Congress and the President: Just Because You Were Bullied, Don’t Take It Out on Our Seniors

Karen Higgins, RN, NNU Co-president

by Karen Higgins, RN and NNU Co-president

Let’s try to remember a lesson we all should have learned as kids. Just because you were picked on by the neighborhood bully is no excuse to go home and kick the dog or punch your little brother. (AP)

Maybe some inside the Beltway need a refresher course. Just because a handful on the right have shut down government and threatened default on the debt that’s no excuse to embrace proposals to slash Medicare and Social Security.

But that is exactly what is on the agenda, the “compromise” reward for those who engineered the lunacy of the last two weeks with the attempt to reverse the results of last November’s election by refusing to fund government services or pay the debt unless the Affordable Care Act is defunded or repealed.

At its centerpiece is a “grand bargain” that would impose additional deep cuts in public spending beyond the budget plan already approved by the Senate that was premised on a floor established by the much detested sequester cuts earlier this year, a budget that the House Speaker had already said was his price for avoiding a shutdown until he reversed course and decided to up the ante with the ACA demands.

Perhaps you might detect a trend here. All the compromises seem to be coming from the liberal side of the ledger. Taking a beating at the polls and unease from some of their Wall Street funders, the ideologues who created the crisis have concluded that the compromisers will let them off the hook by giving up far more.

The next target is two of the most important social reforms in U.S. history, Social Security and Medicare.

For Medicare proposals include raising the eligibility age to 67, “means testing” and other higher out of pocket costs for those with middle to upper incomes to pay more for care. Similar slashes are envisioned for Social Security, adopting the so-called “chained” CPI – a reconfiguration of how cost of living increases are determined to reduce benefits, cutting benefits for middle and upper income seniors, and raising the eligibility age to qualify for Social Security to 68 or higher.

The other not so bright idea, pushed by Wall Street, is to lower the corporate tax rate, already at a historically low rate and avoided altogether by some of the wealthiest corporations in the U.S.

The only thing worse than these proposals is the willingness of too many of the compromisers in the White House and Congress to jump on board.

A stellar list of progressive legislators and some constituency groups are actively fighting it, with good reason.

On Medicare, means testing would fundamentally transform the program into one whose primarily beneficiaries are the poor and the least healthy, making it even more politically vulnerable for additional cuts by those politicians who have repeatedly demonstrated their complete lack of sympathy for the poor and most vulnerable. It would also undermine the concept of the risk pool which works by including the more healthy who need fewer health services with the less healthy who require more care, meaning total Medicare costs would actually increase.

Nurses in particular live by the ethos that no one should be denied care, or be penalized in access to care based on their income. As nurses we already see people of many incomes struggling to get the healthcare they need in a persistent recession and the decades long widening of income disparity.

Social Security too should be off the chopping block. Among other reasons, Social Security contributes nothing to the deficit, its Trust Fund has a huge surplus and is fully funded through 2033 and can easily be strengthened for an even longer term by raising the income ceiling on payroll taxes above the current limit of $110,000.

Cuts to either Social Security or Medicare could not come at a worse time when seniors have been steadily losing ground to the economic disparities so rampant in our economic system today.

With the gaps in Medicare only paying about 60 percent of average medical costs for seniors today, the real poverty rate for seniors is at least 15 percent even with these signature programs, the Kaiser Family Foundation reported earlier this year. Senior Security and Medicare both need to be strengthened and benefits expanded, not cut.

Finally, Medicare and Social Security retain their enormous, broad popularity precisely because they are broad based, available to everyone without differentiation in services – even among those in the Tea Party and others who say they hate government (except when they need it).

Instead of implementing any cuts to programs so essential to a civil society, we ought to be expanding the economic pie. The best way, as nurses have said for some time, is by taxing those who created the current crisis with the Robin Hood tax on financial speculation RobinHoodTax.org as embodied in HR 1579. That would be giving the dog a bone, not kicking it.

Karen Higgins is a registered nurse and co-president of National Nurses United.

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Happy Travel Nurses Day!

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facebook--i-am-a-travel-nurseIt’s finally here — the first annual Travel Nurses Day. Don’t you just love the excitement of a holiday celebration?! One day is hardly enough to say thank you for such awesome, day-to-day dedication — but it’s a start!

Don’t forget to visit TravelNursesDay.com today where you can play Pictograms, Photo Observation, and Anagram Puzzle games for the chance to win one of 15 $50 gift cards to Starbucks, Zappos, and Spa Finder. There’s also a raffle for a grand prize $250 gift card to Scrubadoo!

Whatever you do today, be sure to take a moment to pat yourself and your colleagues on the back. Few can truly understand what a special personality and skill set it takes to work as a travel nurse. Thanks so much for being you and doing what you do.

Happy Travel Nurses Day — enjoy YOUR day!

Travel Nurses Anticipate “Scrubbing In” Premiere

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Couple at the MoviesTravel Nursing Blogs has been following the lead-up to the premiere of MTV’s new reality show which is centered on a group of travel nurses working in an Orange County, California hospital. (Click here to check out the trailer and here for more information on the show.)

As we have followed the show, we’ve certainly noticed a great deal of controversy regarding the premiere. We have heard all sorts of opinions as travel nurses anticipate the “Scrubbing In” premiere. We have heard from travel nurses who are really excited to check out the show as well as those who are very nervous as to how the profession will be portrayed and thus perceived by the public.

The nervous camp has taken action and actually begun a petition at Change.org asking MTV to cancel “Scrubbing In.” As of this posting, the petition had more than 1,300 signatures. The petition’s summary reads: “This show does not and cannot depict the lives of professional nurses and it is an insult to the nursing profession as a whole. We ask that MTV please consider cancelling the premeire [sic] of this grossly inaccurate dramatization.”

Reading this I was reminded of similarly negative anticipation of other MTV shows such as “Jersey Shore” and “Buckwild.” In both of those cases, groups to be portrayed in the shows — as travel nurses will be by “Scrubbing In” — were upset before they even saw the premiere. In the end, it seemed that most people understood that Snooki and The Situation did not represent all Italian Americans or people from New Jersey, for example. But the portrayal was still upsetting to others.

While there is a lot of passion as travel nurses anticipate the “Scrubbing In” premiere, I can’t help but think that no matter which side you fall on, at least one silver lining is that it’s a good chance to have an open dialogue about travel nursing — an industry and group of nurses that is unsung in many ways. Wouldn’t it be great if more people could learn about the industrious, adaptable, amazing nurses who work on travel assignments?

One last interesting note: Aya Healthcare recently re-released its original travel nursing reality show, “13 Weeks,” according to this press release.

Will you watch “Scrubbing In” and/or Aya’s original show “13 Weeks”?

CDC Health Advisory

Recently, a number of previously healthy individuals developed acute hepatitis and sudden liver failure of unknown cause after using a dietary supplement for weight loss or muscle building. CDC recommends increased vigilance by public health agencies, emergency departments, and healthcare providers for patients who develop acute hepatitis or liver failure following use of a weight loss or muscle building nutritional supplement. CDC requests that state health departments report such occurrences to the CDC. CDC also recommends that, as part of a comprehensive evaluation, clinicians evaluating patients with acute hepatitis should ask about consumption of dietary supplements.

Background: On September 9, 2013, the Hawaii Department of Health (DOH) was notified of seven patients with severe acute hepatitis and sudden liver failure of unknown cause. The patients were previously healthy and sought medical care from May through September 2013. Clinicians reported that the seven patients had all used OxyELITE Pro, a dietary supplement marketed for weight loss and muscle gain, prior to illness onset.

The investigation is ongoing and the data presented are preliminary. Thus far, clinicians have reported 45 patients to the Hawaii DOH in response to a public health alert. Of those, 29 patients, including the original seven, were confirmed to have acute hepatitis after using a nutritional supplement for weight loss or muscle building. The median age of  the 29 patients is 33 years; 14 (48%) are male. The date of the first reported laboratory test was used as a proxy for illness onset and ranged from May 10 through October 3, 2013. The most commonly reported symptoms included loss of appetite, light-colored stools, dark urine, and jaundice. Median laboratory values reported at the peak of illness were the following:

  • aspartate aminotransferase (AST) 1,128 IU/L;
  • alanine transaminase (ALT) 1,793 IU/L;
  • alkaline phosphatase 150  IU/L; and
  • total bilirubin 12.6 mg/dL.

Ten patients had liver biopsy data available at the time of this report. Seven had histology consistent with hepatitis from drug/toxic injury, with findings including hepatocellular necrosis and cholestasis. Three patients had liver biopsy findings of acute hepatitis associated with other etiologies such as autoimmune hepatitis. Eleven (38%) patients were hospitalized, with a median duration of seven days.  One patient died, and two patients received liver transplants. Two remain hospitalized, and all other hospitalized patients have been discharged.

Of the 29 identified patients, 24 (83%) reported using OxyELITE Pro during the 60 days prior to illness onset. There was no other dietary supplement or medication use reported in common by more than two patients.

National case finding efforts have identified several individuals from states outside Hawaii with reported OxyELITE Pro or other weight loss or muscle building dietary supplement use prior to the development of acute hepatitis of unknown cause. CDC, in collaboration with state health departments, is collecting additional clinical and epidemiologic information from these individuals to determine if this outbreak is national in scope.

Case definition:

An individual with acute-onset hepatitis of unknown etiology that developed symptoms on or after April 1, 2013 following use of a non-prescription weight loss or muscle building dietary supplement during the 60 days prior to illness onset.

With acute-onset hepatitis of unknown etiology defined as having BOTH:
– ALT > 4 times the upper limit of normal
– Total bilirubin > 2 times the upper limit of normal
AND

-negative workup for infectious or other explicative etiologies for hepatitis. Workup for other potential etiologies should include:

– Hepatic imaging (i.e., ultrasound/doppler, CT scan, MRI) not consistent with alternative, explicative etiologies

– Negative viral hepatitis panel

– No pre-existing diagnosis of chronic liver disease (e.g., autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, Wilson’s disease, hemochromatosis)

– No recent hypotensive shock or septic episodes
– No history of alcoholism documented in medical records

 

Recommendations:

  • Clinicians evaluating patients with acute hepatitis should ask about consumption of dietary supplements as part of a comprehensive evaluation.
  • Clinicians should report patients meeting the case definition to the local or state health department, as well as the US Food and Drug Administration’s MedWatch program online at https://www.accessdata.fda.gov/scripts/medwatch/ or by phone at 1-888-INFO-FDA.
  • People who use dietary supplements for weight loss or muscle gain should do so with caution and under a medical provider’s close supervision.

 

For more information:

State public health agencies should contact CDC at (866) 933-5295 if they identify patients who meet the case definition.

 

 

The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.