Barely Legal

October 16, 2009

Being a nurse can be really fun. You get to watch babies being born. You get to dry a seconds-old human off with a stack of soft receiving blankets fresh from the warmer. You check the first set of post-uterine vitals, clear gunk from the airway, count fingers and toes, adorn the kiddo with her first bling (a hospital I.D. band), and place that slightly smushed pink bundle of joy against her 13-year-old mother’s chest for first the first time.

As you try to help the new mother breastfeed her baby, you can’t help but notice that mom seems confused and distracted. “Let’s put the cell phone away for a few minutes so you can hold your baby with both hands,” you gently instruct this lucky young lady. “Hold on, I’m in the middle of a text,” she replies. You wait patiently. Baby yawns. Suddenly a gaggle of middle-school girls barge into the room and flock towards the baby. “Oh, she’s so cute!” they exclaim. “Is it too soon to pierce her ears?” one asks.

Baby’s hungry and starting to fuss. You tell mom that her baby needs to eat. “Can we do it later? My friends are here!” she says.

Now, I’m not relating this anecdote, which I’ve experienced with nearly every young teen mother I’ve taken care of, in order to laugh at the frivolities of teen girls. Nor is this to say that all young moms and dads are too immature to function as parents. Just most of them. Which is why I welcomed Obama’s strategy to prevent teen pregnancy back in May, which put an end to abstinence-only funding and instead focused on evidence-based interventions. Sadly, the fun didn’t last, and I aspirated chunks of my own partially digested freedom fry when I read this a few weeks ago, which says that those rascals over in the Senate Financing Committee voted to reinstate funding for Jesus only abstinence-only education.

For practical purposes, the most important part of the abstinence-only versus comprehensive sex education debate is the evidence demonstrating how woefully ineffective abstinence-only education is (Kohler et al., 2008; Roosa & Christopher, 1990; Underhill, 2008; etc. etc. etc.) and how effective comprehensive sex-education programs can be (Oringanje et al., 2009). Unfortunately, the paucity of well-designed studies from either camp means that there isn’t really strong support for a definitive statement on the matter. Furthermore, pinning the phenomenon of teen pregnancy solely on the shortcomings of sex education is dangerously short-sighted and allows us to conveniently ignore larger cultural, sociopolitical and economic factors that contribute to teen pregnancy. So why am I choking on my own vomit at the thought of funneling $50 million of federal money into abstinence-only education? I don’t know. Maybe it’s because of the subtle and not-so-subtle messages of sexism, racism and classism embedded in most abstinence-only curricula (Froyum, 2009). Maybe it’s because the teen pregnancy rate is rising at the same time that contraceptive use amongst teens is declining (Contraceptive Technology Update, 2008). Maybe it’s because I was socialized to think poorly of early childbearing and think highly of education and financial independence. Maybe it’s because I didn’t learn Jesus and so I believe that teens will do what their healthy, fertile, baby-friendly little bodies tell them to do. I don’t know. Maybe it’s just because one of my little 13-year-old mamas told me she hadn’t heard of condoms before she started having sex. Had she been privy to the forbidden secret of wrappin’ it up, she might not have to face the emotional trauma and economic instability that naturally arises when one attempts to text message and breastfeed at the same time.


A Cooking Egg

August 14, 2009

Although I don’t want SEMI to go the way of KevinMD with superficial news blurbs lacking any hint of personality and hawked from other blogs or the Associated Press, I am short on time this week and thus unable to provide anything other than content-poor headlines right now. I must leave it up to my dear reader(s) to discuss.

This week in wealth care reform health care reform:

Hey, Obama, everybody knows that secrets don’t make friends. Money, maybe, but not friends.

Ralph Nader and Amy Goodman should just make a baby already. If Amy’s concerned that she’s past her prime, I’m happy to offer my youthful womb as a surrogate. Anyhow, I think Nader is using the term “harmony ideology person” as a euphemism for “pu**y.” (No, not puffy! Or puppy! Or puddy! Or pushy! Or pully! Or pukey! Or pudgy! Ok, maybe pudgy.)

Someone over at T.C. wags a finger at the left for its failure to keep its eye on the prize. To any regular ol’ nurses (as in, not published numerous times over in academic journals) interested in policy advocacy out there, can you name your state’s senators and congress people AND their voting records on issues related to health care reform like T.C.? I’ll just go ahead and take one for the team by admitting that I can’t either. Let’s get crackin’. Stay tuned for a piece I’ll be posting next week on policy advocacy within nursing.

Jon Stewart spearheads public health campaign raising awareness of ideology-associated amnesia (IAA). John Oliver combats national health care discrepancies by advocating for equal access to death panels.

U.S. Dept. of Health and Human Services attempts to bolster support for health reform with a report on how Big Insurance leaves millions behind. A more comprehensive report on health disparities may be found here. Guess what? People living at or below the poverty level and racial/ethnic minorities receive the shittiest care! I am shocked. For those of you who think they deserve it, perhaps you need a little work expanding your social consciousness (by the by, anybody who is actually interested in that article can “borrow” my copy if you send me an e-mail address).

I’ve encountered a lot of provider disillusionment regarding a public option or universal coverage via expansion of Medicare/Medicaid because many of us in the biz know that reimbursement is a big hairy ugly issue with lots of twisting dark tunnels in which to descend without hope of rescue (For example, I sat down with utilization review a few weeks ago in order to understand how much money our hospital loses because of services that would not be reimbursed by Uncle Sam.) I know providers and patients waste endless time, engergy, money and lives strugging with Big Insurance too, but anybody who wants to see quality improvement of Medicare/Medicaid before a “public option” goes live may be interested in venting your opinions here. I’m no expert on this stuff, so I’d love to see a little lively debate going here on SEMI as well.

Business man Dr. Andrew Weil does a bad job of making a decent argument about the misdirection of the health care industry and the medicalization of socioeconomic problems here. I sure hope we see more “wrong diagnosis” puns in the debate over health care reform!

And finally, a few random tid bits:

Ever wonder how much vaccines cost?

Anybody want to meet in Chicago on Sept. 22 for a sexy weekend of healthcare-associated infection debate (see above section on Medicare/Medicaid reimbursement)? Fellow nurse friends, I’m talking to you.

As an RN and an FNP student, it only makes sense that I don’t have health insurance. I’m due to get my cervix scraped, Pap-style. Any fellow (legally licensed and practicing) med folks out there feel like doing me a professional courtesy? C’mon. I’ll get you back when I’m licensed to hand out prescriptions.

Safe driving, y’all.

The Mirror Stage

July 23, 2009

Momma always said that trying to discern the genetic underpinnings of human nature is like trying to reconstruct this recipe for coulibiac merely from tasting the finished product. Now, Momma wasn’t Russian, but she was an alcoholic, so I didn’t take her metaphors too seriously. This article, however, gave me a new appreciation for Ma’s insight. Not only does the article use real science refute a branch of academia that I am prone to detest, but it also quotes former UNM anthropologist Kim Hill, who I know personally. Yeah, that’s right. I gots connections.

The article, which addresses the issue of rape genes and jealously genes and all that hot n’ heavy Darwin stuff, touches on something that I think is really fascinating: human evolution in the past 10,000 years. I mean, like, wow man. Maybe these trendy new genes are the reason why we’re not all dying from leaky-gut syndrome. This whole ongoing evolution thing may turn out to be a boon for chubby chasers, since obese chicks have more children. Does that mean we’re passing on the gene that turns donuts into cellulite with a greater frequency than gene that turns donuts into abs of steel? I’m thinking that the next 10,000 years of evolution will turn us into a species of buoyant blubber balls who can sustain ourselves on nothing other than corn derivatives. Also, new and improved humans will sprout flippers instead of limbs since, you know, global warming and all. Hey, we already have gills. (By the by, how awesome is it that the Missouri Association for Creation website has a tab called Get the Facts?)

Unfortunately, my vision for the New American Century has been sullied by confounding variables. Turns out property values may be the strongest predictor for obesity: that is, as your property value goes down, your waist-to-hip ratio goes up. How do you pass on your property value gene? In a trust fund? Does your property’s value count as a pre-existing condition under Obama’s endangered public option?

Whatever our evolutionary heritage, it’s obvious that we humans are pretty obsessed with figuring ourselves out. Despite the obvious genetic variability in our species, it seems that the gene for self-voyeurism is nearly universal. I hope that the current battle betwixt those macho, speculatin’ evolutionary psychologists and their more egalitarian critics yields a bunch of cool new science for me to blog about. What else am I supposed to do? I mean, I can help treat obesity, but I can’t give anyone a pill to increase their property value. YET.