Happy New Year, with a nod to white guilt

Happy New Year. May our country be preserved as a sovereign state with the guaranteed freedoms on which it was founded. May we continue to experience the bounty of our great nation. May we reap the reward of our hard work, efforts and knowledge. May the rest of the world learn to do the same so that we may continue our course toward national equality, based on competence and not pity and guilt...

To Call a Nurse a Nurse...

To my nurse friends and colleagues:

As you probably already have heard or read, I am appalled at the way the title of nurse is used in inaccurate and disrespectful ways, especially by Medical Office Assistants and the physicians that employ them.  It is very common for both the office staff and the MOA him/herself to refer to anyone in that position as 'nurse'.  The MOA program has no requirements for entry except for a high school diploma or GED, and is usually complete in a year.  It includes subjects such as medical office billing and filing, and includes one term of human body systems (info from LCC).

Compare that to the minimum prerequisites, usually up to two years, the core course of study and clinicals, and often further completion of a BSN, that registered nurses must successfully complete with high grades, and the practice should deeply offend us.  I does me.  It is illegal in most states to identify oneself as a doctor, police officer, lawyer or judge, or any 'officer of the court', in fact. It is interesting to note that police officers often have little training before hiring, although that is changing.  Law enforcement professionals are quick to point out their exact title if it is used improperly, such as Officer, Detective, Sargent, etc.  As are doctors.

I think it is time that we, as nurses, begin to get vocal about the false, misleading and disrespectful use of the title 'nurse'.  It is just another step in claiming our role as medical professionals.  In addition, to insist that only nurses be called nurse is a great benefit to our patients, who often cannot tell a CNA from a housekeeper from a MOA from a receptionist, with all of them wearing scrubs.  Our role as a professional, well educated medical provider is evolving, and this is a natural step in the process, that of claiming and guarding our hard earned credentials.

I have contacted the state Board of Nursing and the state Nurses Association regarding putting some teeth behind prohibiting the practice, but neither have any control or governance over MOAs and both welcome the idea of a grassroots movement.  MOAs are not licensed and in many states not even certified nor regulated, such as Certified Nursing Assistants are in most states.  MOAs are extensions of the doctor's bidding and training, able to perform any procedure the doctor is willing to train them to do.  It is most certainly a monetary issue.  But, if they are training properly and the MOA is performing procedures properly, why is it then necessary to falsely label the MOA as a nurse?  It can only be to mislead the patient into allowing a non-nurse to treat them, as was the case with my medically fragile ninety-three year old mother-in-law.  

I was assured by the staff at the Urology Institute that the instillation of chemotherapeutic chemicals in my mother-in-law's cancerous bladder would be performed by a nurse.  After three successive UTIs caused by three different and unusual bacteria, I demanded to know the credentials of the nurse.  Turns out it was a MOA every time.  My mother-in-law reacted like most medically fragile frail elderly, spending weeks confused, incontinent, unable to walk and in pain from these successive UTIs.  Her chemotherapy had to be halted before the full course because of the UTIs and her deteriorating condition.  

Research shows that all adverse incidences, including infections, complications, even deaths, are reduced when registered nurses care for the patient.  Over and over, studies prove that the deeper training and fuller education create a professional who is able to recognize and address signs of downward trends before they develop into a crisis.  Yet, our very partners in patient care are stealing our title and duping the consumer, and indeed playing with lives and health.

To that end, I am asking of you:  please be vocal at your own doctor's office, where you are the patient/consumer, about how offensive and misleading it is to call anyone but a nurse 'nurse'.  Describe how difficult it is to even earn a coveted seat in nursing school, let alone to finish and to test for the right to be called nurse.  Also, please speak to any other healthcare workers you know to encourage the same. Write to the State Board of Nursing, the state Nurses Association, the state Medical Association, the American Medical Association, your colleagues, your state representative, whoever you think might listen.  Let's make this an important consumer issue.

I intend to write articles to nursing sites and journals, to speak to my legislator and to ask to speak to the house committee on medical issues with the hope of making it illegal to identify non-nurses as nurse.  I think there should be a social media site similar to Angie's List where people can list the name of the doctor in whose office or clinic MOAs and others are falsely called nurse.  Maybe if it becomes obvious that the doctors must be complicit in this deception in order for it to continue, some might be embarrassed enough to cease the practice. (Maybe, the next time we are in our own doctor's office, we should refer to everyone as doctor...)

I would appreciate you input and support.  Although, support for me in this is support for us all.

Good health to you and yours.

An Open Letter to My Adult Children

Today, I mailed our family member's ballots. All of them. I am so very proud of your commitment to the process of determining the future of this great country. I must be difficult to imagine what the world will be like when we finally hand it over to you. I'm sorry for the idiocy, the waste and the debt the previous generations are leaving for you to sort out. And to try to live a fulfilling quality life while doing so.

One time, when you three were small, a friend asked what I wished for you when you grew up. I said the usual: fulfilled, happy, healthy, and then: I hope they become responsible taxpayers who add to our country and our way of life.

And, you have. You are intelligent, involved, and responsible. You are givers, not takers. You are inventors and innovators and do-ers. In a country of takers and stoppers and complainers.

As I placed the ballots in the mailbox, I realized that I didn't care how you voted, because I knew that you voted with your hearts and your minds and as if your very life depended on it. I trust you to do what's right, as I always have.

I am proud to be... 

Your humble mom

A Repost For My Mom, who would be 91 today...

THURSDAY, AUGUST 6, 2009

Happy birthday, Jennie May

Happy birthday, Mom. This is the day I will celebrate your birth, eighty seven years ago today. You got to see your sixty-third birthday, and three days more. You got to see your children grown, and some of their children grown. You got to see what a big beautiful family you had created. You expressed pride and contentment at the family reunion in your honor that last birthday weekend.

In the chaos that was our family life, you taught me love. To love a child or a handicapped person or an old person or an animal. To love a man who is flawed. To 'have a little talk with God' when things crashed in around me.

I miss you, Mom. You are always in my heart, and often on my mind. Your voice is the voice I hear when I need strength and guidance at a patient's bedside. Your hands guide mine as I soothe the sick and vulnerable. Your dedication and uncompromising standards of patient care helped set my own standards. You are never forgotten and always with me.

I only wish you could have been here to see my kids. They are awesome. I know you are with us, I know you can see and feel them from where you are now. I have tried to bring you to life for them through stories and favorite objects of yours. But, I just wish you were here, for them, for us, for me.

Thank you for being my mom, my friend, my example. 

Happy birthday, Mama.

The Language of My Soul

I was given a writing assignment in nursing school; to write something that reflects 'the language of my soul'.  Hmmm... could be open to many interpretations.  But, there are fundamental truths about me, the woman I am, the nurse I was becoming, and the people who made me whole.  Irrevocable truths.  Relationships come and go, but three things remain...


First, I am an outdoors woman.  Before husband, before children, before escaping the birth home, I found solace and meaning in the out of doors.  It is the breath of the wind, the hush of the forest and the scent of pine and moss and water that soothed the soul of a hurt child.  I think the Earth saved my sanity, and thus, my life.


Second, I am a mother.  I have wanted to be a mother for as long as I could remember.  Except for a few short terms in college when, deeply involved in the women's movement, I questioned my desire and probed its source and motivation.  Was I merely acquiescing to a paternal structure designed to exploit women?  Was I giving in to hormones before I was mature enough to analyze their trickery?  Nope, I decided.  I wanted to be a mother, a good one, at the right time, with the right person.


Motherhood is irreversible, thus becoming a fundamental part of a woman's life.  Once a mother, always and forever, a mother.


A third important component to my soul is the long term relationship I have had with my husband; a ten year courtship full of passion and pain and resistance to change and eagerness to change and laughter and anger that commenced at age eighteen for me, twenty eight for him.  Then, a marriage that has lasted thirty years.  I have been married to him as long as I was not.  I have borne his name longer than I did my father's.  I cannot imagine life without him.  


These three things, then, comprise the language of my soul:  the out of doors and my place in it, motherhood and my children, and my love for my husband.


So, this is what I turned in to the instructor, 'The language of my soul...'


'The language of my soul is spoken in babies' sighs and nuzzles against my breast; in a thousand inaudible words of love seen in the eyes of my graying husband.  It sings in the wind on my face as I stand on a rimrock filling my lungs.  It whispers quietly by on the bow of my boat and between my trailing wet fingers.  It hollers its robust pride as I watch my son orchestrate daring complexities on the field with his wondrous young body.  It swirls and twirls gracefully around the long strong limbs of my dancing daughter.  It whispers in awed hushed wonder at my eldest navigating a vast technological world, a world I can neither comprehend or visit.  It soothes me as I soothe others; my children, my husband, my friends, my patients.  As I help them, I help myself.  And I feel whole.'

A Lovely Career...

                                                                               the above is from an Internet Nursing site...

And, an absent gag reflex, the ability to stand up for a patient in the face of a doctor who wants to pass the problem on, families who are confused and looking to vent on the nearest person, the ability to ignore unnecessary alarms and tune into the critical ones, willingness to accept all levels of nut-so-ness, psychosis, religious extremism, and superstition, disapproval and judgement by coworkers and doctors, and resistance to medical advice. Just to name a few...

Trucks Aren't Welcome...

I swear its getting harder and harder to park anywhere close to the store entrance. Handicapped spots, absolutely, compacts (hmm, big families and small farmers/entrepreneurs suffer), low emission (now, I'm getting cranky; we all can't afford a new rig), but now: electrical outlet spaces? Where're the free gas spaces? Someone is paying for that electricity. Someday, I am gonna pull up in my 3/4 ton Chev (USA made) 4x4, run an orange electrical cord under the hood up to one of those plug in pumps and go shop...