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Saturday, December 02, 2017

The Never-Ending Supposed Nursing Shortage in Hospitals

Last night I spent the night at the hospital. My mom had just undergone heart surgery and, as I always do with my family members, I stayed with her all night.

Throughout the night, other patients' family members would drift in and out of their rooms like silent ghosts, making forays into the nearby kitchen or in an attempt to get the attention of a nurse.

As usual, the hospital was understaffed. Hospitals always are. And it's not a particular hospital: It is every hospital I've been in in the last 15 years.

And yet, the cost of care hasn't declined.

Hospitals have discovered that they can use family members as assistant nursing staff.

To encourage this, they keep their staffing minimal. Woe to you if you don't have someone who can take care of you all through the night and part of the day, because you will only see your nurse at the beginning and end of her shift.

You may be told that you're not allowed to get out of bed, but you are treated as a nuisance if you page the nurse to help you in any way. Want water? Get an eye roll. Want to go to the bathroom? Get a resigned sigh.

Hospital rooms have become holding cells. Nurses are no longer there to help you in any real way.

I discovered this the hard way in 2005 when I made the mistake of going in for my neck fusion without any family members or friends on hand. I had assumed nursing care was of the same caliber it had been in the early 90s because, until then, I had been remarkably healthy.

When I woke from my surgery, I found that I could barely breathe. I knew how the problem could be easily solved, so I asked for Benadryl. That's all. Just Benadryl.

For two days, they withheld the antihistamine because it was not a priority to make sure I was comfortable. Every time I asked if they'd been able to get a release from the doctor to give me Benadryl for the swelling, they told me they hadn't heard back from him. No attempt was made to make it a priority, as I battled to breathe but I was too weak to make a fuss.

Occasionally someone would check on me and slap down a tray with a glass of gingerale onto the sticky table next to me. I'd gasp a request for Benadryl, and they'd disappear with insincere assurances.

I was told that I would not be released until I was better. So on the second day, I called a friend and told her to come get me. "Have they released you?" she asked. "They will or I'll walk out anyway," I wheezed.

A nurse told me I wouldn't be released until I was feeling well. "I'm great," I gasped enthusiastically. I won my release from prison, my friend retrieved me, I went home and took 2 Benadryl, and collapsed into bed. My last thought was that I would rather die at home and take my chances. I went to sleep with the full realization that I might not wake up again. But I woke up completely better. All I'd needed was the antihistamine.

After that, I vowed I'd never let anyone I care about go through the same thing.

Apparently, I'm not the only one. Last night proved it to me.

As is always the case these days, most nurses will say hello at the beginning and end of their shift. Other than that, I was the one to raid the kitchen for Mom when she was hungry. I was the one to help her get up to go to the bathroom. I was the one to get her water. I was the one to get her a new gown. I was the one to get up and get help because the nurses all but ignore the "call" button.

At 4:30-5 in the morning two of the nurses stood outside Mom's room to complain bitterly about the hospital, their pay and their benefits. I was so exhausted I slept through it but it woke Mom up, and she went to the door and politely ask them to move off. After that, she couldn't get back to sleep. We were up for the duration.

When we found out that the hospital wasn't going to be serving food until 8AM, I went down to the Dunkin' Donuts franchise on the floor of the hospital and got us food and coffee. When you've been awake for 3 hours already, and neither of you had eaten much the night before, you get hungry.

No one could get my Mom's meds right. Despite a complete list of her meds that was entered into the computer at the beginning, and despite repeated requests, we were given the endless runaround again. We were also told the hospital pharmacy was completely out of one of her meds. Having thrown out all the expired stock some time ago, they never replenished it. And despite knowing she was on that particular medication, no one thought to check to see if the pharmacy even had it until it was too late.

Years ago I was with my dad overnight at the hospital. He is a quiet, gentle man and very stoic. When he began to tell me he was in pain, I knew it was serious. At first I kept hitting the 'call' button. But, as usual, we were ignored or a bored voice would come over the tinny speaker asking what was wrong and assuring us that someone would eventually get to us.

After some time of watching my father in agony, I flew out into the hall, flounced up to the nurses station, and had a complete meltdown. An aggravated nurse then accompanied me, reprimanding me all the way, telling me that pain was to be expected.

But when she got in the room and pulled back the sheets, she stopped talking. Then she hit a button and called a Code Blue.

Dad was bleeding out.

Because I was there, Dad was spared that night. That doesn't make me a hero, but it still makes me very, very angry.

Every time I've complained about one of these instances, the answer is always the same. It's a one-time nursing shortage. This "one-time nursing shortage" has been going on a very long time. It is no more genuine than a politician.

All those silent family members last night proved that we've all received the message, loud and clear. Like a good Marine, you leave no one behind. And like a battlefield, there is too much that can go wrong in hospitals now. The only one that cares enough to make sure your loved one is taken care of is you.

We must pity people without a social network.

If there ever is a large-scale health emergency, we're all doomed to die slow and agonizing deaths, stacked like cordwood in our local hospitals.

There will be no one to help, due to that "one-time nursing shortage."

Monday, October 23, 2017

The NEW Media Pinata: Opioids

I am so sickened by the media's new idée fixe: Opioids. The think they have all the answers.
If it were up to them, people in the end stages of cancer wouldn't be given opioids because they might become addicted. People who are in excruciating pain and doomed to live with it could also be addicted. From their viewpoint it's so much more noble to suffer than live a life worth living.
I have twice been in the kind of pain that, if it had continued, I would have welcomed death. I understand pain. I'm blessed I don't have it to that degree, but I get it.
However, many of these anti-opioid crusaders are enjoying the latest hysteria without considering the cost to others.
And in the midst of all this obscene rabble-raising comes an interesting new angle: Look over here! This obscenely wealthy family is making a ...wait for it... PROFIT on opioids! Maybe we can gin up the masses on THIS new factoid.
And so Esquire now has an article out on the Sackler family out of Brooklyn. It's pretty interesting reading, actually. But the appeal is an obvious one. Since most of the media has socialistic leanings, they see the wealthy elite as boogeymen. They would, in fact, be very surprised to discover you may not. But just in case, they will attempt to manipulate you through envy, if you're not merely aghast at the concept of someone having more money than you.
The real issue is appallingly simple: Do we allow doctors to make decisions on our well-being and medications, or do we give that power to others? CVS has already make a power grab, here. They are now going to be overriding your doctor and allowing you only so many opioids per week in many cases. 
Insurance companies are meeting over the so-called 'opioid crisis' also, seeing this as a great excuse to deny payment in this category. And as we all know, insurance companies only have our very best interests at heart. 
Ahem.
They say Americans consume the majority of opiates, and that may be true. But there are 323 million people here, as opposed to only 65.6 million in the UK, and 67 million in France. So even if the percentage of the population using opiates remains the same, the US will outdistance most other countries. Anyone who's taken statistics knows to dig into figures like this.
This is manipulation.
This is unethical.
This is ginning up the masses, and it has consequences.
Many who are in pain and denied opiates are turning to heroin. I knew a Vietnam vet who had to take morphine daily. He's passed on now, but he had every reason to need it. He'd lost a leg in the war, and his severed, mutilated nerves were never at peace.
We need to stop non-medical interference with opiate prescriptions. 
The answer is to leave this up to the medical professionals. Not their hospital administrators. Not the insurance companies. And not the pharmacies.
Some day the tables will turn. Some day the American public will say they are tired of Big Brother.
Some day the pinata will get tired of being the punching bag.

Tuesday, October 17, 2017

The Close-mindedness of the Modern Conservative

The title is just scraping the top of the archaeological dig. If I had time, I'd dig down to the history of conservatives in the USA. How the conservatives were behind the original Black Lives Matter of the 1800s. How conservatives were conservative in the system they followed but were never closed to ideas.

I am blessed to still know some true intellectual conservatives, but many of them are falling to the wayside of emotions. Irrational, emotional thinking is what the majority of us despise in the modern liberal but now it's their turn to do exactly the same thing.

I am a conservative-leaning moderate. I sympathize. I want to offer advice to these friends the very best way I know how: Through reason.

We've all seen parents give in to a screaming child. But we also know that grown adults shouldn't behave the same way. But we've also seen that government officials sometimes give in to interest groups if their tantrums are loud enough.
We all know the shoulds and shouldn'ts. We shouldn't carry grudges. We shouldn't direct hatred of an idea to the hatred of the person who mentioned it. We shouldn't try to be louder than the next guy: If our ideas are good enough, we should win the argument. In other words, we should try very hard to not be the people we despise.

And when it comes to healthy adulting, we should not allow ourselves to take an issue so personally that it brings us to tears...unless that issue directly affects us. For instance: If you hear of a white kid shot by a black cop and it's obviously an injustice, do you:
  • A) Write to government officials and news outlets demanding accountability
  • B) Go on to Facebook and get into heated arguments with others, start crying, and unfriend everyone
  • C) Do as Obama did and, before all the facts are in, declare that the white kid could be your son
We all know which answer we should choose. But do we choose that? Are we striving to be the people we should be?

I see self-styled conservatives saying and posting things that are - well, there is no other word for it - foul. They post memes that are inappropriate, disgusting, and hate-filled. Those of us who are Christians distance ourselves from such people when we should confront them with kindness, and I am guilty of that just as everyone else is.

The question is: Can you be a true conservative if you are an extremist who loves the fight more than justice? Are ideas no longer important? Is it now only a question of who the biggest bully is? You might eat someone's lunch, but in the court of public opinion... you've lost.

I was recently unfriended and blocked by a Christian who writes for The American Spectator. I had truly admired him. It saddens me, because he is still friends with the people who post garbage memes like this:

But I was never given a chance, never told how I offended the man. I had just been in a discussion of how the recent racially-charged Dove ad was offensive to myself and so many others, and I suppose that must have triggered him, even though I tried to keep it civil as my friends duked it out online.

According to Christian standards, he was very wrong. He should have discussed this with me and we could have rectified the situation. Or at least so I hope. I have another Christian friend who is black and a liberal-leaning moderate. There are times she has to unfollow me because my friends get on her nerves. The Dove discussion also enraged her. I get that. But she always tells me with love and gives me the courtesy of an explanation.

Recently a couple of friends had a dust-up and my friend Todd reached out to his combatant and invited him out for drinks. That is how a true conservative should behave. 

That is how we all should behave.

Saturday, September 02, 2017

Races, Terms, Origins

"I don't consider myself a Native American," says a caller to a conservative radio show who may or may not be anything but a white man living in Alabama. "Instead, I'm fine with being called American Indian. In fact, I embrace it!"
Except...Native Americans really are NOT American Indians. Americans of Indian descent are American Indians.
Likewise, I'm Native American, because I was born in America.
African Americans may or may not be black Americans and black Americans may or may not be of African descent.
We need better terms.

Friday, August 25, 2017

How You Live Is...

I once worked for an exceedingly toxic workplace. 

 Some of you are survivors and we'll have a bond that will always be there as a result of it. 

 What was funny is that they are always trying to polish the turd. And despite how terribly they treated their employees, they would always try to say trite management and sales homilies in an attempt to pretend (at least to themselves) otherwise. 

 Our only place of peace was the bathrooms. 

 And then one day, even that peace was shattered when I went into a stall, closed it, and saw a sickly sweet sign that said "How you live is..." well, I forget the rest. Obviously it wasn't very memorable. But it was a polite chastisement - an attempt to follow us even into the place where we dropped our pants to remind us that we were never going to get away from their toxicity.

 I got angry. 

 Really livid. 

 And so I took that sign, took it home, scanned it, and altered it to be a more realistic one that I then taped in EVERY. SINGLE. STALL. 

 After that, no more stupid signs in our stalls. 

 It was a minor victory, but one which I'll always cherish.


Tuesday, August 22, 2017

The Titan Medical Center: Making Violence Against Women Look Cute

An alert reader shot me over this advertisement that gave her the shudders:

Posted on their Facebook page on 8/16/17     See it here until they get smart enough to take it down.

Well aren't they just adorable. The thick-lipped thug is John Tsikouris, who is listed as the head honcho of Titan Medical Group, LLC, a small company in Tampa, Florida.

Perhaps John is the next best thing to the Pope...or Franklin Graham...or the Dalai Lama. But somehow I can't picture any of them standing there with a perky blond in pants that are as tight as a sausage casing. 

And I can't picture any of them bending her over and getting ready to beat her. 

To be fair, I'm told that she's his partner. What they do in their bedroom is up to them entirely, of course. If they hang from chandeliers smeared in Jell-O while warbling Britney Spears tunes, I have little to say about that (though their neighbors might).

However, this is a public advertisement posted...well, publicly. So it's only fair to subject it to public scrutiny.

Is this appropriate?

Looking at their Facebook page, there are tons of overly-sexualized photos of people, predominantly women. Looking at their site, they also repeat the theme: Sex, sex, sex. Under their FAQs on their site they ask you questions like "Do you have a decrease in sex drive?" and " Are your erections less strong?" and "Has it been more difficult to maintain your erection throughout intercourse?" The front page shows a disgruntled looking woman with a resigned man behind her. She's obviously conveying great dissatisfaction with his performance in bed.

Hmmm. A theme begins to emerge.

This sex-obsessed company is all about healthy living. Oh whoops, my bad... I guess it's pretty obvious what they're all about. This would make it a very threatening environment for some, and it's pretty much a given what you're looking for if you're there.

But this ad really takes it over the top, doesn't it? I wonder what went through John's head at the time. "If she's smiling, then it's OK to pretend to beat her for a laugh."

According to The National Domestic Violence Hotline, domestic abuse isn't a laughing matter. They write "we believe that jokes about violence only serve to diminish people’s perception of its severity. Abuse in any relationship – whether it’s between family members, friends, or people in an intimate partnership – is not acceptable, no matter the “reasons” behind it or the gender of the people involved."

In a great article by Aparna Balakumar (seen here) she notes "There’ll always be a small part of society that says to “lighten up” and “take a joke,” but by staying silent we implicitly condone behaviour. And in this instance, that’s behaviour that could be deeply triggering and hurtful to some."

Let's not stay silent.

Wednesday, August 02, 2017

The Big Brothers / Big Sisters Problem: When the Underprivileged are Overprivileged



When my kids were no longer a daily part of my life, I succumbed to Empty Nest Syndrome.

I moped a bit. 

When you've spent a large portion of your adult life reinventing yourself as a parent, and that role is suddenly removed, you find yourself adrift without purpose for a while.

And so a well-meaning friend suggested Big Brothers / Big Sisters.

Before I begin my complaint, let me be clear: I know of some success stories. But I don't believe that my experience was an exception. Rather, I believe that theirs is the exception. As my story unfolds, you may come to agree with me.

When I went in to the offices of BB/BS, I was very excited. I filled out the applications, went through the screening process, and was accepted. In a couple of weeks, I was called to interview my first prospect: We'll call her Keneesha.

I met the caseworker at the home of Keneesha and her siblings. All 8 of them.

Keneesha was 6 years old, and painfully recalcitrant. I hesitate to use the word 'shy' because the caseworker and everyone in her family assured me she wasn't. But she was having a bad day, apparently, and refusing to talk to me. Her sister "Kendra" did all the translating. 

Their mother sat idly by, saying very little. I found that curious at first, but came to understand why, later. "Lola" was a pleasant enough woman and seemed to be a good mother. She was busy with her brood of 8 and cash-strapped, as the father of most of the children was in prison and couldn't pay child support. The father of the 2 youngest was living with them but working a minimum wage job. 

Lola was, frankly, tired. I imagine she was tired all the time. And Lola needed a baby-sitting service, which is where BB/BS came in. All of her children were enrolled in the program.

As I sat on the couch in their living room, trying to connect with a child that refused to connect with me in any way, I became aware that Kendra was animated, helpful, and willing to step out of her shell. So later I asked the caseworker if Kendra had a Big Sister assigned to her.

"Welllll," said the caseworker, hesitantly. "We usually don't like to pass over one sibling in favor of the other."

"You saw how Keneesha wouldn't have anything to do with me," I argued. "But Kendra is a gem! If she doesn't have a Big Sister, I'd like to work with her."

The caseworker reluctantly said it was a possibility but she'd have to check with the mother first. Lola readily agreed, and the match was made.

We were carefully warned to initially buy the children no gifts at all. As the relationship built, you could buy them an occasional trinket only. BB/BS was aware that people can be taken advantage of, and they wanted this to be about the mentoring of a child and not the enabling of a family. I was fine with that, but still planned inexpensive outings that Kendra and I would go on. I looked forward to our first trip, which was to the park.

However, when I picked up Kendra, she had transformed from a happy, helpful child into an older version of Keneesha. Initially I put it off as the nervousness of being with a total stranger. But as this continued over several visits, I expressed my concern to the caseworker, who urged me to keep trying to connect.

So I did.

I tried humor. I tried exciting her interest in new things. BB/BS gets a lot of corporate sponsorships. Companies will give them free tickets to major events, so we would get regular emails letting us know what concerts or events had free tickets that were up for grabs for us and our "Littles." These children were being treated to better experiences than children who weren't in the program, and they were, frankly. being spoiled by it.

One day when I picked up Kendra for one of our outings, I had very special news that I'd been waiting for a week to spring on her. "Kendra," I said excitedly, "I got us tickets to Jack Hanna's Wild Kingdom next month!"  

"Ah," said Kendra, with her usual lack of enthusiasm.

 What would it take to impress this kid? I'd already taken her to a couple stellar concerts, got her backstage with the band, they took pictures with her and signed the autograph album I bought her. I'd taken her to regular parks, a water amusement park, the beach, and other events. Some of these jaunts were on my own dime, most were sponsored by the BB/BS sponsors.

"Look, Kendra," I said, frustrated, but keeping my tone in check. "What IS it? Why aren't you more excited? Don't you know what it is?"

"Of course I do," she replied dully. "My Big Sister from last year took me to that."

And that's when it hit me. These children from the BB/BS program are, for the most part, living a more glamorous, more exciting life than the children of everyday people who are not enrolled. These supposedly underprivileged kids are actually overprivileged. 

Lola knew what she was doing. Her 8 children were all being taken to Disney World, Busch Gardens, water parks, concerts, events, and more while she got to stay home and not lift a finger as we chumps spent our own energy, money, time, and gas to ferry her children about like royalty. And the kids were so used to it that they were, quite simply, jaded.

I called the social worker and asked when she had been planning on telling me that Kendra had a previous Big Sister. That's when I found out she'd had a chain of them. I assume they grew tired of being a combination of chauffer and royal court jester. 

Certainly *I* had.

I quit.

But although the problem is obvious (and currently being ignored by BB/BS) the answers are easy...though not fun... to implement.

Different tickets and outings need to be rated. Say that an "A" trip is to a major amusement park. Whether or not a corporate sponsor or a "Big" has sprung for the outing, each "Little" only gets one or two "A" outings a year.

Now say that taking in a local ballgame is a "B" trip. That child can have up to 4 "B" trips. They can have unlimited "C" trips to the library, parks, the beach, and other less-costly alternatives.

Additionally, the "Littles" can't just use the "Bigs" for fun. The "Bigs" should be expected to help the "Littles" with homework and other issues. Since "Littles" often come from less-than-ideal circumstances, there are issues like anger management, education, career goals (and more) which a "Big" may be able to help with.

Limiting the fancy goodies that these "Littles" get would force the program to be more about developing genuine mentoring relationships. It also would encourage the "Littles" to not take so much for granted. And finally it would free up the corporate sponsorships and monies to be used more wisely. And isn't that ultimately what Big Brothers / Big Sisters was supposed to be all about? Teaching responsibility and preparing children for the world?

If we want to solve the problems of the Entitlement Generation, if we want to fix the problem of self control in our youth, if we want to truly encourage enlightenment, it must start with our charities and in our homes.