Friday, August 30, 2013

There is No Them

2013 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES
AND THE DISTRICT OF COLUMBIA
Persons in family/household
Poverty guideline
For families/households with more than 8 persons, add $4,020 for each additional person.
1
$11,490
2
15,510
3
19,530
4
23,550
5
27,570
6
31,590
7
35,610
8
39,630

This week in the break room a few of the nurses were asking one another, "If you had the power and the resources to take on one cause, what would it be?"  I remembered reading the night before a mind boggling statistic about poverty in the United States:  more than 35 million Americans now live below the poverty line - which is saying quite a lot given than the poverty guideline for a four person household is a measly $23,550 per year. To put that in perspective, imagine a family of two parents and two children with the primary wage earner* making about $12.25 per hour over a 40 hour work week.  The current federal minimum wage is $7.25 per hour. Needless to say, the standards set by our government are ridiculously and embarrassingly low. 

And then there's the Affordable Care Act.  Apparently drafted in an effort to insure all, under the ACA, many of those working poor who make a wage above poverty line are not eligible for coverage.  Because the government made Medicaid optional, and 27 states opted out, those individuals and their families who make between the poverty line (but not below) and four times that amount are ineligible for both government subsidies under ACA for private insurance and Medicaid benefits.  Which states opted out?  Those with the highest number of families living just at the poverty line.   

As a nurse in a public hospital in a large urban setting, this really strikes a cord.  Every day we are the eyes and the ears of the war on the poor in this country, from the front lines.  But how many times are there grumblings from both nurses and doctors about patients who have not sought out preventative care, who's BMI is "too high", with uncontrolled, underlying conditions, who have had multiple pregnancies, abortions, losses, births, addictions. And how many times are these people blamed for their "lack of initiative" in caring for themselves.  Every day there is someone blaming a patient for poor health outcomes -- or for being overweight or impoverished or having multiple prior pregnancies or for being addicted -- and every day I wonder how these people can care for themselves when we can't - not even for 24 hours - suspend our judgement to simply care for them.  As we should without doubt and without question, as this is the root of our profession.

You aren't cared for because you care for yourself.  You're cared for because others care for you. 

*No the second parent doesn't work because they can't afford childcare.  

Thursday, August 15, 2013

For Every Field There's A Mole

Because I am back with my anonymity no longer in tact, I will be writing less about what happens in the hospital in a detailed manner.  That is to say, it is of the utmost importance to me to protect my patients. Of course, I am confident that many anecdotes of this crazy business will find their way through.

I have been an (employed!) nurse for three years since I last posted here.  Yes, I still see this job as my true calling.  But I am often frustrated and disappointed in the system and I am daily looking for a way to articulate: to reverse the ethnography, so to speak. I have to demonstrate the transition from critic to cog in the wheel, which is very hard.

From the moment I stepped into the role of clinician, I have struggled not to speak too loudly, but I often fail.  I have tried to be fair and to equally, quietly bear witness to all of our patients.  I have tried to burn the injustices that I see and hear every day on my brain so that I can one day, in some small way, try to right them.  I hope that this forum will be the jumping off point for me to eventually do that in a larger way.  I hope that there are eyes here to bear this with me.


All of my life I have watched the masses of the world 
suffering from the same disease for which 
the cure is readily available to them 
but they cannot see it.  
We are all born to take a little share of 
the abundance of this earth. 
When you see that, there will be 
tremendous change. 

You only have to open your eyes to open your mind. 

Where You Going Riding, Boy?

After three long years, I'm back in the saddle.
There is a lot to say.
Maybe someone is listening.