Go Lean…Caribbean

So you love your community, but does the community love you back?!

This is the description of everyday life for nurses at local hospitals. The Coronavirus-COVID-19 is devastating communities; there is an urgent need for good First Responders. Doctors and Nurses are among those First Responders, and yet nurses seems to be under-appreciated.

Put your money where your mouth is. This has been their continued experience:

Low wages
Deficient supply of Personal Protection Equipment (PPE)

Are these First Responders “Essential or Sacrificial”?

I am NOT a nurse; I am only able to report what the nurses themselves are advocating. Here is that reporting & a related VIDEO production:

Title: Why some nurses have quit during the coronavirus pandemic
By: Safia Samee Ali, NBC News

For weeks, Kelly Stanton wasn’t sleeping. She lay in bed gripped with the anxiety of having to go to work at a Washington, D.C.-area hospital not knowing whether she might bring home the coronavirus to her husband and their three children.

It was inevitable, she thought. She wasn’t protected.

Stanton, a nurse for 28 years, had seen federal safety protocols for health care workers begin to crumble amid the pandemic by early March.

Guidelines from the Centers for Disease Control and Prevention regarding personal protective equipment, or PPE, changed consistently. At Stanton’s hospital, nurses were told that they would have limited access to an already low stockpile of protective equipment and were being asked to reuse single-use masks multiple times, she said.

“Never in my time as a nurse have I seen this,” she said. “It was a position I could never have imagined I’d be in, even in my wildest dreams.”

Each time a safety regulation changed, she said, she began to feel more like “a sheep sent to slaughter” than a front-line nurse, and she started agonizing between her job and her family.

By late March, the risks weighed too heavily, and Stanton submitted her resignation.

“It was an extremely difficult decision, but as a mother and wife, the health of my family will always come first,” she said. “In the end, I could not accept that I could be responsible for causing one of my family members to become severely ill or possibly die.”

As COVID-19 has infected more than 1 million Americans, nurses working on the front lines with little protective support have made the gut-wrenching decision to step away from their jobs, saying that they were ill-equipped and unable to fight the disease and that they feared for not only their own safety but also that of their families.

Many of these nurses, who have faced backlash for quitting, said new CDC protocols have made them feel expendable and have not kept their safety in mind, leaving them no choice but to walk away from a job they loved.

‘We’re not cannon fodder. We’re human beings.’

As the nation took stock of its dwindling medical supplies in the early days of the pandemic, CDC guidance regarding personal protective equipment quickly took a back seat.

Supplies of N95 masks, which had previously been the acceptable standard of protective care for both patients and medical personnel, were depleting, so commercial grade masks, surgical masks and, in the most extreme cases, homemade masks, such as scarves and bandannas, were all sanctioned by the CDC — which didn’t return a request for comment — to counter the lack of resources.

Nurses, among other health care workers, were expected to pivot and adapt with no evidence to the view that new guidelines would provide any significant protection from a novel and contagious disease.

“Things they were telling us we had to now do, you would’ve been fired if we did that three weeks before,” Stanton said. “How is this suddenly OK?”

There had been warning that a pandemic was coming, she said. “Hospital administrators, states and the federal government should have stockpiled PPEs. All three failed.”

COVID-19 patients had only slowly started trickling in, but Stanton could see where things would head. It was almost guaranteed that nurses would be at risk under those conditions, she said.

“We’re not cannon fodder. We’re human beings,” she said.

In many respects, nurses who have had to treat COVID-19 patients with little or no protection, especially in the early days of the pandemic, have become collateral damage.

Nearly 10,000 health care workers on the front lines, including nurses, have tested positive, according to a preliminary survey the CDC conducted from February to April.

Because data collection has been slow and not comprehensive and many people with COVID-19 have been asymptomatic, actual numbers are likely much higher.

At least 79 nurses have died from the coronavirus, the American Nurses Association, which has been independently tracking reports, said Thursday.

“There are huge ethical dilemmas that nurses are now facing,” said Liz Stokes, director of the American Nurses Association Center for Ethics and Human Rights.

“Just imagine having to make decisions every day on whether you’re going to fulfill your professional obligation to care for patients versus sacrificing your personal safety or even that of your family because you’re in a situation where you don’t have adequate resources.”

Nurses have a duty to their patients, but they also have a duty to themselves under the nursing code of ethics, Stokes said. Those are equal obligations, and if you feel morally torn, you have to make the decision that’s right for you, she said.

Stokes added that it’s also important to be thankful for the nurses who have decided to step away because they recognized that they weren’t in the best situation physically or mentally to provide care.

‘No, we didn’t sign up for this’

For Rebecca, a nurse in the Albuquerque, New Mexico, area who didn’t want her full name used for fear that she won’t be rehired, the writing was on the wall when she saw a member of her hospital management collect all N95 masks from her floor and lock them in a cabinet in early March, before the country went into full-blown crisis.

“It’s really demoralizing to see someone lock them up in front of you knowing that you might need one of those,” she said. “The whole scene was very symbolic of how all this was going to go down. And it was a bad sign for what’s to come.”

Rebecca, who has been a nurse for four years, said that communication and infrastructure began to break down fairly quickly and that nurses were expected to make terrible compromises.

Masks were rationed to one per week and sometimes shared. Only nurses who dealt with patients who tested positive for COVID-19 were given an extra N95 mask, even if the patient showed symptoms.

During one 16-hour shift, Rebecca was repeatedly in close contact with a patient who later tested positive — and she wasn’t wearing a mask.

“I knew it was something I could no longer handle,” she said. “I know my limitations.”

Rebecca quit in mid-April, one week after she tested negative for COVID-19 after exposure to the patient.

Since quitting, she has been sensitive to the criticism many nurses like her have faced for stepping away during a pandemic. That’s why many of them have kept their decisions private, she said.

It’s especially hurtful when she reads comments on social media that nurses shouldn’t raise complaints because they “signed up for this.”

“We didn’t sign up to be sacrificial lambs. We didn’t sign up to fight a deadly disease without adequate resources,” she said. “We’re told we’re soldiers. Well, you don’t send soldiers to war without a gun and expect them to do their job, but you are doing that to us.”

The sentiments have been shared by thousands of other nurses who feel they are also being put in dangerous environments.

Last month, the New York State Nurses Association, representing more than 3,000 nurses, filed three lawsuits against the New York State Health Department and two hospitals over the health and safety of nurses treating COVID-19 patients.

Among other things, the lawsuits call out the state for not providing appropriate protective equipment for nurses, not properly training nurses deployed from hospital units and not providing safe enough working conditions for high-risk employees.

While the Health Department declined to comment directly on the lawsuit, it did say it was “deeply grateful for the ongoing efforts of New York’s health care workers to reduce the spread of COVID-19 by testing people who may be infected and treating those who are most in need.”

Quitting has been on the minds of many nurses, said Cara Lunsford, a nurse who founded Holliblu, an online community for nurses.

According to a survey conducted by Holliblu, 62 percent of over 1,000 respondents said they are planning to quit either their jobs or the profession altogether.

“They didn’t sign up to go into work and be unprotected from an invisible enemy, and the pressure is really starting to mount for a lot of nurses,” Lunsford said.

This is an unprecedented time, and nurses weren’t trained to be soldiers or handle biological threats with little protection and resources, she said. And if they leave for their sanity or safety, they shouldn’t be treated as defectors.

Constantly being anointed a “hero” by the public also hasn’t helped the added pressure, Rebecca said. While it’s a nice gesture, it gives the connotation that you should be risking yourself without help and that if you don’t you’re a “coward.”

She added that several colleagues reached out to her about wanting to quit after she left but that many just don’t have the option.

“I’ve realized that I’m very fortunate that I had a choice,” she said. “A lot of nurses have student loans, car loans, and they are single parents. They can’t quit, and that bothers me, because they are being taken advantage of right now.”

‘It was one of the most difficult decisions of my life’

Kate, who didn’t want her full name used for privacy, quit her job at a Virginia hospital in April after she was pulled from her floor as a post-anesthesia care unit nurse and reassigned to critical care after only four hours of training.

Throughout her hospital, protective equipment was siphoned for COVID-19-positive patients, but with testing not fully widespread, she never knew whether someone was infected, and worse she, didn’t know whether she was bringing it home.

Kate would go directly to the attic and quarantine away from her husband and children after getting home from work. But the emotional toll was high, and she could no longer be away from her 1- and 3-year-old children.

She knew she had to walk away from her job.

While putting her family first has got her through the painful decision, she still feels tremendous guilt for leaving.

“It’s not just a job, it’s a calling, and to walk away from it is extremely difficult and painful.” she said. “I wish I could have stayed with my patients. It’s not like I didn’t want to be there.”

Had masks been available and pre-pandemic precautions preserved, “without a doubt I’d still be working,” Kate said.

Stokes, of the American Nurses Association, said: “One of the issues that we are trying to emphasize is that nurses must be supported in whatever decision they make, whether they take the risk or choose not to take the risk to protect families.

“It’s a heart-wrenching decision, and many nurses have expressed that they feel sadness and sorrow that they are leaving their colleagues and patients. It’s a difficult decision, and that in itself can be emotionally traumatic.”

Stokes believes the psychological consequences of putting nurses in these dilemmas will be profound and long-lasting. She predicts high levels of post-traumatic stress disorder and secondary trauma syndrome trailing the pandemic.

“Nurses were already burned out before, and this pandemic might push many of them completely out,” she said.

The mental health toll on medical workers was put into sobering perspective after New York City emergency room doctor Lorna Breen died by suicide. A hotline created by physicians to help doctors deal with the anxiety of combating the crisis said it averages up to 20 calls a day. Another hotline, For The Frontlines, has also been set up as a 24-hour resource for other health care and essential workers.

“I would anticipate increased apprehension possibly extending into anxiety or mood problems,” said Dr. Sheetal Marri, a psychiatrist, referring not only to nurses who continued to work but also to those who stepped back. “These effects will impact the way nurses and other health care professionals will deal with workplace health hazards even after this pandemic is over.”

Stanton said she would like to return to nursing but only once guidelines are restored and she can feel safe going to work again. While she is taking this time to focus on her family, she still misses her job.

“I loved being a nurse. You do it because you care, you want to help people,” she said. ” But right now, nurses don’t feel like heroes. We feel expendable.”

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

Source: Posted and retrieved May 10, 2020 from: https://news.yahoo.com/why-nurses-quit-during-coronavirus-104910947.html?.tsrc=notification-brknews

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VIDEO – Doctors and Nurses Reveal the Devastating Reality of COVID-19 – https://youtu.be/OVp2U2p4lmE

The Atlantic
Posted April 4, 2020 – Chaos. Fear. Dwindling stockpiles of equipment. Impossible choices. Patients dying alone. These are some of the things that health-care professionals describe facing while fighting the COVID-19 pandemic. Over the past week, we spoke with doctors, nurses, and physician assistants at some of the hardest-hit hospitals in the nation. In a new documentary from The Atlantic, they bring us into their devastating new reality.

Subscribe to The Atlantic on YouTube: http://bit.ly/subAtlanticYT

Don’t get it twisted, First Responders are dying, some have even committed suicide in this crisis.

This old adage seem apropos at this time:

Never kill yourself for people who would rather watch you die.

This commentary is manifesting a harsh reality: there are Crony-Capitalistic forces at play! Though only indirectly related, the designs of Big Pharma should not be ignored; this was conveyed in a previous commentary by the movement behind the 2013 book Go Lean…Caribbean:

Big Pharma or the Pharmaceutical industry, dictates standards of care in the field of medicine, more so than may be a best-practice. There is [the visual] of a familiar scene where pharmaceutical salesmen slip in the backdoor to visit doctors to showcase latest product lines … there are commission kick-backs [tied] in these arrangements.

As a result, treatments like Chemo-therapy cost $20,000+/month; and the War against Cancer is imperiled due to industry profit insistence.

So there are “Big Profits” in the medical industry, right?! Enough to go around so that everyone benefits, right? Nope; not at all; it becomes obvious very quickly that underlying to Crony-Capitalism is greed – more for them; less for you. In a previous Go Lean commentary, this attribute of Big Pharma was exposed:

Book Review – ‘Thimerosal: Let The Science Speak’
The King of Pop, Michael Jackson, released a song with the title: “They don’t really care about us”; he very well could have been talking about Big Pharma. In a previous blog/commentary, the pharmaceutical industry was assailed over one cancer drug, Gleevec. The commentary clearly depicted the perils of Crony-Capitalism.

Crony-Capitalism is not for the Greater Good. It is not good economics, good security nor good governance. These activities must be monitored and mitigated. [See the Michael  Jackson VIDEO of the song “They don’t care about us” in the link here.]

Accepting the truism of Crony-Capitalism in the medical industry, is there any doubt that nurses consider themselves undervalued by their employers and the overall community?

They have been treated as sacrificial, more so than essential.

This sends a Cautionary Warning to all those medical professionals in the Caribbean that may want to emigrate to the United States.

Stay home – “they do not really care about us”.

For those already in the US, lamenting the sad state of affairs, we urge:

Time to Go! We can readily reform and transform the Caribbean homeland with the lesser Crony-Capitalistic influences.

This was the consideration summary in many previous blog-commentaries:

• The grass is not greener on the other side.
• You’re just a stock on the shelf.
• Always an immigrant; never a settler – we can never catch up.

Consider this sample:

Essential or sacrificial … is a serious consideration for emigrant (overseas ) workers.

If a country shows little – or no – regards for their own people, imagine how much less they would show towards you, the alien-foreigner-worker?!

(There is the documented “bad” track record of American Cruise Lines treating their alien-foreign-workers with little regard – “modern-day-slavery”).

This “inconvenient truth” is related to a strong point conveyed in another previous Go Lean commentary about the immigrant workers who went to England – after World War II – only to find an unwelcoming society and unappreciated employers – their paychecks were likened to poverty wages. It is only apropos to Encore that original July 10, 2014 blog-commentary here-now:

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Go Lean Commentary – British public sector workers strike over ‘poverty pay’

The grass is not greener on the other side.
Go from being a big fish in a small pond, to a small fish in a big pond.

These expressions are relevant in considering the fate of so many Caribbean Diaspora that had fled their Caribbean homelands over the past decades to take residence in Great Britain. Many of them sought refuge as career civil servants; (one reason ^[a] was the acute racism and intolerance encountered in private enterprises). These ones are faced with the harsh reality that pay scales in the public sector have not kept pace with inflation; they are now at poverty level. See the news article here:

By: Tess Little (Editing by Stephen Addison)

LONDON (Reuters) – Hundreds of thousands of public sector workers including teachers, council workers and firefighters staged a 24-hour pay strike on Thursday in a stoppage that has prompted Prime Minister David Cameron to pledge a crackdown on union powers.

Protesters marched through the streets of many of Britain’s main cities in one of the biggest co-ordinated labour stoppages for three years.

Denouncing what they called “poverty pay,” they demanded an end to restrictions on wage rises that have been imposed by the government over the past four years in an effort to help reduce Britain’s huge budget deficit.

In London, demonstrators marched towards Trafalgar Square at midday, chanting “Low pay, no way, no slave labour” to the beat of a drum. A giant pair of inflatable scissors, carried by members of the National Union of Teachers (NUT), read “Education cuts never heal.”

Firefighter Simon Amos, 47, marched wearing his uniform behind a flashing fire engine parading members of the Fire Brigades Union (FBU). “The government [is] making us pay more for our pension for it to be worth the same, and making us work longer,” he said.

The biggest public sector union involved, Unison, said early reports showed the strike had led to 3,225 school closures with more than 1,000 others partially closed.

Refuse collectors, school support staff, cleaners, street sweepers, care workers, nursery assistants and social workers were joining the strike, it added.

Hot spots, it said, included the North East, Wales and East Midlands where most council offices had closed, while more than 60 picket lines have closed most services in Newcastle.

“It is a massive decision by local government and school support workers to sacrifice a day’s pay by going on strike, but today they are saying enough is enough,” said Unison General Secretary, Dave Prentis in a statement.

Britain’s coalition government has enforced a policy of pay restraint for public sector workers since coming to power in 2010, imposing a pay freeze until 2012 and then a one percent pay rise cap, resulting in a fall in income in real terms [compared to inflation].

The Cabinet Office played down the impact of the strike, saying that most schools in England and Wales were open and that fire services were operating throughout the country.

On Wednesday, Cameron told parliament he planned to limit unions’ powers to call strikes.

“How can it possibly be right for our children’s education to be disrupted by trade unions acting in this way” he said.

Tough new laws would be proposed in the Conservative manifesto for next year’s general election, he added.

These would include the introduction of a minimum threshold in the number of union members who need to take part in a strike ballot for it to be legal.

The manifesto could also back the introduction of a time limit on how long a vote in favour of industrial action would remain valid.

The NUT mandate for Thursday’s strike, for example, came from a 2012 strike ballot based on a turnout of just 27 percent, Cameron said.

The issue of minimum voting thresholds last arose three months ago when a strike by London Underground train drivers caused huge disruption in the capital, prompting Mayor Boris Johnson to demand that at least half of a union’s members should vote in favour for a strike to go ahead.
Source: Reuters News Service; retrieved 07/10/2014 from: http://news.yahoo.com/public-sector-workers-strike-over-poverty-pay-105040672.html

Frankly, the Caribbean Diaspora employed in the British public sector can now do better at home … in the Caribbean.

This is the assertion of the book Go Lean…Caribbean. That once the proposed empowerments are put in place, the Caribbean Diaspora should consider repatriating to their ancestral homelands.

Unfortunately for the Caribbean, this societal abandonment has continued, since the early days of the “Windrush Generation”^[a] right up to now. In a recent blog post, this commentary related analysis by the Inter-American Development Bank that the Caribbean endures a brain drain of 70% among the college educated population; (https://goleancaribbean.com/blog/?p=1433).

Change has now come to the Caribbean.

The book Go Lean…Caribbean serves as a roadmap for the introduction and implementation of the technocratic Caribbean Union Trade Federation (CU). This roadmap will spearhead the elevation of Caribbean society. The prime directives of the CU are presented as the following 3 statements:

• Optimization of the economic engines in order to grow the regional economy & create 2.2 million new jobs at home.
• Establishment of a security apparatus to protect the resultant economic engines.
• Improve Caribbean governance to support these engines.

The book posits that the improved conditions projected over the 5 years of the roadmap will neutralize the impetus for Caribbean citizens to flee, identified as “push and pull” factors. This point is stressed early in the book (Page 13) in the following pronouncements in the opening Declaration of Interdependence:

xix.   Whereas our legacy in recent times is one of societal abandonment, it is imperative that incentives and encouragement be put in place to first dissuade the human flight, and then entice and welcome the return of our Diaspora back to our shores. This repatriation should be effected with the appropriate guards so as not to imperil the lives and securities of the repatriated citizens or the communities they inhabit. The right of repatriation is to be extended to any natural born citizens despite any previous naturalization to foreign sovereignties.

xx.   Whereas the results of our decades of migration created a vibrant Diaspora in foreign lands, the Federation must organize interactions with this population into structured markets. Thus allowing foreign consumption of domestic products, services and media, which is a positive trade impact. These economic activities must not be exploited by others’ profiteering but rather harnessed by Federation resources for efficient repatriations.

This foregoing article highlights other issues that have been prominently addressed in the Go Lean book, namely that of the Civil Service and Labor Relations. There is the need for a professional staff in the Federal Civil Service. They require marketable benefits and compensation. There is also a role for Labor Unions to play in the elevation of Caribbean society. The Go Lean roadmap envisions an inclusionary attitude towards unions. The Go Lean community ethos is that of being partners with unions, not competitors. The book features specific tools and techniques that can enhance management-labor relationships.

These issues constitute heavy-lifting for the regional administration of the Caribbean:

• fostering best practices for federal civil service and labor unions,
• minimizing the brain drain, and
• facilitating repatriation to the homeland.

These issues cannot be glossed over or handled lightly; this is why the Go Lean book contains 370 pages of finite details for managing change in the region. The book contains the following sample of community ethos, strategies, tactics, implementations and advocacies to impact the Caribbean homeland:

Caribbean music icon Bob Marley advocated this same charter for the Caribbean Diaspora. He sang to “come in from the cold” in the opening song of his last album Uprisings in 1980. How “spot-on’ were his words in the following music/video:

Download the free e-Book of Go Lean … Caribbean – now!

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Appendix – Cited Reference
a: “There was plenty of work in post-war Britain and industries such as British Rail, the National Health Service and public transport recruited almost exclusively from Jamaica and Barbados”. Retrieved July 10, 2014 from: http://en.wikipedia.org/wiki/British_African-Caribbean_people#The_.22Windrush_generation.22