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By Pattie Lockard
Executive Producer
Nurse Talk Radio

Michael Lighty on the Robin Hood Tax

Michael Lighty, CNA/NNU Director of Public Policy

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Nurses & residents get commitment for full investigation into dangers & public meetings before tar sands can be processed by Valero Oil

January 9, 2014 – San Pedro. CNA RNs from 5 LA Southbay hospitals closest to the major oil refineries attended a special meeting arranged for CNA and neigborhood groups who oppose “tar sands” crude being processed in Wilmington’s Valero refinery.

Tar Sands crude is a thick, dirty crude high in sulphur and much more toxic than regular crude. It has been condemned by leading environmental scientists as ‘extremely dangerous’ and the ‘beginning of the end’ where pollution will tip global warming until the point of no return.

Valero applied to process 60,000 barrels per day brought in by railroad into Wilmington in May 2013. The SoCal Air Quality Management District (AQMD) at first quickly processed the application despite concerns raised by environmental groups and did not investigate the dangers as they stated they would on May 3, 2013.

However, on Nov. 1, 2013, CNA RNs from major SoBay hospitals and together with Communities for a Better Environment, Climate Change.350 and the Sierra Club, demanded that the AQMD not process the application until a full investigation and many public meetings were held to disclose the results. In the meantime, Valero’s embarassing oil tank-car derailment at it’s Benicia, CA refinery and the conclusions of investigations into the Chevron Richmond explosion disaster (sulphur corroded pipes caused the explosion) which sent 15,000 patients into local hospitals, have slowed down Valero’s big rush to push through tar sands.

The AQMD and Councilman Joe Buscaino committed to “keep in touch” with CNA and friends regarding the investigations and agreed to hold public meetings when any substantive updates arise.

Although, nurses believed this meeting was a “definite” advance, there are other oil companies trying to bring in tar sands in different ways such as Phillips 66, so the temporary slowing down of one companys effort does not mean people can rest. Plans are being discussed to continue to hold off tar sands for our patients and our communities.

“Respiratory illneses are now the #1 diagnosis in my ICU. Now, it is year round and patients who are in their 40s and 50s are common, not just the elderly.”
– Lora Smith, RN
Little Company of Mary- San Pedro

• Double the national average- Asthma rates suffered by children in port-adjacent neighborhoods.
• 4,000 longtime residents around San Pedro Bay die prematurely each year from pollution related illnesses.
• 19% of Long Beach residents have no health insurance. Percentages increase greatly closer to the port.
• Between $4.7 & $5.9 billion over the next 20 yrs. Estimated cost of pollution related hospital visits in SoCal port communities.
(source: LB Press Telegram 11/03/09, “Children closest to harbor trade roadways suffer more respiratory issues, study says”)

By Ralph Nader

Consumer advocate, lawyer and author

An epidemic of sky-rocketing medical costs has afflicted our country and grown to obscene proportions. Medical bills are bloated with waste, redundancy, profiteering, fraud and outrageous over-billing. Much is wrong with the process of pricing and providing health care.

The latest in this medical cost saga comes from new data released last week by National Nurses United (NNU), the nation’s largest nurse’s organization. In a news release, NNU revealed that fourteen hospitals in the United States are charging more than ten times their costs for treatment. Specifically, for every $100 one of these hospitals spends, the charge on the corresponding bill is nearly $1,200.

NNU’s key findings note that the top 100 most expensive U.S. hospitals have “a charge to cost ratio of 765 percent and higher — more than double the national average of 331 percent.” They found that despite the enactment of “Obamacare” — the Affordable Care Act — overall hospital charges experienced their largest increase in 16 years. For-profit hospitals continue to be the worst offenders with average charges of 503 percent of their costs compared to publically-run hospitals (“…including federal, state, county, city, or district operated hospitals, with public budgets and boards that meet in public…”) which show more restraint in pricing. The average charge ratios for these hospitals are 235 percent of their costs.

According to NNU’s data, the top 10 Most Expensive Hospitals in the U.S. listed according to the huge percentage of their charges relative to their costs are:

1. Meadowlands Hospital Medical Center, Secaucus, NJ – 1192%
2. Paul B. Hall Regional Medical Center, Painsville, KY – 1186%
3. Orange Park Medical Center, Orange Park, FL – 1139%
4. North Okaloosa Medical Center, Crestview, FL – 1137%
5. Gadsden Regional Medical Center, Gadsden, AL – 1128%
6. Bayonne Medical Center, Bayonne, NJ – 1084%
7. Brooksville Regional Hospital, Brooksville, FL – 1083%
8. Heart of Florida Regional Medical Center, Davenport, FL – 1058%
9. Chestnut Hill Hospital, Philadelphia, PA – 1058%
10. Oak Hill Hospital, Spring Hill, FL – 1052%

The needless complications of the vast medical marketplace have provided far too many opportunities for profiteering. Numerous examples of hospital visit bills feature enormous overcharges on simple supplies such as over-the-counter painkillers, gauze, bandages and even the markers used to prep patients for surgery. That’s not to mention the cost of more advanced procedures and the use of advanced medical equipment which are billed at several times their actual cost. These charges have resulted in many hundreds of millions of dollars in overcharges.

When pressed for answers, many hospital representatives are quick to defer to factors out of their control. It’s the cost of providing care they might say, or perhaps infer that other vague aspects of running the business of medical treatment add up and are factored into these massive charges. Cost allocations mix treatment costs with research budgets, cash reserves, and just plain accounting gimmicks. These excuses shouldn’t fly in the United States.

Few in the medical industry will acknowledge the troubling trend. One thing is undeniably certain however — the medical marketplace is not suffering for profits. Health-care in the United States is a nearly 3 trillion dollar a year industry replete with excessive profits for many hospitals, medical supply companies, pharmaceutical companies, labs and health insurance vendors.

Americans spend more on health care than anywhere else in the world. One would hope and wish, at the least, that this enormous expenditure would provide a quality of healthcare above and beyond that found in the rest of the western world. The reality is that the results on average are no better than in France, Germany, Canada and elsewhere, which manage to provide their quality treatment without all the overcharges.

Much like our similarly wasteful, bloated military budget, the U.S. spends more on health care than the next ten countries combined — most of which cover almost all of their citizens.The United States spends $8,233 per person, per year according to a 2012 figure from the Organization for Economic Co-operation and Development (OECD). The average expenditure of the thirty three other developed nations OECD tracked is just $3,268 per person.

It gets worse. Harvard’s Malcolm Sparrow, the leading expert on health care billing fraud and abuse, conservatively estimates that 10 percent of all health care expenditure in the United States is lost to computerized billing fraud. That’s $270 billion dollars a year!

And unlike other commercial markets, where the advance of technology routinely makes costs lower, the reverse trend is in effect when providing medical care — the prices just keep soaring higher and higher. The flawed, messy Obamacare system will do little to help this worsening profit-grab crisis, which is often downright criminal in the way it exploits tragedy-stricken people and saddles them with mountains of debt.

Steven Brill’s TIME magazine cover story from February 2013 titled “Bitter Pill: Why Medical Bills Are Killing Us” gives an in-depth and highly-researched rundown of the severity of the medical cost problem and provides some of the worst, most astonishing examples of profiteering off of the plight of the sick or injured.

Here’s a fact that puts the full scope of this troubling trend into perspective — Brill writes: “The health-care industrial complex spends more than three times what the military industrial complex spends in Washington”. Specifically, the medical industry has spent $5.36 billion on lobbying in Washington D.C. since 1998. Compare that expenditure to the $1.53 billion spent lobbying by the also-bloated defense and aerospace sector.

One line summarizes the breadth of Brill’s enormous piece: “If you are confused by the notion that those least able to pay are the ones singled out to pay the highest rates, welcome to the American medical marketplace.”

Americans who can’t pay and therefore delay diagnosis and treatment are casualties. About 45,000 Americans die every year because they cannot afford health insurance according to a peer-reviewed report by Harvard Medical School researchers. No one dies in Canada, Germany, France or Britain because they do not have health insurance. They are all insured from the time they are born.

Obamacare, which has already confused and infuriated many Americans — and even some experts — with its complexity made up of thousands of pages of legislation and regulations is clearly not the answer to the problem. Long before the internet, President Lyndon Johnson enrolled 20 million elderly Americans into Medicare in six months using index cards. Canada’s single-payer system was enacted with only a thirteen page bill — and it covers everyone for less than half of the cost per capita compared to the U.S.’s system. (Check out 21 Ways the Canadian Health Care System is Better Than Obamacare)

Enacting a single payer, full Medicare-for-all system is the only chance the United States has of unwinding itself from the spider web of waste, harm, and bloat that currently comprise its highly flawed health insurance and health care systems. It’s time to cut out the corporate profiteers and purveyors of waste and fraud and introduce a system that works for everybody.

(Autographed copies of my book Told You So: The Big Book of Weekly Columns are available from Politics and Prose, an independent book store in Washington D.C.)

With all the clamor over the website woes of the rollout of the Affordable Care Act finally ebbing, let’s hope the media can begin to notice some changes in the delivery of health care that will have more far-reaching consequences for health care quality and access long after the sign-up problems are a distant memory.

Despite the hysteria on the right, some components of the ACA are clearly welcome, especially the Medicaid expansion in those states where the governors are not standing with pitchforks in the door to block health coverage for the working poor.

Yet there’s plenty of trouble ahead, most evident with the cost shifting from insurers and providers to workers and families.

Many are now aware that the insurance plans offered through the exchanges are chock full of added out-of-pocket costs.

The cost problem extends well into the provider setting, as is now just being gleaned through some reporting on price gouging by many big hospitals which jack up costs to patients through steeper co-pays, requiring cash up front before administering care, Medical Credit Scoring to determine if patients are a payment risk, and hounding patients for payment afterwards.

Less reported are the escalating problems on the care delivery side.

Let’s start with a new survey out from Citi Research, via Reuters, which reports that “hospital inpatient admissions in November fell to their weakest level in more than a decade.”

Two big chains illustrate the trend. Henry Ford Health System in Detroit had a 6 percent drop the first seven months of this year, Modern Healthcare reported in August. California-based Kaiser Permanente has reduced its average daily census by 11 percent the past four years.

No one, of course, wants to be hospitalized. Sometimes you must be. A hospital is where you receive 24-hour nursing care, where they have the ability to quickly shift you to an operating room or intensive care floor if your condition suddenly deteriorates, and where they have the most specialized equipment.

But the hospital industry, increasingly dominated by giant corporations, either for-profit or acting like for-profits, are making higher profits elsewhere – in outpatient settings, especially surgery centers and boutique care centers, and investments, for example.

Hospitals overall, note NNU researchers at the Institute for Health and Socio-Economic Policy, have profit margins of 35 percent for elective outpatient services, compared to just 2 percent for inpatient care.

The bean counters and management consultants who, more than ever run the show, have far less financial interest in letting patients into the hospital or staying there.

Like those bad Halloween movies, the worst abuses long associated with managed care are back. Private health insurers, and hospital chains like Kaiser that are also insurers or hospitals that form their own integrated networks through the new Accountable Care Organizations (ACOs) have an economic incentive to restrict care.

For the past few months, registered nurses have been rallying and marching outside Kaiser Permanente facilities in Northern California protesting reductions in hospital services. These include broad cuts in hospital services that have sparked widespread opposition in Manteca, Ca., and the closure of pediatric services in Hayward, Ca.

On a broader scale, Kaiser RNs are witnessing systemic practices aimed at setting up additional barriers to hospital care as fewer patients are admitted, held in “observation units” up to 24 hours and sent home, and pushed out the door prematurely to lesser-staffed, lesser-regulated sites or home.

In a 2012 Health Week presentation in Copenhagen, former Kaiser CEO George Halvorson said that in the near future “for most people the home will be the primary site of care. In-home monitoring, EKGs, ultrasounds, blood and fluid diagnostic and patient communication tools will be increasingly sophisticated, effective and cheap.”

That will increase the burden on families, especially women.

As Patty Bellasalma, president of the California chapter of the National Association of Women (NOW) at a rally of nurses outside Kaiser’s Oakland headquarters, said: “Forcing patients out of the hospital places a triple burden on women. We have to work, do most of the childcare and parent care and then when our family members are most ill and need hospitalization thaey will be sent home; leaving again us to manage it all.”

It also undervalues the professional care provided by registered nurses in the hospital setting. RNs have professional expertise that untrained family members do not, especially when called on to operated the “sophisticated” technology Halvorson boasts. They do not, for example, have the diagnostic skills to recognize problems in tube feeding, oxygen flow, proper care of a urinary catheter or colostomy, or how to respond to equipment alarms or power failures.

A gerontologist study in 2012 predicted an up to 15 percent likelihood of adverse events for home care patients in drug side effects, falls, and equipment malfunctions, and a huge increase in levels of stress and strain for the new home caregivers.

For the very sick patients who are able to still get into the hospital, the care delivery changes have other implications. Technology, promoted as both a way to reduce medical errors and cut costs (even as hospitals spend literally trillions of dollars on high tech systems) are too often used to displace, not enhance professional skill and routinize care.

One example is the rapid proliferation of electronic health records systems. While paper records and charting certainly have limitations, RNs and other caregivers have documented a number of problems with electronic health records systems and the promise of savings are inflated.

These include computerized delays in timely administration of medications, erroneous orders for drugs created by the software, hurdles in nurses’ ability to contact physicians and properly monitor patients, and other treatment delays. Further, many nurses find they end up spending more time with the computers than with patients.

At one Chicago hospital, a baby died in 2011 after an automated machine prepared an intravenous solution containing a massive overdose of sodium chloride, more than 60 times the amount ordered by the physician.

In Northern California this summer and fall, several Sutter Health hospitals, where nurses have reported widespread breakdowns with their new Epic EHR system, has crashed for hours at a time, requiring RNs and doctors alike to effectively work blind without access to individual patient information, including patient histories and medication needs.

This latest wave of hospital and healthcare restructuring, of course, was wreaking havoc well before enactment of the ACA, but the ACA does provide a number of financial incentives encouraging the escalation of care delivery outside the hospital and the expanded use of EHRs inside.

Lives are in the balance. For RNs, the mandate to step up the role as patient advocates is clear. Our organization, National Nurses United, opposes the right-wing attack on the role of government or the calls to simply repeal or defund the ACA.

But we will never stop challenging a callous, profit-centered private health care industry and will continue to campaign for a more humane health care model as in an expanded, fully funded system of Medicare for all.

Follow Rose Ann DeMoro on Twitter: www.twitter.com/NationalNurses

Jim Hightower (Photo by Larry D. Moore)

The congressional Republicans are still whining loudly that the federal government cannot pay its debts, and therefore the programs to help hurting Americans must be cut. What they will not tell you is that it is their own policy that has caused the huge budget deficit — a policy of waging unfunded wars while cutting taxes for the rich and giving unneeded subsidies to large corporations, and perhaps most egregious of all, giving Wall Street a “free ride” when it comes to taxation.

The truth is that the United States is still the richest country in the world, and there is plenty of money in this country to fund programs to help ordinary Americans that are hurting. I have spoken many times on this blog about my belief that the rich should pay a little more (by taxing their capital gains income as earned income), and the corporations should pay their fair share (by removing the billions in unneeded subsidies and loopholes).

But there is another thing that can, and should, be done — and that is to institute a “Robin Hood” tax on Wall Street transactions. This would be a tiny tax on all stocks bought through the stock market. The tax would be small enough to not inhibit any stock trading, but because of the huge volume of trades, would be enough to add hundreds of billions of dollars in federal government revenue.

One of the best explanations of why this tax would be a good thing for this country is put forward by Jim Hightower (a leading Texas progressive). Here is some of what he has to say on the subject at his website, the Hightower Lowdown:

When I buy a $3 pack of toilet paper here in Austin, Texas, I pay an extra 8.25 percent in sales tax. If I buy a cuppa jo, book, bicycle, or blue jeans–same thing.

But if a high-roller in the HFT game buys $10 million worth of corporate stock, $10 million worth of oil futures, and $10 million worth of a Goldman Sachs package of derivatives–he or she pays zero tax on the sales.

First, it’s a rank injustice that even the poorest among us are taxed on their purchases while millionaire Wall Streeters who make high-speed computerized purchases skate through this gaping loophole. Second, the profiteering churners and reckless speculators wrecked the country’s economy, and they’ve never paid for the mess they made for so many millions of families that consequently lost jobs, homes, income, and hope.Third, this is a BIG idea that will let our society do big things again. Plugging this loophole with even a small sales tax on purchases by high frequency traders will generate the money America needs to do what needs to be done.

A Financial Transaction Tax. An FTT is not an idea whose time has come, but simply returned. From 1914 to 1966, our country taxed all sales and transfers of stock. The tax was doubled in the last year of Herbert Hoover’s presidency to help us recover from the Great Depression. Today, 40 countries have FTTs, including the seven with the fastest-growing stock exchanges in the world. Seven members of the European Union (including Germany and France) voted for a financial transaction tax to help blunt rising poverty, restore services, and put people back to work.

This is no soak-the-rich-idea. Rather than asking the Wall Street crowd to join us in paying a six to 12 percent sales tax, the major FTT proposal gaining support in the US calls for a 0.5 percent assessment on stock transactions. That’s 50 cents on a $100 stock buy, versus the $8.25 I would pay for a hundred-dollar bicycle.

Even at this miniscule rate, the huge volume of high speed trades means an FTT would net about $300-350 billion a year for our public treasury. Plus, it’s a very progressive tax. Half of our country’s stock is owned by the 1 percenters, and only a small number of them are in the HFT game. Ordinary folks who have small stakes in the markets, including those in mutual and pension funds, are called “buy-and-hold” investors–they only do trades every few months or years, not daily or hourly or even by the second, and they’ll not be harmed. Rather it’s the computerized churners of frothy speculation who will pony up the bulk of revenue from such a transaction tax.

An FTT is a straightforward, uncomplicated way for us to get a substantial chunk of our money back from high finance thieves, and we should make a concerted effort to put the idea on the front burner in 2014 and turn up the heat. Not only do its benefits merit the fight, but the fight itself would be politically popular. One clue to its political potential is that the mere mention of FTT to a Wall Street banker will evoke a shriek so shrill that the Mars rover hears it. That’s because they know that this proposal would make them defend the indefensible: Themselves.

First, the sheer scope of Wall Street’s self-serving casino business model would be exposed for all to see. Second, they would have to admit that they’re increasingly dependent on (and, therefore, making our economy dependent on) the stark-raving insanity of robotic high frequency speculation. Third, it’ll be completely ridiculous for them to argue that protecting the multi-trillion-dollar bets of rich market gamblers from this tax is more important than meeting our people’s growing backlog of real needs.

Unsurprisingly, then, Koch-funded operatives and other defenders of privilege are rushing out articles that amount to Wall Street blah-blah-blah: “FTT would hurt poor pensioners, farmers, long-term investors, job creation, liquidity… and blah, blah, blah.” Note that there’s nary a mention of who’ll really be pinged: Wall Street’s gamblers and thieves. After all, to concede that they’ll be hurt, even a little, would elicit a coast-to-coast shout of, “Yes!”

The Financial Transaction Tax idea is blessed with broad support, ranging from Bill Gates to Occupy Wall Street to the Vatican, and it’s been embraced by dozens of major economists, including Nobel laureates Joseph Stiglitz and Paul Krugman. But this fight will be won at the ground level of good politics, and that’s well underway. Many grassroots groups and several progressives in Congress have already forged solid coalitions and are going to the country-side with a growing campaign to make Wall Street pay.

A major push is being made under the banner of the “Robin Hood Tax,” led by National Nurses United, National People’s Action, Health GAP, andProgressive Democrats of America. They and some 150 other organizations are backing the IPA. (This IPA is not a beer, though I suggest the organizers brew one to help popularize, cheer, and lubricate the cause.) It’s theInclusive Prosperity Act, a proposal by Rep. Keith Ellison and others for an FTT. Sen. Tom Harkin and Rep. Peter DeFazio have another version with a more modest tax rate.

This campaign offers a remarkable democratic opening. It widens America’s public policy debate from the plutocrats’ tired, narrow-minded mantra of defeat: “We’re broke. Big undertakings are beyond us. Shrink all expectations for yourselves, your children, and your country’s future.” Instead, a new conversation can begin, saying: “Look under that rock. There’s the money we need to invest in people. Let’s get America moving again!”

A sales tax on speculators can deliver tangibles that people need but Wall Street says we can’t afford–infrastructure, Social Security, education, good jobs, etc. Just as important, it can deliver intangibles that our nation needs but Wall Street tries to ignore–fairness, social cohesion, equal opportunity, etc. It’s a holiday gift card for America’s future–a gift that literally would keep on giving.

NNU’s Disaster Medical Relief Mission in the Philippines Continues – Caring for those in Harm’s Way

As the TV camera crews pack up in the Philippines and head out to the next daily headline, the nurses in red are still on the ground.

That’s the hallmark of the National Nurses United’s Registered Nurse Response Network, says Bonnie Castillo, RN, director of RNRN, “we’re here to stay.” In the past week, RNRN marked more comings and goings. As volunteers from our third delegation started home, a fresh deployment, team four arrived. And the next team is already in formation, heading out in early January, 2014.

In this holiday season, RNRN continues to invite public support for this vital project.

Tax deductible donations may be made at: www.SendaNurse.org

Team three, Castillo notes, spent their days providing hands on care on storm-ravaged Panay island, mostly in the City Health Office clinic in Roxas City, but also in mobile medical clinics in Estancia, in neighborhoods where the storm devastation was made even worse by a virulent oil spill.

To date, RNRN volunteers have cared for more than 1,400 patients in Roxas, providing wound care, giving shots, treating respiratory ailments, and providing critical stress debriefing for those who have lost their homes, their belongings, and their livelihoods.

While in Estancia, the nurses also assisted with the distribution of relief goods to impacted neighborhoods. They are seeing hundreds of patients, mostly children suffering from the debilitating effects of the spill and other primary care conditions, including post -traumatic stress.

“Our third team also worked to assess future possible deployment sites in Panay, Negros and Cebu as we continue our commitment, in the RNRN tradition, of deploying regular, rotating teams of RNs over an extended time frame to meet the long term needs,” Castillo said.

Additional photos may be viewed on our Flickr channel at here >>

RNRN representatives also participated in a press conference in Estancia with our Global Nurses United partners, the Alliance of Healthcare Workers (AHW) and other community groups. It was called to heighten awareness to the environmental devastation and health hazards wrought by the oil spill, and to press the case for meaningful redress of the causes of climate change and responsible, immediate clean up of the oil spill.

“As nurses, we advocate for our patients. This is not confined to one country. The fabric of our foundation is patient advocacy as well as health equality and health access,” said Jane Sandoval, RNRN volunteer from San Francisco. “Climate change and global warming has brought this misfortune to the Philippines. This affects us globally. From hurricane Katrina in the United States to typhoon Yolanda in the Philippines.”

“The public health concerns for oil spills are many: asthma, heart disease, lung disease and cancer, shown through studies, are all leading to premature death,” noted Ashley Forsberg, RNRN volunteer from Lansing, Mi. “These are the primary threats to humans and the oil spills further hinders a community’s economic livelihood and is devastating to your environment. Climate change is responsible for higher air temperatures which can increase bacteria-related food-borne poisoning such as salmonella and animal-borne diseases. Ground level ozone contaminants can damage lung tissue, reduce lung function and increase respiratory ailments. The people of the Philippines, whether in Tacloban, Roxas City or Estancia are living testament to that monumental threat.”

The heartfelt voices of our RNRN volunteers tell the story of this incredible effort:

“Driving in the van on the way to the sites – everything from abandoned concrete buildings to churches to existing clinics to set up in and deliver care to areas with the greatest need – you see how the typhoon affected everything. Every one of these little towns we go to has had some serious tragedy. They are not part of the big tragedy everyone is hearing about but their situation is every bit as important as these locations that get the media attention. Acknowledgment of their situation is just so important. They are so moved that we care.” — Jane Sandoval, RN, San Francisco, CA

“The disaster is on such a scale that when you think that over 12 million people are displaced from their homes right now. The casualties might have seemed small, but their livelihoods are in jeopardy. Fishermen who rely on the sea have lost their boats. Businesses have been destroyed. People are living hand to mouth. The nurse is the first one that’s going to be there to hold your hand and figure out the whole picture of what’s going on with you; the different aspects of your environment, be it your socio-economic situation, be it housing, be it financial, all of those things are things that nurses work with on a daily basis. We try to find roads through and around conditions and do whatever we can to get what’s best for the patient.” – Ashley Forsberg, RN Lansing, MI

“Most common are upper respiratory infections. 80 percent of the people we see complain of cough and cold for an unusual amount of days. This is the result of the typhoon, and the aftermath, during which people disposed of debris by burning it as they try to rebuild. The youngest patient was one month old, the oldest patient was anyone in the Baranguy (districts or neighborhoods) who heard about us and just came to see the doctor because I’m sure they don’t have easy access to healthcare or that might have been their first time seeing any doctors or nurses at all. They all have had issues ranging from a child with swollen foot with purulent discharge, to another patient, an elderly man, who was in hypertensive crisis, our intervention helped to save his life. One of the nurses caught that the heart rate of a baby was around 60 so she immediately brought the patient to the doctor. He said that if we hadn’t caught it, an hour later the baby would have died.” — Gandessa Orteza, RN, Burtonsville, MD

“This is why I got into nursing. The people here are so under-served and have been since before the typhoon. When the earthquake happened in Haiti, it was as if someone wanted us to know the people there needed help. Typhoon Yolanda has done the same thing. It has focused the world on people’s needs here that existed long before the typhoon. We have received heartfelt thanks wherever we go.” – Betty Sparks, RN, Norwood, MA

“We were able to check on the oil spill (much of it from a barge of the National Power Corporation) that slammed into the shore during the typhoon. It hit two houses, which killed a mother and a baby right away. We were also able to distribute relief goods, and work with the Alliance of Healthcare Workers and another relief agency to distribute goods to the people. And we met many people who were directly affected by the oil spill. The marine environment is badly affected. You can see dogs walking with oil all over their legs. I even went in the compound of the National Power Company and asked how far the oil spill is, the oil is beyond the spill area, it is all over. On two of the coastal Baranguys, you would just see black gravel.” — Girlie Garnada, RN, Port Richie, Fl.

“I talk to the children we see about the typhoon and tell them to draw where they were hiding when the typhoon came. A child sheltered in in a tree because the whole house was wiped out. For the small kids they aren’t able to communicate much, they vent what they feel through drawing. One stood in front of the others and explained why they drew these pictures in front of the other kids and he was sobbing so hard. The children have PTSD from the trauma of the typhoon. So do some of the adults. There was a lady there who said she had insomnia, couldn’t sleep, everything makes her jumpy, gets so scared. The trauma debriefing is about releasing emotions. We can’t give any medications because they hardly have anything here, so instead we talk to them so that won’t internalize and can release.” – Stella Auto, RN, Chicago, IL

“To have been part of the NNU’s RNRN project helping the victims of Typhoon Yolanda has been a true honor, an experience I would never trade for the world. We had the opportunity to assess and treat over 1,400 patients in six make-shift mobile clinics of different barangays of Panay Island, a few of which had never seen a medical mission in their town. Even with their broken homes and livelihood, they look strong, confident, and determined to rise again. Seeing them rebuild their homes gives me the comfort of knowing they will be okay. This isn’t just about giving back. This is about helping change people’s lives, changing the world one day at a time. It’s definitely changed mine. We should continue to be inspired and do things we dream impossible or we will never know what could have been. During this journey I feel that I was part of healing over 1,000 souls. This to me is the beginning of my journey to healing the world. — Melanie Crisologo, RN, Los Angeles

RNRN volunteer, Mary Ann Libeta, provides care in the Philippines.

Thanks to your donations and willingness to volunteer, RNRN now has mobile medical clinics up and running in the Philippines that hundreds of typhoon victims are lining up to use every day. Nurses have stationed themselves at a ruined chapel, a local gym, and other sites in Roxas City on Panay, one of the islands hard hit by Super Typhoon Haiyan. They are providing much needed medications, wound care, vaccinations for tetanus and other shots, and assessing and treating all kinds of injuries and illnesses.

“What an emotional, gratifying day. Seeing kids debrief about their experiences with the typhoon was just heartbreaking,” said Melanie Crisologo, an RNRN volunteer. Our team was so diligent, efficient, and most of all, fun, which made our long day worthwhile. The first day of my very first medical mission was a true success…an incredible experience I will never forget.”

We are preparing to send a third team of registered nurse volunteers, who will operate as a second advance team and be assessing future deployment sites. Thanks to all of the generous donations that we are continuing to receive, once they identify potential deployment sites we will be able to send our dedicated RN volunteers to help when they are needed most.

As many of us prepare to celebrate the Thanksgiving holiday and count our blessings for all we have, please remember those in the Philippines who now have nothing and need basics like water, food, shelter, and medical care. Please give generously.

Please make a tax-deductible contribution, volunteer, and share!

1. Volunteer to help If you’re a Registered Nurse willing to respond to the tragic situation in the Philippines, please sign up here and provide information on your availability for the next few weeks. RNs have been asked to provide their availability over the next month.

2.  Contribute to the RNRN fund established to support disaster relief services and to help send nurses and supplies.

To donate by mail: Make checks payable to CNF/RNRN and mail them to: CNF/RNRN, 2000 Franklin St. Oakland, CA 94612.

3.  Do you have family in the Philippines affected by the typhoon? Please share your story

4.  Share this PDF flyer with RN colleagues

5. See and share photos from this relief effort with your social networks and ask friends to help.

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Thank you,

California Nurses Foundation
Registered Nurse Response Network
2000 Franklin St.
Oakland, CA 94612

RNRN Disaster Relief Fund: National Nurses United and the Registered Nurse Response Network (RNRN) work to send nurses to disaster stricken areas both inside the U.S. and internationally. Please complete this secure donation form and share it with friends to ensure that RNs are among the first responders. RNRN is a project of the NNU and the California Nurses Foundation, a 501(c)(3) nonprofit. Donations are secure, and tax-deductible to the extent of the law. RNRN is a project of the California Nurses Foundation (CNF)*, working in cooperation with National Nurses United (NNU). NNU is the nation’s largest and fastest growing union of direct-care RNs, representing more than 170,000 RNs in all 50 states. We are our patient’s safety net. RNs are in a unique position to continue our long and proud history as social advocates, fighting for and providing equitable healthcare for all. *CNF is a nonprofit, founded in 1971, dedicated to charitable, scientific and educational purposes.

Published on Sunday, November 24, 2013 by Common Dreams

by Rose Ann DeMoro

As the heart wrenching images crossed across our screens from the Philippines, the largest U.S. organization of nurses, National Nurses United, was getting in motion as well.

Our Registered Nurse Response Network put out a call. The response was overwhelming. In little more than one week, nearly 3,000 RNs from all 50 states and even 19 countries had signed up to volunteer to provide hands-on disaster relief to those in the path of the super storm.

RNRN plans to continue to provide support for the Philippines long after the media spotlight has faded. We invited the public to support this effort here: http://www.nationalnursesunited.org/pages/rnrn-disaster-relief-fund

Within a week, our first delegation, an advance team sent to see where our volunteers would be most effective and provide some direct care themselves, was already on the ground.

Our second delegation is now engaged as well, setting up camp in Roxas City on the northern end of Panay, an island slammed by Typhoon Haiyan/Yolanda.

In conjunction with area public health officials, physicians, provincial government officials, and community groups, our volunteers will work in temporary medical clinics that rotate among various Barangays (local neighborhoods) across Roxas City, providing wound care, vaccinations, antibiotics and other medications, and other general basic medical care.

We’ve also been greatly facilitated by the birth of an international movement of RNs and healthcare workers, Global Nurses United, earlier this year. Our GNU sister union, the Philippines Alliance of Health Workers, has worked with us daily, in scouting locations and working shoulder to shoulder in the clinics. Other GNU partner unions are also preparing to send RNs to work with our deployment.

The need is obviously great. At least 4,400 died, with thousands more injured and missing. According to the Philippine disaster council, about 3 million people have been displaced with 400,000 living in nearly 2,000 evacuation centers.

“What we’ve seen is total devastation,” said RN Joseph Catindig, a member of our first deployment team. “People have lost their homes, lost their livelihood, lost their animals that helped with their livelihood. They only ask for a little. They need medical care. They lack medicine, lack nurses, lack doctors. In each area we go to this is their plea, to help.”

At another rural site near Sara on Panay, RN Marti Smith describes how the economic livelihood for many, based on fishing and agriculture, has also been demolished. “The boats are destroyed. The agriculture they depend on, coconut, bananas, rice, coffee, is devastated. Banana and coconut trees are broken in half and gone. Coffee trees are gone too. Hills are deforested, which will cause big environmental problems and landslides. These peoples’ livelihood is destroyed. They’ve lost not only their homes, but also their ability to feed their families.”

It’s stories like this that have prompted our organization and nurses who work with us to act – even while so many who should be doing more stand on the sidelines.

It is that need to act that sparked the creation of RNRN nearly a decade ago, with multiple RNRN deployments, first following a cataclysmic South Asia tsunami, then the disgraceful governmental indifference following Hurricane Katrina. And on and on, through the earthquake in Haiti, Hurricane Sandy, and other calamities.

If it seems that RNRN has been on call a lot, and that disaster is one of the few growth industries in troubled global economies, that’s not an illusion. Poverty and economic inequality of course contribute greatly to a disproportionate impact among those slammed by the disasters. But the biggest culprit is climate change.

Meteorologists and NASA scientists have called Haiyan/Yolanda the most destructive and powerful tropical cyclone ever to hit landfall. One reason, as noted by U.S. News and World Report, http://www.usnews.com/news/blogs/at-the-edge/2013/11/18/haiyan-sandy-and… sub-surface ocean waters have been recorded at up to 9 degrees Fahrenheit above average fueling the strength and size of the storm.

Hurricane Sandy, which ravaged the U.S. East Coast a year ago, which was also spurred by warmer ocean waters, record droughts that debilitate arable lands and prompt mass population migrations, and many other not-so-natural disasters are similar reminders of our failure to adequately act.

Coincidentally, Haiyan/Yolanda hit during a meeting of the United Nations Framework Convention on Climate Change in Warsaw. The Philippine lead climate negotiator Yeb Sano, called the typhoon a “sobering reminder to the international community that we cannot afford to procrastinate on climate action and that Warsaw must muster the political will to address climate change.”

But as representatives from the wealthiest nations, including the U.S. continued to try to shift the responsibility to poorer nations, even though our country has long been one of the principal producers of the emissions that are a major factor in climate change, a group of 133 developing nations staged a walk out.

UN Secretary-General Ban Ki-moon said that Typhoon Haiyan puts “an anguished human face” on climate change and he hopes that “all tragic devastation would really give us a wake-up call.”

In case anyone still wonders why NNU and so many others also continue to protest the pipeline, which would further accelerate climate change, look at the faces in the Philippines today.

“So many don’t have any shelter, they have lost everything, clothing, belonging,” said Michelle Vo, RN member of the first team. “Many are sleeping on makeshift tents in the rain. We see people who are dehydrated, malnourished, kids sick with fever. They need nurses, equipment and supplies.”

“Being able to help people in need is why I went into nursing,” says University of Michigan RN Tim Launius, a member of the second delegation who also who helped provide medical relief to victims in Texas after Hurricane Katrina. “As an experienced nurse, I have skills and training that can be put to good use.”

The volunteers not only provide medical support and comfort, they come back too, often moved into the additional activists our we so desperately need.

“You think you went there to change peoples lives, but you are the one who is going to be transformed. You will never see things the same way again,” Catindig says.

This is the experience of almost all of the nurses that go on these deployments. They come back changed. It is moving and profound. We are very luck to have people like these in our world.

This work is licensed under a Creative Commons Attribution-Share Alike 3.0 License.

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Rose Ann DeMoro is executive director of the 185,000-member National Nurses United, the nation’s largest union and professional association of nurses, and a national vice president of the AFL-CIO. Follow Rose Ann DeMoro on Twitter: www.twitter.com/NationalNurses

Members of the second team of volunteer nurses – three sisters from California – left Thursday for the Philippines to help in the RN Response Network’s relief project for Super Typhoon Haiyan/Yolanda.

The siblings – Mary Lou Catedral, RN, her twin sister, Mary Ann Libeta, RN and their younger sister, Nancy Canapi, RN – are returning to their hometown, Roxas City, in the province of Capiz on the island of Panay.

Their mother, who will soon turn 80 years old, still lives there, as well as other family members. They all survived, the sisters said, but their homes did have significant damage, including flooding and pieces of the roof blowing off. They report no safe water to drink or electricity.

People in other parts of the city did not fare as well with wooden homes literally blown away.

“We decided to do some volunteer work to help the people in our city. These are people we went to school with, we grew up with. It’s devastating what has happened,” said Libeta, 58, who works with her sisters at Antelope Valley Hospital in Lancaster, CA. “When you see the pictures on the TV, on Facebook, I just feel like crying. We said, We need to help them. We are fortunate enough that we can help. We’re asking all the people of the world to help the Philippines.”

Super Typhoon Haiyan/Yolando slammed into the Philippines on Nov. 8 The damage and destruction is overwhelming – leaving more than 10 million affected and 4 million displaced.

Other members of the second RNRN delegation will join the sisters early next week. More nurse volunteers from around the country will be providing hands-on care in clinics in the northern end of Panay.

So far, 3,000 RNs from all 50 states and 19 countries have volunteered to help in the RNRN relief project. If you have already volunteered, you do not need to take any further action. RNRN is currently calling through the list, and you will be contacted as soon as possible.

We thank those who have stepped up to help – both by donating financially and volunteering their time. This program would not be possible without the compassion of our RN volunteers and donors.

To donate or volunteer, go to here >>

http://www.nationalnursesunited.org/blog/entry/typhoon-disaster-in-the-philippines-what-rns-can-do-to-help/

The first RNRN team arrived in the Philippines nearly a week ago. They have spent time in Manila and they’ve traveled throughout the affected area, visiting clinics and coordinating relief efforts.

“What we’ve seen is total devastation. It pains me to see these people suffering,” said Vallejo, CA RN Joseph Catindig, a member of the first team. “Although they are suffering, they are still able to smile, to laugh, to welcome us with open arms. . . . I am happy to be able to give care and do what we do best as nurses.”

Michelle Vo, RN, works in a clinic in Panay. Click here to see more photos on Flickr >>

Panay has not seen as much aid and relief efforts as other islands hit by the typhoon. Many buildings, schools and homes are badly damaged, including a Lemery birthing center where the roof was blown off. The center’s staff is busy delivering three or four babies a day in their outpatient clinic.

“It broke my heart, they deserve better than that. They deserve a nice, clean birthing chair, better nurses’ station, more medications,” Catindig said.

The RNRN team interviewed children who were participating in critical stress debriefings that asked them to draw their houses before and after the typhoon and tell their stories.

“People should help because there is so much need,” said Michelle Vo, another first team member from Fremont, CA. “There are so many infants, kids, families. They are in need of so much. So many don’t have any shelter, have lost everything, clothing, belonging, sleeping on makeshift tents in the rain. We see people who are dehydrated, malnourished, kids sick with fever. They need nurses, equipment and supplies.”

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The first dedicated RNRN team arrived in the Philippines on Friday and hit the ground running, meeting with disaster relief officials and community supporters, and providing hands on work at a makeshift tent clinic.

It’s a great start – and we have many volunteers ready to help following the ravages of Typhoon Haiyan/Yolanda.

Thanks to all who have already signed up to volunteer and donate financial support for this relief effort. So far, more than 2,500 RNs from all 50 states and 15 countries have stepped up to volunteer.

RNs can volunteer to help in the Philippines here >

Help send nurses! Donate to the RNRNR relief fund, click here >

RNRN team meets with local relief organizations. See more photos on Flickr >

The advance team is still gathering information and assessing potential deployment sites in the Philippines. Once there are confirmed future deployments, RNRN will be contacting volunteers with those details. The advance team is currently setting a very important foundation in order to make sure that our volunteers are the most effective that they can be.

Watch and SHARE this short video message from our RNRN team in the Philippines.

Within hours of their arrival, the RNRN team met with local disaster relief and medical officials, and even helped some of refugees at a tent clinic.

On Monday, the team traveled to the island of Panay in the Visayas region to assess needs there. According to the Panay Center for Disaster Response, at least 6,000 families from sixteen Iloilo towns are being sheltered in temporary evacuation facilities on Panay.

The RNRN advance team met with several relief organizations and the governor and vice governor of the Iloilo province, and will spend the day visiting existing relief sites. They will continue to assess the needs throughout the region and work with our Filipino allies to identify potential future deployments.

This will be a tough recovery process so we appreciate all of your help and patience. If you can’t volunteer, your donations are just as valuable because it’s what enables us to get nurses to the disaster area.

RNs can volunteer to help in the Philippines here >

Help send nurses! Donate to the RNRNR relief fund, click here >

Michelle Vo, RNRN volunteer with patient. See more photos on Flickr >

We also are collecting stories of people who have family affected by the typhoon.

If you have loved ones affected by this terrible disaster, please share your story here >

Thank you again for responding to our call for assistance.

We will keep you posted on the team’s progress.

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