There is not much running content here, but there is someone new in our lives. We went to pick up Miss Velcro in Ogallala, Nebraska last weekend and she has taken over our lives.
Warning: Many cute puppy pictures will follow. She's cute and sweet, and she also has a diabolical side. She can go from sweet innocent puppy to devil dog in a split second. She's an athlete, already has figured out how to climb and descend the stairs, jump over boxes, play fearlessly with dogs three times her size, and knows how to demand things.
I won't spend a lot of time writing this, just showing you what's new in my life. I did have two consistent weeks of running with 30+ miles per week. And we've been doing the Donut Friday runs, except for during our first snowstorm last week, which we made up for today.
Velcro got to see her first snow, and became the boss in a week's time. Her sister Gypsy will be coming to live with us in another 4 weeks.
And this morning at the Donut 5K predict, I placed third at correctly predicting my 5K time without a timing device. I was only 8 seconds off. I guessed 29:30 and ran 29:38. I won a frozen turkey.
I'll have more to report on soon. I have so much more to say.
Right now I can only do things during puppy naps, so it's hard to complete long tasks. Enjoy the cute puppy pictures. Happy Thanksgiving.
I am seeking peace with myself. I am trying to live with the fact that Donald Trump will be President.
I have accepted that as a fact, but it's like swallowing poison.
What kind of people have I been sharing this country with?
Someone who lives on my street was remarking on the mild weather we've been having this month, and she added, "Glad we don't have to worry about global warming anymore." She really meant that. She's a Trumpeteer all the way.
I cannot believe WTF I am seeing and hearing about, even though I have done my best to avoid social media and the news. Trump won't live up to his promises and he has a bunch of Neanderthals ready to start in his cabinet. I'm terrified of these same neocons, with the same agenda, recycled from the W administration, same players, same old POWDERs.Pasty old white dudes explaining righteously, except now they are proselytizing too, trying to force their Christianity down my throat.
I'm angry now. I've had a week to digest this news and I have seen enough and heard enough that I'm terrified. We need education, intellectual curiosity and stimulation, not entertainment. Too much dumbing down for too long. Ever since Reagan initiated the dumbing down of America, took away the fairness doctrine, we have been headed downhill and setting too low a bar. Then we got Rush Limbaugh. And Fox News. And CNN. And iPhones. And Facebook. We've created a society of imbeciles.
I'm not being PC but I don't give a fuck anymore. Call it what it is. I'm not going to be nice. A bunch of crazy stupid motherfuckers hijacking the country, the Constitution, after having achieved, over more than a generation, a dumbing down of a nation sufficient to make it acceptable to have a neo-Nazi, white supremacist, woman-hating, Bible thumping bunch of scoundrels responsible for running our government.
There is not too much that pisses me off more than someone telling me this is a Christian nation. I was worried about Mitt Romney four years ago, that he would follow the LDS directives before the Constitution, but I am even more afraid of Pence. He has close ties to the Blackwater CEO and I know these crazy hawks are licking their chops for another war. Repeat Bush Cheney, except worse. And then blame it all on Obama. Seems like the collective memory of the years 2001-2008 are completely gone. Washed away like a Big Mac with a Supersize Coke chaser.
It seems like everyone has forgotten about the war crimes and irresponsibility of the Bush Cheney players like Rumsfeld and Ashcroft and their questionable contracts with the war industry. Here we go again, but this time we have a dictator paired with a holy roller instead of an idiot paired with a sociopath. Bush Cheney on steroids, as if they needed them.
I can't keep quiet and I know these words are inflammatory and vitriolic, but speaking of vitriol, if you feel the need to be the self-appointed guardian of the sacred testicles I have no intention of stopping you. But I would like to continue having my first and fourth amendment rights kept intact...but to these people the second amendment is so important they forget about the others... Maybe they can't count past two?
And healthcare...that's going to be even more fucked up. If you think they've been greedy and shortsighted under Obamacare, just wait. This administration will not be doing ANYTHING to help labor. (unless it involves giving birth to fetuses)
Pretty soon women will all be wearing tattoos of numbers, rating them on a scale of 0-10, as long as they are young enough to be fetal incubators. Once you can no longer incubate fetuses, you no longer matter, because you lack stamina for anything other than being a grandma to the fetuses. And they're gonna need those grandmas after the fetal incubators die by coat hanger.
Yes I'm spouting off a bunch of crap but I'm so pissed, so hurt, so ANGRY!
Hillary was too centrist and too establishment for me. But now they are wasting their time trying to revive the DNC when they ought to gut it and start over with a new, Progressive party, and it pisses me off to see Keith Ellison being fast-tracked, when he'd do better in Congress, and Howard Dean? I used to like him way back when he ran his primary, but now he's been destroyed by his run with the DNC. Let's start from scratch.
All week I've seen people walking around, staggering, stunned, eyes down on the sidewalk, not talking. Quiet in the coffee shops.
I've seen women supporting each other, it's saved me over the past week being with my women friends. But it has to go beyond the platitudes: honor each other, express appreciation, thank Hillary, and wear safety pins.
That won't be enough. We will have to be vigilant, and can no longer afford to get lost in our cell phones and social media distractions.
I didn't like Hillary so much, but I could live with the moderate approach. She would have been a hell of a lot better than taking us back 60 years.
But most of all, I don't understand the lack of empathy. I don't understand these people who can't understand the fear and the feelings that people have. As if it's not OK to have those feelings. I think a lot of people see things that way, can't possibly allow someone to express a feeling that is different from theirs. They can't just be OK with people disagreeing with their point of view and verbalizing it. They have to be right.
That's a consequence of poor education and lack of critical thinking skills, beliefs are more important than facts, the Bible is the only book you need to read.
I'm so glad my life is half over or more, I am so glad I do not have my own human children to worry about going forward. So glad I lack stamina and I'm no longer visible. I worry about my nieces and nephews, their world will require so much more work to fix their pathetic predecessors' legacy.
I don't know what else to say, my brain's been a jumble between sleep deprivation, the grief of this horrible event, on top of my usual state of intermittent brain fog.
It just sucks, and I don't see a way to improve things without risking my life with these concealed carry-toting wackos.
Time to find some POWDER-B-GON.
This really, really sucks. People are stupid. People suck. Maybe only half of them do, but dammit, thanks for fucking up the rest of our lives.
I am trying to type these words without hyperventilating and it's not working very well. Wednesday I was consoling Dennis. Today, I'm a mess.
The night of the election, things started to look a bit unfavorable for Hillary as we approached 9 pm. We went to bed early. We both woke up around 12:30 and decided to check, even though we didn't want to. They had just called the election for Trump.
I was okay on Wednesday. I decided I wasn't going to worry. I decided that if we got through 8 years of Bush Cheney, we can get through 4 years of Trump. I was hanging on to desperate hope.
I ran for 4 1/2 hours today, starting at 8:30 this morning. I had to get out. I went up to Horsetooth Mountain Park and ran the trails, took Southridge and Westridge up to the Towers, down Mill Creek, back up Mill Creek, down Spring Creek to Wathen, up Wathen back to the Rock Repeat route and back down to the trailhead.
It was more like running about 3 hours, with long, 15 or more minute breaks in between whenever I felt myself hyperventilating with anxiety. I was thinking about everything, another existential crisis. Good vertical, not a lot of miles but I took my time. Hopefully I won't be too sore after not doing that much vertical for a while.
I kept wiping the tears from my face, I was a salty mess between the sweat and tears. No blood, fortunately. It's hard to run or even power hike uphill and cry.
I canceled all my appointments today. I just couldn't face it, I was supposed to talk to a breast cancer survivors group tonight and I just didn't have it in me. I couldn't force myself.
After the run I went home, ate some food, then got in touch with Crisann and we went out for a beer at Odell's. It was a beautiful afternoon, sitting there on the outdoor patio, soaking up rays, in mid-November. I had sandals on.
The sunset on the way home was a reminder that another day went by, the sun is still rising and setting.
On one of my run breaks today, I looked at Facebook and one of my friends posted something about glass ceilings. So I commented, "Off the grid, there are no glass ceilings, only blue sky."
I decided I liked the way that sounded.
I'm trying to understand my acquaintances, even some friends, who voted for Trump, knowing they are not hateful people. Trying to understand what was so bad about Hillary Clinton, and knowing she was not my favorite either. I think we need to do away with the electoral college and also the DNC and RNC should be dismantled and the people can form their own new parties, progressive, conservative. Politicians are entrenched, tone-deaf, bought off, corrupt, and only self-interested. But still, how could they support Trump? Was Hillary THAT bad? Was it just total disgust and frustration with the establishment?
If it was, then we had to face it sometime, might as well get it over with now. We do need reform, but having all Republicans taking the country down paths that don't serve the people well, is my big fear. They could seriously set us back a long way. Maybe we need to let the Republicans run things, let them show us if they can be reasonable, if they can run things, if they can lead. Let's see it. But...
We need to be concerned about more than the second amendment- the first, fourth, fourteenth, and all of them, dammit.
And most of all, when empathy is missing, that's what I don't understand.
Best thing I think each of us can do is to talk with someone who voted differently from the way you did, listen to them, don't judge, try to understand their point of view. You don't have to agree with them.
Just have empathy. We need peace. But we don't need silence and fear. Remember their life experiences have played an important role in shaping their point of view. But when you cannot empathize with another person's experience, there's trouble.
Here's an example.
When the story broke about Trump on the Access Hollywood bus with Billy Bush, the "grab 'em by the pussy" story- that was a glimpse into a sexual predator's mind. That kind of abuse, and yes, it IS abuse, is what so many women have been subject to for all these years. And it is a crime.
I really thought, at that moment, there was no way any woman could vote for him. I was wrong.
"Smile" "Loosen up" "Get over it" and the idea that a man is entitled to force himself on a woman, or anyone else, is the same kind of crap that we've dealt with for years, women of my generation, street harassment, feeling like you're being undressed by someone's eyes as you walk by, having to listen to rude and lewd remarks, wishing I were in a burqa just for that moment to hide myself from their leering eyes.
Do you know how many women have been subject to some kind of sexual assault in their lives- whether it's groping, touching, verbal assault, outright rape? Do you know how many women have feared for their safety or been threatened with sexual assault?
Most of us, if I count all the women I know. It's not okay. It doesn't go with the territory. And it's not a man's birthright to harass or assault women.
People must not realize how traumatic that is for women, or the extent of re-traumatization that occurred when that story broke. Or maybe they just don't have empathy.
I don't need to go into any more stories or details here. There are enough examples from what we've seen during the 18 months of hell of this election, and I am sure there are plenty more that haven't come out yet.
Personally, I don't like Hillary all that much, but I didn't think Bernie was going to win if it was him. Though I know Hillary would have made a great President, had she been supported by at least the Senate. Even if Trump doesn't last the four years, Mike Pence scares the hell out of me. So does Paul Ryan. So do Newt Gingrich and Rudy Giuliani and Ben Carson and Michael Flynn and whoever the damn hell else he is going to have on his Cabinet. Peepol R stoopide.
People are upset. I have seen some ugly discussions on Facebook and I've had people try to pick a fight with me. I don't fall for it.
I am worried about healthcare. I am worried about what will happen to immigrants, what will happen to people who are not white, straight, men, Christians, wealthy, and willing to be silent and compliant. I am worried about hate. I am worried about young women's reproductive health and options.
Being on the "wrong side" of most of those categories, I worry about those who cannot "pass" as I can. Those who don't have privilege that I have as a result. I am afraid that the ugliness we saw from the extremists covered by the media will become more prevalent. I am hoping it was the media stirring things up for a story because that is what they do, but that most people are not that way. I don't think they are.
What I think is that people are lazy, ignorant, and don't think very deeply about anything. I think they are fearful as a result, and I think they are shallow and distracted and have allowed themselves to become that way because it hurts too much to think about what our lives are like, and it hurts even more to think about how they could be if we made the effort. It would be a hell of an effort at this point. But still possible.
I think this is true for both Democrats and Republicans, and across all of the possible categories you could think to label someone.
There's always the possibility of a meteor. Talk about shattering a glass ceiling...
I'm trying to be positive here, but I'm not very successful.
WTF, tomorrow is Donut Friday and I need to get up early.
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.
This morning was the Fort Collins Running Club Tortoise & Hare 4K at Rolland Moore Park. Team Donut Hunters showed up in full force, pith helmets, donut hunting license, and all. This is about my speed these days.
It is really nice to get out in the morning and do a few miles, and not feel obsessive about doing double digits in miles or hours of running! This morning was amazing with the running club though- it used to be we'd have a dozen runners show up at these things. This morning there were over 150 runners! There was even a backup at the finish line! It was a gorgeous fall morning, the leaves are bright, the air is crisp and cool without being too cold.
One thing I was really pleased about was that I ran a faster than usual, but relaxed pace, didn't push it, and felt good the whole way. Ended up averaging 9 minute miles. Didn't know I could do that. I have lost a couple pounds, maybe even more than that. I've been trying to be good, cut out the beer and margaritas for the most part, and just the other day I had my first donut in a while.
I'm still going to work on dropping the rest of this weight because I'm pretty uncomfortable and my clothes are still tight.
The big exciting news is that our new babies could be born any day. We are waiting for word from the breeder in Nebraska to find out if there are any red or black tri girls in the litter due tomorrow, and there is another litter due in two weeks. It's the same blue merle dad for both litters, and both moms are red tris. I'll let you know as soon as I know. We will be able to bring the puppies home at 8 weeks, so we're looking at sometime before Christmas, if all goes well.
I am definitely in mom mode, I was shopping for puppy things yesterday, looking for agility equipment, baby gates, thinking about what we will do with training them- making my home schooling lesson plan, etc. My friend Joanne just got a puppy about a month ago and he was at the T & H this morning, her husband was watching him while Joanne ran. He is adorable, and he'll be more than twice the size of our girls when he grows up.
I even had a dream the other night that I was giving birth!! That's really weird.
I have been stretching consistently in the mornings, and been somewhat consistent doing my core exercises and hip exercises, and some weightlifting. I got my DEXA scan results back and the only thing they found was very mild osteopenia in my lower lumbar spine, which is probably not all that unusual and is unsurprising to me. I'll just continue doing what I've been doing, maybe more lifting and making sure I stay on top of the vitamin D, thyroid etc. I won't be able to get re-scanned for a couple of years at least, and the first few years of menopause tend to be the worst for losing bone, so I'll be curious to see what happens.
I am still missing my mouth with my toes on the left side, a couple of inches to go with my flexibility goal. I can easily bite my big toenail on the right side.
I've been busy doing local speaking engagements and preparing for tweetchats and an international online summit for breast cancer recovery. I've been so busy I haven't had time to work on the book manuscript but October is a busy month in my line of work. Pinktober.
I'm tired today after a long week and another busy week ahead of me. But I'm feeling generally pretty good, much better than I did in July and August.
I'm busy planning a birthday run this year, too. Yes, another crazy birthday themed run, something to do with donuts. Stay tuned!
Donut Triangle Course 35 miles
Saturday, March 4, 2017 Start at Dunkin Donuts in Fort Collins at 7 am sharp. Get there early if you want donuts before you start.
Run to Loveland Dunkin Donuts 9.4 miles (approx. 9 am)
Run to Windsor Dunkin Donuts 22 miles (approx. noon)
Run to Fort Collins Dunkin Donuts 35 miles (approx. 4 pm)
Run one segment, part of a segment, or join Alene for the whole Donut! Triangle.
(Disclaimer: I don't speak for the concept or creators of Healthcare 3.0 but this is a stab at explaining what it might do for nurses, and we need to make sure nurses are included as this idea is fleshed out)
The other day as I was having a conversation over coffee with a local colleague who is a psychotherapist, our conversation shifted to healthcare. There's been a lot of talk about Healthcare 3.0 as an answer to the problems of our current escalating and unsustainable costs that aren't making a dent in our health as a society. As a nurse, I get asked on social media what healthcare 3.0 could do for nurses, who are understaffed, burned out, ready to burn their scrubs and walk out. Let's start at the top.
My colleague said something interesting about people who have executive jobs. Often they think it works for them, but the way they are functioning is not working well. They make a lot of money, they may have status in their communities and workplaces, but they are deeply unhappy. They are unable to connect with the underlying source of their unhappiness. So intently focused on what they think they have to do to maintain their status, money, and power, they can’t face how it affects other people around them: their spouses, children, community, or their own health and well-being.
In healthcare especially, people who have executive jobs often are fostering the climate of creating more work and finding justification for filling positions that contribute little to patient care and outcomes. They are contributing to the problem of the providers’ agony of having to spend more time in front of the computer than they can ever spend talking with their patients.
It’s disruptive to patient health and satisfaction, provider health and satisfaction, public and community health, the economic sustainability of our healthcare system, and our entire national economy as a whole. As healthcare costs have soared along with administrative costs, so has the distress in communities over healthcare access and availability, jobs and security.
We are all connected to the greater community. And when someone is sucking the resources away for their own benefit and not sharing, it hurts everyone.
Look deep into the eyes of a healthcare CEO. It’s been said that CEOs can be ruthless, sociopathic people. You might be able to tell in their eyes if they are truly sociopathic or just in deep denial of what their everyday decisions and actions are doing to those around them.
I believe many, if not most of them, are human beings who have taken to heart the myth that status, power, privilege, and money are what defines a person’s worth, especially for men, and while they might on some level know this is a myth, feel too entrenched in the status quo and fear the discomfort of change, believing that the price they might pay personally and professionally would be too steep.
Eventually they start to pay for it in their own health- mental, emotional, physical, and spiritual health. They might get sick, be depressed, get divorced. Or they might realize it when a family member has a serious illness.
It takes courage to take risks, to make change. They might think they are more comfortable sustaining their standard of living, with the vacation homes, the disposable income, sending the kids to college without financial strain. Their financial security is well-padded with the promise of a golden parachute.
On the other side of the fence in healthcare are nurses. Near the bottom of the totem pole in the direct patient care hierarchy, nurses do the heavy labor physically and mentally. Expected to function as well as machines, they are given the near impossible expectations of being able to safely care for a number of patients of varying acuities, safely administer medications and other interventions, and document everything that happens all day, with every patient.
Nurses have the most responsibility, the least power and authority, and often are abused, bullied, and disrespected, even by their own peers. They are not included in decisions made at the top of an organization that directly affect their working conditions and may pose a risk to their safety, their patients, and their licenses.
When more work is piled on nurses, if they complain, they are told they are not managing their time well, or can’t multitask. If they complain about unsafe conditions, they can be fired. When things get out of control, or a mistake is made, they are the first to be blamed.
The only reason nurses are in the position we are in today is because we’ve allowed ourselves to be lulled into a lie. We have never challenged the old guard of dinosaurs who live in the days when nurses couldn’t be married, never questioned the doctor and could only wear white caps, stockings and dresses.
The fact is, today, nurses need to stop making excuses that we can’t make change or speak up because we are powerless and we’ll get fired from the jobs we need. How badly do you need a job that leaves you insulin resistant, overweight, hypertensive, with back pain, foot pain, or headaches. A job that leaves you sleep deprived, grouchy, unable to spend quality time with your family, but spending a day or two each week uncompensated while you recover from your 12 hour endurance shifts?
Just for raising this point I’ve been attacked by nurses who get defensive, usually because, “I have kids. I’m a single mom. My spouse is unable to work, disabled, etc. I’m supporting my parents, my kid is in college, I’m in debt…” and so on.
We all have choices in life, and there are no guarantees! What if you got injured or sick? What if you got fired? What if the hospital burned down? What if you lost your job for some other reason? What would you do? You’d have to find another job, but what if you couldn’t? You would have to come up with some kind of contingency plan, right?
No one is saying you should give up your job and stop supporting your family. What I’m saying is, you shouldn’t have to be abused while you’re trying to do it. You shouldn’t have to fear for your job and be forced to do things that are not safe, that damage your health and well-being and compromise your own ethical standards just to keep your employment. You ARE NOT powerless, you can do something. The fact that people do make excuses for not speaking up is reason enough for making change. There is ALWAYS a way.
Nurses need to quit attacking each other and having turf battles in the workplace, social circles, on social media, and in the community. We are all connected. Again, we’re not powerless, but we need to be more courageous. True leadership moves us forward, is not regressive, and requires courage. We have to be willing to take risks, to put our ideas out there, expose our ideas to the light of day instead of hiding behind private conversations in quiet corners.
If we were allowed to do our real jobs: to advocate for the patient, educate the patient, and navigate so the patient and family could find and access the resources they need, in addition to providing basic but highly skilled nursing care, we’d be able to practice like the professionals we are, not as wait staff on roller skates. We could each be experts on our own patients and bring in specialized, available experts when needed. We’d have time to have conversations with the patient and identify issues so we can collaborate with physicians, who would get the full scoop on what we’ve seen in our assessment and concerns we have about the patient, resulting in better outcomes.
To lead this change, we need share our vision for nursing, establish we want to see, and make it happen, through policy changes, influencing public attitudes and understanding, and working together instead of at odds. Here’s a partial list of some of the things nurses would like to have:
•Safe staffing ratios that are not just marginally safe, that truly allow us to provide GOOD care.
•Time to think about what we are doing instead of rushing from task to task
•Time to collaborate- with nurses, other staff, physicians, managers, administrators
•Time to give attention to patients, to have conversations with them where we can listen
•Time to take breaks, lunches, vacations
•Adequate time to get our work done within the hours of our shift
•Getting paid for all the work we do
•Feeling safe in expressing concerns
•Not being rushed
•Having our needs acknowledged and addressed and met.
•Not facing bullying or disrespect from peers, other providers.
•Having access to decision making input
•Getting feedback
•Being communicated with
•Transparency from the administration in matters pertaining to our own jobs
•Support and time for professional development and growth and education
•Opportunities to lead, advance, contribute, change specialties or positions, or back down, cut or increase our hours when we want to or need to
•The ability to take time off when we are sick without being penalized
•The ability to work at a human pace without being replaced by robots
•The ability to use technology in the workplace that works for the patient’s best interest and supports our ability to do our jobs well, but doesn’t detract from the quality of our work with the patient.
What is leadership? Instead of an entitlement, it should be a privilege that is earned and kept through service to those you are charged with leading. Instead, many executives see themselves as entitled: to high salaries, nice perks, golden parachutes, and all sorts of other protections and padding.
Poor leadership consists of insecurity and fear of losing one’s job, the unwillingness to support others out of fear of exposure of one’s shortcomings. Instead of allowing people to shine, insecure leaders avoid creativity and keep the innovators out.
Toxic leaders poison the entire organization layer by layer. Morale drops, turnover goes up, and patients suffer. It’s not just a trickle-down effect throughout the organization, it’s a full stream raining down on their heads, like a burst sewer pipe upstairs from the hospital cafeteria.
Leading is not proselytizing, it is not enforcing the blind following and worship of a megalomaniac. It is not about overseeing a passive audience of yes men and women, or the intolerance of dissent. It requires independent, critical, and creative thinking that comes together to make improvements.
We need to clearly define what nursing would look like under 3.0. We must have a place at the table, as equals. Nursing is no less important than medicine. What is less important, is all the administration and extra fluff that does not improve relationships around the level of care.
Healthcare 3.0 would bring nurses fully into leadership, to an extent to which we have never been included or taken seriously before. Healthcare 3.0 is an idea that can be implemented and can save us from the impending healthcare Armageddon. There isn’t a single person who won’t be affected.
We need courage, we need everyone with a stake in this to face the fact that we are humans taking care of humans in healthcare. Outcomes matter, but we can’t lose sight of the real human condition that “outcomes” represent.
We cannot exist solely for the sake of constructs like technology, efficiency, or productivity. The relationships must drive these constructs, not the other way around. Those things can happen as a result of doing our one-on-one patient/provider relationships well. Let’s stop making constructs the holy grail and get back to focusing on relationships.
For more information on the Healthcare 3.0 concept, you can read Dave Chase's article here, or you can also watch ZDoggMD's rendition, Lose Yourself, below.
