Tag Archives: nursing

August 7, 2015 · 14:23

Leave them on the Ice Floe to Die: Post Hospitalization Health Care in the United States

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Friends of Padre Steve’s World

Thank you all for your expressions of support, kind thoughts, positive waves, and prayers over the past few weeks. My wife Judy is doing well, her wound is no longer draining, the sutures are healing and it looks like her staples will come out Monday. She is pretty much able to take care of herself and it looks like she will have a good number of visitors while I am in Gettysburg.

Now this has been an interesting experience. You see when someone leaves the hospital after major surgery insurance companies, even good ones are loath to pay for any in-home care, so everything falls on the family of the person, in our case since we don’t have 19 kids to saddle with the work, that person is me. In fact for most people the work falls on their spouse or their significant other, or possibly a teenage kid.

Now I am lucky, I am a fairly senior military officer and I work in an academic setting where I do not have to deploy and have a command that is very supportive of whatever time I need to care for Judy. I don’t have to worry about my paycheck getting docked ort losing my job. Sadly, a majority of Americans have to worry about that if their family member is sick, or needs post surgery care. I think that is a terrible situation if you ask me; condemn Europeans as socialists who pay too much in taxes, but at least they get something for what they pay, most European countries have effective health care and social service systems that do not let people fall through the crack.

For a nation that considers itself the pinnacle of humanitarianism and which is supposedly “pro-life” the situation is shameful, and frankly I think we should be ashamed. We are not pro-life at all, even the people that call themselves that tend to be pro-birth and the hell with you after that, unless you are rich.

Interestingly enough the Commonwealth Fund, hardly a liberal institution, ranked the United States 11th of 11 developed western countries in terms of health care, including accessibility and outcomes, of course all of those countries are willing to have universal health care, and sorry even Obamacare is not socialized medicine, it is simply a modified version of the Heritage Foundation’s plan that they touted over a decade ago and similar to Romneycare. It still keeps the insurance companies in control of most healthcare decisions. If you want to see where the United States ranks here is the listing:

  1. United Kingdom
  2. Switzerland
  3. Sweden
  4. Australia
  5. Germany & Netherlands (tied)
  6. New Zealand & Norway (tied)
  7. France
  8. Canada
  9. United States

The link to the Forbes Magazine article where you can find the report is here: http://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/

But anyway, I digress. When a person leaves the hospital the family, with very few exceptions is lead to fend for themselves. Post hospital prescriptions may be covered by insurance, ours are, but nothing else is. If you need surgical pads, gauze, bandages, antiseptic wipes or a host of other potential needs, they come out of your pocket, thankfully mine are deep enough to handle these expenses, but think of the person who lives paycheck to paycheck and because they have to take unpaid leave are not getting a paycheck during their loved one’s illness.

When your loved one is recovering you become all the things that the hospital provides while they are an inpatient. You are nursing services, you get to check, clean and dress their wounds, make sure they get their medicines and monitor them for anything that might be going wrong. Now for me this is not a problem, I have a significant amount of medical background as a Medical Service Corps officer in the Army as well as a hospital chaplain working trauma, critical-care and ICUs. Blood, guts, bodily fluids, I can handle them; spot infection, got it; change dressings, and do other things that gross people out, can do. Again, I am lucky; I have training and experience but sadly when most people leave the hospital their untrained and inexperienced relatives get to do this. The family also is the nursing aid, the dietary service, rehab service, housekeeping and laundry service. It is a full time job, which most families are not, trained to deal with and many do not have the resources to do. Let’s say that because they have to pay rent the caregiver has to leave the recovering patient alone, they are hosed unless perhaps a friend or neighbor volunteers to do this, once again at no cost to the insurance company of the health care system.

For those that do not think that nurses earn their money they are sadly mistaken, nursing is hard, it is physical and emotional. I know why nurses only work 3-4 days before they get a break, it is demanding. Judy often tells me from previous experiences with me as her nurse that I graduated from the Leave Them on the Ice Floe to Die School of Nursing. Now with global warming and the ice flows all melting I had no place to put her so I really had to work hard. Actually, I didn’t mind it, I wanted to make sure that there were no complications and that nothing happened to her I really worked hard to care for her, and I wanted to do it. However, that being said that is what our health care system does to people when it puts them out of hospital, it leaves them and their families out on the ice flow and sadly the ice floes are disappearing. We need to really change how we do health care in this country before they are gone.

PearlsBeforeSwine-28Oct2013

 

So anyway, I am now on the way to Gettysburg to lead 20 students as well as some faculty and family members on my third staff ride of the year. Tomorrow and Sunday I will be out and about the battlefield teaching. I’ll post something short tomorrow night.

Again thank you and blessings

Peace

Padre Steve+

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May 18, 2012 · 17:59

In Praise of Nurses

Last week, May 5th-12th was National Nurses Week as well as the 104th Anniversary of the Navy Nurse Corps. Nurses are the lynchpin of medicine. Physicians are incredibly important and as a society we usually ascribe more value to them. However in many case, if not most it is a nurse who is the person that does the heavy lifting in the care of the sick. Before the modern era of nursing was often done by Nuns or by women that volunteered to assist military physicians.

It was in the quagmire of the Crimean War that Florence Nightingale brought about the modern era of nursing, even though physicians and hospitals often saw the women who served as nurses as inexpensive help to care for the sick. Despite this nursing became more and more professional and technical over the years without ever losing that particular calling of ministering to the afflicted that is the essence of their history. In the later 1800s the first nursing schools were established and in 1901 New Zealand was the first country to have Registered Nurses. In 1903 North Carolina became the first US State to require the licensure of nurses.  The US Navy Nurse Corps was established n 1908 with nurses being commissioned as officers and assigned to Naval Hospitals.

However it was the needs of war that brought nursing into the modern age where it is formally recognized as a key component of Health Care. In the World Wars nursing came into its own as a profession. Nurses were among the US personnel that endured the initial onslaught of the war in the Pacific. The Army and Navy Nurses that served and cared for the wounded, starving and emaciated Soldiers, Martines and Sailors on Bataan and Corregidor were heroes in their own right.

The profession of nursing continues to grow and the women and men who serve as nurses at various levels, from the most highly trained Clinical Nurse Specialists and Nurse Practitioners, or other highly specialized Register Nurses many of whom have advanced degrees including doctorates down to the most humble Licensed Vocational (or Practical) Nurse and even Certified Nursing Aides. These women and men are the backbone of medicine and despite the long hours, the years of training and certification required of them, many people don’t fully appreciate them until they become sick and are cared for by these wonderful people.

I have been blessed to have known and worked with many amazing nurses in the course of my career as a Medical Service Corps Officer in the Army and as a Chaplain in the military and civilian settings. As I wrote yesterday I lost a dear friend and co-worker, Commander Marsha Hanly a Navy Nurse who died unexpectedly yesterday. Marsha exemplified the best of nursing and thank God there are so many more like her who serve so well, and care so well for those committed to their. Likewise many a physician and chaplain for that matter owe a great deal to nurses.

God Bless all Nurses tonight.

Peace

Padre Steve+

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May 17, 2012 · 21:08

Too Young: In Memory Commander Marsha Hanly, Nurse Corps US Navy

LCDR Marsha Hanly caring for a patient in the ICU of the USNS Comfort 

“Nursing is an art:  and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit?  It is one of the Fine Arts:  I had almost said, the finest of Fine Arts.”  Florence Nightingale

This afternoon I was stunned to learn that a very dear co-worker and friend from Naval Medical Center Portsmouth had unexpectedly passed away. Marsha Hanly was a ICU Nurse who arrived at Portsmouth about the same time I did in 2008. She had just completed a Master of Science in Nursing at Duke with a specialization in Adult Critical Care nursing.  Marsha exemplified all that is good in nursing and was as devoted to her calling as Florence Nightingale described.

I remember what seem like countless times where I stood beside Marsha as she cared for critically ill or dying patients, comforted their families and helped the other nurses and physicians in the ICU. I also cannot count the number of times that she stood by me as I prayed for patients as they lay in critical condition. She was an outstanding nurse and Naval Officer as well as one of the most kind and compassionate people that I have ever met. She was devoted to her husband and children and to the welfare of those committed to her care. She was funny and joyful person who was real. She was a committed Christian, wife, mother and fantastic nurse. She could laugh and she could cry, she really loved and cared for those that she served.

Last year Marsha deployed on the Hospital Ship USNS Comfort as part of Operation Continuing Promise, a medical mission to the Caribbean Sea, South and Central America. While deployed she was selected for Commander in the Nurse Corps. She returned late in the Summer and in November was diagnosed with Cancer. She underwent successful surgery which left her cancer free but in need of Chemotherapy to ensure that she remained so. She returned to work in late April and began her Chemo this week. Her last post on her Caring Bridge blog ( http://www.caringbridge.org/visit/mahanly )talked about how she described what she believed would be the course of her Chemotherapy, side effects and how long it would take. She was looking to the future and even to this weekend with her children. I don’t know the circumstances of her death but imagine that it was a sudden and catastrophic event related to the Chemo in some way.

When I read the news on Facebook, where I keep up with my friends from that ICU as well as so many others in my life I was stunned. As I read the comments of her fellow nurses and my former co-workers, nurses and physicians alike I felt like I had been kicked in the gut. I couldn’t believe it because I simply expected this otherwise healthy, young and vibrant woman to sail through Chemo and completely recover. I am so stunned that I cannot believe that his has happened.

This is one of those times where I ask God “why?” I have to admit that I cannot understand this and I have a hard time with the whole “God’s will” thing when things like this happen to people like Marsha. People that devote their lives to caring for others and raising their young children.  I grieve for her husband and kids, I remember her bringing them in to work sometimes.  I pray for her husband Scott and their two young

Likewise I grieve for those who knew and loved her in the Portsmouth ICU. For those that have not been closely connected with those that labor in critical care specialties like a busy ICU there are few places where people bond so closely. Critical Care Nurses and Physicians work in a surreal world where life is constantly hanging in the balance and as a result have a camaraderie that is much like combat soldiers, police and firefighters. This is not just a job, it is a calling, in a sense a sacred vocation. Marsha exemplified the best of her profession and what it is to be a friend.

Even though I left Portsmouth in October 2010 to come to Camp LeJeune I still count the staff there as my friends. We went through a lot together. Many of them were there for me when I was going through difficult times as their Chaplain. Marsha was one of those people. I cannot imagine her not being there when I go back at some point or not seeing her serving and caring for Sailors, Marines and their families somewhere else.

Last week we honored Nurses during National Nursing Week and the anniversary of the founding of the Navy Nurse Corps. Marsha was the best of both. The Nurse Corps has suffered a terrible loss.

Marsha touched so many lives. I know that my former co-workers and friends at Portsmouth are taking this hard. It doesn’t seem right and it doesn’t seem fair. I have a hard time theologizing deaths of people like Marsha. While I am sure that the Lord has her with him I don’t understand her loss here.  While I fail to understand I do still pray that God must have a purpose and I do give thanks for the honor and privilege of knowing Marsha and working with her. In times like this I find some comfort in the prayers of the liturgy and find this one from the Book of Common Prayer to be one that I can pray in good conscience even when I struggle.

“O God of grace and glory, we remember before you this day our sister Marsha. We thank you for giving her to us, her family and friends, to know and to love as a companion on our earthly pilgrimage. In your boundless compassion, console us who mourn. Give us faith to see in death the gate of eternal life, so that in quiet confidence we may continue our course on earth, until, by your call, we are reunited with those who have gone before; through Jesus Christ our Lord. Amen.”

Rest in Peace Marsha. Rest in peace.

Padre Steve+

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December 3, 2011 · 23:56

Loose Thoughts on a December Saturday: I’m not a Nurse, the Great Cain Wreck, the End at Camp Victory, LSU went to Georgia and Padre Steve Discovers Twitter….

Sitting on Saddam Hussein’s throne at Al Faw Palace Camp Victory Iraq 2007

Well it has been a week hasn’t it?  I mean really so much has happened and things just keep happening whether we want them to happen or not as the old adage goes “shit happens….”

For me it has been a hard week although in terms of hardness it has been Judy that has to endure more than me. Judy had surgery this week to remove a bone spur that had grown into her Achilles tendon. Remove of said bone spur a partial resection of the Achilles and she has not had a fun week. Especially with the nursing care available to her…me.

I admire and respect nurses beyond belief and now more than ever.  I don’t have a nursing temperament. When the TV show House MD began I was watching it with Judy and remarked that House was “me without Jesus” to which she responded “honey House is you with Jesus.”  I am a Myers-Briggs INTJ  which basically means that I am not the most warm and cuddly person in the world and I lack the qualities that make for a good and compassionate nurse.

Now I am very competent at doing things to help people including medical things, but that does not mean that I am good at the hands on work that nurses do with great skill and care. Unfortunately for Judy I am her nurse.  A few years back she had a surgical procedure and I did so bad that she said that I had went to the “Leave Them on the Ice Flow to Die School of Nursing.”  Now because of Global Warming there are no ice flows in our area so I have worked hard to help Judy. Having endured a broken leg last summer I have more patience and even empathy than I would have before.  However it has been hard on her and trying on me.  This week has made me more appreciative of nurses than I was before because I would last about a half a shift if I was a real nurse. Personally I am much more like House in that I like to be alone, come up with answers save the day and not get too attached to anything.  How Judy has dealt with me for all of these years is beyond me God bless her and for her sake I hope that her recovery goes really well.

But even as I have done my pitiful best to help and comfort Judy other things are going on in the world without considering that I have been too busy to write about them.  It is not right, the world should stop letting important things happen when I don’t have the time or am too tired to write about them.

I guess the biggest domestic news was that the “Herman Cain Train” became the new Great Cain Wreck as in yet another surreal news conference Cain suspended his campaign.  I don’t know if any of what Cain’s accusers stories have any validity.   However Cain’s responses to each accusation caused me to question his credibility.  I think that having a criminal lawyer introduce him at a press conference after the first accuser went public was part of this but not all. It took more than that. Likewise Cain’s plethora of inept interviews and answers to questions that serious Presidential candidates need to have answers have made me doubt his credibility as a candidate. This was echoed in the polls in which Cain had taken the lead and then saw it melt away as Newt, the new “Bob Dole” Gingrich has vaulted over his competition in many key states, no doubt helped by the Great Cain Wreck. I have no idea who will win the GOP nomination but if they want to defeat the most vulnerable Presidential incumbent that I have ever seen they need to do better.  My scientific polling at the Gordon Biersch bar is that most people are not thrilled with another four years of President Obama, and that many really don’t like him, but almost all view the current GOP field as “unexciting” “uninspiring” and “unprepared” and “un-presidential” bunch that they have ever seen. Jimmy Carter would have been so lucky to have had this bunch to run against rather than Ronald Reagan.  One of them may beat this very beatable President but none of them are Ronald Reagan, heck they make Bob Dole look inspired by comparison.

Across the ocean in the Land of Ur the U.S. Military handed over the massive base complex at Cap Victory over the the Iraqi government.  Camp Victory and the U.S. Air Base connected to it at the Baghdad International Airport was the great gateway in and out of Iraq for many US and coalition soldiers.  It was at one time a complex of palaces built by Saddam and from it U.S. commanders prosecuted the war in Iraq.  I went through it on the way in and out of Iraq. At the time it was a virtual city.  You went to bed with the sounds of combat and rockets and mortar rounds would land in the base even as U.S. and Iraqi forces battled insurgents not far from the perimeter of the base.  Despite this the base had the largest PX facility in country as well as many amenities that seemed like a different world when I went out to Al Anbar province and travelled among our advisors with Iraqi forces.  It had a myriad of fast food outlets, coffee houses and things that you might find on a base in the United States.  While there I did get the obligatory tour of the Al Faw Palace which served as the main headquarters building for Multi-National Corps Iraq and and sat in the throne presented to Saddam by Yasser Afafat.  At the end of my tour I travelled back through and was amazed at the amenities on the base.  Since it was only a stop over I never had any attachment positive or negative to it but just the same it is strange to imagine that this base which some imagined would be the hub of U.S. operations in the Middle East for decades is back in Iraqi hands. I sincerely hope and pray for the best for Iraq and all of its people.

Finally today back in Georgia where Herman Cain surprised no one by suspending his campaign the LSU Tigers surprised no one by whipping up on the Georgia Bulldogs in the Georgia Bowl.  The Tigers fell behind 10-0 in the first quarter but scored 42 unanswered points to remain undefeated and to play for the BCS National Championship.  As Bobby “Waterboy” Boucher would say the Tigers “put a can of whip-ass” on the Bulldogs.

Finally I have discovered the joy of Twitter.  Yes though I haven’t had time to put long coherent thoughts together this week I have discovered that I can put rich and pithy comments into 144 character tweets.  I said that I would never do this and I won’t demean anyone that subscribes to my Twitter account @padresteve by calling them “peeps” as I believe that no one besides little marshmallow chicks that proliferate at Easter should be called.

So with all of that said and more serious things to write about I bid you goodnight.

Peace

Padre Steve+

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