Archive for June, 2011
A bold group of mothers gave a new meaning to the term ‘flashmob’ when they bared their breasts at a major shopping centre today to raise awareness of breastfeeding.
More than a hundred mothers of all ages – some accompanied by their partners – descended on the Trafford Centre in Manchester to feed their babies in front of stunned shoppers to promote the start of NHS-backed National Breastfeeding Awareness Week.
The proud women bore all in full view of customers sitting in the shopping centre cafes to highlight the health benefits of breastfeeding.
For the fortieth poem in the series, something a little different. Okay, not seasonal, but what the hell. (The Simpsons’ classic version can be found here.)
I’ve seen this short by TSO Photography a few times now, and it hasn’t grown old yet.
Imagine this: you’ve had the shift from hell, no beds, every other patient is moments away from seeing Jesus/Allah/Buddha and to top it off, the department is down three nurses, another nurse is transporting the multisystem trauma downtown, and you feel really think working conditions were unsafe for both you and more importantly, your patients. So you go to your unit union rep — in the case of most Ontario nurses, from the Ontario Nurses Association — and she says, No problem. Just fill out this document, the Professional Responsibility Workload Form, in either Official Language, in quadruplicate, and all will be well.
Oh, I forgot. Here’s page 2:
So it’s 0730, you’re coming off nights from the shift in which you thought you might finally go postal, and you’re union rep is telling you to fill out this form. The chance of it getting completed? Is zero too high an estimate? Here’s a hint: there’s a four-page guide on how to effectively fill out the form.* And if the form is actually filled out? The union (I think) is supposed to meet with management to discuss the (completed) form, but in truth I have never heard of any outcome of such a meeting, or if in fact such meetings exist. One suspects when the union raises workload issues with management — encompassing such items as competency, patient safety, you know, important things — management says, “It is what it is,” and with a nod and a wink the union goes off to collect its membership dues. In short, we’ve filled out these forms for as long as I’ve been a nurse, and nothing has ever changed as a result.
It seems, to me anyway, that the Professional Responsibility Workload Form is a classic example of appearing to address an issue, while in fact doing absolutely nothing. Doing so lets both the union and managers off the hook for the deteriorating quality of nursing work life. I don’t think I am being unduly harsh. There is a distinct lack of accountability and transparency around these forms, and it’s symptomatic of a general complacency within ONA’s leadership about issues affecting front line nurse. Given that ONAs 57,000 members each pay nearly a thousand dollars annually in dues, you think someone would come up with a better process to watch workload issues.
*The statement on the top of the guide made me laugh out loud:
“ONA members indicate it is important and worth the work to complete Professional Responsibility Workload (PRW) Report forms.”
I am not very clear which ONA members the union leadership was speaking to. Not anyone, I’m guessing, from an emerg.
Posted by torontoemerg in Battered Nation Syndrome, Before I Start Throwing Things, I'd Better Write This Down on Thursday 23 June 2011
On 3 June 2011, an arbitration panel handed down the new contract for the majority of Ontario hospital nurses. The panel was set up when negotiations between the Ontario Hospital Association and the union, the Ontario Nurses’ Association broke down. This is a pretty routine procedure when the union contract comes up for renewal, because in Ontario, nurses are considered “essential workers” and don’t have the right to strike. I’m fairly sure this wouldn’t interest many or even most of my readers — even nurses — except for a obnoxious new contract clause, buried deep in the arbitration award:
Effective April 1, 2011, no sick pay benefit is payable under HOODIP for the first fifteen (15) hours of absence for the sixth (6th) and subsequent period(s) of absence in the same fiscal year (April 1st through March 31st).
English translation: if you have six or more absences because of illness (as opposed to days, it must be noted), your employer will punish you for being sick by docking you fifteen hours of sick pay for each absence.
It is true that nurses have among the highest absentee rate among any employee group, and this clause is an attempt to remediate the situation. It is also true that high absenteeism is for reasons unique to nursing. These are the smartly dressed white elephants you see standing in the corner that the hospitals and the union both ignore: we’re exposed to infectious disease, high stress levels, poor morale and horrendous working conditions. We all know about it, and nothing is ever done but pass the blame to nurses. I can’t see how punishing nurses for factors out of their control is even remotely helpful. It’s a little like starving a child, then beating her when she takes a bite of cake.
Even aside from these generic issues, one can easily see circumstances where the heartlessness of this clause will affect individual nurses. Supposing you had an illness which required specialized treatment over a period of time, such as chemotherapy, which required you to take an occasional sick day. According to the union and the hospitals, too bad for you. We are now, they are saying, going to flog you financially for contracting cancer.
The union will probably say, “Well, it was an arbitrator’s award, it was out of our hands.” This only partly true, at best. The arbitration panel doesn’t pick contract language out of thin air. Both the hospitals and the union make submissions in the arbitration process based on their bargaining positions. Clearly, this little piece of horizontal violence was on the table beforehand. How vigorously did the union contested the hospital’s position on this at negotiations? Who knows. I respectfully suggest, however, that ONA put this clause at the top of its list when new negotiations start in a couple of years.
Unfortunately, ONA has calculated, probably correctly, that the pushback from front line nurses over this clause will be minimal. We can do very little about it, and in any case, there is a huge disconnect between front line nurses and the union leadership — which you would think would be a cause of concern. In its news release, all ONA could offer was some anodyne mush from ONA’s president, Linda Haslam-Stroud. The bash-the-nurse clause was mentioned not at all. ”The agreement,” said Haslam-Stroud, “addresses the priority issues of the front-line registered nurses and allied health professionals – the backbone of health care.”
Uh, huh. How about working with the hospitals to fix some of the root causes of absenteeism, instead of tacitly supporting a policy which punishes them?
Along with Ye Olde Mill By The Stream™ and Child Getting First Haircut™, Insect on Flower is one of the most beloved clichés in photography. But as Jethro, my photographical partner-in-crime says, who the hell cares?
A couple of weeks ago we had a spectacularly bad day, traumas, codes, STEMIs, septic shock, status asthmaticus, what have you, plus (of course) a department filled with
the haunted faces of the damned admitted patients and volumes of epic proportions. Faced with an angry and hostile waiting room overflowing with the walking wounded, the triage nurse made an announcement.
“Can I have your attention, please!” she shouted. “Because of four critically ill patients in the department, THERE WILL BE EXTENSIVE DELAYS TO SEE A PHYSICIAN. Thank you for your understanding.”
Ten patients immediately got up and left.
I know patients come to an emergency department for reasons the health care professionals treating them might question, and that what we consider to be an emergency often diverges wildly from how a patient might perceive it. Nevertheless — I’m thinking, maybe, for those patients it wasn’t that much of an emergency, and just maybe, their GP or (God forbid) a walk-in clinic might have been a better option and better use of health care resources.
The story of how Coleridge came to write this famous poem is probably too well known to bear repeating (but nonetheless
is found here, for example.) I have sometimes wondered if one could write a poem considered (maybe) one of the ten or twenty greatest in the English language intoxicated with opium; I know there many other examples of such thing occurring, but the results have been, well, often disappointing.
Or, a vision in a dream. A Fragment.
In Xanadu did Kubla Khan
A stately pleasure-dome decree:
Where Alph, the sacred river, ran
Through caverns measureless to man
Down to a sunless sea.
So twice five miles of fertile ground
With walls and towers were girdled round;
And there were gardens bright with sinuous rills,
Where blossomed many an incense-bearing tree;
And here were forests ancient as the hills,
Enfolding sunny spots of greenery.
But oh! that deep romantic chasm which slanted
Down the green hill athwart a cedarn cover!
A savage place! as holy and enchanted
As e’er beneath a waning moon was haunted
By woman wailing for her demon-lover!
And from this chasm, with ceaseless turmoil seething,
As if this earth in fast thick pants were breathing,
A mighty fountain momently was forced:
Amid whose swift half-intermitted burst
Huge fragments vaulted like rebounding hail,
Or chaffy grain beneath the thresher’s flail:
And mid these dancing rocks at once and ever
It flung up momently the sacred river.
Five miles meandering with a mazy motion
Through wood and dale the sacred river ran,
Then reached the caverns measureless to man,
And sank in tumult to a lifeless ocean;
And ’mid this tumult Kubla heard from far
Ancestral voices prophesying war!
The shadow of the dome of pleasure
Floated midway on the waves;
Where was heard the mingled measure
From the fountain and the caves.
It was a miracle of rare device,
A sunny pleasure-dome with caves of ice!
A damsel with a dulcimer
In a vision once I saw:
It was an Abyssinian maid
And on her dulcimer she played,
Singing of Mount Abora.
Could I revive within me
Her symphony and song,
To such a deep delight ’twould win me,
That with music loud and long,
I would build that dome in air,
That sunny dome! those caves of ice!
And all who heard should see them there,
And all should cry, Beware! Beware!
His flashing eyes, his floating hair!
Weave a circle round him thrice,
And close your eyes with holy dread
For he on honey-dew hath fed,
And drunk the milk of Paradise.
— Samual Taylor Coleridge