Lessons of a Political Toddler: What you see isn’t always what you get

Nurseinterupted October 11, 2012 0


NURSEINTERUPTED | nurseinterupted.wordpress.com

My attorney, knowing I had been trying to meet and speak with Senate Candidate Richard Carmona (the former US Surgeon General), was kind enough to forward me information about where he would be speaking this weekend. To say I was thrilled is an understatement. There are several reasons I have been happily riding along on the Carmona Caravan for quite some time:

  1. He grew up in a poor Latino family.
  2. He was raised by a single mother.
  3. He is a Vietnam vet like my dad.
  4. He was a nurse.
  5. The campaign commercials won me over with his assertion that healthcare is neither a Republican nor Democrat issue. We have to come together for solutions.
  6. He is not Jeff Flake nor does he even bear a close resemblance to Jeff flake.

Beautiful, right? All things to pull me out of the house during the day (which most of you know I despise)—and with full makeup and hair no less–an everyday miracle. I was up early, thinking of the questions I wanted to ask and trying to pick out an outfit that would look great for a photo-op with this guy I had really come to admire as a Latino leader. Today I was going to be representing the voices and concerns of nurses directly at the bedside, the ones in the trenches. Over the past weeks I have been talking to my politically astute 16 year old daughter about Carmona, though I was unable to drag her out of bed this morning to go hear him talk because Homecoming was last night…

I set out early, caffeine in hand, and made the drive to the venue. I took lots of pictures of Dr. Carmona talking and the official campaign signs—excited about posting them all over my Facebook page later in the day. All of a sudden, someone took a needle and rudely popped the bubble I was so happily floating around in. The hard landing to the floor was not pleasant. Dr. Carmona’s speaking abilities as they pertain to his life story and numerous, admirable accomplishments and qualifications are enamoring. (This portion of the talk also took up a good chunk of time during the event). I don’t need to hear what I already know from the commercials running 10-12 times a day on the television. I want to get down and dirty and hear people engage in discussion about what Richard Carmona is going to “do” for “us” his constituents. I was disappointed to hear many of his responses begin with “we have to do” instead of “As senator I will do, I will advocate, I will push for, I will work to.” At one point he made reference to Jeff Flake not being familiar with the district he represents or the people in it. I’d like to pose that today’s speech by Carmona was an eerie parallel to Flake’s disconnect from the real folks out there dealing with the issues of healthcare reform and access, immigration, the dream act, veteran’s health, the ailing economy, job loss, education, and of course—the struggles of our nurse workforce .

A Bloomberg reporter asked me “what did you hear” from Carmona today? My answer: “Nothing much.” Carmona gave beautiful answers when asked about veteran health, immigration issues, border safety, and the dream act—his passion for these particular issues is readily apparent. The answers were from the heart. I was there for something else though. My nurse colleagues and the people we care for and protect 24 hours a day seven days a week. I wanted to hear verbs in his sentences. I needed to see some concern in his eyes for our safety. What was Richard Carmona going to “do” for us, the approximately 115,000 nursing professionals actively practicing at all levels of the profession in Arizona. What was Richard Carmona going to “do” to protect us from retaliation so that we could do our jobs? What was Richard Carmona going to “do” to ensure nurses could practice, without fear, to the full extent of their licensure and education in the state of Arizona?

The answer (or lack thereof) was the proverbial needle in the pretty, shiny, red heart awareness balloon that’s always floating above my head. Carmona quickly diverted from my questions by saying he would work with the state board to protect the scope of practice of nurses in Arizona, and even made a vague statement about not being able to really say for sure what he could do about retaliation concerns. The canned reply was equivalent to what Senator John McCain did to me when he sent me that zinger of a form letter reassuring me of his appreciation for me writing him and that he “would forward my concerns to the state board of nursing.” What? Dr. Carmona’s reassurance that “I have already addressed the Arizona Nurses Association” did nothing to comfort me either. Actually, it felt more like someone was pouring salt and lemon juice over a second degree burn.

If you are a nurse in Arizona you know the AZNA is primarily comprised of nurse management, administrators, state board members, and instructors from all over the valley, most of whom haven’t been at the bedside in ages and are up there somewhere in the stratosphere of our profession—completely disconnected from those of us at the sharp end of patient care. (It’s actually sharp at both ends—we get hurt and patients get hurt). Dr. Carmona clearly hasn’t researched the fact that less than 4% of all nursing professionals are actually members of the Arizona Nurses Association. They are not the “collective voice for nursing” as they so proudly boast. Addressing the AZNA at an AZNA breakfast is not addressing the critical concerns of the nursing workforce in Arizona. I wanted to know what he was going to do to protect “the rest of us” in a right to work state and at the federal level. No answer to that. I went on to ask how he was going to enforce the recent recommendations of the Institute of Medicine pertaining to nurse scope and the overlap between nurses and physicians. Mid question I was waved off and told “I have other questions to answer.” Perhaps the AZNA gave him just enough of their kool-aid or warned him about this “psycho nurse named Amanda Trujillo running around causing trouble”.

Right away it occurred to me—Carmona is no different than any other nurse who hasn’t been at the bedside (AS A NURSE) in numerous years. He is out of touch with the issues we face–TODAY. He is nowhere close to understanding the dangerous settings we practice in and the unethical dilemma we are forced into when we have choose between the lives of our patients and our paychecks/livelihoods. His campaign commercial is real neat and filled with hope—but I think its appeal is that it speaks to people in all demographics, it perks up your ears, grips your attention—and your heart. Well, I was drawn in a long time ago and what I heard today was a candidate who was staying nice and safe in the middle of the road with well prepared, rehearsed answers—Carmona appeared neither here nor there unless addressing issues he is clearly passionate about. I received more concern and support at the Hispanic White House Initiative in January.

Another hard lesson in politics for me, the political toddler: What you see isn’t always what you get. Just because a candidate shares the same characteristics as you; like background, ethnicity, or occupation, doesn’t mean they are going to be the best one to send to Washington. Dr. Carmona’s accomplishments are truly remarkable and inspiring, as is his life story and journey. He is a remarkable person. In fact I feel like I could kick back on the porch in my backyard with a margarita and listen to him talk about those things all day and never hear enough stories/experiences from his life. Richard Carmona is an extraordinary individual with a commanding presence and it’s clear to see how he has constructed such an inspirational life.

Unfortunately, Richard Carmona will not be the candidate that will go to bat for the nursing workforce in Arizona or at the federal level, and furthermore, he doesn’t seem to understand that the State Board of Nursing does not advocate for the nursing workforce or work “for nurses.” He is nowhere near in touch with the issues affecting bedside nurses in hospitals. It’s easy to see how he may have been misled to think he has addressed nursing concerns because of how many people he’s met who are members of both the Arizona Nurses Association and the State Board of Nursing. It would be both refreshing and inspiring to see Richard Carmona reach out to the nurses in the trenches—the people he talks about as being downwind, out there in battle, on a mission to achieve, the ones he wants to help support. Well, Dr. Carmona, that’s me. A single mom, a Latina voter with both a Bachelors and a Master’s Degree (working toward a Doctorate) in the unemployment line and relying on state assistance because there was no one in government or anywhere else to protect me or any other nurse when it comes to doing what we earned a license to do and abiding by the oath we took.

Dr. Carmona relayed his concerns about the lack of highly educated Latino leaders in the workforce. Well, Here I am Dr. Carmona. One of the few you talked about “who made it out” one of the few who “went all the way” through school and accomplished getting into the workforce to make a living and make a difference. Here I am, Dr. Carmona, taken out of the workforce by a big healthcare franchise because of the misplaced priorities of profits before patients. Here I am, a highly educated Hispanic nurse who was mentoring Hispanic nursing students to promote more minorities in the profession when a major healthcare franchise decided I was a dirty Kleenex to be thrown away into the trash…. like my years of education, my life, my daughter’s life—meant nothing. I’m one of those minorities you talked about today and I was rendered useless by a doctor who never met me or heard my name. One less highly educated Hispanic nurse (and potential leader and mentor and teacher) in the workforce. The sad thing is this tragedy is happening to more nurses all over the country every single day. Some have committed suicide from the trauma of losing everything for doing what they were taught in school to do.

Dr. Carmona emphasizes how badly we need more well educated minorities in the workforce—the question is, how is he going to protect the workforce in a right to work state where anyone can get fired for the color of their hair or skin? What will Carmona do to protect nurses from a doctor who waves a magic wand and decides to throw them in the trash like God waves his hand to calm a storm??? What I needed to hear today as a well- educated single Latina mom, voter, and nurse BACK ON WELFARE was that he was going to sit down at the table to figure out what can be done to keep it from happening again TO ANYMORE NURSES. That he would work WITH US to find solutions. What I HAD HOPED to hear today was that he cared about the preservation of the nursing workforce and that he would do what it took to make sure we could protect patients without having to be placed in the position of deciding whether to act in the best interests of the patient or our own.

Dr. Carmona made a couple of interesting points today. The first one was in reference to the useless fighting going on between political parties in the midst of catastrophe and how it’s accomplishing nothing. The same could be said for how both the disciplines of medicine and nursing interact with each other. The second point he made had to do with the Titanic. “The ship is sinking and we’re all worried about where the deck chairs are supposed to go”….or something like that—you get the point. Again, the same could be said about our healthcare system and nursing’s place in all the mess. Our profession, our scope, our ability to do the very things we are licensed and educated to do is like a big ship going down and yet we are busy writing position statements and having pretty conferences to talk about all the things that should be done instead of just getting down to the business of doing it.

I suspect if I had maybe 10 other nurses with me today— bedside nursing care nurses, I would have been heard and not waved off like a fly. But it’s moments like these that tell you where you stand in the big picture…and it seems I have a long way to go before I make it to Capitol Hill. When you can’t get your own state’s politicians to slow down, make eye contact, and “listen,” how on earth can you get Congress to care when you go there to testify?

Not all is lost. In my sluggishly slow journey to Capitol Hill I have met some great candidates who have done just that-–made the eye contact, the time to listen, and most importantly—showed they cared about the issues. While Carmona has clearly excelled in every way throughout his life, one cannot be good at “everything.” As a politician, staying safe in the middle is a very good way to lose the voters. At the beginning of the morning I eagerly put the Carmona bumper sticker in my purse and fastened a “Carmona” button to the lapel of my jacket. At the conclusion of his “talk” when everyone clamored into a line for photo-ops, handshakes, and hugs– I waved off the opportunity, unfastened the pin, tossing it back on the table along with the bumper sticker I “was” going to put on my SUV. Bottom line: Nurses, and I’m not talking about the ones who have an RN after their name, sit in offices all day, and haven’t done a bed bath in like 20 years, need effective representation in the legislature and at the federal level…..this much was painfully clear today. Dr. Carmona is just not “the one” who will make nurses a priority on his agenda.

I’m not voting for Flake either—I grew tired of seeing his face on my television 500 times a day and hearing him say “you know me.” No I don’t, but I know enough to know I’m not voting for him. Where did Flake lose me? The high rotation of the campaign commercials were a big turnoff. It’s safe to say when you feel like throwing your laptop at your TV screen the vote’s been lost.

I’m left with the same three words that have been in my head since April 21, 2011…the day Banner Health forever changed the course of my life: “Si Se Puede.”

I have to believe in it. Or else…how does one keep moving forward toward accomplishing the dream….