January 17, 2009, 3:12 pm

Change We Can “Live” With

Dear Mr. President,

Well, it’s here.

The campaign has been waged, the victory scored. Tuesday will mark the beginning of a historic era in our country’s history.

You now know the minute details of what faces this country; things you could not know while campaigning and probably wish you didn’t know now.

We, on the other hand will now find out if promises made can be promises kept. Some will be. Some won’t be. Some can’t be.


“Change” was the theme of your campaign. I’d like to throw out some ideas for change we can “live” with.

Change that can help every single American.

Change that can save the health care system in this country.


At the risk of sounding like a Frank Capra movie, I believe America is the greatest country on Earth. I believe it. You believe it. So, even though I did not vote for you, we have one major belief in common.

Given America’s greatness, why is our health care system so fragmented, so focused on illness, so underfunded?

So sick?

There is no one answer. You may be President when the system improves or it may take you starting the ball rolling and a successor to complete. But, there are ways to begin looking at the system now to make it better.

This is what I believe:

  • Every American should have access to the same quality health care no matter where they live, whether they are employed, whether they are healthy, whether they are sick.
  • Health care is a need, not a right. Rights are not purchased (life, liberty, the pursuit of happiness)…Rights are fought for. Needs are purchased. Health care will require funding and adequate payment to those who provide it.
  • The focus of any health care plan needs to be….health! This is the definition of primary care. Regular check ups. Immunizations. Screening tests. Public health is also the definition of primary care.
  • Public health is so much more than just making sure people have a doctor handy. Public health means working on the infrastructure. Decent housing. Good schools. Jobs. Good stores. Stable neighborhoods that invite businesses to invest.

This is what I believe:

  • Anything our government touches becomes mismanaged, misused, misfunded and bloated to high heaven.
  • I live in California, don’t try to tell me otherwise (and this is a Republican talking!).
  • Ergo, health care should not be managed by the government. Health care must be managed at the community level with input from physicians, nurses, other health care disciplines and lay citizens.
  • Drop insurance.
  • Employers pay a percentage of tax for the number of employees they have. Tiny business? Less taxes paid. Big corporation? More taxes paid. It’s got to be less than what employers are paying now.
  • Every individual worker pays a 2% flat tax for health care. Poor? You pay less. Rich? You pay more. But, this is all you pay. Ever. No co-pays, no medication costs. Just your fair share of taxes. On welfare? Then 2% of your welfare check is kept for health care needs. Yep, you pay, too.
  • Add this to monies already spent for Medicare and Medi-Cal. You can cover every person in America and those who can’t pay are covered by those who can. We are doing this already.
  • This is the plan of the Physicians for a National Health Plan – it’s already been worked out and debated and supported by California nurses. Check out the site. Why re-invent the nearly invented wheel?

Things we need to do now:

  • Change our focus to primary health care and not big-bucks disease management.
  • Study other countries’ systems. Learn from their mistakes. Learn from their successes.
  • Make medicine and nursing professions that attract the best and the brightest. It does not come cheap. Anything worth having never does.
  • People are your best investment in health care. Make it worth the time and effort to become a doctor or a nurse.
  • You can’t provide primary care without primary providers, nor can you expect someone to be willing to work for the same (or less!) wages provided to the local waste-management worker after 12 years of education leading to over $100,000 in debt. Let’s get real.

Mr. President, you are obviously able to communicate with the American citizen, or you would not be where you are today. Please:

  • Let Americans know that they are responsible for their health. Not the US Government. We each make our own decisions leading to good or bad health in the long run. What the government can do is provide the infrastructure that gives people the choice to make correct health decisions. That gives them neighborhoods that are safe and where businesses can thrive. Some will come crying to you that they are victims in the health care arena, that they should not have to pay for whatever reason. Don’t let them. Stand firm.
  • Make it clear that health care is not an entitlement. Make sure the patients know that they will be paying for their health care and that they are expected to pay for their health care. With that responsibility comes the knowledge that the health care community is accountable for the care they provide. That is no change from what we have now.

So, Mr. President, I wish you luck and will pray for your success in the office you have won, because your success is my success, and that is bipartisanship at its best.


Kim McAllister, RN

January 16, 2009, 10:32 am

On the Phone With Richard Simmons!

Okay, I am officially totally flying!

I just got off the phone.


This is not a joke!

I wrote him an email about how much I was enjoying the program and that I had lost 15 pounds.

Just a simple little email.


I knew he would surprise people and call them or go see them – but those were other people! Never just little (or big, actually) ME!

He is going to use me as a success story on his website – I can’t even describe what it was like to get that call!

Richard, I’m going to make my goal weight. If you only knew how much that call meant!

When the story is up, I’ll post a link.

For now, please excuse me…

I’ve got some oldies I have to sweat to…

January 14, 2009, 12:52 pm

What Have You Done for Me Lately?

I know I usually try and put something funny at the top of my posts, but I was taken by this photograph.

Images like this are what re-enforced my decision to be a nurse long after Cherry Ames had lit the fire.

This is what I wanted to be.


The photo was taken in 1955, in Detroit, by a Mr. John Dominis for Life Magazine and is from a photo essay of the Polish community in that city.

If it’s an iconic photo, this man probably photographed it.


Well, I’ve lost 15 pounds in 11 weeks and managed to do it over the holidays

Yep! Over the holidays!

And it’s all due to Richard Simmon’s Food Mover Program.

You move the little covers over the food exchanges as you eat and you move your butt and off the weight comes. No magic. Less in, more out, less of me.

But he really makes it fun!

God Bless him and his sequined shorts!


The nursing profession is fragmented.

The are a million nursing organizations that all claim to speak for the American nurse.

But do they really?

Let me give you the images that come to mind when I think of three specific organizations.

Only one of them is worth my time and effort.

Keep in mind that my ignorance will be wide open for all to see – this is just my gut response.

I will opine on the California Nurses Association, the American Nurses Association and the Emergency Nurses Association in that order.

No mysteries here. ENA gives the most bang for the buck. We’ll look at why that is, and why the others do not.


Let’s start with the California Nurses Association. Or more specifically, the CNA/NNOC.

Somewhere along the line my state nursing professional organization turned into a national nurses organizing committee engaging in an ongoing, pardon my expression, pissing-match with the SEIU.

Every year I give over one-thousand dollars to the CNA/NNOC. I have no choice.

The good:

  • High salaries and good benefits
  • Legislation that has improved working conditions, nurse-patient ratios for example. Not that we have any semblance of that in my ER. Sorry, administrators-of-my-hospital, but we don’t. Glad to give you examples if you want ’em.
  • They are partnered with the Physicians for a National Health Plan, a single-payor plan I actually can get behind.
  • Backup to fight for ourselves and our patients. I don’t know why contract negotiations have to be so adversarial, but hospitals negotiate to the bottom line only. (Nice try, Sutter!) IMO, they put more into glossy ads than they do into nursing! You want stats to back that up? Ooops, just my opinion. Sorry.

The bad:

  • They support legislation I do not agree with. One example: they opposed parental notification of pregnancy/abortion for girls under 14. I opened my voter’s guide to see Rose Ann DeMoro’s name at the bottom of the opposition argument. Excuse me?
  • They fought like hell to stop the proposition that would have required unions to get members’ permission before spending their money on political measures. When I called to try and get my dues lowered so angry was I that I had to pay for this, I was told that my particular dues would be added to the “general fund” and used for salaries and overhead and not political purposes. This was good. Except I have no proof that this is what is happening.
  • They gave money to political candidates that I did not, and would not have, supported, including commercials I did not appreciate. I helped pay for those.
  • There is no way I can cease to be a member because membership is mandated at my place of employment.
  • There is no way I can be an “employment only” member, paying only for the cost of what it takes to represent me. I have to be a full member, paying full dues.

So, essentially, CNA/NNOC has me by the proverbial cohones by fighting for decent work environments, while giving me no voice or any chance to oppose their political activities.

The ugly:

  • For months, my daily mail delivery was an ongoing “battle of the junk mail” from CNA and SEIU bashing each other. How much did they pay for those glossy, fancy brochures?
  • I am really tired of seeing angry nurses on my CNA literature, or hearing about them breaking laws and police barriers to get a message to the governor (for example).

This is NOT the 1960s, folks. And we are professionals. We do not break laws.

You want to protest? Berkeley always has something going down.

A picket line? Fine. We need backup to fight for our patients.

A protest? Get Bob Dylan to write you an anthem.

Oh wait, he already did:

“You don’t need a weatherman to know which way the wind blows.”

And I don’t like the direction it’s blowing.

Too bad I have no power within my “professional organization” to “protest” when I disagree with them.

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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