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…

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.

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.