Nurse Ratched’s Place

Portrait by Ansel Adams, 1943
My mother told me to never talk about religion or politics in public. She said it is impolite, but I have to speak up. The woman in this picture is Nurse Aiko Hamaguchi. Look at her closely. Nurse Hamaguchi is the face of racial profiling.

Nurse Hamaguchi was born in Long Beach, California, and lived in Los Angeles and Redondo Beach. She completed two years at Los Angeles City College majoring in pre-nursing. She then completed her nursing education at Los Angeles General Hospital. Her ambition was to become a public health nurse. She told Ansel Adams, the famous photographer who took her picture, that she was interested in human beings. She enjoyed bridge, tennis, horseback riding, and reading. Then, shortly after the bombing of Pearl Harbor in 1941, Japanese Americans were uprooted from their homes and sent from Los Angeles to Manzanar relocation center in northeastern California. Adams met Nurse Hamaguchi at Manzanor. She told him, “Only after evacuation have I come to realize the false sense of security I enjoyed prior to the war.” Eventually, thousands of Japanese Americans were forced into ten relocation centers in Califonia, Arizona, Idaho, Wyoming, Colorado, Utah, and Arkansas.

Fast forward to the 21st Century. Sen. James Inhofe (R-Okla.) announced to the Senate Armed Services Committee that he believes in racial and ethnic profiling. He’s not alone. A new Gallup World Religion Survey found that Muslims face more bias in the United States compared to other religions. According to the survey, Americans are more than twice as likely to express prejudice against Muslims than they are against Christians, Jews or Buddhists, and nearly two-thirds of Americans say they have little or no knowledge of Islam. Still, just like Sen. Inhofe, a majority of Americans dislike the Muslim faith. I understand why this is happening, but racial and ethnic profiling is morally wrong. It hurts innocent people, and it won’t keep us safe. U.S. Muslims who feel alienated are more vulnerable to radical ideas.

Nurse Hamaguchi was viewed as a potential terrorist in 1943. Look at her again. Her ghost haunts us. I hope our country can learn the lessons from the past.

This nurse looks like she’s charting, but she might be fooling you. Perhaps she’s writing down her New Year’s resolutions. I’ve noticed a lot of nurses doing that around this time of the year when they are at work. The number one resolution during a bad shift is “get a new job now!” Too bad this nurse doesn’t have a computer to help her with her job search. My web guy, Shane, gave me a heads up about what’s happening at All Health Jobs and All Nursing Jobs. Shane has created a coupon code just for Nurses Ratched’s Place that anyone can use to post jobs for free on All Health Jobs and All Nursing Jobs through the end of this week to jumpstart their 2010 hiring. Just enter coupon code NurseRatched at checkout, and post as many jobs as you like. And if you are sick and tired of your old job, go look for a new one at All Health Jobs and All Nursing Jobs.

Personally, I’m really happy with my job, but I’m thinking about doing something wild and crazy for the new year. Did you know that there are job opportunities overseas for American nurses? I’m thinking about transferring to a hospital in Europe for a couple of years. I’ve never been out of the United States before, and I’m not getting any younger. Seriously, I think it’s now or never. Time to get a passport before I change my mind. I’ll keep you posted.

I found this video over at Diary of a Trauma Nurse. The video was done at Providence St. Vincent Medical Center in Portland, Oregon. Put your dancing shoes on. It’s time to boogie!

It looks like the girls have been busy cooking Christmas dinner for their patients in the hospital kitchen. Really. Some hospitals will do anything to save a buck. Anyway, it looks like everyone is having fun. Wishing you happy holidays from Nurse Ratched’s Place.

Priceless………

I took this picture a couple of years ago during a trip to Iowa. This is the old Clarinda Asylum for the Insane. The name was changed for obvious reasons a long time ago to the Clarinda Treatment Complex. I grew up in Iowa, so let me tell you a few things about my home state. Among other things, Iowans grow corn, raise hogs, and sometimes elect people to the Iowa State House who need a little schooling about mental illness and the needs of the mentally ill.

Iowa currently has four state hospitals for the mentally ill. Now that number is being cut down to three. Iowa State Legislators, who have no clue about what they’re doing, ordered the head of the Department of Human Services, Charles Krogmeier, to shut down one of the state’s mental hospitals. The Clarinda facility and three other hospitals were put on the chopping block. Krogmeier didn’t want to shut down any of the hospitals. He said that the move wouldn’t save money or improve patient care, but the politicians gave him no choice. Mr. Krogmeier suggested the elimination of the Mount Pleasant Mental Health Institute.

Bravo, Iowa State Legislators. You and Governor Chet Culver are gutting Iowa’s mental health system by ignoring the big picture. State hospitals treat patients who don’t have insurance and cannot pay for private care, and those that no one else will take. You know what I mean. I’m talking about violent patients. They hurt themselves or others, and engage in inappropriate sexual behavior or start fires. Mental health patients without insurance, or those who exhibit dangerous behaviors, can wait many days in a hospital emergency room for a state hospital bed to open up. The consulting firm that Governor Culver hired suggested that the state close down the geropsych beds at Clarinda and the drug treatment center at the Mount Pleasant Mental Health Institute. They told Governor Culver that the geropsych patients could go into area nursing homes, and that the drug treatment patients could pay out of pocket, or find money elsewhere, for treatment in private facilities. Shows you what the “experts” know about the mental health system. Nursing homes won’t touch geropsych patients because of rules concerning chemical and physical restraints, and drug treatment patients wouldn’t be in state beds if they could pay for their treatment in the first place.

The Iowa State Legislature and Governor Culver need to take Mr. Krogmeier’s advice. He is advising the governor to open up a series of small 16 bed mental health centers throughout the state before closing a single hospital. This would facilitate revenue via Medicaid, and allow patients to be closer to home. Of course, opening centers takes time, and the clock is ticking. I hope the politicians can work things out, but judging by their track record, I don’t give it much hope. Shuffling patients to other hospitals and limiting beds isn’t going to solve the problem. It’s going to make things worse.

Check these old gals out. Love the cute nursing caps. They look so dainty. Turn of the century nurses knew how to stretch a buck. They did all the work in the hospital. They cooked for their patients, did housekeeping chores, and whatever else they had to do to keep their hospital humming. Notice the nurse leaning up against the doorway. These nurses look tired. I wonder if they had coupons back then. Coupons are also a great way to stretch a buck while you’re buying new uniforms. I’m sure that these ladies would have appreciated wearing a nice pair of scrubs while they were doing their work. Imagine wearing a long white nursing uniform while stoking a coal burning stove!

My sponsor ScrubsGallery.com has a coupon offer that they want me to pass on to you. They are offering 20% off all Scrubs Tops. This offer is valid from December 12th through December 14th. Just enter the code “nursertops” in the coupon code box at checkout to receive your discount.

Just like old time nurses, hospitals also know how to stretch a buck. Community hospitals are cutting employee benefits, overtime pay, and they are making nurses work longer hours with less help. Nice. I hope that hospitals don’t try and go back to a simpler time when nurses did everything in the facility. Try these recipes just in case you find yourself cooking for your patients again. I originally published this information back in 2006. I can’t believe that I’ve been blogging for three years now, but this information is timeless:

This belonged to my great-grandmother, my great-aunt, my grandmother, and then it was passed down to me. The White House Cook Book, A Comprehensive Cyclopedia of Information For the Home, was first published in 1887. This edition was published in 1912.

Before there were HMOs, PPOs, and primary care physicians, there was the White House Cook Book, A Comprehensive Cyclopedia of Information For the Home.

Housewives used this cookbook, as well as others published at the turn of the century, as a health care resource book. My favorite chapter in the White House Cook Book is “For the Sick.” In the beginning of this chapter, the authors write, “Dishes for invalids should be served in the daintiest and most attractive way; never send more than a supply for one meal; the same dish too frequently set before an invalid often causes distaste, when perhaps a change would tempt the appetite.” Here are some of my favorite recipes from that chapter. Nurses, take notes. You’ll be tested over this material the next time someone you know gets the vapors.

Beef Tea:

One Pound of lean beef, cut into small pieces. Put into a glass-canning jar, without a drop of water, cover tightly and set in a pot of cold water. Heat gradually to a boil and continue this steadily for three or four hours, until the meat is like white rags and the juice is drawn out. Season with salt to taste and, when cold, skim.

Arrowroot Milk Porridge:

One large cupful of fresh milk, new if you can get it, one cupful of boiling water, one teaspoonful of arrowroot, wet to a paste with cold water, two teaspoonfuls of white sugar, a pinch of salt. Put the sugar into the milk, the salt into the boiling water, which should be poured into a farina kettle. Add the wet arrowroot and boil, stirring constantly until it is clear; put in the milk and cook ten minutes, stirring often. Give while warm, adding hot milk should it be thicker than gruel.

Doesn’t this sound good. But wait, there’s more!

Toast Water, or Crust Coffee:

Take stale pieces of crust of bread, the end pieces of the loaf, toast them a nice, dark brown, care to be taken that they do not burn in the least, as that affects the flavor. Put the browned crusts into a large milk pitcher, and pour enough boiling water over to cover them; cover the pitcher closely, and let steep until cold. Strain, and sweeten to taste; put a piece of ice in each glass. This is also good, drank warm with cream and sugar, similar to coffee.

Now that you know how to cook for your patients, why don’t you head on over to Emergiblog and check out Change of Shift. Do a little light reading while you eat your bowl of gruel.

This is Dustin Hoffman in “The Graduate.” He was getting some advise from an old family friend. Do you remember this scene?

Mr. McGuire: I just want to say one word to you -just one word.
: : : Ben: Yes sir.
: : : Mr. McGuire: Are you listening?
: : : Ben: Yes I am.
: : : Mr. McGuire: ‘Plastics.’
: : : Ben: Exactly how do you mean?
: : : Mr. McGuire: There’s a great future in plastics. Think about it. Will you think about it?
: : : Ben: Yes I will.
: : : Mr. McGuire: Shh! Enough said. That’s a deal.

Mr. McGuire had a crystal ball. Or maybe he had a plastic ball. The future was all about plastics. Unfortunately the future would also be filled with debates about BPA. I was invited to sit in on a conversation with Dr. Val Jones from Better Health. One of the guest speakers was Steven G. Hentges, Ph.D. Executive Director – Polycarbonate/BPA Global Group American Chemistry Council. Dr. Hentges discussed the debate surrounding BPA, and allowed bloggers who were sitting in on the conversation to ask him questions. I did my homework before speaking to Dr. Hentges. I didn’t know too much about BPA other than it’s the stuff that caused all my friends to stop microwaving their food in plastic containers. My friends are health conscious. They said that BPA is bad stuff, and that a lot of it goes into your food when you microwave your meal in a plastic container.

I had two questions about BPA when I started doing my homework. First, what is the best science for assessing the safety of BPA? And second, if BPA is unsafe, why was it presumed to be safe for the past 50 years? I Googled BPA and found an abundance of research information. There are a lot of statistics swirling around in this debate. I also found an informative article in the American Journal of Public Health entitled “The Politics of Plastic: The Making and Unmaking of of Bisphenol A Safety.” The author, Sarah Vogel, asked the same questions that I have about BPA, and she came up with some answers. I downloaded her article for 15 bucks ( it was totally worth it), and I learned more about the history of BPA, and about this debate.

I learned that PBA was identified as a possible synthetic estrogen back in the 30s by a British medical researcher when he was looking for the “mother substance.” He finally stumbled onto the hormone DES, which was used for “female problems” until it was banned in 1979. In the meantime, BPA was used in the development of plastic. In 1957 BPA was polymerized and turned into polycarbonate. At the time, BPA’s safety was defined by its commercial use in plastics. It was judged on its toxicity, not on its hormone like properties. Fast forward to 1993. Vogel writes in her article that researchers looking for an estrogen in yeast found that their experiment was being contaminated by estrogen-like BPA from their polycarbonate flasks, and scientists started looking at the issue of “endocrine disruption” from low doses of estrogen-like substances, at levels below the FDA’s threshold doses. Vogel concludes:

“Low dose research is longer on the margins of accepted scientific thought but is moving into the mainstream of accepted knowledge. And yet, although scientific understanding of BPA expanded dramatically over the past 10 years, its 20 year old safety standard, based on a threshold dose model, has remained fixed.”

Of course not everyone agrees with Vogel’s conclusion, but she does ask some valid questions. I also share in her concern. During our discussion, Dr. Hentges said that plastics are safe. Of course he would say that because he advocates for the plastic industry. However I was surprised by his thoughts on plastic research. He thinks it should stop. Dr. Hentges said that plastics are safe because no one can prove that they are unsafe. Say what?! Wouldn’t scientists want to do more research in order to clarify the facts? I know that the plastic industry wants to protect their interests, but let’s get the facts straight. We need to have one more word about plastics. In the meantime, I’m microwaving my food in Pyrex. I want more information about BPA.

Here’s the link to the podcast with Dr. Hentges at Better Health.

I thought I was going to hit a Jersey wall last week while I was driving into work. Yes, I drive like a Mario Andretti on the Beltway, but that had nothing to do with it. It was all NPR’s fault. I was listening to the radio at 4 AM when NPR announced the results of a new research study involving mammograms. The study said that women didn’t have to do self breast exams anymore, and that mammograms are worthless before age 50. I thought I was dreaming behind the wheel of my car, so rolled down the windows. The frosty morning air rushed in and revived my senses, but the announcer kept talking about how this new study will make life so much easier on women.

I know that science is always making new discoveries. After all, we use to think that the world was flat, but really, what’s going on here? Who is doing this research, and more importantly, who is paying for these studies? Research isn’t cheap you know, and all of these new discoveries fly in the face of conventional wisdom. Early detection of cancer leads to a cure. And please spare me the lame explanation about why the guidelines were changed. Stop patronizing us. I was really insulted when I heard that the guidelines were changed so women wouldn’t needlessly worry about test results. It makes me wonder if insurance companies are pimping research projects as a way of saving some extra money. To tell you the truth, I started getting suspicious when another research group announced last week that American women are getting too many pap smears. Maybe I’ll start believing all this stuff when a group advocates that men need fewer prostate exams.

Like Mark Twain said, “Figures don’t lie, but liars figure.”

Nurse, your patient is not a pineapple. I found this ad for a grocery store on the Internet. The new store owners wanted to reassure old customers that they would continue the store’s tradition of caring for their fresh produce. I didn’t know that nursery nurses could subspecialize in botanicals. Coochy coo pineapple, we love you!

At least my sponsor, ScrubsGallery.com, hasn’t asked me to pose with fruit. That’s an offer that I would have to refuse. Go checkout their website. They have good deals over there. Seriously. Pineapples not included.

My blog guy, Shane, also asked me to pass on some information about All Health Jobs and their sister site All Nursing Jobs. Those sites are offering employers free nursing job postings. I like the word “free,” don’t you? Just choose the 90-Day Job Posting and enter coupon code THANKS at checkout. The coupon expires at the end of November.