Tag: Health

New Zealand Postcards: The Greening of Hospitals

1981Sustainable health care has the triple aim of maximizing benefits (and minimizing or mitigating costs) in environmental, economic, and social realms.

According to a 2012 Commonwealth Fund study “Can Sustainable Hospitals Bend the Health Care Cost Curve?” (S. Kaplan, et al.), U.S. health systems (especially hospitals) leave costly environmental footprints. In this report, the authors cite estimates that U.S. hospitals use 836 trillion British thermal units of energy and spend over $10 billion on energy annually–resulting in 8% of all U.S. greenhouse gas emissions and 7% of our total carbon dioxide emissions. Hospitals also generate 6,600 tons of waste every day (resulting in more energy consumption, as well as methane gas production) and utilize large quantities of toxic chemicals. They identified model ‘greening the hospitals’ initiatives across the U.S from the Healthier Hospitals Initiative and Health Care Without Harm’s Practice Greenhealth program. Based on the costs/benefits of these model hospital programs, the Commonwealth Fund researchers estimate that such interventions could result in health care savings in excess of $5.4 billion over five years. Good for the economy and good for Mother Earth and good (health promoting) for patients, staff, and the community.

Debbie Wilson, a New Zealand nurse, doctoral candidate, and Sustainability Officer with the Manukau Health District in Auckland, tells the story of how she and a few other environmentally-conscious nurse colleagues  “rugby tackled the hospital CEO” in the hallway one day to present their concerns to him. “He rather liked it because he’s Welsh.” I assume she is referring to the rugby tackle health policy/advocacy approach and not to any inherent Welsh environmental enlightenment. But their rugby tackle worked and they now have a robust sustainability program underway. They began by working to raise awareness of the issues with hospital and clinic staff, which included measuring their baseline environmental footprint: (measurement + transparency= awareness). They’ve set their goal of a 20% footprint reduction by 2017 and are now in the process of writing a systems-wide sustainability policy. Nurses and health policy/health in all policies and advocacy at work!

I met Debbie Wilson last week at the University of Otago’s public health summer school where she was one of the key presenters. In talking with her afterwards, she told me about the model greening of hospitals initiative at Seattle Children’s Hospital. I admit that I didn’t know much about this model program that is quite literally in my own backyard.

Seattle Children’s Clean, Green Initiative was launched in 2007 and has already won Environmental Excellence national awards. Of note among their multiple and comprehensive greening the hospital programs are: 1) switching to environmentally (and health) friendly cleaning products; 2) providing monetary incentives for staff members to walk/bike/bus it to work; 3) piloting a switch to organic cotton hospital linens (including lab coats); and, 4) reducing food waste/increasing composting and recycling in their hospital kitchen (as well as increasing use of fresh, locally-sourced fruits and vegetables).

New Zealand Postcards: Peace on Earthbench Movement

DSC01318Today we visited the Victory Community Center  in Nelson, a fishing and timber town at the top end of the South Island of New Zealand. We heard from Penny Molnar, the center’s Be Well Nurse, about her work promoting health and well-being in the community. Penny has that solid, smart, cued-in, no-nonsense sort of personality that I associate with all of the best community health nurses I’ve had the pleasure of meeting in various parts of the world. The director of the center told us that having a nurse as a key staff member keeps them focused on the health implications of everything they do, from community and school fitness programs, to community gardens, to low-cost swimming lessons (there’s a high drowning rate in New Zealand), to fighting their city council’s plan to build a truck route where there’s now a bike path as well as fruit trees for the use of all the community members.

This pink bench that their school children’s groups have just completed near the community gardens is a Peace on Earthbench made out of ‘bottle bricks’ (plastic soda bottles stuffed full of soft inorganic landfill), covered with cob (a mixture of clay, sand, straw, and water). It’s part of the world-wide Peace on Earthbench Movement (POEM) started by Brennan Blazer Bird, a 25-year old ecological educator from the Bay Area in the U.S.. A positive U.S. export.

The idea behind the benches is to educate school children in sustainability concepts, to have a creative, community-building activity that results in a useful structure for the community to use. The Victory Center’s version of the bench includes an open BBQ pit and a covered area to store the kindling. So clever!

Radical Hat-Burning Nurses Unite!

IMG_1082Radical nurses are back, or perhaps they never left and are just becoming more visible, more organized. The photo here is of my nurse’s cap-wearing trained seal mascot given to me by a friend in nursing school–who promptly dropped out of school because she was too radical for them.

There is the Radical Nurse on Facebook (aka Rebekah Dubrosky, RN) who says of herself, “Radical nurse goes to graduate school with hopes of starting a nursing revolution!” Her profile photo is of the formidable radical nurse and mother of public health nursing, Lillian Wald. Ms. Dubrosky is a doctoral student in the College of Nursing at the University of Wisconsin/Milwaukee. She just published a very good article “Iris Young’s Five Faces of Oppression Applied to Nursing” (Nursing Forum vol 48(3):205-210, July/Sept 2013).

There is the newly-formed Rebellious Nursing! group, which had its first national conference this past fall in Philadelphia. They state: “We believe that Nursing is an inherently political profession and that all nurses are rebellious.” I’m not sure I agree with their tag line, but I do love their logo of a white nurse’s cap going up in flames. An extension of the bra-burning second wave feminists and the corset-burning first-wave feminists. The third-wave feminists seem to have nothing left to burn so they’re putting the push-up bras and corsets back on. (Just kidding. Don’t burn me all you wonderful third-wave feminists–including my former nursing student who introduced me to Rebellious Nursing!).

Going back to the second-wave feminists, there was Casandra: Radical Feminist Nurses Network from the 1980’s. Some of their old newsletters are on Peggy Chinn’s blog, NurseManifest. Peggy Chinn, RN, PhD, is Professor Emerita, University of Connecticut, but she will never truly retire.

There were also Radical Nurse Groups (RNGs) active in the 1980’s within the UK. A nurse blogger who goes by the pseudonym Grumbling Appendix (gotta love British humor) and who works in an NHS hospital (hence the need for a pseudonym), is now archiving material for the RNG’s. In the recent post in the New Left forum, Grumbling Appendix makes the observation that some things have not changed much. I love the Radical Nurses Archive: So….Just How Radical Are You? It includes a funny-sad multiple-choice test from 1982 (when I graduated from wretched nursing school wearing a wretched nurse’s cap), although I need a Brit to help interpret the final scoring scheme.

For an amazing blast from the past that is also sobering in terms of how little things have changed, take a look at the 20 minute film The Politics of Caring from 1977 (produced, directed, and edited by Joan Finck and Timothy Sawyer in collaboration with Karen Wolf, RN.) It is posted on Peggy Chinn’s NurseManifest blog. The only difference between then and now that I see is that the nurses then were still wearing white nurse’s caps (non-flaming) and white dress uniforms (and oh my! those disgusting thick white opaque pantyhose that kept the oh my! pubic hairs from dropping off onto the operating room floor!) There’s something about ‘radical’ and the use of exclamation points….

In the film they begin by saying that while nurses are the largest component of the healthcare workforce they have the least say in health policy. Familiar? They discuss the disconnect between what is taught in nursing school about providing quality of care, and the reality of what is possible within the practice environment. (I hear this from my students all the time). They also question whether nursing can even be called a profession when the majority of nurses don’t have control over their work environments. And they discuss the tensions within nursing with the then newly-emerging role of advance practice nurses/nurse practitioners, pointing out (somewhat rightly so) that these ‘new nurses’ were mainly working within the medical model of care.

As a community health nurse I was fascinated to hear the nurses in the film talk about “the mecca of community nursing” as a place where nurses could practice ‘real nursing’ focusing on health prevention and promotion within the nursing model of care. Community health is what attracted me to nursing in the first place and it continues to be what I love most about my work. But we need hospital nurses and there are nurses who love working in hospitals and don’t want to have to ‘trade up’ to community health, or to become a nurse practitioner or a nursing professor in order to have greater control over their working conditions. Besides unions and Radical Nursing! groups, what is there for them?

My New Year’s Resolution: Avoid Wellness Programs

Eat more fruits!
(Photo credit: miqul)

An increasing number of U.S. companies are ratcheting up their employee wellness programs in order to reduce their cost of health care coverage and payout in employee sick days (thus, of course, increasing their profit for shareholders and executive salaries). They call these wellness programs by all sorts of cute names like Healthy Journey, Move It Program, and Health Counts. They entice employees with rewards programs including cash ‘refunds’ and free membership to health clubs, weight-loss, and smoking cessation classes. Their advertising materials are sprinkled with fairy dust photographs of smiling, fit people munching apples and carrots and bowls of granola. What’s not to love? Wellness is a good thing that everyone wants, right?

This week I received a welcome letter from my medical insurance company, thanking me for continuing with them in 2014, and encouraging me to participate in their wellness program. The letter included a two page ‘notice of privacy’ about how they supposedly protect (and can use under all sorts of ‘exceptions’) my medical information. It has a reading level of post-graduate school, but at least it does have a clearly marked section ‘For questions or complaints’ with a (non-toll-free) phone number to call.

On the wellness program informational brochure they sent me there’s a chart ‘how to earn points and rewards’ that resembles those annoying frequent flyer ‘miles’ offers. They list eight of their top point-earning activities, including diabetes prevention and smoking cessation classes. At the top of their list is an online ‘General Health Assessment’ which they say takes 15 minutes, completion of which qualifies me for a $30 gift card. Beside the chart is a photograph of a bearded, smiling, white coat and black stethoscope wearing Marcus Welby, MD look-alike, inviting me to sit down and tell him all about my health problems. Who can resist?

So I logged on and took their General Health Assessment (GHA) questionnaire, which is created and maintained by the mega-company WebMD. First, I read through their drop-down ‘terms of use’ disclosure statement. Besides reminding me how glad I am that I ditched the law school idea, the fine print states this about my medical insurance company’s wellness program (named X here): “X does not warrant that any X content, visitor content or any other content posted on this site is accurate, complete, reliable, current, or error-free.”

OK, yes, those pesky ‘accurate, reliable, error-free’ things are too much to ask of a medical insurance company, right? Their GHA begins with the profound question, “Are you living your life to the fullest?” The correct answer happens to be ‘No, not if you are bothering to take this silly test.”

To begin with, their ‘gender-specific health’ questions are woefully out-of-date, sticking with the annual pap smear no matter what your HPV status or age, as well as the out-of-date annual mammogram ‘requirement.’ But then I got to the nutrition section and my (normally low) blood pressure really went up. Here is their first nutrition question: “How often do you eat at least six servings of bread, cereal, rice, or pasta?” Choices are: “1) Daily, 2) Several times a week, 3) Few times a month, 4) rarely.” Their fitness and well-being (as in anxiety and depression) questions, were equally imbecilic. I made it through the silly questionnaire, scored a 100/100, but was told I needed to stop eating a high fat diet (I don’t–I was munching on kale at the time) and I need to follow current guidelines on preventive health screens like for mammograms.

Shouldn’t employee wellness programs be required to at least follow accurate, up-to-date medical information and guidelines? Otherwise it seems they do more harm than good. The federal government, as a part of ACA/Obamacare, stepped in this year to issue guidelines for “Incentives for Nondisciminatory Wellness Programs.” (Because besides being inaccurate, many wellness programs are also discriminatory, coercive, etc. See my previous blog post Corporate Employee Wellness Wants You from 10-29-13, as well as links to resources below). Their new guidelines go into effect January 1, 2014.

Reading through the Federal Register on these guidelines I see that people did raise the same questions I have about following national guidelines for screening and prevention. But they decided to stick with the vague ‘reasonable design’ clause and only: “…require that health-contingent wellness programs be reasonably designed to promote health or prevent disease…” The successful argument against requiring evidence-based clinical guidelines and national standards is the oh so American excuse that it would “inhibit innovation.” Inhibit innovation of poorly constructed, out-of-date, misleading, inaccurate, thoroughly frustrating ‘wellness’ screenings and interventions? I will be avoiding all wellness programs in the New Year.

Further resources:

 

Sweet Charity Or Solidarity?

IMG_0678Or something in between?

When we are moved by compassion and empathy to do something to help people in need, what ethical principles should guide our actions? What should we as teachers be modeling for our students? Is it enough to have good intentions when what we do can have negative unintended (although many times predictable) consequences? The road to hell is paved with good intentions and all of that.

Of course, I have in mind here the latest large-scale natural disaster in our world, that of Typhoon Haiyan in the Philippines. But closer to home (at least closer to my home) I was thinking about these questions yesterday while helping with a university health science interprofessional service-learning project called Teeth and Toes. I work with colleagues in the Schools of Medicine (Dr. Frederica Overstreet) and Dentistry (Dr. Bea Gandera) to train and precept groups of health science students in the provision of basic foot and dental care to Seattle’s homeless populations. We build on long-standing relationships with quality homeless service providers (such as the ROOTS Young Adult Shelter, Mary’s Place, and Downtown Emergency Service Center) to provide this ‘charity care‘ throughout the academic year. We try to build into the student training some element of upstream systems-level thinking about health and homelessness and student self-reflection, but we could do more (given more time and resources, of course!). Despite its current shortcomings, the Teeth and Toes clinics are one of the most rewarding parts of my job.

Charity care is feel-good care for the giver much more so than for the receiver of care. Charity care can reinforce the status quo, including the pervasive belief that individuals are the sole cause of their own problems. But charity care can also be a starting point to a widening world view and to greater civic engagement and involvement in systems-level change. Charity can be a political act. Charity and solidarity can both be sweet.

Good resources on this topic (or closely related topics):

  • Sweet Charity: Emergency Food and the End of Entitlement by Janet Poppendieck (Viking, 1998).
  • Crossing Boundaries–Violation or Obligation (excellent short article!) by Gordon Schiff, MD. In JAMA 310(12): 1233-1234. September 25, 2013.
  • From Charity to Justice: The Potential of University-Community Collaboration for Social Change by Sarah Marcello and Bob Edwards. American Behavioral Scientist, vol 43) 895-912. February 2000.
  • When Healers Get Too Friendly, by Abigail Zuger, MD. NYT, November 11, 2013.

Corporate Employee Wellness Wants You

Uncle Sam I Want You - Poster Illustration
(Photo credit: DonkeyHotey)

At least it seems to want me. A corporate/university wellness program is stirring to life at the University of Washington: Whole U. An unfortunate title since a simple Google search of the name brings up numerous spa and ‘body aesthetics’ businesses offering laser treatments and ‘body composition improvement’ (aka: “We’ll take fat from your butt and inject it into your face”).

We already have a university employee wellness program (of sorts) called UWellness (a much better name than Whole U). The stated purpose of UWellness is “balancing the emotional, intellectual, occupational, social, and physical components of health.” Makes sense, except for the intellectual part. Did they just throw that in because we’re a university and should be doing scholarly and intellectual pursuits? What the heck is intellectual health? Avoidance of all writing by French philosophers?

UWellness currently offers the following wellness services: 1) free annual flu shots, 2) referrals to Weight Watchers for weight loss, 3) links to a student-run group promoting bicycle and walking safety (including selling low-cost bike helmets), and 4) free annual ‘routine mammography’ for all women ages 40 and above at an on-campus mobile mammography van (a mammobile?). The first three offerings make sense to me and would earn an A or B according to the U.S. Preventive Services Task Force (USPSTF), an independent panel of non-federal experts in prevention and evidence-based medicine. However, the mammography offering surprised me since the USPSTF changed their breast cancer screening guidelines in 2009 to recommend biennial routine mammography for women aged 50-75 only (biennial screening for women ages 40-50 is optional/not routinely recommended). UWellness contracts with Seattle Cancer Care Alliance to provide the mobile mammography services, so I suppose they are stubbornly following the old guidelines (that the equally stubborn American Cancer Society still follows). There are, of course, intriguing political and economic self-interest issues there that I won’t touch on here…

The Whole U program is a “holistic employee engagement initiative which emphasizes community building, appreciation of the diverse lifestyles and interests of our faculty and staff and participation in programs that promote healthy lifestyles. Establishes a point system that encourages participation through prizes and engages a network of program ambassadors within departments to serve as key communicators in helping direct employees to the Whole U.” Sounds more than a bit Orwellian to me.

Penn State faculty recently staged a successful protest over the roll-out of their  university/corporate wellness program Take Care of Your Healththat required faculty and staff to fill out a questionnaire asking about workplace stress, marital problems and women’s pregnancy plans–or pay a $100 a month penalty. (Good NYT article on it here.) A recent RAND Corporation report Workplace Wellness Programs Study found that half of all U.S. employers offer some sort of employee wellness program, many of which include individual health risk assessments and the use of incentives for participation. The most popular employee wellness programs include support programs for weight loss and smoking cessation. Rigorous cost-benefit analyses of these employee wellness programs are lacking, but the RAND researchers estimate the programs should be cost neutral within five years of implementation.

Starting in January 2014 the ACA allows employers to offer incentives of up to 30% of health coverage costs to employees who participate in the wellness programs, including completion of the health risk assessments (and biometric assessments like body-fat percentage measurements, blood pressure readings, and blood glucose measurements). So get ready to be queried at work on your health behaviors, to have your candy vending machines taken away, and to have your waist and hips measured by ‘program ambassadors.’

Meanwhile, my version of corporate/university employee wellness includes avoidance of French philosophers. I’ve also bought a bouncy exercise ball to use as a desk chair–mainly because someone stole my corporate-issued office chair. And it may come in handy to fend off the Whole U program ambassadors when they come knocking on my door.

Young Invincible Health Insurance Saga

IMG_1227Last night I had to take my ‘young invincible’ son to a local emergency department to have his toe sewn back onto his body. He had heeded my advice to get back to the gym to exercise, and somehow combined ballet with karate and lost a big toe in the process. His ED physician said he’d never seen anything like it in his 33 years of practice. Oh so reassuring. Also unsettling was this physician mug shot on the vending machine in the ED waiting room. He glared at me all night as I tried in vain to figure out what he was doing there, what his message was. Don’t you dare drink these sugary drinks? You’d better have good health insurance if you want to be seen here? I have some bad news: we somehow lost your son’s toe?

Fortuitously (or so I hope), my son listened to me and signed up for student health insurance–the day before his ballet/karate accident. As a mom and a nurse it was taking years off my life to have him ‘going bare’/uninsured. I now know some of what it feels like to live in fear of an accident, injury, or illness that could ruin my son (and by extension, me) financially. Even though he officially has health insurance to cover his expensive ED visit (X-rays, sutures, IV Vancomycin, physician quips) and ortho follow-up, I do not trust it. There are pages upon pages of exclusions to his health insurance plan, including bungee-jumping and intercollegiate sports–neither of which would seem to apply to losing a toe in ballet/karate. But I know how crafty and devious health insurance companies can be in trying to deny medical claims. I would hope that the university where I am employed and teach (and where my son is now a student) would have a decent health insurance plan option for its students. I guess I’m about to find out.

A Place To Stop

 

Stop
Stop (Photo credit: Swamibu)

 

In our narrative medicine course we have moved into group presentations. On the first day of the quarter I had students sign up to be in one of eight groups to work on group projects and to do a group in-class presentation. I picked eight topics, using the list of topics (keywords) from NYU’s Literature, Arts, and Medicine
database as a guide. The eight topics I chose this summer were: Aging, cancer, death/dying, disability, drug addiction, infectious disease, mental illness, and racism. The group assignment was to research and expand upon the topic resources listed in the NYU database—to approach this as if they were doing an in-service training on the topic at their work site. I asked them to produce a one-page (front and back) handout of their favorite resources, along with two to four possible in-class writing prompts and reflective questions. Each group was given 45 minutes to present on their topic and to lead the class in discussion and reflective writing. (Note: our class sessions are four hours long, although we don’t typically go quite that long).

This past week the first two groups did their presentations (on aging and cancer) and both did an excellent job. The groups used an interactive PPT presentation, weaving in poetry, prose, artwork, comic books, YouTube videos, and movie clips. I was impressed by the range and depth of their presentations and class discussions, as well as their application of the close read drill adapted from Dr. Rita Charon’s work. Group members also shared some of their personal stories related to their health topic and did this in a moving but professional way.

 

When I was planning this narrative medicine summer course, I was resistant to the idea of building in group projects. As a student I always preferred to have individual assignments since I could then control the time commitment and the outcome. I knew that the majority of my students in this course would be busy with their nursing jobs and families as well as with school. But a colleague convinced me to use group projects, saying the students were used to them and that what they came up with was typically of high quality. I have purposefully allowed time at the end of each class session for students to meet in their groups for planning purposes and I stay around to answer any questions that may arise. Some groups have also set up online discussion boards on our course website to facilitate their group planning. (In my mind, this is the only really useful function of online discussion boards.) That seems to have worked well for them so they don’t have to meet in person outside of class.

 

Two things particularly struck me from the in-class presentations and discussions. One was the number of students who had personal experience with either a close friend or family member or a patient who was given a diagnosis of a serious cancer over the phone or in a voicemail message. We talked about how insensitive that is and what nurses can do to influence physicians, nurse practitioners, and other healthcare providers to think through how to give bad news in a more supportive way. The other thing that stood out to me in the class discussion was a comment a student made that this narrative medicine class is “A place to stop and to process these things we don’t get to process.” Other students said they agreed with what she said and talked about how nurses are so much into the care giving role, not only at work but also in their personal lives, that having a time and space to stop and reflect on how it is affecting them is a powerful thing.

 

Ah yes. There were really three things that struck me during last week’s class session. The third was that this is all heavy stuff to process and write about and how much environmental context matters—as in the actual physical classroom setting. We have a nice smallish amphitheater classroom with excellent acoustics, state-of-the-art audiovisual equipment that is easy to use, reasonably comfortable chairs and tables, and a full bank of windows looking out over a grassy marsh full of birds. I’d forgotten what a pleasure it is to teach in a classroom with windows. It also helps that it is one of the loveliest summers in Seattle’s history. Teaching this narrative medicine course in a windowless classroom in the middle of a Seattle winter would have a much different feel.

 

 

Approaching Death

Check out Kimberly Condon’s essay “Approaching Death” (from the anthology I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse, edited by Lee Gutkind, In Fact Books 2013) reprinted today in Slate. In the Slate version the full title includes “A nurse goes from the ER to hospice, and changes the way she thinks about life and its end.”

Congratulations Kim!

Becoming a Nurse: The Events

becominganurseThis week Jane Gross in the NYT wrote a nice review of the new book I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse, edited by Lee Gutkind (In Fact Books, 2013). The title of the book review is  ‘Semi-invisible’ Sources of Strength, referring to the fact that nurses are often the un-sung, un-heard, un-seen cast members in the grand drama that is modern medicine. Semi-invisible sources of strength: I suppose then that nurses are to health care what the backbone is to the human body? Lumpy and bumpy, semi-visible through the skin, at times painful? OK, I’ll stop with the analogy.

In the days following the NYT book review, True Stories of Becoming a Nurse quickly became one of their top sellers. In the past day it has been in the top 20 on Amazon. Fascinating to see the book filed under “healing,” “spirituality,” and “personal transformation,” as if it belongs in Whole Foods next to the crystals and incense and socks made of recycled bamboo. Thanks Jane Gross for writing the review and thanks NYT for including it. That Ms. Gross focused her review on the old old and seriously tiresome rift between diploma-trained and university-educated nurses in tertiary care settings is unfortunate—but understandable given that she was writing the review as a testament to her diploma-trained RN mother. I get it; I’ll move on to more important topics.

Our University of Washington (with support from 4Culture)-sponsored Becoming a Nurse book launch on April 18th at Suzzallo Library in Seattle was a great success. We had a total of five nurse author panelists who read from their anthology essays. Many, many thanks to the four panelists (Kim Condon, Eddie Leuken, Lori Mulvihill, and Karla Theilen) who paid their own way out here to attend the event. I only had to ride my bike two miles in the rain to get to the event—several of the other panelists flew in from across the country). Many, many thanks as well to the mighty team of UW Health Science librarians (Tania Bardyn, Lisa Oberg, Joanne Rich, and Janet Schnall) for organizing, hosting, and recording the event. The video recording of the readings is here . Note that the audio quality is much better than the video but you can see our general shapes as we read!. You can’t see the wonderful audience but they packed the room—standing room only. Thanks all you supportive audience members!

In case you missed the UW Suzzallo Library Becoming a Nurse event, we will have another Becoming a Nurse reading next month (Tuesday June 11th, 7pm) at Elliott Bay Book Company in Seattle. I will be reading along with Eddie Leuken and Karla Theilen). All three of us will read excerpts from our anthology essays, as well as new work.

This Friday (May 24th) at 6:30pm I’ll be reading at the Northwest Folk Life Festival in Seattle as part of the 2013 Jack Straw Writers Program. (6:30-7:30pm SIFF Cinema/Narrative Stage). Kathleen Flenniken, poet laureate of Washington State will be the host/KUOW sponsors the event. I’ll be reading from new work from my collection of poetry and prose I’m working on called Soul Stories: the stories feet can tell about the journey of homelessness. In the essay I’ll read I ask myself (and partially answer) the questions: why am I drawn to the suffering of others? Why have I spent the past thirty years working as a nurse with homeless and marginalized people? Wouldn’t I be happier if I was drawn to work as a shoe buyer for Saks Fifth Avenue? Questions I am sure many nurses and others in helping professions ask themselves.

 ___________________________________________________

The following is the press release for the book.

I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse
Edited by Lee Gutkind
Featuring new work by Theresa Brown, Tilda Shalof, and others.

 

As editor Lee Gutkind points out in the introduction to I Wasn’t Strong Like This When I Started Out, “there are over 2.7 million working RNs in the United States (not to mention our many LPNs and LVNs), compared to about 690,000 physicians and surgeons. There are more nurses in the United States than engineers … or accountants and auditors … And, yet, many of us take the work these men and women do for granted.”

 

This collection of true narratives captures the dynamism and diversity of nurses, who provide the vital first line of patient care. Here, nurses remember their first “sticks,” first births, and first deaths, and reflect on what gets them through long demanding shifts, and keeps them in the profession. The stories reveal many voices from nurses at different stages of their careers: One nurse-in-training longs to be trusted with more “important” procedures, while another questions her ability to care for nursing home residents. An efficient young emergency room nurse finds his life and career irrevocably changed by a car accident. A nurse practitioner wonders whether she has violated professional boundaries in her care for a homeless man with AIDS, and a home care case manager is the sole attendee at a funeral for one of her patients. What connects these stories is the passion and strength of the writers, who struggle against burnout and bureaucracy to serve their patients with skill, empathy, and strength.
Pub. Date: March 2013, ISBN: 978-0-393-07156-6, 5 ½ x 8 ¼, Trade Paper, 278 pages,
$15.95, Distributed by Publishers Group West

 

Lee Gutkind has explored the world of medicine, technology and science through writing for more than 25 years. He is the author of 15 books, including Many Sleepless Nights: The World of Organ Transplantation, and the editor of five anthologies about health and medicine, including At the End of Life: True Stories About How We Die.

In Fact Books is a new imprint founded and edited by Lee Gutkind, editor and founder of Creative Nonfiction. In Fact Books titles help create an understanding of our world through thoughtful, engaging narratives on a wide variety of topics and real-life experiences. All titles are distributed by Publishers Group West. For more information, please visit http://www.infactbooks.com.
For interview requests and other media related questions, please contact:
Hattie Fletcher at fletcher@creativenonfiction.org or (412) 688-0304.