Nurses protesting NATO

Or, a nurses’ union protesting at the NATO meetings, to be more exact. Lots of news stories covered this story today, so I thought I’d touch on it.

 Perhaps this is puzzling to people who think of nurses as doctors’ handmaidens, bedpan emptiers, and bosses at psych hospitals. Or perhaps it’s troubling to people who feel that nurses should be apolitical, providing compassionate care to everyone without ruffling any feathers or making anyone uncomfortable.

The union members at this particular protest seem to be advocating a “Robin Hood tax” along with a general anti-war message. 

 Whether or not you agree with the politics, I think it’s crucial that our society think of nurses, and that nurses think of themselves, as promoters and protectors of well-being. So, yes, you may see your friendly neighborhood R.N. waving a protest sign for a political cause that affects the well-being of the community– more power to her/him. 

(Just to be clear: I’m not talking about bedside nurses engaging in political actions, or god forbid, discrimination, while in the role of direct caregiver. I hope we all agree that at this level, everyone, regardless of politics, should be treated equally. I am talking about nurses as community members, advocating for causes that they feel are important to the health and well-being of the community. Ok? Ok.)

Sotomayor Update

Lawyer: I’ve read and thought some more about this. Below, I reproduce my comment from the Times’s Room for Debate blog about the nomination. (My comment is #27.) The entire debate on the post is interesting to read, though it did raise my blood pressure a little!

Some of these writers (especially Lopez) are missing what seems to me to be an obvious point: that empathy is not the sole criterion used by Mr. Obama. It was a quality he wanted in addition to serious intellectual rigor, a long record of carefully considered opinions, etc. It’s not as though he went out and found the most empathetic individual he could, and nominated her. He found a serious judge with a solid career who also has this particular quality that he values. We will see, during the confirmation process, whether her record and credentials stand up; that kind of test is built into the process. (cf. Harriet Miers.) But a president has the privilege of appointing justices, so he gets to have a say in which secondary qualities he wishes to focus on.

A little from column A, a little from column B

Lawyer:

Bad news first: Prop 8 stands. No more gay marriages in California. (They’re trying to play it down as a question of semantics: civil union, yes. marriage, no.) At least until the next election when we introduce that measure that repeals prop 8 for another referendum. Existing marriages are allowed to stand. This saddens me — I believe the prohibition of gay marriage to be unconstitutional. Heading for the Supreme Court?

Which brings us to the good news: nomination of Sonia Sotomayor for the Supreme Court. I won’t repeat all the qualifications and comments about her (that’s what the New York Times and the Huffington Post are for), but I will say this: there’s been chatter about her only abortion ruling (yes, we can prohibit gifts of federal money to groups that promote/allow/offer abortion overseas).  But I think people are really asking the wrong question there. Any judge worth her salt, which this one seems to be, isn’t just going to focus on “do I believe abortion is wrong?” but rather, does the Constitution allow for this?

I don’t know enough about her to know to what extent she is willing and able to do this. She has shown someone of an inclination to side with the worker/victim/discriminee. But I don’t think we can generalize from there. And I’m not sure we should. President Obama is selecting someone to make judgments, not selecting a pre-determined slate of judgements.

And the senate republicans seem to realize that barring some major revelation, they probably can’t oppose this. Nor should they — she seems to be a well-qualified judge. And anyway, can they afford to alienate the Latino voting community any more?

The new judge — Sotomayor if confirmed, which I imagine she will be — is likely to face a Roe challenge and a gay marriage decision. Both of which are nurse and lawyer type topics. I’ll be interested to see how the confirmation hearings go — what kind of info they try to weasel out of her, and what she is and isn’t willing to say. I personally hope that she doesn’t spill too much.

The Vermont Crackdown

Vermont has been busy passing a law that restricts gifts to doctors (and nurses and pharmacists and hospitals) from drug and medical device companies, and requires them to report all gifts they receive that ARE still allowed. A few other states have laws to this effect, but this one seems to be the toughest.

Lawyer says: bravo Vermont! One of the best ways to work on big problems is to expose them to the sunlight — if this business has to be conducted out in the open, it will have to be conducted more cleanly.

The New York Times reports that the Pharmaceutical Research and Manufacturers of America  (PhRMA) has a code that companies can voluntarily sign that prohibits gifts that aren’t educational and places some restriction on meals.  Apparently PhRMA objects to Vermont’s law because… it’s redundant? And will waste doctors’ and companies’ time?

Well, PhRMA, I’m glad you have a code. That’s a good step. But come on!The code limits some types of gifts, and the law limits others. It also does something the code does not: requires reporting of things that continue to be allowed. Reporting requirements are, if you ask me, the best way to fix this problem. It encourages both good behavior on the part of doctors and pharma companies, AND  it can create public investment in and awareness of the process – very important where healthcare is concerned.  In addition, unlike the code, the law applies to everyone in the state  – not all pharama companies have signed the code.

Side note: previous regulations (and those that still stand in many places) allow large gifts to slip through, protected as trade secrets. Last time I checked, shady business practices (i.e. bribery) were not legitimate trade secrets that would allow other companies access to proprietary information about a company’s inventions.  Close the loophole!

Patients have a right to unbiased care. Vermont is helping them get that. Way to go, Vermont.