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Monday, April 16, 2012

Women Are Watching: Guarantee Access To Women's Healthcare

Design Reflection. Image © Alice Merkel Photography 
From The Savannah Set on Flickr.
Guarantee Access To Women's Healthcare

 How can uninsured and underinsured women in this country possibly be comfortable when they are refused affordable health care services such as family planning, contraception, hormonal therapies, counseling, cancer screening, vaccinations, physical exams, etc?  

How can women be comfortable when forced to carry a pregnancy that resulted from date rape, family rape, incest or that is likely to cause death or serious damage to the mom or fetus?

When and how did these services become the business of politicians, most of whom KNOW that pregnancy prevention and knowledge are the best alternatives to abortion?

Planned Parenthood Services Essential To Women’s Comfort And Strength

 I recently attended a local informational meeting to hear Tara Broderick, CEO of Planned Parenthood of NE Ohio (PPNEO) and Ashley Thornton, local organizer who helped dispel myths and explore issues that have been extremely public and controversial this past year. 

They wanted us to know that:
  1. PPNEO started in Cleveland in 1928 as a maternal health center and that remains its primary focus today. 
  2. Nationally, only 4% of its budget (all from private donations) is used for terminating early and unwanted pregnancies. (Their preventive services have radically decreased the need for abortion which is what we ALL want.) 
  3. The rest of Planned Parenthood’s budget (96%) is used for women's health. This part of their mandate is funded by insurance companies, private pay for services based on a sliding scale, and supplemented by limited Federal and state funding most of which will be lost if radical Republicans gain control in their legislative branches. 
  4. For every dollar spent in preventive services to women, a national budgetary savings of $4.00 (per dollar spent) is realized. 
  5. In addition to working to defeat anti-choice legislation at the state level and in DC, Planned Parenthood is working proactively to advance legislation regarding prevention of unplanned pregnancies (SB190/HB281) and promotion of sexual health education in public schools (SB232/HB338).
Planned Parenthood is the Number One provider of health care services to women. Those of us in healthcare MUST advocate for women as we all enter into the political campaign season in earnest. Letters, phone calls, and e-mails to potential voters have the collective power to CHANGE OUTCOMES.  

Empower Our Conversations Around The World

Learning about candidates who support preventive and health services for women is critical, and spreading the word on social media such as Facebook and Twitter will help dispel falsehoods and elect pro-women candidates . 

Follow the "Women are Watching" campaign and/or check out the informative national Planned Parenthood (PPAO) web site. America Votes is another very informative web site.  

As a nurse, it is my ethical obligation to support women in this fight. Can you help me by passing my message along to everyone you know?….

Thank you very much!    
 Dr. K

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Copyright 2012 Kathy Kolcaba, PhD., RN. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Cleveland, Ohio USA. Phone: 440-655-2098 Web: http://thecomfortline.com/

 -Betsey Merkel, Comfort Is Strength Communications
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Thursday, April 5, 2012

Comfort Applied At Miami Children’s Hospital

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Magnet Redesignation March 21, 2012 
Shown: Miami Children's Hospital Chief Nursing Officer, Jackie Gonzales
and Dr. Kathy Kolcaba during the MAGNET redesignation consultation March 21, 2012. 
Take Me To The Miami Children's Hospital Photo Set On Flickr
Preparing For Magnet Redesignation At Miami Children's Hospital 

Last week I was worked with nurses at Miami Children's Hospital, where dedication to  patients and families was awesome and inspiring. Indeed, I find that working towards Magnet (for more information see American Nurses Credentialing Center (ANCC) Magnet Recognition Program) whether for the first or third award, brings health care workers together and helps them focus on and remember all of the wonderful things they do every day. Blog continues below photos.
 

 Recognize and Celebrate Comfort Theory

When they choose Comfort Theory for their journey, they also see that the comforting strategies they employ intuitively, and which mean so much to their “clients, ” are legally
invisible!

 The invisibility of comforting strategies was brought home during this visit when I discovered that one of the nurse leaders at Miami Children's Hospital had gotten her MSN (Master of Science in Nursing) and was now close to finishing her Law degree.

 Invest  In Comfort Theory For Competitive Advantage 

 After discussing with the larger audience of nurses some of their comforting strategies (which were so inspiring), I asked the nurse/lawyer if, legally, any of these strategies were being done. The answer was, of course, “NO,” because there was no place in the patient record to document this type of important nursing work.

 This absolutely must change…..and is my goal for every health care institution that utilizes Comfort Theory as its framework for practice.  I always offer lots of suggestions for meeting this challenge, and hopefully, change will begin happening in this arena.

 - Dr. K 

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Copyright 2012 Kathy Kolcaba, PhD., RN. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Cleveland, Ohio USA. Phone: 440-655-2098 Web: http://thecomfortline.com/

-Betsey Merkel, Comfort Is Strength Communications

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Patient Comfort: Engaging the Full Nursing Arsenal

Response to the NYT Op-Ed Contribution, March 15, 2112, by Theresa Brown, Oncology Nurse. The article is entitled, “Hospitals Aren’t Hotels.” 

 Article link: http://www.nytimes.com/2012/0/15/opinion/hospitals-must-first-hurt-to-heal.html 

 In this article, Nurse Brown made the observation that questions about “Patient Satisfaction”  fail to reflect the true nature of hospital care, which tends to be (by its nature) “invasive, painful and even dehumanizing.” She goes on to say that “sometimes we cannot give them the kind of help they need” and ends with, “In order to heal, we must first hurt.” 

 From my patient comfort perspective, nurses may participate in painful procedures, but the WAY IN WHICH THE PRIOR EXPLANATIONS AND THAT PROCEDURE ARE DONE can make all the difference in the world.  In other words, the expert nurse does both: he or she may deliver a painful chemotherapy, but while doing so holds the patient’s hand, explains what is happening, sometimes distracts,  and always offers comfort and soothing words in order to give the patient a life line. The patient’s needs are acute and pervasive during such procedures, and the best nurses address all of them, including physical pain, immobility, anxiety, terror, depression, dread, hopelessness, or loneliness.  I would hope that NO nurse would become hardened to a patient’s distress, but rather engages the full arsenal of comforting nursing strategies to help patients transcend pain and suffering. For it is these important nursing functions that are the only things that can give our patients hope and courage in the face of extreme stress.

 Copyright 2012 Kathy Kolcaba, PhD., RN. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Cleveland, Ohio USA. Phone: 440-655-2098 Web: http://thecomfortline.com/

 -Betsey Merkel, Comfort Is Strength Communications
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Intuitive Comforting Care

The following is a powerful quote about comfort that I found in a current best- seller, Cutting for Stone by Abraham Verghese. The story is primarily about family, lost and found, and what the biological father (Dr. Stone) passes on as his legacy. The fictional letter that is quoted by the esteemed Dr. Stone to a hospital team was sent by a parent and written to Dr. Stone (he was stone-cold in many instances in the novel), but in this legacy a vision for sick-care that Dr. Stone wishes for in the future is revealed:

“Dr. Stone – My son’s terrible death is not something I will ever get over, but perhaps in time it will be less painful. But I cannot get over one image, a last image that could have been different. Before I was asked to leave the room in a very rought manner, I must tell you that I saw my son was terrified and there was no one who addressed his fear. The only person who tried was a nurse. She held my son’s hand and said, ‘Don’t worry, it will be all right.’ Everyone else ignored him. Sure, the doctors were busy with his body. It would have been merciful if he had been unconscious. They had important things to do. They cared only about his chest and belly. Not about the little boy who was in fear….I saw no sign of the slightest bit of human kindness. My son and I were irritants. Your team would have preferred for me to be gone and for him to be quiet. Eventually they got their wish. Dr. Stone, as head of surgery, perhaps as a parent yourself, do you not feel some obligation to have your staff comfort the patient? Would the patient not be better off with less anxiety, less fright? My son’s last conscious memory will be of people ignoring him. My last memory of him will be of my little boy, watching in terror as his mother is escorted out of the room. It is the graven image I will carry to my own deathbed. The fact that people were attentive to his body does not compensate for their ignoring his being.”

 After reading this letter out loud to his staff…”Stone stood there, silent, looking out, as if considering the letter’s context himself, unaware of his audience. No one spoke.

As the moment stretched on, even the smallest noises were stilled until there was only the hum of the air-conditioning. Thomas Stone’s expression was reflective, certainly not angry. Now, as if waking up, he searched the room for a reaction, seeing if the writer struck a chord. The scoffers had reconsidered their position.

When Stone finally spoke, he asked a question, ‘What treatment in an emergency is administered by ear?” (meaning intuitively).

 The author states, “I knew the answer from reading his book…I met my father’s gaze and I did not blink. ‘Words of comfort.’

 ‘Thank you,’ he said, his voice altered. ‘Words of comfort.”

I have thought about this passage many times – but now I would like YOU to think about it. What lessons do you draw from it? And just remember, NOW we don’t have to administer comfort “by ear.” We have a scientifically based pattern for care that, if practiced, assures no family or patient will experience what is so poignantly described above.

Your thoughts? Oh, and by the way, I highly recommend that YOU read this book too – just for pleasure.

Refs: Verghese, A. (2009). Cutting for Stone. Vintage Books, Random House, Inc. NY, NY
Photo from The Art of Nursing (1st ed). Edited by P. Donahue
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Copyright 2012 Kathy Kolcaba, PhD., RN. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Cleveland, Ohio USA. Phone: 440-655-2098 Web: http://thecomfortline.com/

 -Betsey Merkel, Comfort Is Strength Communications

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Location: Cleveland, OH, USA
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