Tag Archives: #trump

Celebrate the Opportunity to Do What is Right this Fourth of July…

We have all heard that “freedom isn’t free”, and that it is our armed services who are preserving our freedom. Not so much in this digital age. The Senate Select Committee on Intelligence released it’s investigative conclusions yesterday (July 3, 2018), which support the findings of the joint efforts of the NSA, CIA, and FBI. These findings include,

We assess Russian President Vladimir Putin ordered an influence campaign in
2016 aimed at the U.S. presidential election. Russia’s goals were to undermine
public faith in the U.S. democratic process, denigrate Secretary Clinton, and harm
her electability and potential presidency. We further assess Putin and the Russian
Government developed a clear preference for President-elect Trump.

We also assess Putin and the Russian Government aspired to help President-elect
Trump’s election chances when possible by discrediting Secretary Clinton and
publicly contrasting her unfavorably to him.

Russia’s intelligence services conducted cyber operations against targets
associated with the 2016 U.S. presidential election, including targets
associated with both major U.S. political parties. We assess Russian
intelligence services collected against the U.S . primary campaigns, think
tanks, and lobbying groups they viewed as likely to shape future U.S. policies.
In July 2015, Russian intelligence gained access to Democratic National
Committee (DNC) networks and maintained that access until at least June, 2016.          Source: https://t.co/YFXgwl3BG9

As you gear up to celebrate, please prepare to enter into the most important battle for our freedom yet – one that depends not upon the military but upon civilian action to actively #resist, to speak out to #vote and to take back our country from foreign powers and puppet presidents. We, the nurses of this country, have pledged to do what is right for our patients, and to maintain a strict code of ethics. It’s now time to apply that to our country as the population to be cared for, to fight for, to know that our very values and fundamental structures are being subverted and to work against that subversion by all means possible. Please support the young people on their #RoadToChange, the #MarchForOurLives, and all efforts to use our #VoicesandVotes to remedy this situation.

Please. Ask yourself, what would Flo do?  Resist. It’s the only truly patriotic thing to do.

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Hill Day for Nurses 6/21/18 and the Need to Act to Restore Justice

On Thursday, June 7, 2018 the United States Department of Justice indicated it will no longer defend the Affordable Care Act’s protections for patients with pre-existing conditions. Department of Justice. Yes, you read that correctly. Merriam-Webster’s dictionary lists as it’s first entry for the definition of justice;

the maintenance or administration of what is just especially by the impartial adjustment of conflicting claims or the assignment of merited rewards or punishments :meting out justice: social justice.

It is unfathomable what this administration considers to be just, just action, or justice. But it is clear that justice is not for the many, only for the few who can pay the entry fee. This runs completely contrary to the four essential ethical principles which underlie nursing and medical practice – beneficence, nonmaleficence, autonomy and JUSTICE. Justice, in a civil society, requires that all people be treated equally under the law. Justice ensures that the weak are not steamrollered by the strong, and have access to important resources such as food, clean air and water, shelter, and reasonable medical care. Are we not a civilized society?

Apparently not, if this administration continues to destroy our environment, deny people essential dignity, and reap financial gain by preying upon the most vulnerable. It makes me want to both cry and vomit. #Cromit, I guess…

What can we as nurses do? Ask yourself, what would Flo do? Get involved! The American Nurses Association Hill Day is on June 21st this year. I know it’s coming up fast, but if you can possibly make it, it promises to be a phenomenal opportunity to speak directly to those who are charged with representing us in this government. You can learn more (including discounted hotel rooms and how to register) by reading the ANA’s Capital Beat post from June 12, below:

http://anacapitolbeat.org/2018/06/12/trump-administration-again-takes-aim-at-pre-existing-conditions/

And please, please, please, whatever you do, #Vote.

 

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The “Gag Rule” – Trump’s Kowtow to the Religious Right. How we can Fight Back.

Title X provides federal funding for family planning services. Organizations like Planned Parenthood utilize this funding for services such as ;

  • Wellness exams
  • Lifesaving cervical and breast cancer screenings
  • Birth control
  • Contraception education
  • Testing and treatment for sexually transmitted diseases (STDs) and HIV testing.

These services are provided at affordable rates to low-income patients, thanks in part to this funding source. However, a cabal of conservatives has requested that Trump issue a rule that would  effectively ban Planned Parenthood and similar organizations from providing abortion and related services under the same roof as operations funded by federal family-planning grants, according to an administration official. This includes offering patients information and/or referrals to safe abortion providers. This rule would effectively do three things to the Planned Parenthood clientele – 2/3 of whom are below the federal poverty level in terms of income –

  1. Impose new rules designed to make it impossible for patients to get birth control or preventive care from reproductive health care providers like Planned Parenthood.
  2. Prevent health care providers across the country — including doctors, nurses, hospitals, and community health centers — from referring their patients for safe, legal abortion.
  3. Remove the guarantee that patients get full and accurate information about their health care from their doctor.

Just at the moment when historic gains are being made in Ireland regarding a woman’s right to control her own reproductive system, this rule seeks to take the  United States backward to a time when women had little to no control. Shades of The Handmaid’s Tale.

Physicians and nurses have considerable clout. Doctors because of their well-funded lobbying efforts and socioeconomic status. Nurses have two things: sheer numbers and the confidence and trust of the American People. Nurses have now been for 16 years voted the most trusted professionals in this country. It’s time to join our collective voices and advocate for those who cannot – namely the marginalized, socially, economically, and culturally disadvantaged.

OK, so maybe you don’t believe in abortion except in cases of rape or incest. Well, then you do believe a woman should have a right to an abortion, based upon the reason. Who is to judge what is a good or valid reason? If you agree that a woman who was raped should not be made to carry to term, then you believe in abortion rights. Period. You can’t pick and choose the reason. The Supreme Court has again and again reinforced the constitutionality of a woman’s right to choose.

If you believe that no women should be able to have an abortion, then you must also care for their children by providing a safe home, adequate food and health care, education, and support for the parent’s ability to obtain decent child care. Failure to do so rescinds your moral high ground. Christ implored his followers to clothe the naked, feed the hungry, take in those in need in Matthew 25:35-36, “For I was hungry and you gave Me something to eat, I was thirsty and you gave Me something to drink, I was a stranger and you took Me in, 36 I was naked and you clothed Me. I was sick and you looked after Me…” I believe that is pretty clear directive – as we know he goes on to say that whatever you do for the least of his brothers is done directly unto him.

What can you do if you would like to fight the gag rule? You can submit comments to the Department of Health and Human Services via this website

https://www.weareplannedparenthoodaction.org/onlineactions/yOKxyIomxUO-EFoTcvQbHg2?_ga=2.91165785.213420659.1527432943-1212086471.1527432943

You can call/write/text/email your Representatives in congress to ask them not to support this effort to take needed health care services away from those with the least ability to pay. Please, help. So many people are depending upon Nurses to take a greater role politically. The IOM said as much in its vision for the future of health care. Now is the time.

 

 

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Nursing: The Last Ethical Profession? Ethics and mHealth – Published.

It is well known that nurses are the most trusted professionals in the United States. Perhaps this is due to the immutable and fundamental nature of ethics in nursing. The complete LACK of ethics, respect, integrity and honesty in our political system presently, embodied by the person occupying the White House, is appalling. As nurses, we continue to fight the good fight in our jobs. But we must do more, we must # resist on every level.

I had the honor of having another article published in the Online Journal of Nursing Informatics. The link is below. It deals with ethical design for mobile health applications. As nurses, we work to ensure that ethics permeate every aspect of our profession. Now it is time to ensure that this commitment extends to every aspect of our lives. The American Nurses Association offers any number of ways to be involved. Let’s do this… after all – #whatwouldflodo ?

 

Here’s the link to my most recent publication:

http://www.himss.org/library/using-classical-ethical-principles-guide-mhealth-design

 

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Medicaid Expansion Fiscally Sound: Trump Policy – Not So Much…

The powerful image above is Dr. Pamela Cipriano, President of the American Nurses Association (ANA) addressing Congressional staffers. The ANA is the voice of nurses in this country, and advocates for better health and health care for all. The link below will take you to an article explaining the title of this post. Simply put, offering people primary care through Medicaid keeps them out of the Emergency Department, ultimately saving money all the way around. Trump has decided to undo his predecessor’s freeze on funding uncompensated care for states who refused to expand their Medicaid programs as offered by the Affordable Care Act. Not a good move.

States who refused federal funding to expand Medicaid did so out of political spite and fear of criticism by the extreme right wing of the Republican party. They did so not thinking or caring one bit about the people who live in their state. They did so knowing their actions were fiscally irresponsible and detrimental to the health of their constituents. Really? How much longer can we keep this farce going?

Thanks to the ANA for its continued advocacy on the part of those who are vulnerable, uninsured and clearly unrepresented. Inform yourself. Call your Congressional representatives. Be a part of the solution. #Resist !

http://anacapitolbeat.org/2017/05/02/new-study-highlights-positive-experiences-of-medicaid-enrollees/

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Travel Ban, Boehner, and Obamacare – The Importance of Sane Policy

The photo above was taken on the last day of  #HIMSS17, the Health Information Management Systems Society’s (HIMSS) 17th (inter)national conference in Orlando. The people are all “program assistants” – students who were selected by a very competitive process to attend and assist with the conference. I was fortunate to be one of them.

But look closely. As a white American woman, I was not really “one of them”. I was in the minority. The students were from all over the world –  Nigeria, India, China, Latin America, Singapore, and some were from the USA. But as an old white woman, I was an anomaly. These are the best and the brightest in the world of health information technology (HIT). We are made stronger by their presence in our country.

It was at HIMSS17 that John Boehner uttered the now famous words that a full repeal and replace of Obamacare is, “not what’s going to happen”. I saw it. I heard it. I believe it. Also brought up in the keynote discussion between former Speaker Boehner and former Pennsylvania Governor Ed Rendell was the fact that 30% of the American People want to repeal Obamacare but keep the Affordable Care Act. Oy vey.

How can we educate the American People as to the importance of allowing immigration which benefits all of us, and informing themselves about health care policy and what it truly is and means for them? It’s up to each one of us to continue to #resist and educate our fellow Americans as to the realities in today’s health care sector. Our health depends upon it.

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Trump Travel Ban Bad for Veterans’ Health Care and the VA

The writer is fortunate to have the time to read several news feeds including the American Nursing Association’s (ANA) “Smartbrief” and Medscape’s various updates. In both of these, analysis of recent political action demonstrates the gravity of the repercussions from poor policy making.

Donald Trump issued an executive order recently, banning immigration from 7 countries with largely Muslim populations and suspending the Visa Interview Waiver Program. According to a recent article in the New England Journal of Medicine, this is causing not only chaos, fear and uncertainty, it is undermining medical education and patient care (Ault, 2017).

Physicians have expressed widespread opposition to the ban, stating that it threatens the very foundation of American medicine – the free exchange of ideas, experience, and perspectives. But it affects them on more than just a philosophical level. On an individual level, fear is palpable among patient and physicians, who are unsure of their immigration status. A shortage of primary care and internal medicine residents is also a likely result. More than 50% of the internal medicine residency slots are filled by international medical graduates. These Residents care for America’s veterans in VA facilities, and any number of underserved populations. Some international medical students were not allowed to board their flights back to the US when the ban was issued. Others are in the process of obtaining a Visa. A large number of residents and medical students originate from Muslim-majority countries, and their inability to enter the country would deeply impact primary care for these vulnerable populations (Ault, 2017).

The numbers are there. Medical school graduates from Iran, Iraq, Syria and Sudan accounted for 753 applications for Internal Medicine residencies in 2013, and 40% of these were matched into a program (got a job as a Resident in the US). In addition, 1879 doctors in the US were here with J-1 Visas in 2015. J-1 Visas require that these doctors return home for 2 years after finishing their training, unless they take jobs in medically underserved areas (Ault, 2017). The impact on primary care and vulnerable populations is clear.

The writer can attest to this. Her daughter is a first-year Resident in an Internal Medicine. Previously, she studied medicine in downtown Detroit at WSU. In both cases, she has worked at VA facilities, and with underserved and vulnerable populations. Should this country be unable to fill its Internal Medicine Residency slots, veterans and minorities will suffer.

The medical community has come together to advocate for allowing qualified international medical graduates to enter the United States, regardless of country of origin. Residency programs’ selection committees are already reacting to the ban, altering their rankings of applicants based on country of origin – essentially discriminating against qualified young physicians on the basis of race and religion (Ault, 2017). This is not only ethically repugnant, it diminishes the quality of medical care for all. As nurses, we must advocate for quality care for all of our patients, and stand with physicians against this ill-advised policy.

Reference

Ault, A. (2017, February 2). Trump immigration order causing chaos for medical centers: NEJM [Blog post]. Retrieved from http://www.medscape.com/viewarticle/875302?src=WNL_specrep_170207_MSCPEDIT&uac=175171HR&impID=1285650&faf=1#vp_2

 

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Nurses Provide Vision for New Administration – Letter to Mr. Trump

Dr. Cipriano, head of the American Nurses Association has sent a letter to the President-Elect, with guidance and goals for achieving health care reform that promotes the health of the nation, progress, and economic growth.

It is well worth reading, which you can do by clicking the link below:

http://nursingworld.org/HomepageCategory/NursingInsider/ANAs-Letter-to-President-Elect-Donald-Trump.html#.WEwP-_br5G8.facebook

You can also print, share, send it via email to those who would benefit from having this information, and take an opportunity to participate in the conversation.

Nurses must get involved in policy and politics at all levels. As the most trusted group of professionals in the country, the voice of nursing speaks with authority! We are called to action by our own code of ethics.

Please read and share this important letter with colleagues, friends, representatives, and anyone who might be willing and able to join with nurses in prioritizing health and wellness for all our citizens.

 

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The Pillaging of Medicare – Paul Ryan’s Privatization Plan

It’s true. Paul Ryan would like to eliminate Medicare, and replace it with a voucher system very similar to that of the Affordable Care Act. Speaker Ryan’s plan would give seniors vouchers that they could use to purchase private insurance. Sound familiar? In addition, the President Elect’s choice to head up the Department of Health and Human Services, Tom Price, supports Ryan’s push toward privatization. You can read more about it here:

http://www.chicagotribune.com/news/nationworld/ct-paul-ryan-medicare-privatization-20161203-story.html

Why is this important for nurses? First of all, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) have spent a lot of time and resources devising and implementing programs that prioritize and incentivize technology and informatics as a means of improving the quality and safety of care.

Health care is precariously poised at this time. Nurse leaders will face great challenges as programs such as Medicare and Medicaid face political surgery with potentially grave consequences. Should current efforts to dismantle the Medicare program and offer seniors ‘vouchers’ instead succeed, all of the quality of care initiatives and informatics incentives in existing programs will disappear. Nurse leaders will be challenged to get involved in order to protect fragile seniors and prevent the destruction of this invaluable resource, which has been paid for by monies contributed throughout a lifetime of work by the very seniors who are enrolled.

If things follow their present course, Medicare will continue to add new quality indicators and move reimbursement from a fee for service to a value-based purchasing model (Medicare.gov, n.d.). Nurse leaders will need to be aware that the care provided on their units drives a large part of the reimbursement, and be willing to ask for what they need to provide quality care to each patient.

In order to effectively lead and manage, nurse leaders will need to be informed and actively participate in the use of data and device integration to provide safe, high quality care. They will also have to advocate for their staff and patients by ensuring that technologies implemented are facilitating rather than hindering nursing workflows, and adding value to the nurse-patient experience (Roussel et al., 2016). Advocating for those at risk, such as patients covered by Medicare and Medicaid, is a fundamentally important challenge that nurse leaders must take up, as they are ethically bound to by the ANA’s Code of Ethics for Nurses.

References

Medicare.gov. (n.d.). Hospital VBP program payment adjustments. Retrieved from https://www.medicare.gov/hospitalcompare/data/payment-adjustments.html

Roussel, L., Thomas, P. L., & Harris, J. L. (Eds.). (2016). Management and leadership for nurse administrators (7th ed.). Burlington, MA: Jones & Bartlett.

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Innovation and Diversity – Why the US MUST Welcome All Immigrants

A team of biomedical engineers working in Germany has developed a low-cost alternative for skin sensor technology which would make this application widely available at little expense. A brief description of their work was provided by the lead researcher:

The sensor, which is called Paper Skin, performs as well as other artificial skin applications currently being developed while integrating multiple functions using cost-effective materials.

Wearable and flexible electronics show promise for a variety of applications, such as wireless monitoring of patient health and touch-free computer interfaces, but current research in this direction employs expensive and sophisticated materials and processes.

“Our work has the potential to revolutionize the electronics industry and opens the door to commercializing affordable high-performance sensing devices,” stated Muhammad Mustafa Hussain, KAUST associate professor of electrical engineering from the University’s Integrated Nanotechnology Lab, where the research was conducted.

“Previous efforts in this direction used sophisticated materials or processes,” Hussain continued. “Chemically functionalized inkjet printed or vacuum technology-processed papers — albeit cheap — have shown limited functionalities. Here we show a scalable ‘garage’ fabrication approach using off-the-shelf and inexpensive household elements.”

Speaking on behalf of the team, Muhammad Mustafa Hussain described their revolutionary and humanitarian approach. Taking a wild guess, I do not believe his grandparents came from Germany. It is of note that Germany has one of the most liberal immigration policies in Europe, and over great protest Germany’s Angela Merkel refuses to shut the door to fleeing Syrians refugees. Perhaps she knows people like Professor Hussain.

Politicians have made bold and provocative statements about “building a wall between the US and Mexico” and “not allowing ANY Muslim immigrants” to enter the US. These are inflammatory statements designed to provoke fear among the public, and do much more harm than good. As nurses, we have an ethical obligation to speak out and speak up for the oppressed, underprivileged, underserved, and excluded. It’s time. If you don’t want to speak up, at least make your voice heard as you make your way to vote. We cannot permit our country to be run by extremist fear-mongers.One such notable political leader in Germany’s past was named Adolf Hitler. Is this really the path we want to follow? I prefer Angela Merkel’s approach.

 

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