Friday, December 12, 2008

Universal Healthcare Making Nurses?

From today's Huffington Post: Maggie Mahar on Healthcare Reform
(Bold italics added by this nurse)

...Will Universal Coverage Create More Nurses?
Gruber cheerfully assumes that if we just invest $100 billion a year in universal coverage, the money will quite naturally flow where it is needed to create "high-paying, rewarding jobs in health services" that will add value to the economy. "Most reform proposals emphasize primary care" he explains, "much of which can be provided by nurse practitioners, registered nurses and physician's assistants. These jobs could provide a landing spot for workers who have lost jobs in other sectors of the economy."
Here, he ignores two realities. First, the guy who loses a job in Detroit--or on Wall Street--is not going to be in a position to become a nurse without a few years of training, if then. Nursing is a demanding profession that requires a keen intelligence, a cool head, physical stamina, and empathy. Not every former investment banker would make the grade.
Secondly, and more importantly, because the pay for U.S. nurses is relatively low--and working conditions in our chaotic health care system are poor--we have a very hard time filling the nursing positions that we have today.
As I reported not long ago, while the U.S. lays out substantially more for doctors, drugs, devices, and medical procedures than every other developed country in the world, there is one exception to our medical largesse: the "salaries of [U.S.] nurses are roughly equal to salaries in other countries." In addition, salaries for nursing school professors are often lower than the salaries we pay nurses. As a result, nursing schools have had great difficulty recruiting teachers.
Meanwhile, given the high rate of medical errors in our hectic healthcare system, nurses find the job exceptionally stressful. "I was just too afraid that I would kill someone," one former New York City nurse told me.
As Dr. Val points out over at "," nurses are not lining up to provide primary care services in our healthcare system "for the same reasons that physicians aren't too keen on it: the pay is low, the workload is grueling, and there are other career options that offer better lifestyle and salary benefits."
So while universal coverage would create greater demand for skilled nurses able and willing to provide primary care, it would not create greater supply. One would think that, given the fact that Gruber is a board member of the Massachusetts Health Insurance Connector Authority overseeing Massachusetts effort to provide universal coverage, he would be aware of the shortage of registered nurses in that state.
As of 2006, federal government estimates show that Massachusetts had 5,000 fewer nurses than it needed. In 2010 it is projected that 10,000 positions will be empty, and five years after that Massachusetts will be looking for 16,000 nurses.

Mitzi here: 16000 nurses for one state? Where will they all come from, if not Detroit or Wall Street? Although the thought of a Wall Street investor in a suit cleaning up vomit or giving medication to a combative Alzheimer's patient is very intriguing. Especially if "he's" a "she" in Manolos.

Hiding behind.....

...a wall of books. This picture is similar to a wall in my apartment.
My shrink tells me that's not good. She says that's why I have so many books - so I can stay inside and read instead of going out and being with people.
I've been out with people. I go out with people.
I just prefer the people inside books a lot more than many of the ones I've encountered outside my wall of books.
When I was a kid, I used to go to sleep with books on my bed - just in case my bed became a magic carpet, I would have something to read on the trip
I already have over $100 in B&N gift cards. I'm certainly NOT getting $100 worth of lattes. I'll be buying books.
My shrink will just have to deal with it.

Wednesday, December 10, 2008

Mad at herself....

In the latest issue of "O Magazine", Oprah takes issue with....herself for gaining weight...gaining weight that she had lost - several times over.

Well, honey, join the group - a big group, no pun intended.

Lots of us have been there and back and there again. And my advice to you, O, stop beating yourself up - you're a beautiful, powerful, intelligent leader. But somehow to women, being all of that is not enough, we MUST be thin.

My story:
I lost weight after my divorce. It seems that every night my husband went out I would lose my sorrows in a huge bowl of spaghetti and butter. He went out several times a week and my already overweight body ballooned. For years I was at my healthy weight. I dated (lots) and finally found someone that I loved and was to be married. He died. Over the last twenty years, I've gained half of that originally lost weight back.
Oprah, I'm a professional who's "made" something of herself. I'm a writer who's been published frequently. I've raised a good, intelligent, loving daughter. I'm a self-sufficient, caring woman of 61. I have friends who love me.
BUT, I am overweight - obese, like you, on the BMI scale. So, somehow, all of the things I've accomplished mean nothing.
I struggle with that identity everyday.
I struggle with that lack of self esteem everyday.

At least I know I'm in very good company.

I will try to adopt your attitude - not to long to be thin, but to work to be "healthy and strong."

Monday, December 08, 2008

Not in NYC

It's December 8 and I'm not in New York City. I've broken a long tradition.

For many years (most of them with Heather), I would go to Strawberry Fields on December 8. I would take flowers for the mosaic and stand with many other people, most of them tourists.

There would also be one gentleman who made a small tribute with pictures, flowers and candles. This tribute on this day seemed to be the highlight of his life. I think of that poor man today and wonder if he has any life outside of Strawberry Fields.

That's not what John would have wanted. He didn't want to be an Icon with a capital "I" - he was just a regular bloke who had talent and causes.

Instead of remembering the day he died, my new tradition will be to remember his causes - His Cause for Peace. That someone who called for Peace and for The World to Live as One should be taken during the holiday season that represents those values is ironic - and still very sad.

And so it is Christmas...

Friday, December 05, 2008

The End of the "American Dream"?

The American Dream concept began after WWII with the GI Bill and veterans able to go to college, get a decent paying job, afford a home, car and family.

The car companies are going in the economic toilet, jobs are being downsized, homes are in foreclosure....and college? The cost of college will soon be out of reach of the average American family as reported recently in the New York Times:

Now, this doesn't affect me personally. I have no children or grandchildren standing on the brink of college. My daughter has paid off her college loans. I don't own a house; my job is fairly secure; my car is a Chrysler and almost paid off. I do have a lot of books but not a lot of "toys".

I believe the beginning of today's economic problem started a long time ago with college loans.
The end of the "American Dream" began when college costs became so high that we made our children debtors before they had a profession. They began their adult lives with high loans. Since the 1059s we've become a society of materialism - a society of things, of toys. "He who dies with the most toys, wins."

In order to get the next part of the "Dream", many people gambled on the increase in housing values and got mortgages that would be unaffordable with those college loans and car payments.

Cars of course are needed because there is no public transportation from the suburbs where those mortgaged homes are to the jobs in the sprawling industrial parks or distant cities - where the better-paying jobs are.

Then we have the children, who live in front of the TV or the computer and see ads for high-priced products that they want. And their parents get these things with credit cards or home equity loans.... And those children of things, of toys, of materialism will soon want/need to go to college. The question is How?

The bottom is dropping out of the economy and our age of commercial materialism is slowly changing.

The new American Dream should include a college education, decent health care and a clean environment - not a stockpile of things.

The person who dies with the most toys may "win" but he still dies.

Thursday, December 04, 2008

Something I noticed...

I stopped at a mall near Bloomsburg on my way home yesterday. I was searching for a blouse and it seemed that Sears, Penny's and Bon Ton had only sweaters. But that's not what I noticed.

What I noticed was the age of many of the sales clerks. They were old - not 50 or 60 - older.
Men and women.

It bothered me as I walked out of the mall with only one very small purchase. I hoped that the sales clerk didn't have to work, but deep down I knew better. Then I remembered seeing older men and women working everywhere - fast food restaurants, diners, grocery stores.

And then I wondered if that would be me.
As much as I want to retire and write full time, I know that is a fantasy. My last writing check was for $200 and that was months ago. Even with social security, my downsized 401K and Medicare, retiring for me may now not come at 65 as I had once hoped.
But how much longer can I be a nurse? I can't physically be a bedside nurse. And for what I do now, even with limiting my driving, how much longer will I have the energy to keep up with the changes in technology and regulations.

Will I be one of the older women standing in Sears, asking shoppers if they want to fill out an application for siding? With my back problems could I stand long enough to do even that job?

I know many seniors work because they want to, but more are working because they have to.

Without a "significant other's" second income to help me, I may be one of the seniors who has to.

Monday, December 01, 2008

Christmas in Rough Economic Times

I really never had this problem with Heather. We certainly weren't wealthy. But especially after the divorce, my daughter realized that money was limited. She never asked for designer jeans - the big thing in the 80s - never expected more than what I could afford.

But what about when she was younger?
She was never a get-me-give-me-I-want-kid. I've thought about this and I think it was because deep down she knew that we (then I) always put her first. Maybe she didn't need "things" to make her feel special.
Not long ago I asked her just what was it that I did "right" in raising her.
"I never had a TV in my room. We always watched programs together."
And we always watched the commercials together, too.
Recently a parents group requested the toy companies to dial down their ads because of the poor economy. That seems to be backwards.
It's not up to toy companies.
It's up to the parents.
Try watching the commercials together.