Archive for January, 2007

– N=1

The progressive left usually has a handle on treating people fairly, with tolerance, with accuracy, with respect and with evidence-based reporting. But there’s one glaring omission in the progressive agenda: the lack of support of professional nurses.

Not us! We love nurses. They are angels. They take care of all the stuff that the doctors leave behind. They are so good. Hey - my sister, mother, cousin, niece, aunt, best friend is a nurse, and I love her.
Here’s a sample:

At one point I remember someone commenting that the staff at Saint Johns had been fantastic and we really needed to do something to thank them, and the next thing I knew three huge boxes of confections from Sweet Lady Jane’s arrived for them with no note attached. I still don’t know who to thank for that, but it was exceptionally thoughtful. And finally, to my doctors, Armando Giuliano (who was told by a fellow practitioner, “if your Republican clientele falls off, you’ll know why”) and Jay Orringer (of whom Digby says, “that guy is deep”) — well, what can you say. They saved my life.

And there-in lies every stereotype of nurses and nursing: submissive, female, angelic, handmaiden, obedient, loving and caring woman. Intelligence and autonomy of practice are never mentioned.

What’s missing?

Reality.

Nurses, almost three million of them in the U.S., are educated beginning at the associate degree level through post-doctoral study. They provide professional nursing which aims at supporting patients to attain, regain, or maintain health or to achieve a peaceful death. They deliver care in the home, in schools, in communities, in healthcare organizations, in academia, and in research settings. They serve as officers in the military and in the national public health service.

Although most are women (about 94%), nursing is wide open to everyone who is committed to lifelong learning, to ethics in providing patient care, and to everyone who is committed to achieving health and providing for the common good.

Nurses are repressed, oppressed and fettered in delivering professional nursing care. Because the vast majority work as employees, they are constrained by employer policies and procedures that limit nursing via staffing decisions, replacing nurses with unlicensed personnel and with policies that do not allow nurses to dictate nursing.

Nurses are fettered in prescribing nursing care by insurers who exclude nursing care from covered services. They are fettered by physicians who do do have the power to prescribe nursing care and who fail to do that. Physicians are more than happy to steal recognition for excellent nursing care. But strip nurses from any patient care situation, and patients suffer.

Worse is that nurses are fettered by a willfully ignorant public that demands professional nursing but which does not recognize it as a full and autonomous profession. The public does not demand fair and healthy work conditions for nurses. It does not support professional nursing’s health agenda. It lumps nurses with all hospital “staff” and thereby doesn’t even care to know what nurses do, how they do it and what its importance is to patients.

It’s hazardous to your health to continue to think of nurses as angels of mercy, of being cute chicks in hot uniforms, of serving as taskmasters at the behest of physicians and of having no professional voice.

Nurses are the professionals who teach patients about their health problems. They are the professionals who assess, monitor and treat patients in every healthcare institution. They are the ones who monitor children’s growth, development and health in schools. They are the ones who are with you when you are born, and they are with you when you die. They are the ones who teach you to manage your medications, to change your dressings, to take care of your family members, who answer your questions, who are concerned with how your problems affect you, and who are doing their darnedest against all odds to get you well and to help you keep yourself that way.

And the progressive left wants to acknowledge them with Hallmark verses and candy?

It is past time to strip the cloak of invisibility from nursing and strip the blinders from the progressive left. The goals are the same. To ignore professional nursing is to do so at your peril - and that of the nation.

Professional nursing, empowered patients. Good health.

– N=1

We all have been been under pressure to perform accurately or suffer dire consequences. Remember the pressure to do well on SAT’s? Or to pass your driver’s test? Or to measure twice, cut once on a big woodworking project?

In all of those situations, we were motivated to perform well so that we got the reward - admission to college, driver’s license, beautiful piece of furniture. We practiced, we asked questions, we practiced some more, we commiserated with others in similar situations, and we were supported by our families and our teachers.

When the big day arrived, we had ample time to prepare, we had our game faces on, our time carefully mapped, and then we went in and did it.

Now, consider healthcare. We take people at their most vulnerable, when they are in pain, when they are injured, when they are dealing with the shock and disbelief of life-altering information about themselves, and then we cram some rote information down their throats, demonstrate how to operate complex equipment, give them complicated sets of instructions - often by many different people, and then, without validating that they have any inkling in how to take care fo themselves, we shove them out the doors of healthcare and off into the unknown of their lives.

What happens when you only get one chance to get it right, and the consequences are life and death? (more…)

–Quinn Doyle, PA

I am a twenty-six year old female, working in a high-powered medical malpractice firm. I have been here for 16 months. This was the first organization to offer me health insurance after college. In the three years immediately following college, I was hospitalized twice without health insurance, and I had surgery for a broken ankle, which I am still paying for. In my initial interview at my firm, the HR director referred to my current boss as a “monster” which at that time was a fairly accurate description. I have no other options.

 – N=1

(note: the views of N=1 are entirely independent and do not necessarily reflect the views or opinions of United Professionals. N=1 does not represent United Professionals and is not associated with creating or advocating positions of United Professionals.)

HR676, commonly referred to as “Medicare For All,” has been re-introduced. It has been referred to the Committees on Energy and Commerce, Ways and Means and Natural Resources. This model of universal healthcare is attainable, is financially reasonable, provides for all Americans to receive healthcare coverage, and does away with for-profit suffering-inducing healthcare insurance wastage which accounts for over 20% of all healthcare expenditures.

Healthcare Now is a grassroots organization that is spearheading efforts to have HR 676 adopted. The sponsors of HR676 are listed there, as is Rep. John Conyers’ sponsorship and explanation of the bill, who is covered, how it is financed, and what it aims to do.

Please visit, read over the information, and then get busy! Contact your representative to encourage sponsorship. Email Healthcare Now and get your video of Rep. Conyers. Talk to your neighbors, your co-workers, and talk to members of your community.

We’re all in this together, and together, we can assure universal healthcare, sound fiscal policy and the freedom from unnecessary suffering and disparities in healthcare.

Denver Post columnist Jim Spencer devoted a recent column to readers’ suggestions for links for his new blog. He mentioned unitedprofessionals.org as a “fascinating” site for the “unemployed, underemployed, and anxiously employed.”

— N=1

Want to be a nurse without having to study for years? Want to be in the thick of life and death issues without the messy blood and guts?

Work for the healthcare insurance industry.

That’s right. Barrel right through those pesky medical and nursing education and practice requirements. Forget about licensure. Codes of ethics? Fuggeddaboudit.

Instead, reap unlimited profits! Work bankers’ hours. Take leisurely, uninterrupted vacations. Enjoy a regular work schedule.

Complaints? Put in place a tedious, lengthy appeals process.

Wear them down, wear them out, and strip off the high cost “covered lives” ones. Covered lives - isn’t that a joke? More like exposed and hanging on the edge of a cliff.

Market your policies to employers that hire only healthy, young and low-health user employees. Squeeze every dollar from the reimbursement to physicians and therapists. Make the claims process cumbersome - and hope that physicians’ offices can’t keep up with your changing demands. Even more profits for you to keep!

And who says the U.S. healthcare system isn’t the best in the world?

Free market, baby. Yeah.

– N=1

Healthcare policy in the U.S. is all about protecting and nourishing shareholders. While the healthcare insurance and pharmaceutical industries record record profits and growth, the haves are increasingly squeezing the have-nots.

The have-nots include not just the uninsured 47 million and growing pool of Americans, but they include the 123 million more under-insured Americans, who suffer catastrophic financial distress with just a single major health expense.

And they include the three million nurses and most of the 475,000 physicians, whose incomes have shrunk, and whose professional practices have been usurped by demands placed on them from employers (hospitals and healthcare facilities), healthcare insurers and other regulatory agencies.

Individual patients are treated with assembly line tactics by hospitals, diagnostic testing facilities and many physician office practices. Care is fragmented, intense and filled with risks and gaps.

How do you retain control over your health care?

Wallet healthi s one practical and painless way to retain control over at least some of the important aspects of your healthcare.

Here’s how to do it:

1. Collect all of your prescription and over the counter medication instruction guides. Collect all of your available patient medical records (not the bills, unless they describe what procedures and tests were done, and you don’t have the medical records that demonstrate that).

2. Organize the records by date of service: the most recent on top and then work backwards in time. Place these records in a file folder, a notebook, or scan them onto a CD or USB drive.

Your Wallet Reference Guide

a. On a separate sheet, type the names, the doses, and the number of times per day you take each and every medication, supplement and vitamin and what the reason is for taking it. (Everything you take counts - whether it comes from the grocery store, health food store or pharmacy doesn’t matter.)

b. Type your allergies and sensitivities of medications, of foods, of known triggers (pollens, trees, cat fur, detergent, etc.) and list what happens (can’t breathe, skin rash, hives, wheeze, etc.).

c. Type your resuscitation and extraordinary care preferences. These are commonly known as advance directives. Each state has differing patient protections, and if yours uses a health care proxy, or a healthcare durable power of attorney, type the name and working telephone number of the person who serves in that role for you. Know what a do not resuscitate directive means. Know what a living will entails. Include the properly signed forms with the medical records file contents. Make sure that your treating physician or nurse has a current copy.

d. If you have a physician, a nurse or a primary healthcare provider, such as a clinic or office practice, type the name of the provider and include the working contact information.

e. If you are an organ donor (if you’re not already, you should be if you can), type what you intend to donate (solid organs, such as heart, lungs, liver, or skin, bone, and corneas).

Repeat these steps for each member of your household. There should be one file for each person, and there should be one typed reference sheet for each person. If you are the parent, carry the typed sheet for each minor child, as well as for yourself.

Shrink the typed reference guide to a size that you are comfortable carrying in your wallet. Laminate it.

Store it next to your most used form of identification, such as your driver’s license.

Whenever you have a healthcare contact, bring out your wallet reference guide, and use it when completing patient history forms, when being asked for a patient history by any and all healthcare providers (such as a paramedic, an ambulance crew, a clinic receptionist, a physician, a nurse or a registration worker), and whenever you encounter a new healthcare provider, such as when seeing a consulting physician.

In the case of a situation where you aren’t able to communicate, first line providers and emergency department staff will go through personal belongings looking for exactly this information. Your laminated wallet health guide will help them get the precise information they need in order to follow your directives, your preferences and your wishes.

Update each reference guide as anything changes on it.

In all other situations, when there’s time, bring your file of medical records with you. The nurses and physicians will use those records to be able to rapidly and accurately plan your care and treat you most effectively. Those records save time, they save money, and they save you from unnecessary tests, procedures and distress.

Finally, ask for copies of all of your medical records with every healthcare contact. Immediately add them to your personal medical records file.

Take back control of your personal healthcare decisions.

Knowledge and organization are two powerful tools to help you stay in control of your healthcare.

– Name Witheld by Request

I have been gainfully employed & happily married for my most of my adult life. I am covered under my husband’s health insurance which has excellent coverage since he works for the public works dept. I, however, was terminated after a 3-month leave due to battling breast cancer. My job states that I can return when I recover. I worry for the future of this country & my children’s future(13 yo & 10 yo).

With virtually no defined-benefit pensions available & sky-rocketing health insurance, if you can find it, I fear that our country is heading toward an ever-widening gap with the middle-class sinking deeper & deeper into the muck. I also personally worry for my health because I feel that I may need to partially support my children into their early adulthoods due to the increased cost of living (without frills). I am excited about this new organization & look forward to its growth & potential to make a difference.

– Name Witheld by Request

After 17 years, I left a large telecomm company to go with a spinoff. Although disappointed in the amount of money I received as compensation for my pension, I left the company to get more updated skills to make myself more marketable in the future. Well, in the dot com crash, the spinoff died. I’ve been searching for interesting, challenging full-time work since. I have been on contract assignments but I’d like to hang my hat in one place and enjoy time off (vacations, sick days), benefits, and a decent salary. My salary has dramatically been reduced. Technical writing work is often off-shored. What isn’t off-shored seems to be given to younger, cheaper employees.

Now, I’m over 50. My income is back to what it was in the late 70s because I’m only able to get employment with small companies or contract positions. I’m faced with paying my own health care benefits. If I need to go with a Comprehensive Heath Insurance Program (CHIP) provided by the state, my health care costs are over $500 a month, which is often over a fourth of my take home pay. When I can least afford health care costs (being underemployed), my heath care costs are the highest … and headed to get higher.

CHIPs programs are available to people who have been rejected by a health insurance provider and/or someone for whom the quoted rates are higher than the CHIPs program. I was on the CHIPs program a few years ago. It was underwritten in IL by Blue Cross/Blue Shield. It thought the coverage was pretty good. Currently, I have coverage for 18 months through a past employer. Here’s the link for the IL program.

http://www.chip.state.il.us/

I was researching that for my brother, who lives in FL. The CHIPs program there hasn’t taken new folks for many years — too many people wanting to take advantage of it.

– Janice Hicks, Ft. Worth, TX

I am 53 years old, with an M.A. degree and over 30 years work experience. Two years ago, I relocated to Texas from Chicago because my husband’s company was bought by Pfizer and closed. He was lucky to find another job. I have worked in Human Resources and Training and as a Training Consultant/Writer. I am unable to find a permanent position which I truly believe is due to my age. Currently, I work as a contract writer, picking up jobs where I can.