May 12th, 2009 by Emergiblog in Better Health Network, True Stories
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I love this ad.
I was about this age when I decided to become a nurse.
Maybe a little older.
I was holding a book instead of a teddy bear.
I wouldn’t have been caught dead in that cap, though. Even in those days I knew how to make a totally cool nursing cap out of paper.
That looks like a pillowcase.
Sometimes it’s hard to remember why nursing sounded like a good idea.
********************
You don’t realize it’s happening.
You set a goal and you do what you have to do to get there.
For awhile, you manage to do it all.
Nine semester units.
Working 24 hours a week.
No sweat.
Been there, done that.
Lived through it.
*****
But things start piling up.
Work needs you to pick up some hours. Coworkers on leave, folks needing time off.
You say yes, because when you need time off, they will make sure you get it.
Only your body isn’t cooperating.
You are in bed for the night at 1600.
And up at 0530.
Then you can’t fall asleep before you go in at 1900.
So you’re up for 28 hours. Straight.
Twice in one week.
That worked when you were eighteen.
It kills you at fifty-one.
*****
So you work, and work is uncharacteristically busy.
You start getting depressed four hours before you go in.
Then you start getting depressed because you have to work the next day.
Your coworkers are getting on your nerves.
You are really getting on their nerves.
You hit the ground and twelve hours later you sit for the first time. In the car. For the ride home.
To sleep for ten hours so you can go back and do it again.
Before your one day off.
That you sleep through.
*****
You fall behind in class; the professors are cool and allow you extra time for the assignments.
Which you need because you are so exhausted you cannot think.
But you won’t give less than an “A” effort so you stress and research and study and fine-tune and finally turn in the missive 48 hours after it is due.
Only to discover your classmates managed the assignment in two paragraphs.
How the hell did they do that?
*****
You start to lose it.
You don’t leave the house on your time off.
You stay in sweats all day and don’t bother to fix your hair.
Your husband thinks you are having a breakdown because he hears you laughing hysterically one minute and bursting into tears the next.
Except it’s not a breakdown, you are just watching “Scrubs”.
(Why the hell did they kill off LaVerne? Idiots.)
You start scanning the ads for a desk job. Part-time. Days. No weekends.
No blood. No pain.
No death.
*****
I’ve been here before.
The demon is back.
I’m in full blown burn-out.
But no major life changes.
Not this time.
I know what to do.
No more extra shifts.
The money is nice. Sanity is nicer.
No more twelve-hour shifts. Kudos to those who can do them.
I can’t.
No summer school.
I’m 12 units away from a BSN. I can graduate in the Spring of 2010. I gain nothing by sacrificing my mental health to do it by December.
*****
I’m scaling back, I’m taking a break.
For the next few months, it’s all about me.
More visits to Starbucks to read blogs.
More visits to Starbucks to read novels.
More concerts.
More mini-vacations. Son’s graduation. Nascar race in Sonoma. BlogHer in Chicago.
*****
I wish I could do it all and be it all and have it all.
It’s hard to face the fact that I have limitations.
But, I know,
I’m no Superman.
And that is a major bummer.
I’m No Superman
*This blog post was originally published at Emergiblog*
May 4th, 2009 by Emergiblog in Better Health Network
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That’s Edie Falco.
You remember. She played Carmella Soprano.
Great actress; I love her.
Too bad I won’t be watching her new character on Showtime.
*****
“Nurse Jackie” is a new series.
I received an email from Showtime asking me if I would curate a selection of nursing experiences for an upcoming “Nurse Stories” web site that would coincide with the debut of Nurse Week and “Nurse Jackie”.
Whoa.
I don’t get email from Showtime every day, so this sounded pretty interesting.
I went to the website to check out the show before responding.
I made it through one video.
*****
Nurse Jackie is a competent, hard-as-nails, take-no-prisoners ER nurse.
With a heart, of course.
One minute she’s telling a doctor he’s full of it, the next minute she tells a patient to get out of her ER (classic!).
Edie Falco is perfect as the title character.
You’ve all worked with her.
Hell, you might even be her!
*****
My first reaction?
Oh..my..god, they did it!
They made a show with a strong nurse protagonist, and damn! if they didn’t get the ER environment down!
I had goosebumps, literally.
I was ready to (a) start getting Showtime, (b) spread the word far and wide and (c) take the job.
But then…
*****
They started grabbing her chest.
I think in a the short video I watched (five minutes?) Nurse Jackie had her breasts fondled by three men.
Oh great.
My first thought?
Here we go again with the nurse-as-sex-object stereotype.
(Actually, my first thought is that I must be working in the wrong hospitals.)
But it got worse.
*****
Nurse Jackie is a drug addict.
Has back pain.
Snorts crushed up Percocets.
Oh no they didn’t………
*****
Oh yes.
They did.
Now, would somebody please tell me why, why? they had to portray this nurse as a drug addict?
Did they not see that they had the potential for one hell of a nurse character here?
Did they not see that they could break the mold of media stereotypes in nursing and pave new ground?
Did they not see that there is enough material to build a nurse character out of what happens in the ER alone without adding the oh-so-subtle touch of drug addiction?
*****
If you’re an nurse who spends a lot of time with other people fondling you, you might like this show.
If you’re an RN and addicted to drugs, you might like this show.
In fact, why don’t you go check out the website for yourself.
Watch the video, get a feel for the character.
Tell me what you think.
Tell Showtime what you think.
And if you are really pissed, write to The Truth About Nursing.
I already did.
*****
As for me?
I (a) am not subscribing to Showtime, (b) will not promote the show to anyone outside this blog post and (c) did not take the job.
I am so sick, and so tired, of stupid media portrayals of nurses.
Didn’t watch “ER”. No “Grey’s Anatomy”. Won’t watch “House”.
Here goes trying to explain to my patients, again, that “no, I don’t watch that show because of the portrayal of nursing.”
*****
You blew it, Showtime.
Of course, it’s not too late to rectify the issues, the show has not debuted yet.
But know this:
No matter how funny, how dramatic or how well written “Nurse Jackie” is, you are doing nothing to advance or promote the nursing profession. But then I guess the goal is ratings and nothing defines a “hit” like sex and drugs.
*****
“Nurse Jackie” is described as “Saint! Sinner!”.
Saint.
Sinner.
Sound familiar?
Yeah.
Sigh.
May 1st, 2009 by Dr. Val Jones in Expert Interviews
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I recently interviewed the CEO (Bill Reed) and SVP (Stuart Segal) of AllOne Health at the World Health Care Congress. Their enthusiasm for mobile technology rivals Better Health’s own Dr. Alan Dappen. Will mobile technology get people more engaged in healthy behaviors and assist with disease management? I hope so.
Dr. Val: What is “All One Health?”
Reed: All One Health provides a bundle of customized offerings to small employers – including insurance and health and wellness programs. We provide the same kinds of benefits that large insurers offer to large employers except we spend a lot of time analyzing the specific needs of small companies before initiating a health program for them. Some small companies have employees with diabetes-related challenges, and others might be more concerned about asthma. We also use predictive modeling (health risk assessments) to help the companies customize preventive health strategies for their employees.
Engagement and compliance are very important in bringing about substantive changes in healthcare – and good health can be incentivized by employers. All One Mobile is our means for connecting patients (or employees) with health coaches and nurses, which we believe is critical for affecting lifestyle changes.
Dr. Val: What does your “menu of services” look like from the employee’s perspective?
Reed: Each employee begins the relationship with a health risk assessment (HRA). That HRA recommends programs for the employee based on their risk factors, and prioritizes the top three things for them to work on. There are performance trackers linked to employer incentives for health improvements and the programs are available via the phone so that employees don’t have to be in front of their PC to interact with their health coaches. We have proactive outbound calling with an opt out feature. We believe that the mobile phone is critical for encouraging consistent participation in health programs. Our services center on phone-based reminders and personal relationships with coaches.
In the near future we’ll include blue tooth technology to have patients upload data from their home monitoring devices for their coaches to review. This is a more proactive approach to health management.
Dr. Val: And Stuart, tell me about the All One Mobile program for the Department of Defense (DOD).
Segal: The DOD was having difficulty with follow up care for military personnel returning from Iraq and Afghanistan with traumatic brain injuries (TBI). Once they returned to their communities, it was very hard to reach them. All One Mobile won a contract with the army to provide constant messaging services to soldiers with TBI because they need regular reminders to keep their rehabilitation on track. Army case managers can push out questionnaires to soldiers and depending on how they answer, the case manager might be triggered to give them a call while they have the phone in their hand. So the phone-based communication tool is the primary tracking device for soldiers who return to the US with TBI.
Dr. Val: What are the educational qualifications of your coaches?
Reed: Registered nurses, dieticians, and psychologists.
Dr. Val: And what if the patient needs to see a doctor?
The coaches are trained to refer patients to their doctor when it appears that they need it. We can also track their prescription patterns and send the patients a “gaps in care” letter to remind them to fill their prescriptions. Non-compliance with medications is a major problem that All One Health can address.
Dr. Val: How would a doctor use All One Mobile?
Segal: We’re currently working on making EMRs accessible via phones – so that no matter where a physician is, he or she can review patient records and track their progress remotely.
Dr. Val: Or better yet, when one doctor is taking call for her group, she can have access to patient records so that when she’s called in the middle of the night, she’ll be fully informed about the patient problem list and understand the context of the concerns much better.
Segal: Yes, and All One Mobile can be used in the Emergency Department setting – so that when patients are discharged home, they receive 30 days of our service. The hospital can send them their lab results (that were drawn in the ER) and easily contact patients to bring them back in if necessary. In addition the patients can take photos of their wounds, for example, and have the physicians see how they’re progressing.
Dr. Val: Any closing thoughts?
Reed: This kind of health communication is incredibly convenient. Patients don’t need to carry around a smart card, a thumb drive, or a paper record. They’re already carrying around what they need – their own cell phone. And almost everyone in the US, regardless of economic class or age, has a phone.
April 28th, 2009 by Dr. Val Jones in True Stories
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Doctor: Mr. Smith, your urine test is positive for cocaine.
Mr. Smith: [Blank Stare]
Doctor: Have you been snorting cocaine recently?
Mr. Smith: No.
Doctor: Then why is there cocaine in your urine?
Mr. Smith: Maybe your nurse put it in there.
Doctor: If my nurse had cocaine, I don’t think she’d put it in your urine.
***
Bonus tip for pain management specialists: cocaine’s half-life in the urine is 2-4 days. “Random” urine drug testing on Mondays offers a higher yield than other days of the business week because most patients abuse illicit drugs on weekends>>weekdays.
April 24th, 2009 by Dr. Val Jones in Humor
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I’m currently at a medical conference for my specialty, Physical Medicine and Rehabilitation. I happened to look around at everyone’s shoes and realized that many medical specialties can probably be identified by the types of shoes they wear. Check out the footwear at your next conference and tell me if I’m on to something. And by the way, this is more or less what rehab docs wear on their feet:
