Category Archives: health and wellness

The Principle Of The Thing.

November 2, 2018commentary, grief, healing, health and wellness, human behavior, psychology, social behavior, social commentary, sociology, tributes, Uncategorizedacting on principle, Allegheny Health Network, bedside care, dialysis nurses, dialysis patient care, E.R., Grey's Anatomy, health management, medical dialysis, nurse practitioners, nurses; corporate health care; health care staff scheduling, registered nurses, televised medical drama, The Good Doctor, the principle of the thingruth ann scanzillo

My partner is a registered nurse.

He works in the hospital where I was born.

But, it’s not a hospital, anymore. A medical center complex, owned by a huge health corporation which also provides insurance, it is one of the area’s largest employers.

One would think that, being enormous in scope and financially well endowed, said corporation would be able to sustain the employment of at least one person whose job it would be to enforce fair practices.

Like, staff scheduling.

Instead, the man I love is forced to fill his week with days which often run fifteen consecutive hours or more on site. And then, add being on call, which ties his hands and his imminent presence at least one day per week until 5:30 am the following morning.

And, he isn’t even in the Emergency Room, the scenario which provides fodder for more televised drama than the field of poorly managed medicine deserves. He’s in the dialysis department. This is where patients come, three times a week, to have their kidneys flushed so that they don’t die in a matter of hours from uremic poisoning. And, unlike other departments, such as the cardiac catheterization lab, the doctors aren’t actively on site throughout the shift; the entire week is managed by the nurses, and their supervisor.

Most dialysis patients are in house, admitted, many for weeks or even months at a stretch. These are individuals who are vastly unwell; most have multiple afflictions, including morbid obesity, all of which must be factored in when the four hour, tri-weekly dialysis commences. Each is wheeled to the department on a gurney, where the line forms in the narrow hallway leading to the shallow bay of treatment cubbies.

But, unlike a hair salon, which effectively staggers multiple customers between wash, rinse, cut, set, dry, and style, each of these patients must be watched carefully. First, their vital signs must be monitored for sudden drops in pressure or heart rate; next, potassium levels must be regulated, these directly affecting heart rate. In short, each nurse must be ready to administer the safest, most effective intravenous cocktail of chemicals intended to maintain patient stability throughout the four hour procedure.

Imagine some fourteen patients, in the course of a shift, all of them in a long line awaiting treatment. Visualize eight of these, in active dialysis, at various stages across their four hours. Now, realize that several may be in significant discomfort. One may be thrashing about, yelling; another may be hovering at death’s door.

But, then, there are those patients who have been admitted to the ICU. These are critically ill, but in need of dialysis, perhaps due to drug overdose or sudden sepsis.

Now, consider how many nurses would make for secure, attentive coverage of fourteen patients plus ICU in a given fifteen hour shift. Would you be surprised to discover that the dialysis department currently employs only 5 nurses?

That’s five, in total. Scheduled across a six day work week. Covering a contingent of sick patients, patients who don’t get well. Not on dialysis.

Dialysis is extended palliative care. Patients on dialysis either get a kidney transplant, or expect to reach the end of their lives within five to seven years.

And, for their troubles, these get: five nurses. (There had been six, but the one most willing to work the longest hours tore her meniscus, and now needs surgery.) Has the medical center hired her replacement? Oh, no. Easier just to stretch the remaining five thinner than a dime.

Money. Money drives everything. Allegedly the reward for a job well done, at least it used to be. Now, we have to ask “Who benefits?” Why? Because a job well done is no longer rewarded. Now, a good worker is exhausted, with little recourse against a killer schedule which, especially critical in the health field, renders most nurses chronically sleep deprived, socially constrained, and increasingly embittered.

Let’s require of our massive corporations that they use their equally vast resources to establish a department for accountability to devoted workers. Delegated supervisory roles only work as far as the individual assigned is willing to make the extra effort necessary to create scheduling which both serves and benefits those over which he or she has domain. On principle.

Principle used to represent that moral, conscience-driven act to which one adhered, in process and procedure, even when one stood to benefit nothing. Now, unless there is something in it for the “me”, nobody does anything.

Except the nurses.

The nurses will always do the hard thing. The dirty thing. The critical thing. And, they’ll be asked to do it all on four hours’ sleep, five days a week, irrespective of their advancing age or the responsibilities they maintain when they finally get home at night.

An army of these rising up would force a revolution.

Protected: The Big Sink.

September 21, 2018healing, health and wellness, human behavior, psychology, short stories, social behavior, social commentary, sociology, UncategorizedAmerican health care, assembly line mentality, Bonzai food chopper, bread maker, Bullet food processor, children of the Great Depression, clock watching, deferred dreams, deferred fantasy, double wide porcelain sink, downsizing, Duct tape, Dudley Moore, French press, George Foreman grill, hoarders, holiday potpourri, hospital nurses on call, hot h'ors doerves, incremental planning, incremental thinking, InventHelp, Jack LaLane juicer, late night television, linear thinking, low self esteem, mudroom, needing closure, nursing schedules, open endedness, Pampered Chef, philosophizing about regret, planners, planning against nature, portable fryer, Princess crystal, public education, Pyrex, rice maker, Ronco Tv, Rubbermaid, simplifying, sink load of dishes, steel wool, storage systems, the philosophy of expunging, tomato staking, wafflemakerruth ann scanzillo

Bring It To The Table.

September 16, 2018arts education, civic commentary, commentary, contemplation, dreams, film reviews, Good Food, gratitude, health and wellness, human behavior, interviews, memorials, political commentary, psychology, Recipes, slum culture, social behavior, social commentary, sociology, travelogues, tributes, Uncategorized, vacation destinationsAnthony Bourdain explorer, Anthony Bourdain found hanged, Anthony Bourdain journalist, Anthony Bourdain visionary, Anthony Bourdain's legacy, Anthony Bourdain: "South Africa", Anthony Bourdain: "Spain", Anthony Bourdain: "Thailand", Anthony Bourdain: Parts Unknown, Anthony Bourdain: The Final Episodes, Eric Ripert, preserving culture through food, sociopolitics and culture, sociopolitics and food, story telling, What happened to Anthony Bourdainruth ann scanzillo

He probably had no idea.

But, many women crushed on Anthony Bourdain, myself included.

Given what we have now been told about his life, his worth, and the scope of his experience, this fact may have come to bear no importance to him. Like everything he’d touched, women were likely a “been there/done that” episode in an otherwise keenly focused and ultimately vital social intention.

Because, Anthony Bourdain wasn’t just a fantastic chef. He was an explorer, a journalist, and a visionary. He may also have been, in spite of his rugged earthiness, rather an idealist – receiving, with private reflection and no small frustration, the socio-political realities he encountered.

And, he found them all.

From the rapid fire race of the planet’s cosmopolitae to the cramped corners of primal civilization, Bourdain covered the story – by boat, rickshaw, taxi, mule and the boots on his own feet. And, he reached the very heart of it all, at table.

There is something about the art of not just preparing good food, but in the eating of it. When this man sat down to share a meal, be it finger fried or stew pan steamed, he brought his open mind. And, as his interviews sat with him, they ceased being subjects and became friends. And, so many of them had, until he came along, never been seen or heard by anyone outside of their tiny place in the sun.

In many cases, neither had the culture they represented. And, this was Bourdain’s fascination. He didn’t just bring his appetite. Anthony Bourdain was hungry. He really, genuinely, wanted to know them all, and everything about their lives.

And, they told him.

They told him, both through their food and the act of sharing it. By coming to the table, the story itself unfolded – unprovoked, and unrestrained. It spoke candidly, about the political upheavals of the day and the ancient history in a single pot of oil. It openly expressed the views of its people – their ideas, their needs, their hopes for survival and preservation.

I don’t know what happened in that hotel room in Paris. We are long past the proving of any of it. And, maybe that is just what Anthony Bourdain wanted. Beyond marketing and media ratings, release to our eyes and ears his legacy. Let the story tell itself.

But, do pass the mushy peas.

Please.

©9/16/18 Ruth Ann Scanzillo All right those of the author, who wonders just how many private islands there are. Really. Thank you for respecting original material.

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