A Girl Named Velcro, and Random Thoughts

I have puppy brain! We are announcing the arrival of the newest member of our family, Miss Velcro. She is a red tri and she was born 5 weeks ago. We will be bringing her home in another 3 weeks.

We are so excited! As soon as I saw her picture, I knew she was the one. It was love at first sight. I could not stop thinking about her, and as things unfolded with the litters at Sky Blue Aussies, she was available. We have our eye on another pup who is only 3 days old as of today, so I will fill you in as soon as we know everything is certain with our second puppy. Velcro will have a sister, and most likely she will be coming home a month after Velcro.

Running is minimal but more consistent. I'll talk about that below, after I get the shitstorm off my chest.

Recent Random Thoughts

I haven't been writing on my blog much, it's been hard with all the distractions, between puppy brain and it being Pinktober, the month where cancer and pink become intertwined and there are a lot of things going on. I spoke 3 times in one week, and I have more coming up before the month is through.

I had somewhat of an "aha" moment yesterday when I was thinking about my struggles with getting my program off the ground. It's a challenge to get people to want to do something. Everyone I talk to about it, including healthcare providers, sees the obvious and intense need for this type of education for patients and their caregivers. But there are a lot of barriers to people being able to use it in the way it is intended. I've been barking up the wrong tree trying to get it through the traditional healthcare channels.

One thing I am doing, that should help, is writing a book, which will not only have the program in it, but will also discuss why everyone needs to be in on this. Healthcare is so screwed up and it's only getting worse. Absolutely unsustainable. Yet cancer is about to overtake heart disease as the number one killer of Americans, and our healthcare costs are rising at an insane rate, and our health outcomes and general public health are getting worse. We have more obesity and diabetes, more lifestyle-related illness, and our administrative costs of running the healthcare system are exceeding our ability to put our resources into patient care and education.

Healthcare Heretic Again

I am being the healthcare heretic again, and working to make nurse groups aware of a documentary film project. Health 3.0 is a concept that goes beyond this transactional model, we call it 2.0, of healthcare where physicians or providers don't have relationships with patients, instead they are more of a factory, cranking patients through appointments in 15 minute intervals. Check this out for an example.

This short video is being mild about it. What I wish I had time to say is that all of these cancer centers and freestanding emergency rooms popping up everywhere are only being built because the current system incentivizes it. The hospitals get paid more. They can get reimbursed at a higher rate for emergency room visits and can charge a facility fee for setting foot in a cancer center, rather than an independent oncology practice. This disincentivizes patients from visiting their oncologists for follow-up visits. The hospitals can charge up to $400 for a facility fee alone (not including the doctor's bill) just for having an appointment in a room at the cancer center.

Had I realized just how slimy this whole process was, I would never have supported the local facility as I did half a decade ago. The Big Heist is right. It is a heist, to the tune of 20% of our GDP. Not acceptable. But people need to wake up and get off their obesified butts!

Remember how when we were talking about the need for the Affordable Care Act just a decade ago, lamenting the overuse of emergency rooms because people didn't have insurance for primary care and preventive medicine? Well, now we have high deductible plans again, with rates rising, driving people out of the market, but hospital executives can clean up on higher reimbursements and facility fees. And we're not doing a better job for patients. Dumb and dumber.

Here we are again. The vicious cycle of healthcare, now has consumed independent physician practices, has doctors all working as part of the giant healthcare factory, working at the whim of their employers, being told what to do by insurance companies, and nurses are understaffed and miserable again, physician suicide rates are rising, and nurses are leaving the profession because of burnout and injuries from overwork. There's no nursing shortage, just a shortage of nurses willing to put up with the abuse.

And the people who wrote the ACA: lobbyists for the pharmaceutical industry, hospital executives, and insurance companies, have ensured they will rake in big bucks while starving the masses.

General Random Thoughts about Running

I've been running about 4 days a week on the average. About 6 or 7 miles each time.
I know!!!

It feels good to run when I feel like it and I feel refreshed afterward. My friend Emma is training for her first ultra, so doing long runs with her has gotten me out on the trails. I'm so enjoying this.

I miss my hair color. I now have a streak of reddish brown in the front of my scalp. It's a deep brown with a reddish tint, but it's my natural color. People pay a lot of money to get their hair tinted to that color. Now I have just a streak of it to contrast with my grayish white. What are you gonna do?

I refuse to dye my hair. I am getting too many thumbs up when I run, and I need that for the motivation. Plus it keeps the creepos quiet. Nobody catcalls their grandma. Much preferred this way.

Oh, and one more thing- one day I was actually able to reach my mouth with the toes on my left foot. I haven't been able to do it again, must have been a good flexibility day. I'll keep working on it until I can do it consistently. Then I will post pictures.

photo credit: Donna Rohde, Sky Blue Aussies

Obesification Again...

I saw this article today on Modern Healthcare and it pissed me off, and even more so in the context of what's been happening in the headlines recently.

It’s long past time for American politicians to grow up. What a bunch of immature privileged frat boys we have in Washington.

Defending the gun lobby and preservation of a hateful symbol endorsed by state governments. Refusing to tell the truth about what’s going on with the proliferation of mass shootings and racially motivated violence. Lining their pockets from the even wealthier sociopaths and narcissists writing them checks.

But immature, spoiled little boys need more than a slap on the wrist. They need responsible adults to hold them accountable and take away their toys until they clean up their act.

Here’s a laughable thought…what if we could make a scale that was super cheap, purchased at Walmart, where you plug in your height and it calculates your BMI, showing you where you fall in the green, yellow or red or danger zones, corresponding to healthy, overweight, obese, and morbidly obese, since people can’t “see” body mass index.

If only it were that simple.

We’re not educating people about health, physical activity, and the consequences of what they put into their mouths while not moving their bodies.

We’re not teaching kids habits of taking care of their health from an early age, we’re not funding PE and sensible health education in schools.

We’re not building safe communities that encourage parents to let their kids play outside and safe streets for people to walk and commute by bike, not promoting healthy lifestyle habits, reasonable work hours, a chance to get enough activity during the workday, short commutes, healthy foods instead of fast food garbage.

Not only should we curtail the marketing of junk food and unhealthy activities on TV, we should curtail sedentary TV watching. We’ve been irresponsible in allowing corporate lobbyists from junk food industry to influence education, entertainment, and communities. Not only have we failed to invest in our infrastructure, we’ve failed to see that our infrastructure consists of the health of our people.

We've given science a back seat while putting money in the driver's seat. Except money doesn't have brakes.

When are we going to wake up? We have a political problem, and it’s intimately related to our 75% overweight and obese population, our dwindling life expectancy, our number 37 rank in the world on health care, our growing numbers of those impoverished and struggling economically.

We hear about the lack of investment in infrastructure- the things used by the little people- roads, bridges, communities, or the basic things a civilized society needs- public education, a future with promise, not debt and enslavement by a culture expecting people to pledge allegiance to the corporate states holding a noose around their necks.

Killing us with insurance premiums that keep expanding in the name of healthcare, you look down at us from your luxury C-suite seating. While the insurance companies, hospital industries, and pharmaceutical giants keep growing their profit margins, people’s waistlines are expanding just as fast as quality and length of life are declining.

We are headed into another election cycle with a larger than usual assortment of boy clowns with even larger gonads to deny and defend as needed the policies that keep the few and rich safe and secure while ensuring the continued decline of the American quality of life.

These boys continue to lie as their lapel flags disappear into their ever-growing bulk.

Because they know they will get away with it until American adults wake up from our sugar-fueled coma and roll our supersized bodies off the couch…

Mental Paws

Feeling like I'm stuck in quicksand both mentally and physically has gotten old already, so I made an appointment with my primary care P.A., to discuss this downhill slide and how to turn it around. I needed to get labs done anyway since I haven't had my thyroid checked in a while. We did a CBC with diff, thyroid labs, and a vitamin D.

I am super deficient in vitamin D, which doesn't surprise me, so I will begin taking a supplement. That alone should help boost my mood and possibly make me less achy. Everything was fine with the thyroid, so it's not that. My CBC with diff was perfect. Not anemic, no blood issues whatsoever.

After we talked about all that's going on, we arrived at the same conclusion, that it's hormones and menopause and I'm right there in the thick of it, so this is how it's affecting me. I'm up 11 pounds, and I can't run right now because my back is still not quite right. I am able to walk and get on the bike though the motivation is the problem with the bike. My brain is out to a two margarita lunch, and I have no idea when it will be back.

I feel like I'm 90, but I'm about 7 weeks away from 51. It's nearly 70 degrees here today, and I can't even get out running to take advantage of it. I took Iris for a walk and she was dragging her butt. It hurts my butt and back with every step. Isabelle didn't even want to go. We're all feeling old today.

Speaking of old, there are lots of fossils and dinosaurs in the world, and they need to move on. We have a lot of them in our government, and in positions of power in our institutions such as health care. Even if they aren't old in years, sticking to the old way of doing things in a world that has changed, and fighting for dominance to continue the old ways, not only looks kind of silly but is unproductive and wasteful.

Spoiler alert: You'll be hearing more about Fighting Dinosaurs in the near future. When you see dinosaurs fighting each other and bashing each others' skulls in, you have to wonder why they are trying to hasten their mutual extinction, and killing everyone else off with their counterproductivity. I would have to describe the nursing profession as a bunch of dinosaurs. They are still trying to train people, in the 19th century image of Florence Nightingale, with a 20th century mindset, in the 21st century of the health care reform corporatocracy. To borrow a dinosaur term from last century, Stay tuned...

Overflowing...

I have so much on my mind, it's hard to hold my tongue, it's overflowing!

The past few days have been busy and full. I'm trying to prepare for an hour-long radio show next week, and I got a new client last week, and then got a call from a former patient yesterday who wants me to come work with her. I met with an advertising rep from a paper in a nearby town, and I'm staying on top of things, but the pace has increased.

Working with clients has been rewarding and satisfying beyond description. I loved working with patients at the hospital but you were so limited in what you could do or say. There wasn't enough time to give them. Now I can spend the time, and give them the attention I always wanted to.

When I got the call from my former patient, it was this feeling of gratitude that came over me, I felt like melting into the ground. I happened to really like working with this person and I felt like I'd just been handed a gift. To be able to help someone in ways that they never can be helped in traditional health care.

It was a strange coincidence, maybe, that the same day I got the call from the former patient, I also ran into one of my former co-workers, and was contacted by another former co-worker on Facebook. I was out running and saw one of the nurses I used to work closely with. We spent a lot of time talking and catching up, and whenever I hear from people I used to work with, they say things haven't gotten better. They look tired, spent, and are looking for ways out.

It's so sad. I think it's sad that in our rush to implement the ACA we've allowed the new health care model to be a wholly profit-centered big corporate one, where the people calling the shots have no idea about what it's like to work directly with patients as a health care provider. Fits right under the armpit of our oligarchy. I have a lot to say about that, as you already know if you've followed this blog for any length of time.

And I am writing about it...and will be putting quite a bit of time into that project before long.

Which reminds me, this cartoon from this tweet by @MalwareTechBlog cracked me up this morning!

Ran with Wheaties Boy at the cemetery this morning. I ran as hard as I could but only got into the 7:20s for my miles. My legs are still tired, but at least I was consistent and I did them. I will have improvement in the coming weeks. I feel better this week but my legs are still sluggish. The half-marathon on Sunday should be interesting. I am so glad I didn't sign up for the full marathon. I will end up with between 75 and 80 miles this week.

Last night I made a pizza at home on my travertine tile in the oven. It was for sure the best pizza I have ever made, thanks to the tile. It works the same as a pizza stone. You have to use an unglazed tile. I need to get motivated to post the recipe on Bitchen Swill. I got the ingredient ideas from Whole Foods but I did it differently than they do.

A few weeks ago I was starving and walked into Whole Foods (generally a verybad idea) but they had these different pizzas, and I tried a couple, and this one was amazing. It was a barbecue sauce base with barbecue beef brisket and pineapple, some hot peppers, and I can't remember what else. But I decided I needed to make it for Dennis. I used fresh mozzarella cheese, cilantro, red onion, and tabasco in addition to all those things and of course my own pizza dough recipe, which worked out much better on the tile.

For our anniversary I asked for a pizza stone- or something like it, and a tile is a lot less expensive. Even though I do shop at Whole Foods on occasion, I don't like to pay more for something than I can get at a much more reasonable price. When I found out you can use an unglazed tile as a pizza stone that's what I asked for, on one of Dennis's trips to Home Depot. Where else can you get your wife an anniversary present for a couple of bucks?

The one thing I've had to push back is writing. I really want to work on my writing project and all these other things are priorities right now, but I have one more presentation in mid-July to prepare for, and it won't take too long, but as soon as the radio show is done I will have more time to focus on the writing. I have so much I want to say, things that want to spill out of my brain constantly and I've been making notes and the notes are piling up and taking over! So much to say...

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.

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.

Got the Belt Buckle This Time!

As every ultrarunner knows, the belt buckle for finishing is one of those perks. It's never about the buckle, it's about the satisfaction of finishing and succeeding at what you set out to do. There's a lot that goes into that belt buckle, not just in the race itself, but in all the preparation, dedication, discipline, focus, and pure enjoyment along the way to holding one of these in your sweaty, sticky palms after being up all night and into the next day.

About a month and a half ago I tried to do something and failed. I tried to quit my job but somehow came away with a DNF, did not finish, I didn't quite accomplish the task. Somehow I ended up taking on a relief position. Well that was a mistake. I should have gone with my gut the first time. I'm paying for it by having to do another 4 weeks of work, but today, I finally got the buckle. I turned in my letter of resignation and in 30 days I'll be gone for good.

Why? There are multiple reasons why, and as you've read through my tirades about nursing over the past months, it's obvious that I am completely burned out. I'm burned out on the things that are wrong with both nursing and health care. I'm burned out on the things that are wrong with corporate dominance and our ruined legislative and judicial systems. It happens everywhere, and I just don't want to be a part of nursing in the corporate world anymore. I'm not going somewhere else, it's the same everywhere. I'm getting out.

I am tired of spending maybe four times more time in front of a computer than doing actual face-to-face, hands-on nursing care with the human beings who come in. I'm tired of watching an endless parade of nurses marching out the doors, I'm tired of them eating their young, and not-so-young. I'm tired of watching nurses (mostly women nurses, unfortunately) backstab each other, playing the dead even rule, attacking those who shine in some way, are recognized, or have skills or talents that make them stand out. I'm tired of those evil little passive aggressive games like in junior high. I hated every minute of junior high. It sucked. It was traumatizing. I don't care to relive it.

I'm tired of executives and administrators who live in their own little self-contained world and don't speak to nurses, and don't include us in making any decisions about how things are implemented that will affect patient care. I'm tired of watching the Peter Principle in action and people trying desperately, and sometimes viciously, to hide their incompetence from anyone who might question or threaten their qualifications to be in their comfortable positions. I'm tired of knowing about the well-padded lives these people live as they play games with the bone-on-bone lives of those who do physically and emotionally draining work for long hours to directly support the needs of human beings who are sick, scared, and vulnerable.

I'm tired of the people who talk out one side of their mouth about cutting budgets, staffing, and unnecessary spending, then out the other side dictate decisions that enrich the executive class like huge extravagant severance packages, or slashing staffing based on the bean counters of some expensive consulting firms. Adopting their suggestions that don't have any basis in the reality of what goes on in the patient care areas.

I'm tired of watching them backpedal and pull themselves back from dangling over the edge of a cliff because they put too much faith in those bean counters and now, they have to hire expensive travel nurses because they got rid of too many of their staff. Putting tons of money into building up their public image while providing less care for the real people who use the services, because they cut staffing.

I'm tired of hearing people talk about concepts like leadership and accountability when they couldn't lead their way out of a cardboard box, or account for which box they'd been in. And the list goes on...

What's hardest for me? I wish it had been more satisfying, more understanding, more caring, more empathetic, more supportive among nurses themselves. It creates toxic work environments that leach waste into everyone and invade the deepest crevices of their lives in every possible way, on their days off, during their sleep hours, into their family lives, and more.

Oh yeah, and I made quite an investment of my time, almost the last 10 years of my life have been devoted to this. I went back to school at 41 and got my first nursing job in 2006, and almost exactly seven years to the day after starting that, I am done. That's all it took. Seven years to burnout.

Now I'm trying to salvage my health, aware of my increasing age, knowing what stress can do, in the back of my mind knowing my family history of breast cancer and leukemia, and who knows what else, hoping that I haven't done irreversible damage to my body, and lately my stomach feels like it's getting a hole in it. And trying to keep track of my own mental health, too, making sure I'm not falling into a pit of depression.

The main reason I'm leaving corporate nursing is simply stated by the bumpersticker I happened to see on this car in front me as I drove over to the hospital to deliver my letter of resignation to my boss this morning.

There is a great need for more kindness. In life in general, in workplaces everywhere, yes, but nursing could use an infusion of this stuff, at least twice a day. Corporations might have certain rights as human beings, but they are not human, and certainly not humane. The larger they get, the further removed they are from being able to recognize the real needs of people who are served by them, or work for them.

So it's time to heal again. This nurse is healing herself. I'm healing from health care.

And more fall pictures. This year has been so colorful. Maybe it just looks that way against the dull backdrop of my mental state lately, but I know it's real. This is the world I'm returning to.

Passion and Serendipity

Passion means, I give a $@&# and I intend to do something about it until I'm satisfied with my efforts.

It means you don't stay silent and sit back allowing things you care about to be destroyed.

Serendipity means, an occurrence of events in a positive, unexpected way.

Yesterday was a weird day. All good, I believe. But the chain of events were unusually numerous, validating, and supportive within a short number of hours. I kept getting emails, messages, and phone calls from people about things I've written lately.

"I read your most recent blogpost and felt like I was reading my own thoughts."-RN

"I have not heard a nurse say that she loved her job in many, many years."-RN

"Would you please turn this into an op-ed piece and submit it to the New York Times or your local newspaper?"-RN

"Your DNF means "Do Not F@*# (With Me)"- massage therapist

"It's been estimated that more than 20% of U.S. women in their 40s and 50s take antidepressants." -Med Page Today, September 6, 2013

"Perhaps 'Health Care' in this country should be more accurately renamed 'Profit-Centered Illness Enablers.'"- Geri Kilgariff, freelance writer, and my friend.

Sometimes you need to put your passion first, because if you don't, you're compromising your own values to the point where you can't live with yourself. I am not made of the same material as most corporate players. I couldn't walk around with a clear conscience doing things without considering the consequences of my power, being enriched by the sweat off the backs of those who work in the trenches.

As much as I'm disgusted and fed up with nursing, I'm passionate about it. I'm even more passionate about people being treated like human beings in the workplace, and leveling out the disparities of wealth in this country.

As for me, right now, I have not run in 12 days due to fear of re-injuring my hamstring, have not been on my bike in 10 days due to fear of my brainfogged state endangering my health and life if I were to crash, have not been able to motivate myself all week to do anything more than walk the girls. Even though I no longer feel my hamstring, I am not motivated to go out and run. Getting my butt going is proving to be difficult. I need to make myself get out, which I will do at some point this weekend. I need to at least test the hamstring with an easy short run.

I did file articles of organization for my newly formed limited liability company on Wednesday morning when I met with our accountant, and filed the other necessary paperwork with the City of Fort Collins. I'm moving toward launching a business sometime next year, and I'm chipping away at the business plan. There are a lot of things still to be decided and put in place.

Tomorrow morning is the signup for Umstead 100, a race I've been wanting to do for quite some time. I will get on the website at 10 am our time and attempt to get an entry. If I do, that will give me a long-term goal I can shoot for, and might help a little to motivate me through this fall and winter. If I don't get in, I'll figure out something, maybe another trip to Iowa to run on the track. One thing's for sure, I will not have the budget to do much traveling to races for a while, but that's okay. I can find more inexpensive trips and races closer to home. Right now it's more important for me to get my overall health back.

Then, late last night, out of the blue, I was contacted on Facebook by a friend from junior high, Carla in Pennsylvania, we have not talked in 35 years, since I moved to Arizona at the beginning of high school. Turns out we have more than a few things in common these days, one of which is a passion for writing and blogging.

We chatted for a while and laughed about the mutual trauma we experienced in our clique-ridden junior high school days. And, turns out she's a cancer survivor, and a gifted photographer. So it's been great to reconnect, it's fascinating to see where people's paths have taken them when you meet up at one point and go your separate ways. I'll look forward to sharing our stories of where this adventure called life has taken us.

photo credit: Nathan Nitzky

Work Hangover Wednesday: DNF

Everybody has a limit. One of the downsides of being an ultrarunner is that we are able to withstand discomfort and adverse conditions for a long, long, time before we throw in the towel.

Sometimes we put up with harsh conditions long past the point where we knew better.

I attempted to give notice at my job yesterday. I was actually going to quit altogether, but after a long discussion with my boss about everything that's been chewing at me for the longest time, we arrived at a workable solution, pending more thought on my part, at least for now. So I caved. Nothing is decided. I guess that qualifies as a DNF for quitting my day job.

It's like bailing at mile 90 in a hundred mile race after puking your guts out all night when your crew has one thing in mind and your mind has long since left the planet. Do I want to? Does it really matter at this point?

There is an option, where I would no longer have a regular schedule or be obligated to work these back to back 12 hour shifts that are killing me, and it would be a more comfortable transition for me as I ease into my future plans. But I don't know yet. It might not happen.

So Work Hangover Wednesday might soon become a thing of the past.

Today the hangover is intense, I am getting close to going down for a nap because I have not slept much all weekend. I feel like I've been operating a jackhammer, I feel completely rattled to the core with the emotions of the past few months and days as I've been contemplating this transition and finally arrived at a time limit for myself to wean off the teat of steady employment.

When your job takes you so far away from who you are, and where you want to be, it's time to change. I'm not running, I haven't run since vacation, I did a couple of bike rides, other than that I've been a zombie, doing a few walks.

I've been physically, emotionally, spiritually drained. While I'm far from alone, my friends and colleagues who are in the same boat as me all have limited resources to support each other through this challenging time. And there are a lot of us who've had each other's backs through the toughest days, and those days are far from over.

I love the work I do with the patients, but the old advice "don't quit your day job" does not apply when your job is taking more from you all the time and is hazardous to your health physically, emotionally and spiritually. It's not the work I do, it's all the other crap that gets piled on top of us that has nothing to do with the work of true patient care. It makes you crazy.

It's almost a joke that since becoming a nurse, in 7 years, my hair has turned gray, I've gained 20 pounds, take more medications for my health conditions, and drink more alcohol than I ever have in my life. Good thing I'm a lightweight or I wouldn't be able to afford myself. Unfortunately it's NOT a joke. It's true.

It's not right that the business of delivering health care has to be so hard on the people who actually deliver the care.

Health care reform is not taking us to a good place. We need health care reform desperately, but we've gone about it in a way that cannot succeed unless we reform the political process and legal system in this country, and stop the corporateering, profiteering and gaming by those who hold the power. People need to step up and say we're not going to take this. Until we start caring about each others' well-being independently of our rungs on the socioeconomic ladder, we are going to continue our downward slide in quality of life and the quality of our future.

Have you seen the movement by the people in Boulder who took on a big energy corporation? Well the same will happen to health care if things don't start to improve. People are being pushed to their limits. Things will change but only when everyone decides they've had enough. When things get rolled out later this year for the Affordable Care Act, if it's not well-orchestrated, there could very well be protests in the streets and a lot more forceful action on the part of the people. And long overdue, in my opinion.

When our politicians do nothing and we let them get away with it, we have only ourselves to blame, and the only way to fix it is to start cracking the whip.

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...

A Change of Seasons

Good morning, I was up well before I looked at my watch at 4:14, even though I have averaged only 5 hours of sleep a night for the past three nights and I'm going into my third shift in the past 3 days. I'm trying to drink enough coffee to get my eyes to open like these flowers, but so far it's not working.

Summer has arrived with a vengeance, it's been near 100 degrees and everyone is complaining about it. I haven't been able to enjoy the heat, I've been stuck inside a temperature controlled building without windows for most of the past two weeks, but I'm looking forward to next Wednesday. Not because of the massive cumulative work hangover it will have in store for me, but because it is the beginning of 5 days off work, that at this point I so desperately need to restore my soul, spirit, attitude, and sanity.

The colors in my flower garden change over time, the purples came out first this year, then the pinks and reds, and now the yellows and oranges of sunflowers are coming. Sunflowers have a special meaning for me because they remind me that summer is going to end, and fall will eventually be here, and that is my favorite season. Seeing the change in colors tells me that the season has changed so subtly. I usually live one season ahead anyway, I think January 1st is spring and July 1 is the beginning of fall.

The spring date is most likely because of living in Arizona, where it really was spring in January, but it helps to think of spring in January while living in Colorado too, because it makes the winter go by faster for me. The beginning of fall date is due to my time living in Crested Butte, where the trees actually did start changing in late July, and the raspberries were ripe, and there was a change in the air to slightly cooler mornings.

Having these wildflowers outside my window helps me every day. They are my contact with reality and the natural world, on days when I hardly get to see natural or outdoor anything.

I was mad because yesterday I was so tired after my first of three shifts. I hate it when the first shift wipes me out, I was there nearly 13 hours, and ran my butt off all day, got out late, and that's not a nice way to start a long stretch of work days. I wanted to run yesterday morning but I could not get to sleep after that first long day, I guess I was too wired, and only slept from about 2 am to 7 am, and when I got up I was too groggy and irritable, and it was already hot, so I decided not to run. I'm getting pissed because the month of June turned out to be only half a month of good training.

This morning I woke up early and it's going to be another blast furnace of a day, but since I'm up, I might as well get a few miles in. It will make me feel better mentally, if not physically. I know I am going to pay for this over the weekend, I've been doing these two or three shifts on, two days off for two weeks now, and two days are not enough to recover from the type of workdays I have. The fatigue builds up in so many ways, and after a while you can hardly think straight.

That's where you start to resent work, when it gets in the way of your normal life functions, your ability to take care of yourself in all ways: nutrition, exercise, sleep, family time. It's NOT okay to neglect those things. I don't understand why people don't get that. But then, if they did, we wouldn't be able to keep running a dysfunctional health care system for profit.

We've been working like dawgs, and right now I'd rather be outside in the triple digit heat, I'd rather be preparing to go to Death Valley in 2 weeks, but instead I'll be doing another mega-work week that middle week in July. Damn computers.

Yesterday I went for my lunch break, it was around 1:30 pm and I found my quiet spot on the grass under a tree outside. It was blazing hot outside but I needed air. I ran into a former coworker who gave me an earful about "stuff". I really think that these companies are barking up the wrong tree with their approach to cost saving. Yes we need health care reform desperately in this country but we also need profit reform.

In case you haven't noticed I did post a disclaimer on my blog, see the right hand column under "Said With A Groan" because it seems that some people get very upset when people post their opinions on their blogs. If you look out in the nearest pasture, you'll see all the new calves that have been born lately. Really, it's getting to the point where it's ridiculous, but it's so that no one misunderstands that I am not dead, that my vital signs include having an opinion in addition to breathing with a heartbeat, therefore they don't need to call 911, I am living.

Really, if you live in that much fear that you can't open your mouth because you've got a big fake smile bandaid plastered across your face to hide your personal misery, you do need someone to call 911, because you might be warm, but you're as good as dead.

That's MY opinion, and I'm sticking with it.

Seeking Peace at the Grassroots

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

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

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

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

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


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



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


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

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

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

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

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

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

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

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

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

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


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

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


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

Coming Up

It's May 1, and I'm really over it with the shoveling. We got something like 10 more inches of snow today. It sucks.

You know, this whole day really sucked. Ever have one of those days when you know you're just going through the motions and your heart is not in it, and then you realize just how much you are forcing yourself to endure?

Then I came home to find one of our trees in the backyard, the juniper, was uprooted by the heavy snow. I'm hoping we can save it once the snow melts, we'll need to figure out a way to stabilize it. Seeing the juniper lying down in the yard, buried in heavy snow, made me see myself and where I am.

I've been reading a lot of crap lately, mostly because I am procrastinating. Procrastinating taking some sort of step forward. Feeling like barfing up something from this hole in my gut, but there's nothing there, it's just dry heaves, empty. I feel sucked dry, with no hope of repletion.

I've been suppressing a rant.

So I get these newsletters in my e-mail every day that talk about medical news. And I read other people's blogs in medicine and get news about the pharmaceutical industry, and other things related to health care and reform thereof. And the shit continues to be cranked out. All the trouble in healthcare is the same trouble we have in every other sector of our world, which is, corporations have too damn much power and all the wealth is concentrated at the top, because politicans can be bought by wealthy interests. The "I've got mine, screw you" mentality.

And then I see snippets and links to things on Facebook. And I see what people post, divisive, politically charged, mean-spirited crap, because they are angry and frustrated with the way things are. They are afraid. It makes me wonder just how much the recent rash of violence we've seen is related to how upset, frustrated and powerless people feel.

So I want to talk about fear. People are afraid for their livelihoods. They are afraid because they want to keep a roof over their heads, food on the table, and live their borrowed, temporary, fake comfortable lifestyles full of gadgetry that they sell their souls to live. And they'll lie, stab someone else in the back, cheat, and steal to keep going, because they think they will be safe.

And so they put up with a lot of crap, that affects their health and well-being, sometimes staying for years in the same place because it's comfortable, but it's a false comfort because underneath they are afraid, very fearful every day that their paycheck and way of life will dry up suddenly. And they know it all depends on keeping a smile plastered on their faces, on being apologists for bad corporate behavior, acting like domestic violence victims who will come back no matter how many times they are beaten because they just don't get it, that they are enabling it themselves by their complicity.

But the way things are has us by the proverbial family jewels...and most people see their only hope of survival to be docility. It's not a good thing when you see multiple instances of people going berserk, and the copycats who follow, and you never know what it was that pushed them over the edge. There is way too much mental illness and not enough care for people who can't deal with the stresses life throws at them. It doesn't have to be this way. We have created this situation.

Over the years I have heard of so many people who got sick from their jobs, the stress, the inability to wake up in the morning and face another day of faking it, of making excuses for the sick and perverse way they enable the poor treatment of other people, of toeing the line and shutting up. And the behavior of corporations is dependent on fear, because those in the highest tiers are fearful of losing their control, so they rig the system to work in their favor, because they can. It makes people sick.

If you have the ability to see what's leading to a downward spiral, taking back control over your life and refusing to be sucked into the quicksand is what you have to do. You cannot force yourself to do things, you'll be bitter, angry, hateful, and sick. You'll be lucky if all you need are antidepressants.

I love the words to the song/poem "Coming Up" by Ani DiFranco. Reminds me of our politicians. Indulge in some wishful, idealistic thinking for a moment.

Congress, having formed its own set of rules for its members' behavior, works with their own code of unethics to guide them and obstruct any progress that might be in the interest of most citizens. They don't want to abide by the Affordable Care Act. That's for the little people. Whether they are on the side of attorneys or Big Pharma or insurance giants or big banks, they're all pitted against the common good and only acting in their own interest. As long as your ass is covered, it doesn't matter who's winning. What we need to do is remove them from office. Voting won't work. Hog-tie and carry them out if we have to. They are not serving us, they don't deserve be called our representatives. Send them back home where they can learn to work paycheck to paycheck like the rest of us.

The people are numb, anesthetized by their own gullibility for shiny flashing objects...necks flexed and mesmerized by their little mobile devices. When you spend most of your leisure time focused on a tiny little screen and fingertip-operated keyboard, and the remaining time focused on a bigger screen operated by a remote control device, there's not much brain space left for focusing outside, for thinking critically, or seeing a bigger picture.

Can't step outside yourself and your situation for a moment to ask yourself: Why? Why are we doing this? Why are things the way they are? Does it have to be this way? The thing is, we have short attention spans. No sooner is a thought thought, than it dissolves into the atmosphere. Can't hang onto it long enough to pursue it. It's true that we are powerless as individuals but wrenching ourselves from our butts and banding together with other people is what needs to happen.

It doesn't appear that anyone will be waking up from this societal coma anytime soon.

No, people want to find the next distraction, they're stupid enough to fall for fake "quizzes" as marketing devices for fake cures for middle age, or the latest snack food to support the obesification industry, or anything else of which irresponsible journalists enable the marketing: camel's milk, red bean Triscuits, snake oil, Androgel...

As long as they can still buy these things, they don't seem to care about changing anything.

You can't regulate stupidity. There's a whole industry built on it. It's called "America".