Category Archives: psychology

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.

The Tree of Life.

October 28, 2018Christian fundamentalism, Christianity, commentary, contemplation, Deep Questions, Deep Thoughts, faith, Fundamentalism, grief, healing, human behavior, Judaism, mystical experience, personal testimony, psychology, Questions, religious belief, social commentary, sociology, UncategorizedAdam and Eve, Genesis, Holy Bible, Jews and Christians, Massacre at the Pittsburgh synagogue, the Garden of Eden, The Old Testament, The Torah, The Tree of Life, the Tree of the Knowledge of Good and Evil, unityruth ann scanzillo

Just about every child in the United States now over the age of 30 has heard the story of Adam and Eve.

For many Americans, and scores of others across the globe, this was the beginning of life as many had been taught to believe it.

And, for every patriarchal society wallowing in male dominance, the first woman and her original sin became the bane of all who walked in her shadow.

But, whether man or woman what many may not know is that this story is shared by both Christians and Jews. The Torah, the sacred Hebrew book, predates the Biblical canon by a swath of time and contains the first five books of what would later become the Christian Old Testament.

And so, both Jewish children and Christian children were raised by the story of the Garden of Eden, as told in the book of Genesis.

Now, when we read those early chapters in Genesis, we find that Jehovah Elohim, after creating everything else, including Man, put not one but many trees in Eden. And, then we are told that he singled out not one, but two trees: a.) The Tree of Life, in the midst of the garden, and b.) The Tree of the Knowledge of Good and Evil. And, then Jehovah commanded Adam. He told him he could freely eat of the fruit of every tree in Eden, except that of the Tree of the Knowledge of Good and Evil, lest he surely die.

Then, God created Eve.

The story continued, painting Eve as both approachable and easily confused. The serpent tempted Eve, by challenging the words of Jehovah and putting a question in her mind. But, beguiling her, he made reference not to the Tree of the Knowledge of Good and Evil but to the tree in the midst of the garden. This was the Tree of Life.

(So, which was it? From which tree was she permitted to eat? And, whose fruit would bring certain death?)

We all remember what happened. Eve partook of the fruit of the tree to which the serpent had led her. Sharing with Adam, they knew their nakedness, were ashamed, and tried to hide from Jehovah. And, Jehovah banished them from the Garden of Eden.

But….the Tree of Life. In the midst of the Garden.

I have pondered this wonder, for most of my own life.

Perhaps the Jewish children know the secret.

Of note is that, whether male or female, the Jews as a people are equally thoughtful, equally respected. Equally forgiving. Equal.

They still worship in the midst of the Garden. They still honor the Tree of Life. Regardless of our faith or the absence thereof, let us all offer up a prayer for those who will meet at the synagogue which bears its name, in Pittsburgh, Pennsylvania, again this Saturday. Perhaps there is one reaching out to us in spirit, from among those whose lives were taken. Whether Jew or Greek, bond or free, let us clasp hands and sit under the Tree of Life, together.

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Yesterday.

October 21, 2018arts education, commentary, musicians, nostalgia, professional musicians, psychology, social commentary, sociology, tributes, UncategorizedBilly Joel, concepts of history, establishing value, Food Co-ops, Live in The Now, Paul McCartney, SiriusXM, the classics, the generation which remembers, the Millennials, the popular song, the test of time, Yesterdayruth ann scanzillo

I love the past.

1970’s superstar Billy Joel has his own SiriusXM station. Unlike the breadth of his continuing career, he gets to keep Channel 30 for just a few weeks, kind of like a feature. I’ve been enjoying his retrospective, while driving to the Food Co-op, or out on errands – every time I’m behind that wheel. Along with legions of others, I get this brief chance to travel across his repertoire with him, in between snippets of commentary and gems from his recollection.

Of particular interest is the story of how he became a songwriter. Apparently, his mother always played her favorite records, at home. She loved Gilbert and Sullivan, and others from her era. Billy absorbed solid songwriting from these masters but, as he recounts, his fire wasn’t really lit until he heard the Beatles.

And, the other day, while presenting his Songs I Wish I’d Written segment, he invariably cited one of them: Paul McCartney’s “Yesterday.”

Now, everybody knows that the popular song is the capsule for every memory, in our lifetime. And, most of us have a narrative for every favorite we can name. But, only the psychologists have warned that nostalgia isn’t particularly “healthy”; they, along with those Be In The NOW proponents, argue that living in the past is oppressive, even toxic.

At least two songwriters might challenge that.

Here we have legends, in their own time – Joel, and McCartney. I’m betting neither of these song meisters are wallowing in whatever happened to them. Their respect for the past is a real religion; they both know that, if we lose faith in what has made us who we are today, we’ll have little upon which to grow for tomorrow.

The Millennials, who live in a world of instantaneity, may not have a concept of history. They may be missing a reverence for that which is foundational, upon which the new must be built. They may not realize that what they deem worthy may have come from the mind of one for whom effort to produce it was lifelong. From their perspective, that which isn’t current is both passe and dispensable, devoid of value. Displacement has supplanted any concept of what used to be termed “classic.” Yet, how many of their pop celebrities are producing music which will endure? Whatever happened to “the test of time”?

We may long for that which is past, but we can hide away, even believe, in our yesterdays. I’m grateful, today, to be part of a generation which can still embody that which it can also remember.

Sing on, gentlemen.