Friday, November 21, 2008

un-American values

I saw a bumper sticker on the back of someone's car that read:

Because we can't all be on welfare

The word 'REPUBLICAN' was very large. It wasn't until I got up close that I could see 'Because we can't all be on welfare'

When I first saw it, I gasped in horror. Then I thought maybe it's tongue and cheek; perhaps my denial that someone could be that mean-spirited and have such little insight. But since the words under REPUBLICAN were very small and could only be seen when I was right behind this car, I decided it was not tongue and cheek, but rather a dangerous and hateful person driving that car. I say dangerous because to have such little empathy is dangerous. It keeps the poor, poor and that helps to foster inequality.

You would think this kind of sticker might be on an expensive car but it wasn't. It was on an older mid-sized American car. What un-American values on an American car.

Thursday, November 20, 2008

Cycle of Poverty (2)

She was crying so hard on the phone I could hardly understand her. She hasn't slept for days and here is why:

She was checked into the hospital at the beginning of the week to have some tests run since her stroke last month. This overweight 47 year old also has diabetes and high blood pressure. While she was in the hospital, her 14 year old son was admitted to the hospital. His bolts and screws that hold his leg together after he was hit by a drunk driver while crossing the street a few years ago, had become so infected that he became septic and almost died. So she checked herself out of the hospital to be with him.

Her 16 year old son was assaulted by 4 men and when he was able to get away, they decided they weren't done with him yet so he then became the victim of a drive by shooting. He was not actually hit by any bullets but he's so afraid they will kill him, he won't go to school. I'm guessing he's part of a gang but I didn't ask her.

Her husband decided he'd had enough of this and so he up and left the family this week. She's had terrible financial problems for a long time and today her car was repossessed.

I assured her I would get a doctor to write a prescription to help her sleep and told her I'd call her right back. In the 10 minutes it took me to call her back, she received a letter in the mail from her neurologist saying her tests for Lupus had come back positive.

After much coaxing, I was able to make an appointment for her to see our Social Worker.

I feel sorry for this woman and can't imagine living her life. She is part of the wheel that spins out of control. And now I think the real victims here are her 4 boys. They live in poverty and in fear. They have no father and their mother may not live much longer. I shudder to imagine their day to day life. I try not to think about what their house looks like, what they eat, what they can't buy, and if anyone ever said "I love you" to them. I wonder what will happen to them and to their children in this cycle of poverty.

Friday, November 14, 2008

Dangerous Budget Cuts

There's a pharmacy near the clinic where I work that has been a God send for our patients. Here are the criteria someone has to have to fill a prescription there: you have to be a patient at our clinic or another of two clinics it serves, have either no insurance at all or using medical coupons. Patients get their medications there at cost plus a small dispensing fee. So it's possible for someone to get their blood pressure medications and their diabetes medication for less than $10 a month. (Even this amount of money is difficult for some of our patients). They also have interpreters on staff. It's subsidized by the county and it's supposed to close at the end of the year because of budget cuts.

I happened to speak to a pharmacist there and she told me the county and city officials have said they don't feel there is a need anymore for this kind of pharmacy. I knew I had to do something. I called the city council office and asked what I could do to try and stop this pharmacy from being closed. I was told I could write a letter and directed me where to send my letter. She told me there will be a final budget hearing on November 24 so it's important they hear from me immediately.

I decided I had a mission. I sent an email to all the staff at these clinics regarding this and then sent my letter. Here is my letter with the name of the clinic and pharmacy left blank:

I work as a Registered Nurse at the X Clinic. I know the X Pharmacy is due to close very soon. This letter is in support of the X Pharmacy.

Our clinic serves the poorest of the poor in our city and this pharmacy has been an invaluable resource for our patients. Here's an example of why this pharmacy is so important:

I saw a patient the other day who stopped taking his diabetes medication and his blood pressure medication because he couldn't afford them. His blood pressure was 170/112 at the visit. He told me he had to make a decision to pay his rent and buy food for his family or buy his medications. He didn't know about the X Pharmacy where he could buy his medications at cost plus a handling fee. He told me he would even have a hard time affording it there but at least he would manage. This patient is just one of so many examples of patients whose lives would be put in danger if this pharmacy was closed.

We also have so many patients who need the interpreter service only they can offer.

I know your job is not easy; trying to figure out the budget for the next year. Please do not forget about the poor in this county. With such hard economic times I think there will be even more need for this pharmacy where our patients can buy their medications at a reduced cost.
Thank you for your consideration.

By the end of my workday today, a total of 6 staff from our clinic had sent a letter. I'll be working on getting even more letters sent. I don't know if these letters will change their probably already made up minds but I do believe it is our responsibility to do what we can to speak loudly for those whose voices are not strong.

Wednesday, November 5, 2008

The day after...

I went to work today, sure we'd all be talking about last night. I was busting at the seams; still clapping and cheering. Alas, it was business as usual. How could that be? My life has changed. I felt like I just had a baby and no one noticed. Oh, they're just young and don't know how hard we've worked to get to last night. I told myself that to quite my emotional swell. But the patients...why didn't they say anything? Their lives will change. Don't they know that? Our social worker noticed. We hugged for a moment and then he left to pick up free baby clothes from a donation site. I want to bask in it. I want to talk endlessly about the future.

HELLLLOOO AMERICA!! We are going to ROCK this world!!

What an amazing night it was. Getting together with friends, eating and drinking Champagne, clapping, cheering, crying. Seeing Jesse Jackson weep, watching people in NY and Chicago fall to the ground with joy and relief, and listening to John Lewis who sounded stunned. I think he was having a hard time even talking. When he worked so hard during the civil rights movement, he probably couldn't even imagine this night would come. The young people and people of color will forever have their say.

And now---

It IS a beautiful morning indeed...

I feel like dancing in the streets...

And then I want to lie beneath a shady tree and think about how much I love my country...

Saturday, November 1, 2008

The cycle of poverty...

uneducated, poor, demanding, distrustful. I talk to a patient on the phone and she yells at me. I tell her if she doesn't stop yelling at me I will need to hang up the phone. She says, "I'm not yelling. Believe me, you'd know if I was yelling". I tell her I think she is yelling at me and she needs to stop. She calms down, and proceeds to tell me she will be at the clinic in a few minutes and has to be seen right away. I tell her there may be a 2 hour wait because she doesn't have an appointment. She hangs the phone up on me and comes to the clinic anyway. I bring her back to a clinic room and do my assessment. Her lip is swollen and she thinks she was bitten by a spider. She spent the last two nights in an abandoned van. She's African American. She has fake two inch purple fingernails. She tells me she must be out of the clinic in 20 minutes because she needs to pick up her 8 year old son who will be waiting for her outside the YMCA. I beg one of our doctors to see her ahead of other patients because her son will think he was abandoned. They are homeless. 

A Cambodian man comes to the clinic with his 14 year old son. They do not have an appointment as he rushed him there from school. He tells me his son was sent home from school because he's sick. I do my assessment. He has a slight fever of 99.5 degrees and a sore throat. I do a throat culture and it's negative for Strep. I tell them it's probably just a virus and he should feel better in a few days. The man, who was difficult to understand because his english is poor, acts as though his son is dying. He tells me he wants me to give him medicine so he can get better. He asks me how he got sick. He asks me if 110 degree fever is a lot. I fax in a prescription for some Tylenol and he feels like I'm helping his son. He has no understanding of illness.

I talk to a patient on the phone who needs more percocet because she's on a wait list to have her tooth pulled. She says when she went to the community health clinic dentist, he couldn't get her numb so she's on the wait list at the county hospital to have her tooth pulled with general anesthesia. She's been on the list for 3 months. I tell her I'll call the hospital and see how much longer they think she'll have to wait. Surely it couldn't be much longer. When I call the clinic in the hospital, I'm told she probably has another 9 months to wait.

I call a patient and ask if this is Charlene. She says, "Who's this?" This actually happens a lot. I wonder if they think I'm a bill collector. I asked someone one time why she asked me that question. She said, "I don't wanna talk to anyone I don't haveta."

I see an 8 year old boy for a well-child check. He comes in with his mother and older sister. They're all eating Big Macs and fries in the clinic room. The boy has fat cheeks and a fat body and weighs a whopping 110 pounds. The mother tells me she's a little concerned about his weight and wonders why he's so overweight. I look at the boy eating his french fries. I look at the mom with her long fake fingernails and wonder how she'll clean all the food out of them. I can't help it. I start laughing. After I compose myself, I start talking to her about nutrition. She doesn't know what a "protein" is. I give some examples and the 8 year old says, "You mean like Chicken Nuggets?" The mother tells me when she was growing up, her mother would give her fried sandwich meat and a soda for breakfast. I set them up to see our nutritionist.