Zen and catholicism

There is nothing like having a Priest pull up your profile and then post it saying you aren’t Catholic because you love Zen to get one thinking about books to read or reread and all the reasons I love Zen. I think Richard Rohr captures it best.

Reading List

  • McDaniel, Richard. Catholicism and Zen, 2013
  • Macinnes, Elaine. Zen Contemplation for Christians, 2003.
  • Macinnes, Elaine. The Flowing Bridge: Guidance on Beginning Zen Koans, 2007.
  • Kennedy, Robert. Zen Spirit, Christian Sprit: The Place of Zen in Christian Life, 1995.
  • Chetwynd, Tom. Zen and the Kingdom of Heaven. Boston: Wisdom Publications, 2001.
  • Eusden, John Dykstra. Zen and Christian: The Journey Between. New York: Crossroad, 1981.
  • Graham, Dom Aelred. Zen Catholicism. New York: Crossroad, 1999.
  • Hackett, David G. The Silent Dialogue. New York: Continuum, 1996.
  • Hart, Brother Patrick (ed). Thomas Merton/Monk: A Monastic Tribute. Kalamazoo, MI: Cistercian Publications, 1983.
  • Inchausti, Robert. Thomas Merton’s American Prophecy. Albany: State University of New York Press, 1988.
  • Lipski, Alexander. Thomas Merton and Asia: His Quest for Utopia. Kalamazoo: Cistercian Publications, 1983.
  • Kadowaki, JK, SJ. Zen and the Bible: A Priest’s Experience. London: Routledge and Kegan Paul, 1982.

Websites

Videos


Insurrection, anger, and self-reflection

“You have heard that it was said to the men of old, ‘You shall not kill; and whoever kills shall be liable to judgment.’ But I say to you that every one who is angry with his brother shall be liable to judgment” (Mt. 5:21-22).

Wednesday my husband called me and said turn on the TV. It is never good when you get such a call. It always means something awful and shocking just happened. The longer I watched the more my anger grew. Usually it quickly fades and in a few minutes I am able to adjust my emotions and my perspectives, but not this time. In the hours that followed the attack on the Capitol there were comparisons with BLM protests in the last year and how protesters were treated by the police. There was a brief moment when I wondered why all the reporting was about race rather than political ideology, but race is the political ideology of the insurrectionist and those that supported and encouraged them. What followed was a moment of realization that we have repeated the deification of the founding father in all aspects of our society. Our government was created by white men who saw everyone else as less than and now we are expected to revere them and believe that their original view was inspired. We are asked to believe that men that enslaved others and thought of women as property without rights should still be honored for their perspectives rather than admit they were men who reflected the local politics of their time. I love my country, but I do not like where it is headed. The mentality that idolized the founding fathers has been recreated over and over in our society.

The more I learn about the people and the events of January 6, the more I realize that we have been avoiding the truth our society has been hiding. The government was designed by white men, for white men and to this day is mostly governed by white men. Is it then any surprise that a significant number of Americans openly support white supremacist ideology and the associated domestic terrorism? It is all most Americans have ever known. How can anyone be surprised that the vast majority of the insurrectionists attacking the Capitol were white and predominantly male? We have taught them throughout their lives that they are superior and their wants and needs take priority.

Throughout the following days many professional organizations issued statements. Let me use the American Nurses Association (ANA) as an example because it is an organization to which I regrettably belong. ANA changed their policy and chose not to endorse a Presidential candidate for the first time in my adult life. Then they posted a condemnation of the violence and yet they supported the man that incited it. I wish it ended there, but one nurse pointed out online that the ANA has long been on the wrong side of race and gender based politics. I had not realized the ANA did not admit Black nurses until the mid 20th century or that they opposed the equal rights amendment until 1975. What I did realize is that when they revised their recent definition of nursing and in the background information they cited predominantly the same white women that historically defined the profession. They did embarrassingly little to call out racism and the impact it has on profession and the care we provide. In light of their change to the endorsement policy, which seemed designed to keep from opposing Trump, is there any question that they maintain the same ideology that got us to this point. Like those that idolize the all white, all male founding fathers the ANA seems to still idolize the all white, all female “founders” and theorists. Are we surprised they supported those that continue to endorse white supremacy and like the other rats abandoning ship now offer words of unity when they failed to speak out when it was obvious where this was headed?

The American Association of Colleges of Nursing (AACN) also put out a milk toast statement that didn’t even bother to condemn the violence but rather to focus on what unites us rather than divides us. There is nothing that unites me with an insurrectionist that attempted a violent overthrow of our government. Again, why should this surprise me. The AACN has long had a hierarchy that does not represent academia, but rather the Deans. The only voting representation are deans or their equivalent of Colleges of Nursing. The Deans of US colleges of nursing are predominately White women and the leadership of the AACN throughout its history has been predominantly White women. Is it surprising that they want to focus on what units us? It is much easier than focusing on a legacy of exclusion of people of color in leadership roles. I appreciate their work in increasing diversity, but I think their statement was tone deaf.

“Anger that is motivated by compassion or a desire to correct social injustice, and does not seek to harm the other person, is a good anger that is worth having.” His Holiness the Dalai Lama

I need to acknowledge my anger and focus it toward social justice in the area of the world in which I work, nursing. In the word of Matthew Dowd, if we “really want to heal this country then the need to go through the four Rs of dealing with what they [we] have done: responsibility, regret, resolve, repair. Take responsibility. Express regret. Resolve to do better. Repair the damage they have done.” It may seem an insurmountable task to fix the racism and the racially charged politics that lead us to this day, but it is possible for each of us to have eyes to see and ears to hear. It is possible to identify the history, policy, practices, and attitudes that were designed not to be inclusive all but to prioritize some.

  • I am responsible for my own ignorance of racism and any insensitivity I have expressed even when unintentional.
  • I regret not endeavoring to learn more about the history of my profession.
  • I resolve to explore channel my anger toward social and racial justice especially within nursing.
  • I will work to repair any harm my closed eyes or uninformed actions perpetuated and being willing to hear the pain of others.


volunteerism, service learning, and free labor

Using Healthcare Volunteers During Disasters 

Distribution of COVID vaccines once again has me thinking about the importance of volunteerism in public health preparedness and the role of nurses in volunteering their time and talents. Volunteerism has been part of the American culture since the 1803 Portsmouth, New Hampshire fire that resulted in the first legislation that dealt with the need for emergency preparedness. Since that time emergency response has largely depended on volunteers. Following World War II, the Department of Health, Education and Welfare (1961) recognized that nurses have conflicting roles and responsibilities and the Department also acknowledged the critical need for nurses during a disaster. The government’s attempts to ensure nurses availability and willingness to respond during a disaster resulted in the recommendation to remind staff of their responsibility as public servants – all nurses were considered public servants. In today’s terms we may call them essential workers. Unfortunately, there remains little emphasis on educational training in disaster response at any level in nursing education. Despite the efforts of the AACN to include disaster preparedness in the Essentials documents there is little done to ensure schools of nursing comply.

A volunteer is any paid or unpaid person who offers to perform a service of his or her own free will. Four categories of volunteers are:  (1) professional responders, (2) trained responders, (3) citizen volunteers, and (4) spontaneous unaffiliated volunteers (SUVs). No one questions whether professional and trained volunteers should be utilized during a disaster. However, the new public health threats –pandemics; terrorism; and changing expectations of citizens –challenge the government and private sector organizations to adopt new systems that make more effective use of volunteers. I accept the premise that a large-scale disaster will require more trained professional nurse responders than are presently available. Thus it is likely, as we are seeing in the current mass vaccination campaign that there is a need to use students and faculty as volunteers.

Background 

The 9/11 attacks in 2001 and Hurricanes Katrina and Rita in 2005 forced the realization that disasters occur requiring the use of volunteers in addition to professional and trained responders, even in a country with tremendous resources, such as the U.S. The U. S. Public Health Service (USPHS) had the largest deployment of nurses in its’ history in response to the 2005 hurricanes (may have been exceeded by COVID), yet this number of deployed nurses was not adequate enough to fill the need. In addition to the USPHS, the American Red Cross (ARC), Medical Reserve Corps (MRC), and all three components of the National Disaster Medical System (NDMS) (medical teams, patient movement, and definitive care) were utilized. NDMS deployed approximately 5174 personnel, the majority of who were trained volunteers and full-time employees of the NDMS.   

In an attempt to handle the outpouring of compassion from medical personnel that wanted to help in the response to the hurricanes in 2005, the Department of Health and Human Services (HHS) created a website and process to register and credential those wishing to volunteer who were not already part of established systems such as NDMS or ARC. Through the website and phone banks over 34,000 people signed up to become temporary unpaid federal workers. Three thousand eight hundred forty-two healthcare personnel that volunteered were credentialed through Credential Smart in 3 weeks and over 1,200 were deployed. This is why it surprised me to get push back from nurses about volunteering to give COVID vaccines when I mentioned it online. Why was there so much desire to help during Hurricane Katrina and so much less during COVID?

Federal, state, or local, systems can be logistically difficult for volunteers. The level of protection the volunteer receives is based on the type of disaster declaration from local to federal. Moreover, states have licensure requirements for nurses to protect the safety of the public by preventing unqualified persons from practicing as a nurse. Some states offer licensure reciprocity to member compact state (e.g., Tennessee, Maryland, Virginia, etc.), while other states waive or grant licensure reciprocity for nurses during emergencies. Fortunately COVID-19 vaccines are covered countermeasures under the Countermeasures Injury Compensation Program (CICP).

Liability Concerns 

An important consideration for nurses who volunteer is legal liability. In addition to licensure and scope of practice issues nurses must consider basic legal liability protection. Coverage from state to state varies; some provide coverage for Tort Claims, Worker’s Compensation, and Good Samaritan laws, while others do not. Some volunteers will also be covered under the Volunteer Protection Act of 1997 (Public Law 105-19), which protects volunteer clinicians working in nonprofit organizations from lawsuits for simple negligence. Hodge (2005) identified three factors on which legal protections depend, (1) the profession of the volunteer, (2) the person or facility to which the service is being provided, and (3) the existence of an emergency declaration. During the early phases of the COVID response we say Governors doing executive orders for everything from liability coverage to changes in scope of practice.

Current Systems of Volunteer Registration 

Federal government.  HHS has the authority to hire unpaid federal employees, which provides them liability protections and resolves issues of state licensure.   

State registries. Emergency Management Assistance Compacts (EMAC) now exist in 49 states and provide a broad immunity and tort liability coverage for responders (Hodge, 2005b) and additionally provides for licensure reciprocity during a disaster declared by the governor if the nurse is responding through the EMAC. Those SUVs who responded on their own were not covered.  

One of the items authorized in the Bioterrorism Act was the creation of ESAR-VHP to address the issues of credentialing healthcare professionals following 9/11. The system has established interoperable, state-based registries of healthcare professionals who have pre-identified themselves as persons willing to respond to a disaster.  The state then has the ability to verify their credentials and training in advance. Additionally, many states have adopted a version of the Center for Public Health Law’s Model State Emergency Health Powers Act (MSEHPA) that allows for such actions as waiving state licensure requirements for healthcare personnel from other states, thus providing some level of liability protection when a public health emergency is declared. 

Hospitals. In addition to the state licensure requirements, nurses must also be credentialed by the hospital at which they will be working.  This process is very time-consuming under normal circumstances and may be impossible in a disaster The Joint Commission for Accreditation of Healthcare Organizations (JCAHO) requires accredited facilities to have a system in place to grant privileges during a disaster

Professional associations. Professional associations have the ability to encourage large numbers of nurses to volunteer, but generally lack the financial resources for registries.  However, because of their leadership in the profession and ability to partner with state and federal organization, they potentially can have a significant impact.  For example, through a partnership between the Georgia Nurses Association, Georgia Nurses Foundation, ARC, Georgia Board of Nursing, and Georgia Department of Human Resources, the Georgia Nurse Alert System was developed to identify licensed nurses who have the skills to deploy during a disaster, Similar partnerships have developed in other states. Professional organizations such as the American Nurses Association (ANA) are encouraging a model state legislative act through the National Conference of Commissioners on Uniform State Laws to establish a uniform law dealing with volunteer healthcare services during a disaster. A law that addresses the licensure recognition and scope of practice issues during a disaster is definitely needed, but the National Council of State Boards of Nursing will not consider any special considerations for disasters and instead wants people to buy into their current compact and consensus models. This is not likely to happen and thus leaves us unprepared. It is also a prime example of inflexibility that still rules much of the nursing hierarchy at the state and national level.

Dependence on Volunteers

Disaster response depends on volunteers who are trained and organized through programs such as the DMATs, MRC, ARC, or local hospitals and public health organizations. Disaster response does not/should not depend on the SUVs that show up to disaster sites. These SUVs are not part of organized teams and their identification and credentials are not verified; thus, they should not respond to a disaster because they can impede the response. The MRCs are now robust and exist in almost every community. It would be helpful if as part of every nursing program students were encouraged to join one of these organizations to help ensure their personal preparedness.

The extent to which volunteers are credentialed in advance of an emergency does affect the ability of hospitals to utilize them. In response to the problems with credentialing Congress directed the HHS Secretary to develop ESAR-VHP. Nonetheless, while ESAR-VHP provides advanced credentialing verification, hospital administration is not relieved of their JCAHO requirements to credential volunteers and grant privileges based on primary source verification. The size of the disaster will likely be the deciding factor in how much information a hospital requires. The often-cited case of New York City’s ability to utilize health professional volunteers after the World Trade Center attack still remains a prime example of the inability to utilize them due to the challenges imposed when attempting to verify volunteers’ identities, licensure, credentials, and training.   

Not surprisingly, nurses are the most requested health professional for most types of disasters. A combination of modeling supported by the Agency for Healthcare Research and Quality and past experience in deployments led to estimates for the number of nurses required to respond to a disaster ranging from a low of 436 for hurricanes to a high of 507,150 for a pandemic. The federal, state, and local professional responders, such as USPHS officers and DMATs, could easily deploy 436 nurses, but the concern is for how long. All of the nurses have full-time jobs elsewhere, frequently in direct patient care settings. However, the total number of federal nurses and DMATs combined do not equal 507,150. Therefore it is necessary when considering worst-case scenarios to include citizen volunteers and to enhance the existing ability to effectively and efficiently identify, credential, and utilize those volunteers including students and faculty. 

Civic Duty

I have long recognized that I consider nursing more than a job. It is my passion and my life’s work. Nurses, physicians, and all those in healthcare that must do their jobs during this crisis do so with dedication and more than a little bravery and self-sacrifice. At this moment we are asked to help with vaccinations for our neighbor and our country. It is an opportunity to engage students in service learning.

The best way to find yourself is to lose yourself in the service of others. — Mahatma Gandhi

Serving selflessly includes taking the time to model desired behaviors we hope to instill in students. We can show this to them through service learning and shared volunteering. Service learning is a strategy that integrates community service with guided instruction and student reflection to elevate the learning experience, teach civic responsibility, and strengthen communities. The last 10 months have convinced me that it is more important than ever to come together as a community, instill in students the desire to serve humanity with shared purpose and goals, and move out of our own comfort zones. It is one thing to read about mass vaccinations in a book and another to have hands on experience.

Free Labor

It is easy for me not to be concerned about giving my time and labor for free to some of these activities. I am well paid and that pay largely comes from tuition and taxes. Many students do work to afford their education and while they may want to volunteer they may not have a lot of free time. One solution to this issue is incorporate mechanisms for student to build up service learning hours that may count for clinical time even during semester breaks. In fact, this may provide greater balance to their schedule and provide working students the same opportunities as students from privileged backgrounds. We need to find ways to be more flexible and that may take us back to liability coverage that covers students between semester breaks. As a person that worked full time while doing my undergraduate degree and my PhD I understand that work is often not optional and scholarships for nurses in graduate programs are limited. Surely we can do better.


Don’t Turn on others over COVID vaccines

In the last few days I’ve seen a growing number of people turning on others they perceive cutting the vaccine line. Most of the people complaining of line cutting are not healthcare workers but community members. I’m sure many mean well are are trying to be supportive of physicians, nurses, and other frontline workers while some come across as angry.

I understand that many people are justifiably frustrated with those politicians that either directly said or through their behavior made clear they thought COVID-19 was a hoax, but were first in line for the vaccine. Then there were those people who are not healthcare workers at all, but hold positions of privilege like religious leaders. Finally, there were healthcare administrators who do not have direct patient contact but managed to be in the first group. Of course, there are also people like me that volunteered to give vaccines and as a result of being present at the end of the day when they needed to use up the vaccines that would expire was lucky enough to be given one.

I don’t think we should be frustrated or angry with any of these people. Let me begin with the politicians that promoted COVID-19 as a hoax and or acted in ways that were irresponsible by not wearing masks, social distancing, and encouraged others to do the same. By taking the vaccine and rushing the line they are clearly admitting they were wrong. Their vaccine selfies are their public confession of misleading the public, errors, and/or dishonesty. We should accept it as the statement it is and recognize that the. people that voted for them would never listen to someone like me. However, they may follow the example of that person they trust. If that gets people in communities to line up for the vaccine that is good.

One person who was the brunt of public outrage was a 70 year old Bishop. I agree by any current criteria he was not on the list of first in line, but the reality is there are a lot of people that will see him getting vaccinated and follow his example. We need people in positions of leadership (political, medical, religious) to be examples and show their belief in the vaccines. I think it is especially important for the Bishop since there have been a couple of Bishops that were very negative with weak arguments about abortion that were refuted by moral theologians. Thus seeing a Bishop getting vaccinated sends a strong message that the claim that getting vaccinated is complicity with abortion is inconsistent with Catholic teaching.

As for the hospital administrators that never touch patients getting vaccinated ahead of front line providers it is important to remember they are part of the structure that keeps hospitals going. The average clinician has no idea how the supply chain works or how to keep the facilities going. Administrators are as critical to the a well functioning hospital as the facilities staff and custodians. A hospital is a team activity. It will not function well or long with only physicians and nurses.

As a country we are tired, frustrated, and honestly a little scared. We have made it this far together and will make it to herd immunity by working as a country. We need to pull together and support vaccinations because vaccinations are the solution to COVID-19. If anything we need to focus our efforts toward better vaccination plans, getting the vaccines out into the communities, and arranging mass vaccination clinics. This may mean we need to make people more responsible for their record keeping and get shots in arms rather than time consuming computer data entry tasks. My experience was the paperwork was taking much longer than the vaccinations and thus slowing the process.

I don’t care how much you denied that COVID-19 was real or dangerous. If you are willing to get a vaccine I’m willing to volunteer my time to give it and thank you for showing up. Please don’t let this divide us. Remember, some of those people being criticized have been asked to get vaccinated as a show of public support, others because of the federal continuity of operations plans, and others maybe out of fear. Let’s support everyone with a compassionate heart.


covid-19 vaccine blessings

This week I had the pleasure to be a volunteer vaccinator. Day 1 I supervised nursing, pharmacy, and medical students who had volunteered to be vaccinators during their holiday break. Day 2 I was one of the people blessed to be giving vaccines to frontline healthcare workers. The entire event was well organized to make sure not a single vaccine went unused and that the vaccinators were not pulled from the frontline staff, but rather faculty and students. Everyone was prescreened and consented. They were then entered into medical records and the appointment for the 2nd vaccine schedule with an appointment card handed to each person. When each got to the vaccine station everything was triple checked and they were again ask about history of fainting or allergic reactions. Each vaccine was appropriately labeled and rechecked for dosage.

In my career I’ve been part of flu vaccine clinics and many emergency responses, but this felt different. This time the people I vaccinated were my friends, colleagues, and neighbors that had been risking their lives for others for the last 11 months. They were tired and stressed, but when the needle went in their arms it was as if months of fatigue and stress melted away. The expression was a cross between relief and gratitude. And yet, with each vaccine my sense of respect and love grew for them. They served knowing the risk and when they got vaccinated not one responded as if it were owed to them, but rather they were grateful. These men and women who had given their all for months were grateful to us because as one young man said to me, we were told that all of you volunteered your time to help us. I almost cried looking at what months of wearing a mask had done to the bridge of his nose and he was thanking of us. It gave new meaning to selfless.

When I became a nurse I felt that it was a calling. Most days I can’t imagine having ever done anything else, with maybe the exception of viticulture. I hope when you look at these physicians, nurses, housekeepers, and other frontline healthcare workers you see the love of God. They did their jobs when no one knew if there would be a vaccine. They did their jobs as people continued to not wear masks and acted irresponsibly. And, they did their jobs with inadequate PPE, squabbling politicians, policies made by people who knew and cared nothing about public health, deaths of coworkers, and through myriad lunatic conspiracy theories.

When I imagine the love of God the mental image will be of the masked face of a healthcare worker.


Wisdom from prudence

Prudence is my friendly road runner

Most of my friends have been introduced to Prudence. She is my favorite neighbor and stops by everyday for lunch. I give her dried meal worms and she drops empty snail shells on the porch as a thank you. During this year filled with social isolation I’ve had more conversations with her than anyone else.

Today, in addition to discussing when I thought COVID vaccines would be available to the neighborhood (she thinks it is important to keep bird lovers healthy and safe) we discussed things that make us emotional. It surprised me that seeing FedEx trucks loaded with vaccine made me cry tears of joy and filled me with pride in a country that worked so hard to create it. Prudence says that is how she feels when FedEx shows up with more meal worms. But today, I was surprised that I was moved to tears watching nurses being vaccinated. I thought of my many friends that have worked tirelessly during this pandemic while people like me were safely working from home.

There are ways that all of us who were safe at home can give back to our communities. We can help our neighborhoods plan. Sometimes it is the little things we do for each other that makes us all more prepared.

Make a Plan

  • Ask your family members to commit to getting vaccinated.
  • Ask your pastor/priest/roshi to help spread the word and provide public information.
  • Have your parish nursing community help with public messaging.
  • Talk to your neighbors when you see them outside.
  • Make sure older neighbors have a ride.
  • Keep yourself updated on local distribution plans.
  • Talk to your health care provider if you don’t know who to ask about vaccines.
  • Get your students and faculty involved.
  • Have a vaccine buddy you commit to go with to get vaccinated.
  • Commit to being responsible for getting one additional person vaccinated.

I have never been more pleased with the healthcare community for all it is doing. I hope in 6 months I will look back and say I have never been more proud of our country as all who are able chose to get vaccinated.

My conversation with Prudence ended with her suggesting a new bowl would be a great Christmas gift since I broke the one she is using. She wanted me to tell you “Vaccines Save Lives.”


Rejoice: COVID-19 vaccinations begin

The third Sunday of Advent is a day to Rejoice. This year it feels especially true as I cried watching the first trucks loaded with COIVID-19 vaccines pull away from the facility headed toward you. I was grateful for the scientist who used their intelligence to imagine new vaccines that can be produced quickly and safely. I was grateful for the FDA that insisted on following the safety procedures even in a crisis so we could all have faith the vaccines are safe. I was grateful to FedEx, UPS, and Boyles that are doing the deliveries, and for the U.S. Marshalls that are escorting them. I was grateful for all of those that have served on the committees that planned how to distribute the vaccine when it arrives in communities all across the country. And I am grateful for all of those that are working in their communities to be advocates for vaccinations.

Two days this week I am volunteering to administer COVID-19 vaccinations. It will be the first time since March that I have been inside in a room with a large group of people I don’t know except to go to the grocery store. While I have concerns about doing indoor vaccination I think it is worth the risk to keep hospitals and communities from using nurses that are caring for patients. I also believe it is a small way to give back to all of the frontline personnel that did so much for all of us during this pandemic. When this over we owe them so very much more.

The first day I’m eligible I plan to show up, roll up my sleeve, and get vaccinated. It is important for everyone to get vaccinated. We need to reach a minimum of 70% of the population vaccinated to achieve herd immunity and that means the majority of us have to play our role as good citizens. It is what Americans do. We show up when we are needed and we come together. We see the whole as more important than any one individual. And we enter each crisis as a community. I don’t want this crisis to be any different.

To me it is simple:

  • Love yourself enough to stay healthy by being vaccinated.
  • Love your community enough to reduce risk and be able to fully participate.
  • Love your country enough to help end this pandemic, end the isolation, and make it possible for everyone to get back to work, school, and church.

I miss seeing my friends and my students. I miss taking the time to talk to the people in the grocery store. I miss restaurants, concerts, plays, and travel. Most importantly, I miss a time when the daily news didn’t involve numbers of the dead, ICU availability, and new positive tests. I hope each of you will do your part and get vaccinated.

I know that many fear vaccinations and there have been things in our past that add to that fear. There are others that believe conspiracy theories, it will most likely be impossible to change their views. By their nature, conspiracy theorists are not rational. They can no more control their irrationality than a person who is afraid can control their fear. The difference is the person who is afraid may recognize the fear as not in their best interest, but the person that believes conspiracy theories will not. Therefore, it is important to walk with the people that are afraid and be their strength and comfort. We should not equate people who are afraid with those who buy into conspiracies. I hope that each of my friends who has influence and trust in their community will take the time and effort to walk with those that are afraid or lack trust. Lend them your compassion and your strength.

The light at the end of the tunnel may just be UPS and FedEx headlights. Give them a warm welcome and for the next few months pull to the side and let them through traffic.


Rosary for the republican national convention

IMG_4560Tonight when I watch the RNC I will be holding two things: a) a glass of wine, and 2) the Rosary of Modern Sorrows. I have a large collection of rosaries that have been given to me by my husband, Priests, friends, and some I picked up because I wanted to support the people that made them. Why I want a glass of wine should be obvious, but the Rosary of Modern Sorrows is different. I like it because it represents what I think are the issues we need to address to make America a better and more equitable community. 

I will pray this rosary for all people that have turned a blind eye to caging children, denying access to refugees, or discrimination against those who are LGBTQ. I pray for those that don’t understand Black Lives Matter, believe people chose poverty, and refuse to see the harm that is being done to our environment. 

Rosary of Modern Sorrows

We pray for the lives of women and their children, born and unborn, and the unjust societal structures that steal hope, healthcare, and economic security from these, our most vulnerable mothers.

We pray for mother earth, our fragile environment, the animals, land, and oceans entrusted to our stewardship and care.

We pray for immigrants, refugees, Dreamers, and all who seek a life free from violence and the threat of death and abuse. May we imagine ourselves in their place, knowing we would do anything to secure safety for ourselves and our families.

We pray for those discriminated against because of the color of their skin. We pray for those who are caught in the school-to-prison pipeline, trapped by corporations that gain financially from incarceration. We pray for our innate biases, that we may recognize these and then choose to move beyond them. We pray for awareness of the attitudes and structures that remain from our history of slavery.

We pray for a welcoming of LGBTQ people by all churches, temples, mosques, and synagogues. We pray for LGBTQ couples, their children, and extended families. We pray that they may be supported and loved, with full acceptance as people truly created in the image of God, a creation that God saw as “good”, and who deserve to live every aspect of life to the fullest.


ANA’s Lack of Moral Courage is Shocking

When the ANA PAC called me for a donation I declined and took the time to explain why. I have been an ANA member since I graduated in 1991, have been actively involved in many ways over the years, and am a fairly reliable donor. However, I believe that the ANA failed us when they showed up for a photo op with President Trump. It ignored the early failures of the COVID-19 response and the harm it had caused to nurses, in fact the death of nurses. Those early failures were only the beginning of what what has now been the worst response in our history with over 154,000 deaths including the deaths of many nurses, physicians, and other healthcare workers who are still reusing N95 masks despite the evidence that it isn’t safe. Nurses in some hospitals are even being told they only need a surgical mask when caring for COVID patients if the patient isn’t getting an aerosol treatment.

I went on to explain that by not supporting a candidate for President they in-fact did just that by their silence. Through their silence they are ignoring children who were locked in cages and separated from parents, the gassing and beating of peaceful protesters in the streets, the call for the delay of the elections by the President which is a clear threat to our democracy. They ignored it when the President did nothing as bounties were placed on the heads of our soldiers defending us abroad. And they are silent as the President continues to disrespect women, people of color, and anyone that disagrees with him. This administration has been all our code of ethics opposes. By their silence ANA is saying the code of ethics is meaningless words. They are silent as nurses and their patients die.

Last night I received another call from the ANA PAC and this time from someone in a leadership position who heard I was not happy. She tried to convince me that I should overlook this because they didn’t want to alienate Republican nurses to which I must ask what they would have done not to alienate Nazi nurses in Germany? I want to make clear there are many Republican nurses that don’t support Trump or his tactics. This isn’t about a party but a particular candidate that is evil.

The representative went on to say that they had members that were friends of Al Gore to which I replied that is like saying I have a black friend so I can’t be racist. Not giving up she told me that the decision was made two years ago by a task force. Really? Who selected the task force and under the current conditions when children are caged, citizens are gassed and beaten in the streets, white supremacists are referred to as some good people, reporters are surveilled by the Department of Homeland Security, citizens are arrested without charges and thrown into unmarked vehicles, and our President thinks he can delay the elections isn’t it time to reverse that decision? Does ANA not recognize that if you are silent in the face of evil you become part of that evil?

Bad men need nothing more to compass their ends, than that good men should look on and do nothing. – John Stuart Mill

Finally, she tried to tell me that ANA PAC post on their website their view on issues and that she had been to Homestead and been at a protest. Mind you I’m an active person on social media and ANA PAC is shockingly uninvolved on any form of social media and silent in the news. If it were not for the nursing unions, other nursing organizations, and individual nurses our voice would not even be heard on these critical issues.

My question is not whether I think ANA PAC has lost their moral compass, I do. The question is whether I’m willing to stay a member of the ANA if they are not willing to take a stand during the greatest moral challenge of my lifetime. ANA is notable by their silence and by being silent in the face of inhumanity you are indeed taking a stand. You are saying rather than offend those that support caging children, gassing and beating people in the streets, surveilling the media, not providing a national response to a pandemic, grabbing people off the streets in unmarked cars and holding them without charges, and even delaying our presidential election, you will be silent and let the myriad forms of abuse continue.

You are not the ANA I joined. I don’t know you.


Wear A Mask

Over the last few weeks, I have been angered by the large number of hospitals threatening nurses and physicians for wearing masks and telling the truth. Nurses have primarily been told to remove their mask or be fired. While physicians seem to be told to remain silent about shortages and conditions or be fired and while at the same time to remove their masks. I’ve collected a large number of such stories from people I know and trust. They have come from nurses and physicians. One physician, a friend of a friend, was working in an ER and the administration told him to take off his mask or be fired. He quit on the spot rather than take off the mask. The husband of another friend is also an ER physician and he actually had to go to his car and get a mask when a symptomatic patient came in because they had absolutely no N95 masks in the rural hospital.

This was sent to me by a friend who has spent her entire career at the beside.

I can’t speak out publicly and be identified because I cannot afford to lose my job. I can tell you that nurses are being bullied not to use their own PPE especially if they are working in areas that it was previously not routinely necessary. Even nurses and therapists with asthma, COPD, immunosuppression and/or recommendations from their personal physicians are being bullied about not wearing an N95/PPE that they provided themselves. My area was recently told we “can” but are not required to wear a surgical mask after repeated complaints from the Radiation Therapists we work with that their professional body (ASTRO) is recommending they wear a mask during all patient care. However, the administration here has been “working around” the nurses in administration to roll back that protection in the name of not “wasting masks”. None of them wear masks when they come through the clinic. Combined they’ve spent almost no time in the clinic before or after this began. They act as if we are overreacting when we wear masks to work with our patients, but in the same breath tell us to stay out of the clinic if at all possible and “protect ourselves” as if our front line staff is disposable. With the transition to no visitors we have folks that counted on caregivers coming in with them that are now upset and unable to do their own intake paperwork and needing more hands on care. But the culture coming down from the top is that the front end staff are overreacting if they want to protect themselves and patients by wearing masks. I feel like we are a pressure cooker ready to go off. We have young folks that are going home to families and roommates (that are working in Walmart’s and driving busses) and they are the ones helping immunosuppressed patients with their paperwork (so much more because now they can’t have a family member to help them) and when they use a physical barrier mask they get side eye from our nurse manager (whose boss is non clinical and was on the Hoax train up until last week and still makes flippant “just wash your hands, you’ll be fine, comments”) and others. They along with the rest of the management team are hoping/thinking they will “roll back” the decision to allow our folks wear masks this week… all of this from the big executive suite where a few folks, all sitting in private offices are dictating what the hands on people can do to protect themselves. It’s just wrong. They are intentionally talking amongst themselves to reach a consensus against protecting our folks before including equally/higher ranking nurses on any conversations. At a time when nurses should be at the forefront of decision making we are being railroaded and overridden. I am the only one that seems to understand the magnitude of what we are facing. Since our doctors are a separate group they can do what they want for themselves and although they can ask that we protect the patients and employees, they have no sway.
I have been working to make sure we have local seamstresses lined up and donations of fabric surgical masks so that we have some protection. However our hospital system will not allow employees to wear them, even/especially when we are in areas that they don’t deem masks “necessary” which is almost all our front line folks in non COVID19 treatment areas. It’s incredibly short sighted. One of our employees was sent to employee health after they developed a nasty cough this week. They were told no test needed, no quarantine needed, no mask needed, they could go back to work, the cough alone was not concerning.
Thank you.

CDC Failure

The guidance on the use of masks needs to be clear for both clinicians and the public. While CDC says it has been updated that does not appear to be the case and remains so vague that there is great flexibility for facilities to do what they want. Fortunately, the Joint Commission has now been clear in their recommendation that not only should staff be allowed to wear their own PPE if they have it and the hospital is not providing it, but they refute the CDC guidance and cite evidence while admitting it is incomplete. The Joint Commission confirmed that they are receiving reports from across the country of hospitals refusing to let staff bring their own N95, surgical, and homemade masks.

Use of Mask for the Public

As bad as the CDC guidance has been for healthcare personnel it has been equally bad for the general public. Statements have ranged from it isn’t need and handwashing is adequate to masks can increase a person’s risk of contracting the disease. Both are clearly misleading. The rational was first:

  • We need to conserve the PPE for healthcare personnel and the general public is at low risk. Because the virus is spread through droplets from coughing or sneezing you would need to be within 6 feet of the person that is sick.

When it became clear that many cases were actually being spread by asymptomatic people and that the virus may linger in the air longer than they first thought they still did not change their recommendation. They did change their approach.

  • People do not need to wear a mask when outside because they will wear them improperly and may increase their risk because they will be more likely to touch their faces and it will give them false confidence.

Obviously, we all know that we need to conserve N95 and surgical masks for healthcare personnel. They are our front line and deserve all we can do to protect them. However, the government is now telling us that a minimum of 100,000 to 240,000 Americans will die and 50% to 70% of the country may contract COVID-19. Spare us the rhetoric that the risk is low. Also, don’t insult people. No one thinks a mask is a protective forcefield. What the average person feels is that even a homemade mask is better than no mask. When a homemade mask or other non N95 mask is worn and combined with social distancing, handwashing, and not touching one’s face it decreases an individual’s risk when a person must venture outside.

As the nation’s leading public health organization, the CDC should remember that education is critical. If they believe that putting on a mask makes the average citizen suddenly forgets that they should social distance, wash their hands, and not touch their face then the answer is a public service campaign to remind people. If they believe that people will wear masks improperly again education is critical and they should immediately make an infographic or short video demonstrating how to properly put on a mask, take it off, and clean it or dispose of it. The real risk would be people reusing disposable masks and/or not cleaning masks. Of course, this ignores the fact we are asking healthcare personnel to do just that. This is public health 101. Treating the public as if they lack any reasonable amount of intelligence is insulting and not helpful.

What Does the Research Show

In a Lancet article  that reviewed different countries’ use of masks and the available evidence they pointed out that “there is an essential distinction between absence of evidence and evidence of absence.” They concluded, “community transmission might be reduced if everyone, including people who have been infected but are asymptomatic and contagious, wears face masks.” A cluster randomised trial of cloth masks compared with medical masks in healthcare workers found that medical mask are significantly better and should be preferred during a pandemic for healthcare providers. However, they also pointed out that medical masks are not always an option. It was suggested that cloth mask with multiple layers and tighter weaves would be more effective than the current cloth masks that they tested.  Testing the Efficacy of Homemade Masks: Would
They Protect in an Influenza Pandemic provides some insight into what materials may be best for a homemade mask. Smart AIR took the information and put it into a useful graphic that compares homemade masks to surgical masks.

Screen Shot 2020-04-01 at 10.05.30 AM

While the graphic below also isn’t evidence it makes clear that places that routinely do wear masks have fewer cases of COVID-19. Of course, there are other confounding variables and this is just one piece of data.

Screen Shot 2020-04-01 at 9.21.55 AM

Information on Making Your Own Mask

I think everyone should take the time to make their own mask. It will serve as a reminder that we are in a battle to save lives. It will remind us that in many poor countries this is all they have when they care for patients. It will give children a craft project while they are out of school that can be used to teach science, health, public safety, social responsibility, and even math. And most importantly, it may give you just a little extra protection when you absolutely must go out.

Making your own mask is not that difficult for anyone with basic sewing skills.  I’ve provided a couple of links that have instructions.

I wish you all good sewing.