joe posts

So I’m reading a news story about American hospitals and their struggles to retain nurses. It’s a struggle almost everywhere, for sure – to call it an extremely stressful job doesn’t really do it justice. And in Ontario, thanks to two decades of neoconservative and neoliberal leaders, things are imploding. Cutbacks in the hospitals in the 1990s meant a decline in quality of care and poor working environments for professionals, and cutbacks to education have raised tuition costs and have made it difficult to attract new people to the field. It costs at least $25,000 to study to be a nurse, and there’s about a 1/4 odds that your $25,000 degree will be useless a year after graduation and you’ll be working in a warehouse, self-medicating for job-related PTSD. ( But I digress!) Add the baby boomer retirement schedule… and you get the picture.

So I’m reading this article and I had to laugh because AMERICAN HOSPITALS can’t keep nurses! AMERICAN HOSPITALS! What they’re trying to do is introduce a residency-style program for new nurses. I have to say it makes sense. Emphasis mine!:

The Versant plan pairs new nurses with more experienced nurses and they share patients. At first, the veterans do the bulk of the work as the rookies watch; by the end of the 18-week training program, those roles are reversed.

The new nurses must complete a 60-item checklist. They must learn how to put in an IV line and urinary catheter; interpret different heart rhythms and know how to treat them; monitor patients on suicide watch and do hourly checkups on very critically ill patients; know how to do a head-to-toe physical assessment on a patient, as well as how to inform families about the condition of their loved one.

For Yaima Milian, who’s currently in the program at Baptist, this is markedly different from the preparation she got at her first hospital in New Jersey. She left after a six-week orientation because she didn’t feel ready to work solo. – AP

18 weeks. Four and a half months. And the nurse mentioned left after a six-week orientation program at a hospital in New Jersey. I can believe it. I would say two month minimum. A nurse might have the skills, but every floor is different and requires a whole lot of learning.

My orientation at the Sudbury Regional Hospital lasted three days. And they weren’t 12 hour days, they were 8 hour days, as I recall. At the end of the three days, I told them I was wholly unprepared, so they generously extended it for another six days or so. I quit after a few months – just couldn’t handle it.

Suddenly I feel less guilty about leaving the profession. No wonder I felt unprepared – it wasn’t even a cushy American hospital (I’m kidding about that America, don’t worry, I know your hospitals aren’t that cushy, unless they don’t allow poor people in). I think a residency-style program would work wonders for retention – unfortunately it’s that kind of creative thinking that our political parties despise. Sounds like it would cost tax-dollars, doesn’t it? That might make it hard to cut taxes and raise MP pay again.

Private healthcare, here we come.

According to the Ontario Hospital Association, almost half of Ontario’s hospitals will be running illegal deficits this year. In 2005, when a similar situation arose, McGuinty handed hospitals billions of dollars to keep them in the black. But not this time!

Dire predictions that half of Ontario’s hospitals are facing illegal deficits were dismissed by the province today as a pre-budget plea for cash, but Heath Minister George Smitherman wouldn’t rule out cuts at cash-strapped hospitals as they scramble to avoid the red ink.

“What is a cut?” Smitherman said after announcing a $100-million plan to add a new prescription drug to the province’s publicly funded list.

“If a hospital alters its administration and some people are exited from that environment, is that a cut? No, I don’t think so.” – Toronto Star

According to the Star story, Smitherman doesn’t really believe that half of Ontario’s hospitals are in financial difficulty – rather, he thinks they’re just whining so they can get higher budgets. He may be right, but it’s worrisome that our leaders think it’s cool to play ‘chicken’ when it comes to health care. It could go either way – next year we could see cuts if Smitherman is wrong and he sits on his hands. Cuts, especially staffing cuts in today’s healthcare environment, can mean major hardships for patients and their families, but it seems like that’s where we’re heading.

“I wouldn’t be announcing the budget today,” Smitherman said.

“But let’s just say that in every year, there are these dire predictions made about hospitals being in deficit circumstances and usually, that storyline doesn’t carry through the year.” – Toronto Star

Is it all a scam? The OHA would have a lot to answer for if that’s the case.

“I still feel don’t feel guilty because I still feel it was the best thing to do.” – Robert Latimer

And I still feel he should be in jail.

Pushing for his parole/release/pardon seems to be a cause célèbre among a certain segment of the Canadian population. And it’s not just the dummies who support him – I’ve gotten into heated arguments with well-rounded intelligent people (some of whom are dedicated health care workers) over this one. And I readily admit that I have some sympathy for the man, even if I think he deserves to be in jail. There’s no question caring for the disabled can be extremely stressful. I just think there are a lot of misconceptions about the case.

To his supporters, the story goes something like this – Robert Latimer, devoted and loving father of a severely disabled 12 year old could no longer stand to see his daughter suffer at the hands of surgeons and doctors and physiotherapists. He was convinced her pain was unmanageable, was convinced surgery was hopeless and he took her life to spare her any more suffering. Therefore what he did was not murder in the strictest sense of the word – it was a ‘compassionate homicide’ because Latimer’s motive was seen as altruistic. And since people outside his family can honestly have no idea what Robert and his wife were going through, there’s apparently no way we can judge what he did. The fact that he received the minimum jail sentence for his crime proved to his supporters that the law was incapable of dealing with this kind of situation.

But I’ve always questioned his motive. After Robert killed Tracy by poisoning her with exhaust fumes, he pulled her lifeless body from his vehicle, brought her to the house and tucked her into bed. Then he told his wife and the authorities that she had died naturally (¶ 10-16) in her sleep. It was only after the autopsy that Latimer confessed to killing his daughter. His sister has said that Robert wouldn’t lie his way out of prison, but he did lie to try to avoid the consequences of his crime. To me this always stuck out. He maintains he did nothing wrong and that he’s innocent of murder, but his first reaction was to try to cover it up to keep authorities off his back. If the autopsy hadn’t revealed that she had been poisoned, would he have ever admitted to killing his daughter? Would he just continue on with his life and let his family and friends think his daughter slipped away peacefully in her sleep instead of confessing that he had gassed her to death in his truck as he watched from the house? Was he feeling guilty for committing this crime?

Latimer’s supporters claim Tracy’s suffering was continuous and permanent and that there was no way she would ever find relief, so premeditated murder was the best option. But from what I’ve read, it is not quite so black-and-white. Witnesses called to trial testified that she would laugh and smile and didn’t show signs of unremitting agony. The multiple operations and constant care were stressful and painful for Tracy and her family, but that’s nothing unique to this case – ask just about anyone who’s worked with or cared for people with serious disabilities. Tracy had four operations and was due for a fifth. This isn’t unusual for someone with severe CP. The Latimers were more fortunate than some; they had care for their child outside the home (¶ 8). Shortly before Latimer killed his kid he was offered a chance to have Tracy placed in a group home (¶ 9). He declined that offer, claiming that her condition didn’t make that necessary. Almost two weeks before committing the crime, he already had a plan to kill Tracy.

The suffering she experienced was comparable to the suffering experienced by thousands of people with severe CP and other medical problems, and this is where I have issues with condoning Robert’s decision. Since his actions were supposedly merciful, can the parents of living children with severe disabilities be considered cruel for letting their children live? Robert Latimer maintains that killing Tracy was “the right thing to do” – does it not follow that letting a child with a severe and painful disability live is the wrong thing to do?

It’s not a fallacious ’slippery slope’ argument. I’m well aware that accepting Robert’s reasons and arguing that he should not have been punished does not mean every parent of every disabled child has the right to murder their kid. Obviously if a child is in pain and suffering but can verbally express a desire to live, the parents would be considered monsters if they used the child’s suffering to justify murdering the child. But in this case simply because the child couldn’t express a desire to live, some see it as acceptable or moral. Perhaps this idea has taken root in Canada; according to a well-known advocate for the disabled there’s been a significant increase in filicide in Canada since the Latimer trial.

There are enough people that I’ve seen in similar circumstances to Tracy – nonverbal but able to cry out to communicate discomfort and pain – that I wonder why we don’t see the same level of support (and 15 years of protests) when other parents kill their severely disabled children.

Recently a woman named Xuan Peng was convicted of killing her autistic daughter by drowning her in a bathtub. Like Latimer (prior to the autopsy findings), Peng denied being responsible. She still maintains that the child drowned in their bathtub accidentally. Peng’s husband has had said nothing but nice things about his wife – she was apparently a devoted mother and dedicated caregiver, and he maintains that she is innocent. Like CP, autism is thought to be incurable and children with autism do experience pain, both physical and emotional. Often they spend their whole lives cut off from the rest of society, communicating (if at all) with difficulty and often isolated from their peers. Programs and therapy can only go so far, and may not have helped at all. Medication is ineffective. Xuan Peng could have been trying to spare her child the pain of being autistic, much like Latimer tried to spare his child the pain of having Cerebral Palsy. Certainly nobody can understand what the Peng family was going through – perhaps this was as “justifiable” as Tracy’s death. Half of parents who murder their child genuinely believe it was for the child’s own good. So why isn’t anyone stepping up for Peng?

Ultimately there’s the question of whether death can be better than life. How can people say she’s better off dead? Nobody knows what happens when we die! There’s two basic possibilities: afterlife or oblivion, and neither of those possibilities can promise ‘relief.’

All we can know is that Robert Latimer deliberately took the life of someone with no concept of death and no way of communicating a preference. Now he says he did it because there was no magic pill to make her stop crying.

One of the biggest battles Mr. Latimer will wage is to identify the “pain medication” proposed by the government as an alternative to killing Tracy.

During Mr. Latimer’s trials, the prosecution said he could have controlled his daughter’s pain by giving her stronger pain medication instead of killing her. However, no such medication was ever identified, and a doctor testified that Tracy was already taking medication to reduce her seizures, and that mixing that with strong pain medication could have killed her.

Mr. Latimer said he believes the pain medication claims were outright fabrications. – Globe and Mail

What kind of excuse is that?

I wouldn’t wish Tracy’s life on anyone. I may prefer death if trapped in similar circumstances. But I’m not Tracy, neither are you, neither was Robert Latimer. So how can anybody act like this was an act of mercy when the person who was killed couldn’t express an opinion either way? Tracy had her own understanding of what life is – every living creature does – so comparing her life to my childhood and saying “Well, I’d rather be dead than have a life like that” is disingenuous to the extreme. But that’s what I hear in the media and ‘on the street’, so to speak.

We have a lying murderer’s word against a dead child’s silence, and I’m bothered by the fact that people accept Robert Latimer’s word.

As long as he conveniently believes he did the right thing, he should be in prison. Some proclaim that he’s not going to re-offend. I don’t agree that that’s the best way to determine the length of a prison sentence but putting that aside, what are people basing that assumption on? He doesn’t feel guilty – he did what he thought was morally right. Why wouldn’t he do it again, given the chance? As a condition of his parole, he’s not allowed to care for people with disabilities. I’m curious to see if his supporters take the next logical step and try to get that restriction rescinded. After all, he did the right thing, and he doesn’t feel remorseful.

And why should he feel remorse? Canadians have given him the support he needs to avoid confronting the fact that he murdered an innocent child. He can live in denial for the rest of his life.

When people need dental care but can’t afford it, they either ignore it, end up in emerg with a bad infection or find someone willing to do the work for cheap. That’s where “Dr.” Jimmy Connolly came in. For a small fee he’d operate on your mouth in his basement “office.” He was only found out after someone developed serious infections as a result of his work, which wasn’t conducted in the most hygienic of environments. From the Ottawa Citizen:

Police seized equipment and a dental chair from Mr. Bytyqi’s ‘office’ on Thursday, and he then turned himself in the next morning.

“It wasn’t your typical dental office,” said Det. Sisk, adding that he was surprised Mr. Bytyqi performed dental procedures in a carpeted room.

“It was in the basement of a home and it wasn’t what you would expect as far as sanitation goes,” he said. “I wouldn’t expect any of that in my dental office.”

Very sad.