, while I know there are always a good number of those that are fake spambot-type hits, the readership has gone up exponentially over the last year. I find it interesting that I get so many readers from health care as I do running. I know there is a need for expression of the frustrations of health care workers and since they can't express it freely in their own workplaces due to the inability to trust others, and the suppression of free speech in the workplace, they look to other outlets. There's a lot to say, worthy of a big fat manuscript.

Reading social media comments makes it obvious that it's a widespread phenomenon. The sociopaths of the world who buy politicians and shape the political landscape to their advantage don't care if they are exposed, because sociopaths have no conscience.

But there are plenty of warped, fundamentally insecure individuals who reside in the organizations that benefit from these conditions that are fertile for exploitation. With their sick, twisted motives to protect their self-interest, for power, status, money, or sadistic thrills, they thrive at the expense of a lot of wounded human beings who thought they were getting into it to care for others.

And our numbing apathy or apathetic numbing enables it. Good health is important, but we don't value it nearly enough until we get sick. When you enter the health care system, whether against your best intentions as a patient or as a health care worker who needs a paycheck, the lights go on. The true sickness of our health care system is exposed. But much of the general public doesn't see this until it's too late.

I want to chip away at the conscience of people who are already feeling the effects, and I don't have any illusions of changing the world or health care. What I do hope to do is make a few people more aware and remind them, again, as others have, that we are not doing ourselves any favors by sitting back and allowing the country to slip deeper into the oligarchy we have. And from there, to move into action.

Even if it's only a few who take action, it chips away at the outer shell. Eventually if you chip away enough, the core gets exposed and the guts fall out. Health care needs a good exenteration.

Happy Re-Birthday: A Year Out of the Dungeon

It's been one year since I left my corporate nursing job.

Just one year. Seems impossible that the time could go by so quickly, and so much could happen. But it seems like forever, really, like a distant nightmare. I was reading over some of what I wrote last year, and I am happy to say that I'm able to look at it without the emotion engulfing me. I've done a lot of healing in that time.

At first I missed the patients and some of my coworkers. But I've stayed in touch with the coworkers that mattered, and have more meaningful relationships with several. I've run into many of my former patients in town, and continue to work with a few of them, but in different ways now.

The work I do is so much more satisfying, I don't miss sticking needles in people or filling their veins with poison one bit. And I certainly don't miss punching a time clock so I could get a steady paycheck but feeling like I would have to sell my soul in order to keep getting one.

I have learned so much more since I left because I have more energy to read and research information on what's going on in cancer care far beyond the confines of a dingy little windowless cave subjected to the whims of toxic people who made decisions without considering the people they would affect most or asking for input from the nurses who worked with those people every day.

There are thousands upon thousands of nurses out there who have left what they felt were oppressive conditions in the workplace and moved on to something else. And I am just one.

Before I left corporate nursing I was surrounded by other nurses who were afraid. Some of them did not-so-nice things to each other, and to me. I no longer take it personally. Now my true colleagues are nurses who are not stuck in the system. They are not afraid. They have found a way out, and many of them have suffered great pain and loss to get to where they are now. Much worse than I did. They are a diverse group, some are employed in the profession, many are self-employed, many are out completely.

There is a common thread among most of these nurses, they love nursing and they would like the profession to change for the better, but there is a long climb ahead and it seems we lose ground on most days. Occasionally there is a bright moment, but then we fall back into the void. 

There is a definite hum that's picking up in intensity, the misplaced blame on nurses in the Ebola situation fueled it, but that's only a glimpse of the problems. Nurses have HAD IT.

I've been listening to and talking with a lot of nurses over the past year, all over the country, and in other countries too. I've been thinking about ways to fix things, ways to improve things, and most of the work I've done has focused on individual people, which is good on my own, but always knowing that in the big picture of health care, most of the work nurses are doing in those workplaces is like building sandcastles at low tide.

And when the tide comes in, it's more of a rip current, a crashing of water with overwhelming force, an undercurrent that knocks you off your feet and threatens to drown your breath and silence your voice forever.

And the damage it does comes from all of the following forces and more...

1. A two-tiered system where managers, administrators and executives answer to money and quantitative data (numbers that are now called "metrics") that have everything to do with what they like to call "quality" but really mean more busywork for the people who are supposed to be doing patient care, but that data really translates to "reimbursement" aka money. Meanwhile the other tier, nurses, physicians and other health care staff, take seriously their professional oaths and training to not do harm, and the two tiers have little mutual understanding of each others' obligations to their own callings (money/boards/shareholders/stockholders vs. moral and ethical obligations to patients, oaths and licensure), each speaking it's own language not fully understood by or ever truly communicated with the other tier.

2. Lack of leadership in the highest ranks of nursing organizations, which consist of leaders from industry and higher education who protect their own turf which goes against the best interest of working nurses.

3. A great amount of fear among workers that has been exacerbated by the past three decades of eroding workplace protections, a mainstream media that fosters unrestrained hate and divisiveness and fosters paranoia and misinformation, ignoring facts in favor of hype. Attacks on free speech (in the craze over the second amendment, seems we've forgotten the first) and organized labor, and legislation that favors the big corporate money interests, giving them the rights of individuals.

4. A system on steroids that intensifies the poor people skills and lack of empathy held by a great number of those who advance to administrative positions and executive power, leaving the staff at the bedside populated by people who care about patients' best interests but without a voice or support to help them.

5.Lack of advocacy or assertiveness by nurses for their own interests in their workplaces in the face of strongarm tactics used to intimidate and dismiss their concerns.

6. Eroding job security as employers look to part-time hiring, reducing staff, decreasing benefits, and electronic spying on employees both in and out of the workplace.

7. Increasing burnout due to the task-oriented nature of nursing work and increased demands to do more with less staff, working equipment, support, training, at the same time being faced with expectations to increase the amount of documentation time and checklists, taking away clinical judgment opportunities and interpersonal connection in patient care duties.

8. A work culture that values "yes-men and women" more than clinical skill or attention to safety, that provides disincentives to speak, disagree, or otherwise question the status quo, motives, or actions of "leadership".

9. A capitalistic system run amok where the distribution of wealth becomes more skewed all the time with no brakes to stop it.

10. A legal system run amok with power that works in favor of the wealthy white collar criminals who can afford to buy their own teams of attorneys, and can buy lobbyists to buy politicians who will work even more in their favor, with no brakes to stop it.

11. A health care system that enriches the top-end insurance companies and pharmaceutical companies, but makes no investment in the base of the pyramid: health education in schools to teach children how to manage their health from an early age, universal basic health education for people at all stages of their lives with and without disease, teaching chronically OR terminally ill people about palliative care, the options not to treat some illnesses, death education so it is accepted as part of life and not so feared and avoided at all costs.

12. A public health system that has been underfunded to the point of endangering public health by promoting misinformation and being embarrassingly unprepared for a crisis.

13. A for-profit so-called health care system (even though some of it calls itself not-for-profit but it is still working for profit) that results in competition to a degree that hurts patients' best interests by withholding information about options and resources available to them outside of an organization's domain. Health care is not at all about health, and it is not about caring. It is about making money off of chronic illness, of various types and trajectories.

14. The collective personality-disordered nature of "leadership": with it's insecure, narcissistic, sociopathic bent that has no empathy for patients or their families true needs, or the needs of direct patient care workers. This distorted method of leadership pursues matters in the interest of building their egos, power, status, bonuses, perks, and the ultimate perk of all, the insurance policy of guaranteed future personal economic security via outrageous sums of money upon leaving an organization regardless of the reason.

There's a lot to say, and I'm not done saying it. Just getting warmed up.

I'm not dead yet, and I won't be done until I'm dead. I don't know how long I'll live, but if I died today, I'd be okay with it.

Because at least I will know I tried, I spoke from my heart, I called out what I saw, and I felt the passion and the horror, witnessed the suffering and the relief, and I know I lived true to myself and my own principles.

And unlike those narcissistic shadows holding nooses around the necks of hardworking direct patient care nurses, I didn't look the other way knowing what I was doing, despite what I claimed and hid behind, was really not about caring for people but instead lining my own pockets and enriching myself at the expense of other people's well-being.

There are at least three differences now.

One is that I can say these things calmly, without the raging anger that I felt a year ago.

Two, I am on the lookout for solutions, and I know I am not alone, as I felt a year ago.

Three, I am pursuing my passion, and I have no one holding me back, I have lost the shadow and the noose of a year ago. 

Every day I wish the same for my fellow nurses who are feeling alone, stuck, and fearful in those oppressive environments. I hope they find their way out of the dungeon, because they already have the key, they just have to turn it.

Celebrating A Year: Something Different

This is a video I made today as I was preparing for an upcoming set of online interviews. I was out in the woman cave playing with the webcam and of course I did not do hair, makeup or professional dress etc.

This is just me, raw footage, speaking about my transition from traditional nursing to having a nurse-owned business, what I do now, and why.

It's pretty long, nearly 30 minutes, but if you care to watch the whole thing, you'll learn more about the AleneGoneBad outside of running, nursing, and gaps in cancer care in our health care system.

It's been nearly a year (November 16th to be exact) since I left my nursing job and started my business. That calls for a party!!

On the running front, today I could not motivate myself to run. I'm not worrying about it. I'll get back to it when I'm ready.

If you do watch the video, I'd love to hear your thoughts.

Color, Sky, and Trails, Pain-Free

As we move later into the month of October, which is my favorite month, along with September and May, I am mesmerized daily by the colors and the sky.

This morning I went slightly out of town and hiked Arthur's Rock with Emma. I have not been in Lory State Park at all since we came back from Arizona, except to watch the staging area at the Quad Rock race. I always go to Horsetooth Park instead.

I forgot how much I love the trails in Lory. I used to run there all the time back in my Leadville training days but since my ankles went bad I haven't been up there.

I've been wanting to get out and do some vertical, and even though this is hardly challenging vertical it was so good to get out. The trail is rocky in a few places but not bad. I didn't have any ankle pain at all. Not even one little twist or peep!

I've been working on my hip adductors and hip strength in general, and I think it's helped. Less likely to twist my ankle and not be able to correct myself.

I kept having to stop along the way to take pictures.

I am starting to go a little stir crazy from not doing much. In a way I'm enjoying it but my body is not too happy about being so sedentary. I'm looking forward to starting the workouts. I've been pretty much of a sloth this past week. I will start something next week, at least consistently get an hour or so of something with an effort each day. I've been walking a lot but that doesn't get my heart rate up very high.

I've been busy, between webcasts, Hanginars, radio shows, tweetchats, speaking to students, the exercise support group I started, a book chapter I'm writing, a couple of guest blogposts and podcasts here and there, a magazine feature here and there, some advertising, and attending social and business gatherings, I stay busy. And of course, my clients. I love this.

I finally got my hair chopped shorter yesterday, I realized I haven't had a haircut since April! It was starting to look like a gray haired granola hippie version of myself at age 17.

Not much to report on the ranting end of things though, just a mild one today. I was happy to hear that both nurses who were exposed to Ebola are now clear and discharged from the hospital. I hope the other doctor in New York is able to recover. We have so many more problems in our health care system that need to be addressed, Ebola is a tiny problem by comparison. It's not a tiny problem in West Africa though, and they need help there.

In the U.S., hospital acquired infections (HAIs) like MRSA and C.Diff infect and kill so many more people and cost so much more. So do medical errors. Yet the people in power don't get that underfunding and understaffing lead to these problems. It is interesting to watch the reaction of the health care community and the media hype and paranoia machine, Ebola is the pornography of the day and HAIs are just boring now. Doesn't anyone remember all the hype about MRSA a few years back? Most people probably forgot what it was. It's not this month's centerfold.

Nobody ever said you have to be smart to be in health care. Just because someone is a doctor doesn't mean they can think outside any box. Sometimes the people who are supposed to be the smartest are the ones who have the most inflexible ways of thinking and functioning. I've seen a few dumb nurses, but I think I've seen a lot more dumb physicians. And even more so in administration, Dumb and Dumber, because you always have to have the VPs and alphabet soup of chief executives to prop each other up.

I am looking forward to next Wednesday because the election will be over. I am sick of the political ads and disgusted by how much money is being spent. I got these huge oversized postcards, full color, from the Colorado Democratic Party to remind me to send in my ballot. Are you kidding me? I would think if someone bothers to register with a political party these days, they are going to vote. Why spend all that money on direct mail? I already sent in my ballot.

I wasn't happy about the choices either. Don't tell me that Udall is going to do anything special. I only voted for him because I think his opponent Cory Gardner is terrifying. Needless to say the Colorado Democratic Party is not going to be getting any donations from me. We waste so much money in this country on these stupid political campaigns to elect people who don't do shit. And then we pay them even more to do nothing.

You know what scares me? Over the past couple of weeks I've been paying more attention to the mainstream media online than I usually do. I know about trolls who stalk the comment sections on most of these media sites. But I never read their comments. Until this week, because I was curious to see what people were saying about the Ebola thing and health care, to see if the real important messages were getting across to the public.

Nope. It became the same old slugfest of people who don't think because they can't form a rational thought. They can't write sentences, either. It's ignorant, hateful, racist and creepy. I hope that they just represent a small percentage of public opinion and voice because if this is mainstream thought, then we're in big trouble. We might as well forget about Ebola protection, let's have an epidemic and wipe everybody out and start over in a few million years. I am convinced that those people who troll the comment sections are not human. No hearts, no brains. Chilling.

There's color everywhere. Just this week the leaves started to fall down, I know what's coming next, gray skies, bare trees, and ice. I'll enjoy the clear streets while I can.

This, by the way, is the mother tree to our apricot trees. I took the pits from the fruit on this tree a few years ago and sprouted the seeds, and I planted 5 of them in our yard. Three of the five are doing well, two are as tall as me and another is 8 feet tall.

And the Buffaloes are enjoying the crunchy leaves.

Is Ebola the Cure?

Ebola is shouting at us, but is anyone listening?

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

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

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

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

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

We don’t value preventative care or good health.

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

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

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

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

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

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

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

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

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

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

Leadership is just another word for...

Yes. As in yes men.

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

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

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

Leadership has become simply another word for yes man.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A Day Late...

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Curse The Nurse: Not Gonna Fly

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

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

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

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

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

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

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

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

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

The truth comes out. Oops.

Here is my friend Andrew Lopez on the issue.

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

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

I'll have more to say later.