Yep. All riled up.

Update:  found this blog thanks to a post on Facebook :What if Collapse came and nobody noticed?

We really got into politics during class.  Particularly the politics of health care, insurance, and why we don’t have socialized medicine.

I think I am the most politically aware person in class.

What we have is a two tiered health care system.  And too many doctors and providers – indeed too many health care staff period – to serve the few who can afford our high tech health care system.  What we’re facing is a crash.

Some of my classmates were outraged that France (and other nations like them with socialized care) does not pay for things like dialysis or heart surgery for those over 75 (for France, not sure about other countries), instead choosing to spend that public money on sectors of their society who still have a chance to be productive and contribute for many years to come.  They just refused to understand that those same French elderly CAN afford, like most of their society, to purchase private insurance that DOES allow them to receive those treatments.  They are not denied them, they are merely on their own to pay for them.  My classmates were insistent that it should be on a case by case basis.  Really?  How cost effective is that?  And how can one not understand that their system, BECAUSE it is offered to every citizen, allows them a much freer life without the stress of trying to navigate the health care system and worrying about how they’ll pay for their care? How can one not understand that insurance is so very much less expensive even when purchased for the simple reason that it’s NOT required?   How can one not understand that the French have a longer life span, even so, than we in the U.S.?

How can one not understand that in the U.S., we spend 9o% of ALL THE MONEY SPENT on health care for a person in the LAST YEAR of life?  How does that make for sound fiscal policy?

Regardless, even those systems are on the verge of crash.  Look at Spain, where they just recently declared they will no longer offer health care benefits for illegal aliens.  Look at the controversy here in AMERICA where people are outraged at that – like we have any sort of a higher ground to stand on?  We don’t even offer services to all of our citizens, let alone illegal aliens, and people here have the gall to be outraged that Spain is doing what it needs to in order to attempt to preserve some sort of health care for its actual citizens?  It will crash soon, violently.  And they too will have a two tiered health care system with far too many medical providers and staff.

Some classmates were dubious because they thought they would be told where to work and would make less money if they were employed in a socialized system like Canada’s.  Since I have in law family in Edmonton, when they started saying how awful a system it was because people had to wait so long for treatments and surgeries, I called BS on that.  I explained that issues that affect nothing but one’s quality of life may have to wait, but issues that affect life and death get first priority.  Unlike here, where those that have the most money go first, regardless of the seriousness of their issue.  And that in Canada, there is still a thriving private practice of doctors and nurses, it’s not illegal as far as I know to purchase private insurance and many Canadians actually do purchase it just in case.  The key here is that it’s optional, not mandatory, and even if they don’t purchase it they’re covered via the public option anyway.  It seems the Canadians they treat here in the American hospitals – who are being treated courtesy of the health insurance that it’s mandatory they purchase if they are traveling here – like to gripe. And misrepresent a very good system.

Regardless, it’s going to crash.

Why do I keep saying it’s going to crash?  Well, for the simple reason that taxes are dependent on employment; other things as well, but primarily on that.  And employment is down everywhere in the Western world.  50% of Spanish young adults are unemployed.  More than 24% of the population is unemployed.  These people aren’t paying the taxes they were, and they’re drawing on public benefits paid for by taxes.  How long do you think that can continue?  And it’s the same everywhere.  Demands on the system keep going up but tax revenues aren’t rising at the same rate.

It’s even worse here in America.  We offer subsidies to banks, coal and gas companies, oil companies, insurance companies, car manufacturers, ‘green’ energy companies, agribusiness, … the list goes on.  Plus what we spend on keeping our military overstaffed, because to make our military smaller would mean releasing massive numbers of angry young men (and women) who are overly familiar with firearms and accustomed to viewing life through the lens of the conquering occupier, onto our streets with no jobs for them.  We can’t afford to offer any sort of safety net (such as it is here) to our citizens when they need it, because we’re tapped out doing all of that.  It’s going to crash.  It’s bound to.

And the idea that Americans don’t buy into it is because we’re supposedly so ‘independent’ is utterly and completely crap.  Independent?  As in not following fashion trends…? As in not watching the Kardashians, and others equally insipid and irrelevant…?  As in not tweeting our every boring move…?  As in not merely parroting what we hear and see on the news….?  Riiiight.  We may have been independent 100+ years ago, but not for a long time.  And this country was ripe for socializing medicine at the turn of the 20th century, but the AMA got involved in undermining that, and now they get to reap what they sowed so long ago.  Shitty reimbursement, other people telling them what is and isn’t approved for medical treatment, and the reality that in order to survive they have to work for a big corporation and be just a cog in a really big machine instead of an independent, wealthy, respected individual who offered an important SERVICE to their community.  Which, by the way, are they very bogeymen the AMA invoked to prevent our country getting any sort of socialized medicine all the way down the line.  The only time they lost was when Medicare and Medicaid were passed by Congress.  Only it’s not the government imposing those restrictions on doctors now, like they claimed, it’s insurance companies…after all, the insurance companies have stockholders and bottom lines to protect.

I looked up how much it would cost me to get insurance – because since quitting my full time job I no longer have any – through the ObamaCare Pre-Existing Conditions Insurance Plan.  It would be a minimum of $240 per month.  For the two of us it would be nearly $500 per month.  That’s just not feasible, and to think that I’ll be assessed a tax penalty because even at this price (as opposed to the nearly $2000 per month it would otherwise cost me) it’s too expensive makes me feel trapped.

Medicare benefits for all – the true public option – is the only answer, and it’s not the answer because our system is unsustainable.  So as you can see, there is no answer, only a soon to be overabundance of plastic surgeons, aesthiticians, orthopedic surgeons, and dermatologists and no primary care for the great majority of regular citizens.  Prices will come down, dramatically, but still most of us won’t be able to afford care. Maybe the system will keep lumbering on for a long time yet, and the crash will be slow and gentle, more like a ride down a hill than a step off a cliff.  Maybe.

And what do I think I’m doing furthering my education?  Just to do my best for the people I live among.  I have never been out to get rich, just to get by.  What do I expect for all of my sacrifice to become an NP?  Just to be able to pay my own bills, and to be able to help those who come to me to live the most healthy life they can.  You know, a life of service.

What is the answer?

I wish I knew.

I wish I still believed in the ability of the system to be responsive to the needs of its citizens and to change.   I hate politics.

How my master’s program is going

Photo taken from here.

I have a 4.0 still.  I just started my 4th class, Issues in Advanced Practice.  It’s a class on the politics of health care as they affect patients and nurse practitioners. This is a dangerous class for me; I’ve been one who tries very hard to walk the walk on those issues I feel strongly about.  I am not perfect, of course, but I try unbelievably hard.  So hard, in fact, that I had a meltdown of sorts due to the difference between what I was doing, what I was seeing, and what I know is right.  So how is it dangerous?  Well, I have tried very hard to just walk away from politics, from engaging in activities that frustrate me, and cause emotional distress.  This class is bound to require me to engage in all three.

Already I have learned that, even though I have no desire to get my doctorate, that it will probably be necessary in the near future due to the simple fact that I may not be able to be paid unless I have one.  I have learned that I really hate nursing research, and simply cannot overcome my disdain for qualitative research in the nursing arena – there’s a lot of money being wasted on research that applies to no one but the group studied.  I have learned that because American medicine/nursing is completely profit driven, there’s very little research being done here because it’s viewed as a waste of time.  I’ve learned that doctors feel that nurse practitioners with no actual experience in nursing make much better primary care providers because they follow the medical model better (this is based on one study, so it may not be applicable everywhere but I found it fascinating none the less).  The irony in that study does not escape me…if I wanted to be a doctor, I would have kept on my path 20 years ago when I was a student at the University of Arizona. The fact that I want to be able to provide care to my community does not mean I want to be a doctor.  It means I want to provide what doctors don’t want to, haven’t been trained to, and can’t.

I’ve learned that, while doctors are running from primary care/family practice in droves, nurse practitioners are setting up in that same area in droves.  Which totally threatens doctors, according to the AMA.  So they are lobbying hard to take away prescribing privileges, denigrating the care nurse practitioners provide, and working with officials at Medicare to eliminate reimbursement or recognition for nurse practitioners.  In some ways they have been very successful – a nurse practitioner can no longer write home care orders.  Plus, while here in Arizona a nurse practitioner *can* get privileges at hospitals, I am unaware of any who have been granted them.  So if an NP’s patient goes into the hospital, he/she is unable to see them while they are there, and the follow up will most likely be with the hospitalist or specialist who sees that patient while they are in the hospital. Which further fragments care.

I’ve learned that only about half of all insurance companies even offer recognition and reimbursement for nurse practitioners, and that many insurance company administrators don’t even understand what a nurse practitioner IS.  I’ve learned that when reimbursement *is* given, it’s at a rate that is about 57% of what a primary care doctor is given, even though the care is the same.

I’ve learned that if an NP counsels a patient for emotional or psychological issues, that is not reimbursable (which is why so many people are on psych meds – doctors don’t get reimbursed for that either, so they just write a script to make the person go away).

That’s what I’ve learned so far.  Oh, and how to make movies with Xtranormal, which is really fun and much more engaging than yet ANOTHER PowerPoint presentation.

Garden in shambles still, no time thanks to my (thankfully) just completed nursing research class. I’m hoping to get out there this week.  New chicks in the coop, two blonde bombshell Buff Orpington beauties, and two scrappy Rhode Island Reds.  That’s it for now, hope your gardens are going better!

Don’t go to Grand Canyon University if you want an online degree.

Got a collections call from Grand Canyon University yesterday, the people I got my bachelor’s from. Told them I have not one but two letters from people at the school stating the balance is paid in full and a receipt from my employer to prove it.

They are trying to now say that since I took out a student loan to pay for the extra stuff my employer didn’t (maxed out before I reached the end of 2010 school year) that I owe them the money back. Huh? It’s a student loan, not a grant or scholarship, and I owe the federal govt not you.

Wouldn’t you think that if I DID owe them money they would have held onto the degree…?  And since I HAVE the piece of paper that I probably don’t owe anything…?  And since I have an email from one of the VP’s stating I don’t owe anything that I probably don’t…?

I was accepted into the master’s program there but I can see I’ll need to be applying elsewhere, if they still can’t get their $h!t together after nearly six months I know that they’ll just add this UN-owed balance to whatever the new balance will be when I start…I can’t wait for them to take me to collections, because I would love a chance to bring this up in court.

Sadly enough I’m not the only one having this problem – almost everyone where I used to work was having the same trouble. Three people actually got dropped from classes for nonpayment even though our employer had receipts and emails confirming payment!

Upgrades. Designed to confuse on purpose???

To those of you who are subscribed, I apologize – I posted late last night, it was a post about putting one of my spinning wheels up for sale but after I posted it I realized if I sold it without having a replacement I would not be able to complete any yarn. Since I have to have it until I get all my holiday sales and family gift projects done, I deleted it. Sorry!

Between Facebook’s ‘upgrades’ and the brand new design of WordPress, I waste minutes each time I visit trying to figure out what is where, and why. Do the designers just have a need to change things for change’s sake???

That is all. Just venting and apologizing for being stupid.

New jobs are going well, but I need to cut back hours soon, no time for my business.

Got a wood stove, my contractor is flaking on me so it’s still not installed. It is however in the living room with 99% of the parts. The cat thinks I bought a nice cool bed just for him…he’ll be in for a surprise if we ever get it installed and fired up!

Labor on Labor Day

Our old stove exploded last night. Or more specifically, the aged and brittle tempered glass that covered the oven door did. Mr. Tin Foil got up to get some water; he didn’t turn the light on because he didn’t want to wake me. He walked into the kitchen and hit the oven handle with his thigh, which because of his balance at that point spun him into the door. His knee was enough force to shatter the fragile glass, apparently. The POW! woke me up in time to see glass shatter everywhere.

Above is our ‘new’ stove. It’s 3 years old, bought from a family with six kids who upgraded to a much larger stove. This has been (mostly) Mr. TF’s labor today, getting it installed and properly adjusted flamewise.

I like it! I hope it lasts as long as our previous stove did; while we only had it for 4 or 5 years, it was made in the early 80′s and 30+ years is a long time for that glass to last.

ETA:  Mr. TF did most of the work getting this up to speed; I kept out of his way.  Which is unusual for me, because I feel obligated to help in a project like this.  What else was unusual is that we did NOT have any arguments during this whole thing!  Maybe I should stay out of the way more often…?

Thinking two seasons ahead

IMAG0206

Originally uploaded by susancoyotesfan

Like our ancestors, it is time to start thinking about being warm this winter. Since hand made items take time, it means that if I want to have gifts for holiday giving and warm things for myself, now is the time to start making them.

I spun this yarn earlier this summer; I dyed 775 feet of it with cake dye; it turned out a heathered color that ranges from a deep sky blue to a royal purple. The rest I left the natural color.

While I’ve taken projects from dirty fleece to finished object, this is the first of many projects that I plan to take from dirty fleece to woven object. Like most of my ‘firsts’ this scarf has issues – but it is my first attempt at weaving with my hand spun and I’m happy to report that my yarn is more than strong enough for the stresses of weaving.

In keeping with thinking two seasons ahead, the fall garden will be planted later this week. We’ll grow broccoli, cauliflower, and carrots, as well as chard. I’ll try cabbage again, but I don’t hold out a lot of hope for it.

I’ll be placing an order with Johnny’s Seeds for some greenhouse plastic and the clips to hold it to PVC pipe; I think I can manage a cold frame that won’t blow away this winter. I’ll also be hedging my bets with my free sliding glass doors, using those over a couple of our beds and getting hay bales as necessary to keep the glass high enough to allow the plants growing room.

I have to go back to work soon; I am not sure how I feel about that. In the mean time, I’ve been busy preserving the bounty of summer. If it were from our own garden I’d be happier, but from the farmer’s coop is good too. So far I’ve made 100 pounds of tomatoes into sauce with 25 pounds blanched and waiting in the freezer to be made into paste. Today I roasted 30 pounds of green chiles and put them into our freezer. Mr. TF was aghast at the sheer poundage until I reminded him that last year we got 15 lbs from the store and it wasn’t enough.

I’ve been drying herbs like rosemary, oregano, thyme, and marjoram; I need to get out into the garden and pick basil to make into pesto for the winter.  I wish I could live a little more like our ancestors; I would love to exhaust myself all summer long with projects and preserving, knowing that this winter I will have a well deserved rest time.  Modern life makes that impossible though.

I hate my job.

According to my charge nurse, EIGHT new administrative positions have been created in the last 18 months or so. Which trumps my count of FIVE by almost half. At a salary of $250K minimum.

Yet they are pleading poverty. And cutting staff. And making us take classes on ‘customer service’ and pointing to US as though the lowering of patient satisfaction ratings (publicly available) is OUR FAULT.

I have to find another f*ing job. Today made me sorry to be a nurse. Which was made even more poignant by the fact that a patient took the time to outline what I did for her, how much she appreciated it, and told me she was grateful. I don’t think she saw the tears in my eyes.

Since when does a nonprofit hospital have ‘competitors’….?

It’s not the nursing that I regret. It’s the job. Gotta find a new one where I can actually feel like I’m not being treated like a robot where you can just turn up the ‘speed’ button and get more productivity (work) out of it. Yes, you might get more work, but I don’t think any of us can speak for the quality of the job done.

I told one of the other nurses who said I should be grateful I have a job this: “as long as you are fearful for your job, you are the perfect employee, and exactly what they want, a corporate drone. That way you are too fearful for your job to speak up for what is right.”

I am a whore; I work there because I owe them time for paying for my degree, but I am no drone. I also told her, when she said that we really don’t have a choice, that I DO have a choice. I can work anywhere and be overwhelmed and treated like shit, I don’t need to do it here.

It’s just so frustrating, and angering, and sad. I’m a strong person, but I am close to the breaking point.

On to the Master’s program

I received a call from a counselor at my alma mater the other day asking me if I would be interested in applying for a master’s degree program through them.  I am, of course, interested in getting my master’s degree and that is definitely on the ‘to do’ list.  Naturally, I thought they were only asking because then they would get more money (cynical much…?) so I didn’t think too much of it – they’re a low second choice on my list of possible schools.  As a teaser, they told me I would have my graduation fee refunded and could possibly have the ‘resource fee’ waived if I was accepted.  (resource fee being the rental for the online books, which I’m not interested in anyway.  I want a BOOK in my hands)

But then I asked around a little bit from people who graduated from the same school, and they weren’t asked if they wanted to apply.  Hmmm…maybe there’s more than simply getting my money involved…?

So.  I have an interview in July with the dean and a panel.

Tsunami of human need and dysfunction.

That about describes my day to day environment at my job.

I have applied for a transfer, to two different places. If you are of a mind to, please light a candle, send energy, or pray that one of these places deems me worthy of employment.

I never thought I would see the day that I would be afraid that I would lose my license because of decisions on staffing made by administration, people who don’t work the line and have no concept of the difficulties a line nurse faces.

The words completely overwhelmed, unbelievably fatigued, and frightened, about accurately describe my feelings.