Of cheese, erectile dysfunction, and health reform

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And jewelry.

Those were the main take-away messages of yesterday’s nurse practitioner conference at the Washington State Convention Center. There was a lot of mention of the role of nutrition in health, and of individual responsibility for health in some of the sessions I attended—and in the booths at the vendor section. I saw very few obese attendants at this conference—are nurse practitioners skinner on average than their RN counterparts, and if so, why?

The Washington State Dairy Association had free cheese sticks and food pyramids or food Great Walls of China, or whatever architectural wonders they are using now to rank food groups. At a session on health care reform, the speaker spent a lot of time talking about the nutritional content of ‘fast foods’—the winner of the junk-food hall of fame seems to be Baskin Robbins’ Oreo Milkshake at a gazillion calories. As if that is the cause of the dismal health outcomes in our country.

This was at a workshop session by Louise Kaplan, a nurse practitioner who has her doctorate in health policy. She is past president of the Washington State Nurses Association, founder of the first Washington State Nurse Lobby Day in 1984 (in serious need of reform itself–see previous blog post The Nurse Lobby Day That Wasn’t–Feb 15th, 2011), and currently is a Senior Policy Fellow at the American Nurses Association. Besides the information on the Oreo Milkshake, she said we didn’t have health care reform, we had health insurance reform. This statement got applause from the audience, but not from me. This is a profound statement? This is news to anyone? And health insurance in the US is not a significant part of our health care system?

After her talk I asked her if the ANA was looking at reform of the health professions regulatory system in the US. She asked me what I see as the problem with this system—what is in need of reform. I told her in 20 words or less—including that it is not effective in protecting the health of the public, that it drives up health care costs and worsens health inequities. She replied that it was up to each individual state to regulate health professions, and that the ANA would have nothing to say about that—only what the IOM Future of Nursing Report recommended in terms of a consensus on scope of practice for nurses and nurse practitioners. Her response did not surprise me, but I was disappointed in the stock reply.

I loved the vendor area because it was so informative about the role of nurse practitioners in our health care system. Somehow it felt like reading People Magazine—as Paul Farmer says, it is a cultural touchstone. There were many of the major drug company’s represented, including Lilly’s erectile dysfunction “weekend pill” that seemed popular among the ladies. The Washington State Nursing Quality Care Commission had a booth that included a 10-question survey on knowledge of the role/responsibilities of the Commission. There were many booths for local educational programs for nurses, as well as Seattle-area employment agencies/hospitals—and farther afield employment opportunities—the US Navy, the Federal Prisons, Alaska Native American clinics.

But what astounded me was that the most popular booth in the vendor area was a jewelry store. Not fine jewelry, not jewelry for a cause—like for healthcare in Haiti—just glitzy, glittery costume jewelry. Really? There are some things about nursing I am convinced I will never understand.

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