Friday, November 21, 2008

Talk Hard


There's a scene in the cult classic film, Pump Up The Volume, in which Christian Slater's character, Hard Harry, loses his voice disguiser while being chased by FCC vans for illegally broadcasting his hip, outrageous and teenage angst-laden rants on a pirate radio station he's rigged to his mother's jeep.  Stripped of his cover, he and Samatha Mathis look out over the athletic field of his high school, at the hundreds of adoring fans listening to their radios, hoping that Hard Harry will stay on the air, not be intimidated by the authorities closing in on him.  "This is me now," he says.  "No more hiding behind the phony voice."  And what follows is an adrenalin-soaring soliloquy to all listening and assembled to use their voices to say what needs to be said, to clear their throats and unburden their hearts.

I'm always thrilled every time I watch this scene because it's me up there, just wishing so bad I had the nerve to say out loud what needs to be said, to question the established, politically correct order, to probe assumptions without fear, to throw a pie or two in the face of organized thuggery, no matter the form it takes, to talk hard.  So in the spirit of emancipation....

The Sacramento Bee headline told the story:  "Judge rules only nurses can inject insulin in kids." Score: 1 for the grown-ups, the California School Nurses Association, the California Nurses Association and "other nursing groups;" 0 for the 14,000 kids with diabetes who go to public schools.  In California, there are 9,800 public schools and 2,800 nurses to serve them.  Do the math.  Someone's getting screwed here.  And all in the name of "scope of practice," "work to union rules," and flexing political muscle through the courts.

What started out as a desperate attempt by the parents of diabetic children and open-minded school personnel to expand the number of people at school who are willing and who can be trained to give a shot to kids when they need it during the day, crashed and burned last Friday.  Now, only a licensed nurse may administer that insulin.  Unless of course the parent can rush to the school from his or her job or from home, before little Johnny or Maria goes into shock.

It's a bully's play.  It's about putting unimaginable pressure on the schools to hire more nurses.  It's about salaries and benefits, not about solving the problem of how to keep diabetic kids on their meds, able to function and learn in school.

A letter to the Sacramento Bee's editor from Chris Andre, a former school nurse, a diabetes educator, member of the CNA and parent of a child with Type 1 diabetes: "Learning to give an injection is a piece of cake and does not require a license.  A license is needed to develop safe parameters to give the injections...Remember, unlicensed parents are injecting their children every day."

I have spent some good years toiling in the mines of health care workforce issues, the nursing shortage and the dominance of medical doctors over the scopes of practice for all of the healing arts.  That rigid, politically-charged paradigm, the one where Our Father (or Mother) the Doctor, the Nurse, the Business & Professions Committee shall dictate the pace and reach of innovation for providing care, well that's running headlong into the other charging train called the Economic Melt Down Express.

Those 14,000 kids and their inability to get a shot when their lives depend on it are emblematic of what's wrong with health care today.  The doctors, nurses, technicians--the whole pecking order--have worked themselves doggedly into these tightly engineered, legally defined slots, totally at the expense of those in need of care.  Talk about rationing!  Embargoing health care, holding patients hostage for wages and benefits, is no different than OPEC jiggering the cost of gasoline or Detroit refusing to make a fuel-efficient car.  You can see how well that's working out.

P.S.  This just in: According to a November 15, 2008 USA Today survey, "those touched by childhood diabetes seek more support from schools and about half of young people with the condition have trouble coping.  Eighty percent of parents and seventy-three percent of young adults thought that teachers should be better informed about diabetes."




Tuesday, November 4, 2008

Down Is The New In!


We're dancing in my house tonight, while loud strains of Stevie Wonder and hope and jubilation fill the rooms!  WE did it America, WE have turned away from our darker impulses to embrace one another, to form a new and miraculous tribe, to be led by someone with probing intelligence, calm and a commitment to the change we all hunger for.

God Bless America for being such a cool country that we could produce Barack Obama, could nurture his ascendancy to the highest office in the land and allow all of us, Red State, Blue State, all the States to unite again.  

Yes.  Yes We Did!