Join us on Facebook

This blog gets little activity and methinks it's because my acquaintances don't really blog. They often come here when a new post is shared on my FB page and then return to FB to leave commentary on my "share." OK, fine. So Jadon and I set up a page you can easily "like" and follow posts: facebook.com/recliningsociety.

I don't know how I feel about the change. While I am hoping for more activity, FB makes it too easy to become carried away with posting every thought and interesting article that comes around... And then it becomes overkill and loses its value. I'm really hoping that it doesn't turn into that.

We are also planning to do an actual live podcast, which was actually the main ambition when starting this little endeavor. We hope to have a show up soon.

I still plan to post actual blogs here for those that want to anonymously read without having to "like" anything, but please feel welcomed to join us on the dark side.

Healthcare CO-OPs

I had to write a paper for my course Professional Aspects of Advanced Nursing and "take a position" on a current healthcare issue. I had to limit it to two pages using APA format. This is what I came up with. Let me know what you think:

  The Patient Protection and Affordable Care Act (PPACA) passed in 2010 is an ambitious attempt to make healthcare a reality for every citizen, mandating that employers provide health insurance to its employees and that every individual has health insurance. This might become problematic for small businesses and the self-employed or unemployed individuals. As it currently stands, small businesses and the individual have more expensive plans than large employers and coverage is often minimal within these plans. Small businesses and individuals are relatively too insignificant to create favorable change within the current market. Healthcare providers, including nurse practitioners, often feel the strain of their patient’s financial burdens when they are compelled to stray from the standards of practice due to the patient’s lack of coverage or inability to meet high deductibles and co-pays.

  To offset the burden of the mandate and avoid forcing people onto government-run healthcare, section 1322 of the ACA created the Consumer Operated and Oriented Plan (CO-OP) and provided each prospective CO-OP the potential to borrow up to $56.4 million in federal funds to cover the expenses of start-up. CO-OPs that take out a loan have several contingencies they must follow: the health insurance issuer must offer plans on a statewide basis, it must be governed by its own members, and it must be recognized as a nonprofit organization as defined by the state while reinvesting its profits to improve benefits or lower the premiums.

  There is some opposition to the implementation of CO-OPs. Since the CO-OPs are using federal dollars and there isn’t a guarantee that they will be viable, some think that it’s too much of a risk for taxpayers to invest in. Initially, the goal was for all states to implement CO-OPs but because of pressure to decrease federal spending, only 24 states received these funds before budget cuts were made.

  Oregon is one of the 24 states that received federal loans and is the only state to attempt two co-ops—Freelancers CO-OPs of Oregon and Oregon’s Health CO-OP. A major appeal of a healthcare CO-OP is that with each member being a part-owner, the individual will have more autonomy within the healthcare system. Focus groups within Oregon found that consumers are interested in established flat rates for their appointments, being able to contact providers through email, having alternative medicine as part of the plans, and affordable premiums. Enrollment for these two CO-OPs begins in October 2013 and coverage will start in January 2014.

  Oregon nurse practitioners should consider supporting healthcare CO-OPs for several reasons. First, the nature of a CO-OP not only respects the patient’s autonomy but it promotes it. As part-owners of their healthcare policy, patients will be able to vote on the type of care they want covered and the rates that are willing to pay. Second, it is also a form of social justice. As the healthcare system stands today, access to care is limited by the ability to pay. By providing healthcare insurance with predictable costs, patients will be more likely to seek early treatment for both acute and chronic diseases and injuries from their primary provider and reduce emergency room visits. Patients will also be more able to afford medications and procedures that they previously could not.

  Since healthcare CO-OPs that received federal loans are unable to advertise and solicit membership, nurse practitioners should draw attention to these healthcare plans by working within their communities and informing small businesses and self-employed individuals about this option. Having a large enough membership is crucial as it will determine the CO-OP’s viability.

Edding toward a Den of Snow

Edward Snowden has had his passport revoked, and is stuck in Moscow, according to Time.

http://world.time.com/2013/07/02/snowdens-worst-case-scenario-what-if-no-countries-take-him/?hpt=hp_t2

The list of countries willing to take Snowden is shrinking as more say either "no" or "apply in person."

Whistle blowing keeps getting more dangerous.  While Assange is holed up in an Ecuadoran Embassy, Bradley Manning is still facing a whole host of charges for having a greater allegiance to exposing the truth to the masses then protecting them by...what exactly?  Withholding that information?

We are moving to an open source information age.  Secrets are getting harder to keep.  It is up to us to demand open access to information.  We children of the 80's 90's and 00's are the next generation of policy makers.  Our apathy is the only thing stopping us from greater knowledge, and secrets are like water slipping between the fingers of those that would keep it from us.

By my count, Snowden is a patriot.  So is Manning.  Dissent is patriotic.

---

Obama said something about protecting whistle blowers once...

http://www.techdirt.com/articles/20130726/01200123954/obama-promise-to-protect-whistleblowers-just-disappeared-changegov.shtml

"Work-place Violence"?! A Government Cop-out is More Accurate

November 5, 2009

Where were you on that day? I distinctly remember wearing my navy blue nursing scrubs, the pocket embroidered with my nursing school's logo, my white tennis shoes. I was assisting a patient to sit-up in bed when a breaking news announcement on the patient's television buzzed in the background. I turned my head to see headlines about a shooting at Fort Hood. There has been an attack on soldiers preparing to deploy, the newscaster said.

You know how during a climatic scene of a movie the world slows down, you can hear your heart beat and you lose your peripheral vision? That's how that moment felt. Two names flashed into my head: Bergmeier and Burnett.

I gracefully excused myself from the patient's room and retreated to the breakroom, my squeaking shoes echoing off the walls and shiny linoleum. A fellow student found me propped up against the lockers, furiously texting everyone and anyone who might know about the two soldiers from my unit that were at Fort Hood preparing to deploy to Iraq. She tried to comfort me, insisting that it's a large Army and my friends were probably fine, probably at a different location all together.

I nodded half-heartedly, dropped the phone into my pocket and returned to the patient's room. I mindlessly fluffed pillows and checked IV lines, all the while having my ears tuned into the reports as they became available. My patient did not mind my obvious distracted demeanor as he was incredibly focused on the television as well. He called it a terrorist attack. I swallowed and nodded as initial death tolls and suspected injured ran across the scrolling banners.

Terrorist Attack.
13 dead. 32 injured.

That day, before all the details and investigations were known, we knew in our guts that it was an act of terrorism. My extra sense also told me that the soldiers from my unit were there.
While not close to either Bergmeier or Burnett, it was hard for me to comprehend how someone I played poker with or spent drunken nights at the local karaoke club with a few months ago could be victims of terrorists attacks.

Bergmeier was not physically harmed during the incident. In fact, he carried on with the mission he set out to do and finished a tour in Iraq. He could've stayed home, but didn't. He is a HERO.

Burnett was shot three times and has been trying to physically and mentally recover for 3+ years. Burnett fought back against the terrorist. He is a HERO--I can only hope that if I ever encounter the same situation that I can be just as brave.

These men were expecting to encounter danger in Iraq, not at home while doing routine paperwork, not by an officer in the same uniform with weapons of war.
BUT:
Our government has refused to recognize it as an act of terrorism. They call it "work-place violence" and our soldiers have not been compensated for wearing their uniforms that day and coming under fire for being soldiers. I follow SPC Burnett on Facebook. The whole time he was being treated for his injuries, he was also being treated as a no-good bum unworthy of respect while being compensated very little for his war injuries.

It is appalling, disgusting and abhorrent that the government, the Army, the powers-that-be are still dicking around three years later. It was so obvious on the day Hassan became infamous that he is a religious extremist, a terrorist, a traitor and a murderer. Why hasn't UCMJ been swift in trying and convicting him? Why hasn't he been served the death penalty yet? Why is he still alive? WHY IS HE STILL BEING PAID???

Can we please let go of being politically correct? Stop worrying about offending a particular religion? Of being afraid that yes, terrorism really does exist? Can we say it together? "TERRORISM EXISTS, FORT HOOD WAS TERRORISM."

I am embarrassed once again to call myself a freedom-loving, patriotic American while these shenanigans exist. My heart goes out to SPC Burnett and all the other injured and killed soldiers, to their families and loved ones. I apologize for my role as a citizen.

In the meantime, I want to solicit the knowledge of the masses. Who do I write my strongly worded letter to in order to correct this injustice? Who's contact information should I share with others so they can add pressure to the situation, too? How do we fix this?

Defining Health

As I become older, I have become more confused about what "healthy" really means. (A fair warning that there is some rambling in this blog.) Most textbooks would have you believe it's a perfect balance of physical, mental and social well-being, always depicted with an equilateral triangle. If one of the sides becomes disproportionately large or small, then the "triangle of life" is unbalanced and, for reasons unknown, needs correction. 

But I reject the triangle because there's a fourth side of spiritual. Spiritual captures a person's emotional well-being--feelings of self-worth, connectedness to others and their environment, etc. For the religious, it's about a connection with a higher power. Spiritual is separate from mental. Mental is the accumulation and application of knowledge--whether it's book or street smarts. A person can have a high priority for their mental health while have a very low priority on the spiritual. Anyway, please enjoy my diamond--my initial depiction of perfect health when trying to define it myself.

Perfect Health

Except now on reflection, I don't know anyone who is a perfect diamond. More or less, we are all various shapes of quadrilaterals. I looked at my own diamond model and tried to determine what sort of form I would take. Currently with school, I find myself expanding on the side of mental (LOL) and because of the type of  field I'm entering into (advance practice nursing), I find that my spiritual side is also expanding. It's interesting to me that I used the word "currently" in describing my health. I am learning that health is dynamic and in perpetual transition. Anyway, while focusing so much on the mental and spiritual, my already small social side has diminished to nil and the maintenance of my physical health has shifted. 

What health really looks like

Anyway, I want to switch gears and address that nagging "physical health" aspect. Previous to returning to school, the gym was my second home. My mantra of health was the same as the rest of Western society: "Fat Bad, Lean Good." It's a given that too skinny is bad as well.

We know that fat is bad.

We know that anorexia is bad.

But what about this?

Being far removed from going to the gym 5+ days a week, I have gained some new insights. This woman on the right is not the picture of health, either. Sure, she is in pristine physical shape (IMO), but to what cost? (And there are many that would look at this picture and they would not see health, they would see an unattractive "bulky" or "manly" figure, but I digress.)

Even going to the gym as frequently as I did and for the moment in time I "cleaned up" my diet, I was no where close to looking like this. Let's consider, then, what constitutes health--I could argue that she is not the picture of health. She is not a perfect diamond. She totally blows physical health out of the water, no doubt, but what about the other aspects?

While being bombarded with images like these at the grocery checkout line recently, I objectively considered the cost and effort to look like her. There is no way I could be like her and maintain my other priorities; my other priorities are extremely important and rewarding to me. It was an "AHA!" moment a few weeks ago when I recognized that I am not a failure because I am not ready for a magazine cover photo. In fact, spending time in the pursuit of my other priorities have created intense feelings of self-satisfaction. 

Don't misunderstand, this blog entry isn't an attempt to excuse bad health behaviors--without good physical health, the other aspects of health will also suffer. And truthfully, I don't know the exact reason I felt compelled to write about this topic. I think it's because I want to see others being more kind to themselves, to recognize that there isn't a start or end point to health. I hope that we can begin rejecting the notion that there is only one right way to exist and all others are somehow a form of failure.  We are all in motion, our health--physical, spiritual, social and mental--included.

With this explanation, here's my cornball "feel-good" suggestion: Go live your best life on your own terms.

A Nation of Stuff

My beautiful daughter turned 10 last week so on Friday we celebrated with family and 12 of her friends.

This picture doesn't even begin to show how many gifts she received for her big day.

We brought home these new treasures to recognize that she did not have any space in her room to put them. It forced us into an impromptu spring cleaning and I was surprised by how much she was willing to donate.

This picture doesn't show the items we ended up recycling or throwing away--things that are not accepted at thrift stores such as partially used coloring books or half a page of stickers. We could always lie to ourselves and say that we will eventually use these items, but as we wiped off several years of dust from them it was ridiculously obvious that they had to go.

But I look at the pile of stuff and I think about how much she didn't play with these toys. It killed me to see several pairs of shoes (and consider the associated price tags) that didn't have more than a couple weeks worth of wear--she had so many shoes that even when rotating through them she was never able to make good use of them before her feet became too big. Stuff! TOO MUCH STUFF!!!

And this leads me to thinking about the bigger picture. We are so focused on stuff. You send a kid to a birthday party and it is an expectation that he comes home with a goody bag full of pencils, cheap dollar-store toys and stale candy.  You know, STUFF. Through evolution it has become the natural inclination of man to hoard--initially a survival instinct, now a possible source of a mental health disorder, so we hang onto this crap. You don't want to throw the stuff away because somebody went out of their way to give it to you and someday you might actually need it.

But before we ever decided to hang onto this crap, we purchased it. We somehow had it in our minds that these purchases were necessary, it had to be done. And we gift-wrapped the stuff in fancy paper and plastic to try to impress the receiver with the burden inside.

Take it back even further and consider the amount of time Americans work. We work 40+ hours a week to have the money to purchase the stuff and the space to put the stuff in. In the meantime, we are exhausted, overweight and depressed. Those eight pairs of shoes in the picture weren't necessities but somehow I felt that they were needed at the cost of X number of hours at a job that is only so-so in my book.

This stuff will ultimately end up 1) in the garbage 2) in the garage or 3) at the thrift store. And while the last option sounds reasonable, even charitable, I don't know that some of the things being passed along and re-purchased are really favors and acts of goodwill(<--- "acts of goodwill," get it?! LOL.)

Then my last step (leap) takes us all the way to the national debt. It's the best of times and the worst of times, nationally speaking. I consider how people tell me that times are hard, but I'm thinking it's all relative. It's hard in comparison to the Clinton years, yes. But it's not hard compared to the Great Depression, or the pioneer days, or the Stone Age. We have redefined what necessities are, have become a country of STUFF and are completely unwilling to give it up no matter the debt and expense and overflowing landfills and polluted air and we say that times are hard.

We are slaves to our jobs. We are slaves to taxes. We are running out of room. We are slaves to our stuff. But we are volunteer slaves and I propose that we start a liberation. And more than anyone else, I'm telling myself that I should really start with not buying so much STUFF!

Women's Rights in 2013, a book review (and then some) of Sheryl Sandberg's "Lean In"

Recently I finished listening to Sheryl Sandberg's Lean In on audiobook after the suggestion of a dear friend. It is a feminist book encouraging women to be successful in their careers and lives. For the most part, I found myself thinking "YES! This is what I've always thought but never had the forum to say it!" A woman, performing the equivalent work as a man, is compensated with less. Women are always the person in a relationship to forfeit careers, dreams and goals for her family. Women love to compete with and tear other women down. By highlighting these things with research and anecdotes, she is able to say the things that my friends roll their eyes at when I say them.

Sexism is alive and rampant and I want to suggest that it's probably our own (women's) damn fault at this point. In reflection of my life, it's always been the men in my life--friend, supervisors, boyfriends--that have recognized my potential and either encouraged me or paved some of  the way for me to be successful. Then I consider the women influences in my life and it's a fuzzy, grey abstract with only a few distant examples from my military career. In fact, it was only women (not all of them, but some of them) who told me to "get real" or other comments to instill doubt. Only with starting my Master's degree have I finally met strong, intellectual and ambitious women that I can learn from and consider my mentors. (These include the FNP I work with, my preceptors, instructors and fellow students.) I agree with Sandberg that it is for women to start lifting up other women. She was vague in her book on how to do this, but I have a little checklist I would like to propose:

1) Don't be the one to instill doubt.
If a friend tells you she wants to aspire to a successful career, please don't "look out for her" by asking questions such as "What about your husband? Who will take care of the baby?" or comments such as "Make sure you take time for yourself" or "Just remember the important things." These sorts of comments make a person second guess themselves, make them question if they can really have it all.
Let's be honest, these sorts of things would never be said to a man. While said with good intentions, they are not helpful.

Instead:

2) Be encouraging
How? Provide feedback such as "You will be amazing! I think you'd make a great executive!" or "That sounds challenging, but if anyone can do it, you can." Of course be sincere. If nothing encouraging comes to mind, you can say something like "That's a good goal. Good luck!" And like they said in Bambi "If you don't have something nice to say, don't say anything at all."

3) Remember other women are not your competition. The only person to compete against is yourself or the person vying for the same position as you, female or male.

Anyway, there were a few things that I didn't appreciate in Sandberg's book. She says that we still can't act like men even in traditionally male roles. Where a man can simply list off his accomplishments as proof of his value, a woman is perceived as bragging and being self-centered. Instead, Sandberg encourages women to continue to be "communal" to get what we want--identify a need that you can fill, explain how it can be fixed and what you intend to do to "help." Gag me. It's frustrating because she has a point. When I served as a sergeant I could lead the same ways as a man but I was called a "bitch" where my male counterparts were just taking care of business. It's not that I want to act or be manly, but I just want to be matter-of-fact instead of dancing around the circle. Instead of insisting that women still have to act different, I wish that Sandberg offered a way to change the perception--a way of coming to full androgyny in the professional realm.

There were some naysayers to Sandberg's book--mostly stay-at-home moms, single-moms, those coming from poverty, and racial minorities. As a single-mom who hated "staying at home" and has pushed her way through poverty while attending grad school alongside quite a few racial minorities, I return the NAY to these naysayers. Sandberg acknowledges her privileges and she was still able to reach me. She never belittled those who choose a different perspective or life path. Just because one doesn't agree with her doesn't make her wrong.

All-in-all, a great read for everyone, especially for women that are struggling to make it in A Man's World.