From Relief to Ruin: The Gazillion Year Flood

The rain has not stopped, and continues on, supposed to continue through the weekend. People are stranded, or evacuated, many are on high ground but are surrounded by water. I woke up this morning to three alert messages on my cell phone.

We are fortunately on high ground and surrounded by enough high ground here that so far we're doing okay. just waterlogged. I haven't been out and about to see anything that's flooded, but the videos and news from local sources are all showing washed out roads and bridges, buildings and cars washed away, flooded streets and bike paths, and devastation.

I can only imagine that this rain is doing some major damage to the areas hit by last year's High Park fire, and places downstream.

Fort Collins itself has been lucky, we haven't received nearly as much rain as surrounding areas like Denver, Boulder, and the foothills. But when the Interstate closes, something big is up. All the major roads that lead from the foothills down to the Front Range cities are closed.

Looking out the window, it's a steady rain, all the smaller trees and shrubs are flopped over with the weight of the water. Headed out this morning to walk between earthworms and puddles, counting myself lucky, and hoping there's relief for those flooded soon.

In the Rain

It's been raining on and off all week and it's been a huge relief.

Being on my work hangover day, I'm pretty worthless. I don't ever expect much of myself the day after back to back shifts. Certainly nothing that requires brainwork. I'd love to have the energy to go out and run on this rainy day, maybe after a nap I can do it. I feel pretty much depleted to the core, but looking out the window at a scene that looks like the Pacific Northwest, makes me happy.

Today I'm meeting an old friend for lunch, we knew each other nearly 20 years ago, and we've been talking about getting together forever, and never get around to it.

The Buffaloes are staring me down, waiting for their walk. I guess I need to get something done...

I will give it a shot at getting on a routine of working out again next week. I don't remember any other time in my life when I lacked the desire to get out and move. It's raining again. Time to break out the Marmot jacket.

Work Hangover Wednesday: Dropping Like Flies

Another one bites the dust.

What an emotional couple of days these have been...

Tuesday I worked on negotiating the terms of what's called a relief position, at work, which would give me some hours but I wouldn't be putting in these long shifts or back to back exhausting days anymore.

That would start as of October. It would give me a way to transition out, and restore my health, and start putting energy into things that help me move forward, like going off on my own.

It was an exhausting day, I went home after work and crashed for an hour. Today it was busy, we had barely enough help and then got slammed at mid-morning.

By 6 pm it was all I could do to make it through another three patients when I'd been going since 8, plus a 4 am killer calf cramp that woke me up to my own screaming out loud, then being unable to go back to sleep.

The saving grace was around 10 am when I was about to start an IV, and a friend stopped by to drop off a bottle of water for me, and told me to drink it. Being up early, I'd facebooked him about the calf cramp, and he surprised me.

But by the end of the day I couldn't wait to get out the door.

Another nurse is leaving. She resigned and came by to tell us today. When she did, one of the nurses on our staff cried. "How can this be happening every day," she said.

Great nurses, the best nurses anywhere, leaving. Nurses who learned to practice under the best and most supportive of conditions and took pride in the work they did.

On my way back from lunch today I was in the stairwell and ran into a nurse from another unit. She told me she's been hearing about my blog. She said, "You could be our leader."

Well as one person I have very little power. I can write my heart out because I am a writer, it's what I do. That's how I process things. As a writer who happens to be a nurse I can write about nursing. I can write about the workplace. I can write about health care. I can write about how demoralizing it is to feel like there's a mutiny going on.

I can't be the only one, though. It takes more than one voice. If no one believes anything will change, that's because there aren't enough people making enough noise to make the people who have the power and resources to change, change.

I have already felt the backlash, that certain people don't like me writing about what's going on, they are embarrassed, they feel it reflects poorly on them. They are fearful of the competition, which is coming.

Well you can try all you want to blame the people with no power and no resources to change things, but that doesn't make it okay for the people with the power and resources to go ahead and trample the resistance, like in Tianenmen Square.

It's a result of inhumane resources. No, it's not a new department name. It's the misguided use and distribution of resources that ends up hurting people.

When people feel like they work for an organization that doesn't care about them, that they are bodies filling shifts, that they are disposable, especially after years when they had all the support in the world, it's a hard landing, like crashing on concrete.

Strong organizations have clear direction, strong leadership, strong accountability for those in the highest ranks of the organization, know where they're going and allow employees to do their best work, and provide the conditions for that.

They don't blame the people who are hurting as a result of cutthroat policies and have little outlet for their frustration, and lack power and authority to change things. They don't make excuses by slashing already marginal pay and benefits from the people who do the dirty work, they cut the fat from the top if they're smart.

There has to be several million dollars to save in excessive salaries and perks. For example, Vanderbilt University, which in 2008 paid $20 million dollars alone to just 10 of it's top positions, several of which are health care executives. Instead of going without nurses, how about going without a CEO or President?

Strong organizations don't flinch too much if there's competition coming. If they are secure in what they're doing, there's no reason to worry. If they give consumers a reason to stick with them, show them why they're superior, then they end up winning. Like in an ultramarathon, you wouldn't go out and run as fast as you can in the first few miles because everyone else is doing it, when you risk crashing and burning. You run your own race, you conserve your resources, and in the end you end up way ahead of the competition.

Nurses, you wouldn't hesitate for a second to advocate for your patient's needs. But when it comes to yourself and your coworkers, why are you silent? When you have to get tough with a physician who is resistant to returning your calls, when you need an order NOW and you're not getting a response, when some jerk doctor acts like a prick and is condescending and pulls rank that they fantasize that they have but they don't, you don't take their bullshit. You don't get bullied into silence when it comes to your patient.

The fear of losing your job is one thing, but losing a job that is taking advantage of you and making you miserable- isn't it worth the chance of setting some things right? of making something better? If they continue to demoralize the workplace anymore, you'll be too sick and too tired to keep your job anyway. Case in point, right here behind the keyboard.

I really don't care if people think I'm idealistic and live in a fantasy world with justice and treating people fairly. I hate that the corporate world works the way it does. We as citizens have allowed it to get to this point. But when enough people are hurting, doesn't it make you want to do something other than zone out on Facebook? Can't we do something about it? One small thing? Today?

Vanderbilt Runs Amok

Two consecutive days of running now with no hamstring issues. I realize though, that I need to get with the program on the strengthening exercises so I can avoid backsliding.

So much for my plan to start rehabbing the hamstring at the beginning of September. I've just been slightly distracted...this coming week I am scheduled for four 12 hour shifts at work, what was I thinking? But that is my very last week from hell at work. After this, regardless of whether I quit altogether or do some per diem work, I will not be having any more weeks like that.

After this week, I will be able to recover from my fatigue, start the strength training and cross training and ease back into the running. I feel like I'm starting to rise out of the intense fog of what I can only describe as a persistent low grade depression, that's been dogging me for months.

I look forward to soon being able to share my training runs, races, and running anecdotes on this blog. And I will.

For now, I just cannot get off the topic of corporate health care, this is what I feel like writing about these days, since I don't have any races going on. Last night I saw an article about something that's happening at Vanderbilt University, with their nursing staff.

The administration there came up with the brilliant idea of cutting back on housekeeping staff and making nurses do some of the cleaning, though it's not specified how much. Nurses would be expected to take out the trash and linens, and mop up spot cleans on the floors, among other things.

What's interesting is reading the comments at the end of the article if you scroll down. Vanderbilt is going to suffer a huge backlash from this. First they mentioned Florence Nightingale doing this type of work. But good ole Flo didn't work these days when nurses do much more than light lamps, give baths and put warm compresses on people. She wasn't responsible for titrating IV medications, giving chemotherapy, or bringing someone back from cardiac arrest. And she didn't have to document everything she did on a computer either.

The thing that outraged me even more was the response of the administrator who told the nurses not to vent about it to the patients, to go to the administrators and vent.

First of all, that heavy handed approach always backfires. People are already talking about it in online nursing forums and other social media. No one trusts the higher ups, few people want to risk their job by speaking up. But the truth comes out in other ways, and makes it's way to the mass media.

Second, does the administration really believe patients live in a vacuum and are incapable of independent observation and thought? That they don't view and observe and think about what their caregivers are doing as they watch them work and see how stressed they are? Do you think it makes them feel good about their health care when they know their nurse is trying to juggle 5 or more patients at once and is being pulled in 3 different directions all at the same time she or he is giving the patient their medications?

I for one can vouch for the fact that my coworkers and I regularly remove trash, linens, and meal trays, clean chairs between patients, wipe down surfaces, keyboards, computer equipment, pumps, and so on throughout the day. I don't have a problem with that. We do it when we have time. But if we don't have time, we are paging housekeeping.

I can tell you something else. Spot mopping in a hospital isn't just mopping up spilled jello. It's more like drippy Clostridium difficile infected diarrhea, that is super contagious. Or Hepatitis infected blood that can carry transmissible virus from hours to days on a surface. Or any number of viruses, bacteria, or fungi that would like nothing better than to find their way to an immunocompromised host and have a feast, i.e. you or your family member in a hospital bed.

Housekeepers are trained in what cleaning solutions to use for different spills, how to properly dispose of things, and how long things need to be scrubbed, cleaned, and dried so they are infection-free. Nurses do not get that kind of training.

Nurses are trained in physical assessment, life-saving skills, applying both critical thinking and highly technical skills to our knowledge of physiology, disease processes, pharmacology, safety, and optimizing patient outcomes for quality of life.

Vanderbilt is a Magnet institution. This tells you what good Magnet status is. It's actually a detriment anymore. My brother, who is also a nurse, always says, Magnet status means it's a reverse polarity magnet- it shoots people out the door.

Magnet status at this point is just a bunch of academic and administrative types shilling for their own industries. It's a marketing ploy that doesn't even work as a recruiting tool anymore, nurses see right through it. Magnet means people spouting "Get a BSN" out one corner of their mouth, and talking out the other side, saying, clean rooms too. I'm sure they have a special course in the Bachelor of Science in Nursing programs for learning how to do basic housekeeping.

These Magnet proponents prop up higher education, so they can continue to crank out excuses for raising tuition for jobs that don't guarantee any upward mobility. Promotions are few and far between in nursing. There's almost unlimited lateral opportunity, if you're interested in getting a few cents a year pay increase for experience and no more influence over the way things are done in your workplace.

Do Magnet institutions back their claims of nurses needing BSNs with financial incentives? Often they offer just a pittance, with negligible or no increase in pay for the degree. It could take a working nurse 5 years or longer to complete a BSN program going one course at a time in order to be fully reimbursed.

Just some food for thought.

Oh, by the way, I was thoroughly delighted reading my junior high friend Carla's blogs yesterday, and I saw that she gets some flak about what she writes, as I do too. We write from our hearts, for ourselves, about what moves us, not to please anyone else.

If all we do is cower in the corner all the time, we might as well dig ourselves a shallow grave and tip over in it right now. Nurses, remember that apathy and fear are as good as death. And in the case of health care, might just be the equivalent thereof.

Simplicity is Better

I had divine intervention this morning, the universe prevented me from being able to sign up for Umstead. I wrestled with it all morning, knowing that when I'm injured I should never sign up for a race that predetermines when I will have to be un-injured. Fortunately, when I got on the website, I sat there for a few minutes refreshing the page with no luck and then decided it wasn't worth it.

So, no trip to North Carolina next spring. I'll figure something out. I might even go back to run Cornbelt again in May since that was so fun and low-key. But right now, there's no plan.

I did my first run this morning, in two weeks. I ran 32 minutes, about a 5K loop in my neighborhood, with one hill, and not a peep out the hamstring. It was already hot and humid. It did feel good to get moving again but I wasn't overly motivated to go out first thing this morning. Iris dragged me on a walk first, then I had to wait around for the big nothing of Umstead registration, so it was 10:30 before I went out the door.



Yesterday I had an interesting conversation with someone who knows the business of health care a lot better than I do. It occurs to me daily that the people who work directly with the patients and provide the direct care speak a completely different language than the people who make the decisions about how to run things.

They don't speak to each other. But when the decision-makers start throwing terms around like "value stream" and "evidence-based" and pick and choose how they want to apply those concepts without considering the hard, tangible reality of how their decisions affect the real live people providing the daily services, and consequently, the recipients of those services, it's a big mess. Ignoring evidence that is right there screaming in your face is not evidence-based practice.

Whenever you complicate a concept or task, adding steps and analysis to it, you get further away from the simple process of just doing it. You add all sorts of unnecessary in-between costs because you have all these overpaid bodies who get in on analyzing and tearing it apart, but actually make it much harder and more expensive to deliver the product. They accidentally forget to include the people who do the work of delivering it, who would most likely tell the analysts to put that in their pipes and smoke it.

Each day I'm feeling a little more positive about my future, less trashed, and more determined to move forward. I'm still very much trashed, though. If I can salvage my health before something seriously goes wrong with my body I'll be in good shape. Being a nurse, especially an oncology nurse makes you a little paranoid at times.

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.