Friday, May 28, 2010

Change of Shift at "The Makings of a Nurse"

The latest edition of Change of Shift is now up at blog called "The Makings of Nurse". After a hiatus, I actually managed to submit a blog post for this edition, and I look forward to hosting Change of Shift myself at the end of June.

Saturday, May 22, 2010

MCS and the Search for a Safe Community

As some readers of Digital Doorway may know, my wife and I have been traveling in our mobile home for the last seven months, writing about our experiences on our travel blog.

In honor of MCS Awareness Month, we are posting this co-written article in order to share more deeply regarding one of the most significant reasons that we undertook our current journey around the country. Because we both live with Multiple Chemical Sensitivity (MCS), finding a safe place to call home is paramount to us, and those who have MCS understand what it's like to live like a "canary in the coal mine" in a world saturated with substances that undermine our health and impair our ability to function effectively.

With recent reports showing that even ADHD may be linked to pesticide use, there is a crucial necessity for us to be more public about our MCS, our search for safe housing, and the need for greater awareness about the effects of chemicals, pesticides, and manufactured fragrances on the health of humans and the environment. That said, many hospitals and other health care facilities are now becoming fragrance-free in an effort to support the health of patients, thus awareness is indeed growing about this important public (and personal) health issue.

We offer this article as a missive of support and hope to other canaries, as well as a plea to those without MCS---especially intentional communities---to more deeply understand our plight.

---Mary Rives and Keith Carlson
When it comes to finding safe housing, everyone with Multiple Chemical Sensitivity (MCS) will agree that this is one of the most daunting challenges of living with this most highly inconvenient and disheartening medical condition.

After living in New England for 20 years and becoming chemically injured in the process (most likely due to hidden mold in our home), it was no longer safe for us to live in our beloved neighborhood or continue to work in our meaningful jobs.

Our lovely arboreal homeowners’ association provided what at first appeared to be a healthy sanctuary for our family of three, but our blissful existence was often impeded by the imposition of a variety of common household toxins, including the fumes of lighter fluid, charcoal, dryer sheets, and lawnmower and vehicle exhaust. Lying in hammocks or eating home-cooked meals on our custom-made screened-in porch, we were often driven indoors by clouds of the aforementioned toxins filtering through the forest and onto our property.

When exposed to various chemicals and environmental toxins, we each experience a similar yet somewhat different constellation of symptoms, including headache, confusion, sore throat, irritability, asthma, hives, joint pain, muscle pain, and burning eyes. When mold was discovered in our attic after our house was put on the market, the potential culprit of our mutual MCS only added to our intense desire and need for a safe refuge.

In our workplaces which had fragrance-free policies, we were both exposed to environmental insults that exacerbated our condition and underscored the need to radically change our lives. Policies are virtually ineffective without enforcement, often driving wedges between people of varying cultures and levels of acceptance, support and awareness. The commitment to educating others can be exhausting, and workplace exposures impair job performance and strain professional relationships. Thus, we canaries often find ourselves frequently leaving otherwise satisfying and meaningful jobs in order to preserve our health and sanity.

Having lived in an intentional community early in our relationship, we decided that ecologically-minded intentional communities with a focus and commitment to sustainability would offer the greatest potential for finding a safe home. We hoped that this form of community would use earth-friendly, biodegradable and non-toxic products in keeping with that vision of sustainable living, and provide for us a safe place to live our lives in peace and health.

Hitting the proverbial road in a 29-foot mobile home, we began to scour the country for an intentional community or eco-village that offered an opportunity for healthy living. Traversing the East Coast, Deep South, Gulf Coast and Southwestern United States, we visited over two-dozen intentional communities in more than twenty states over the course of seven months.

Many of these communities profess to live close to the earth by using sustainable building and permaculture techniques, renewable energy sources, organic gardening, and other well-meaning practices. In our naivete, we did indeed assume that “sustainable living” would include the use of earth-friendly and non-toxic products, but we’ve sadly found that many such communities simply reach for the cheapest common denominator, with Tide, Bounce, Palmolive, Cascade and other products being the easy mainstream fix.

Our disappointment and disillusionment were great when many visits to such communities revealed that people were often unwilling to “walk the talk” when it came to using safe and healthy products. As to the issue of being fragrance-free and MCS-friendly, most communities appeared oblivious at best, much to our dismay.

Earthaven Ecovillage in Asheville, North Carolina, Sunflower River Community in Albuquerque, New Mexico and The Commons on the Alameda Cohousing Community in Santa Fe, New Mexico are the three communities that we have found in our travels to best embody earth-friendliness and consideration for those living with MCS.

While people at Earthaven do indeed burn a great deal of wood for winter heat and state that they are not well-equipped to have people with severe MCS join them, many of the residents appear to embrace true sustainability. Sunflower River has no openings for new members at this time but they are a growing community that truly walks their talk. Twins Oaks and Acorn communities in Southern Virginia are runners up, but they use lavender scented natural detergent which neither of us can tolerate without becoming symptomatic.

Although the numbers are few (and we have only visited a fraction of the intentional communities in the United States), we are grateful to have found a few that seem to understand how important it is to use biodegradable products that are healthy and earth-friendly. And of these few, the Commons on the Alameda is the only one who uses all fragrance-free products!

The Commons on the Alameda Cohousing Community in Santa Fe is a relatively MCS-friendly community that has adopted a relatively strict fragrance-free policy in an effort to create a safe haven for residents with environmental illness. A handful of "canaries" live at The Commons at any given time, but some have found it less than ideal on some levels, environmentally speaking. Championed by a medical doctor specializing in environmental medicine who lives at the community, the shared spaces at The Commons are for all intents and purposes fragrance-free, and guests and residents are urged to comply with the policies. We are actually planning to live at The Commons this summer in order to test the waters and see how their experiment in MCS-friendly community is going, bringing with us great hopes that we will find it to be a safe haven where we can, at long last, feel comfortable and at peace.

For canaries considering looking into intentional community as a possible source of safe housing, we would like to warn those with MCS that even eco-villages and communities that espouse sustainable living as a way of life so often overlook the very products that people put on their bodies, into the water, and onto the ground. As many of us already know, mainstream products are often cheap, readily accessible, and have brand recognition that even the most alternative individuals cannot resist. The tendency (can we even say addiction?) to purchase such products is rampant, and even those who live in intentional communities often choose to drive to Wal-Mart and buy whatever cleaning products are on sale. We understand that communitarians also have to make ends meet, but when one’s habits as a consumer fly in the face of one’s proclaimed ecological lifestyle, questions are raised as to whether that community or individual is truly thinking clearly about their choices as a consumer and their commitment to the earth (and their health).

Based on our research and experience thus far, our conclusion is that intentional communities are not a safe bet for those with MCS and environmental illnesses, and the learning curve remains steep even for those who claim to be living a sustainable and healthy lifestyle.

Meanwhile, many of our fellow canaries live with severe MCS which prevents them from exploratory adventures like the one we've undertaken. They are unable to risk the dangers--and expenses--of the unknown, despite the fact that they have so much to contribute. Living with MCS sadly often necessitates social isolation in order to minimize symptoms which only worsen with subsequent exposures to the most basic of chemicals. Adding to the isolation are the common financial hardships caused by the medical need to let go of jobs in toxic work places. Employees with MCS are also frequently discriminated against by employers who are unwilling to make reasonable accommodations, despite the fact that MCS is recognized as a disability by the Americans with Disabilities Act.

Having MCS inconveniently interrupted our careers and engendered enormous out-of-pocket medical expenses in order to prevent our illness from worsening. Even with good health insurance, access to treatment has been very expensive and limited, and the fact that the AMA refuses to recognize MCS as a physiological illness makes finding sympathetic medical providers an additional challenge. Avoidance is the best medicine, thus our radical lifestyle change and quest for safe community living.
Our hope for the future is that more and more intentional communities will realize the importance of the need for safe housing, including across-the-board use of fragrance-free, environmentally friendly products. May they become safe havens for canaries of the coal-mine while taking their commitment to the earth and her inhabitants even further. Meanwhile, perhaps a few MCS communities will even be born from our collective desire for a safe place to rest our weary heads!

We remain hopeful that we will find a place to call home for the long-term where we can live safely and in better health. We also remain realistic that uphill battles and further education will be needed for those with whom we share living and breathing space, perhaps for the rest of our lives. For now, the two of us will continue to explore whether intentional community will fit the bill when it comes to healthy living as we land in our temporary nest with great hopes for a healthy future for all.
(For more information about MCS, please visit The Canary Report.)

Friday, May 21, 2010

Nurses on the Run

Recently, I was honored to have two chapters published in Nurses on the Run: Why They Come, Why They Stay, a new collection of nurses' stories edited and compiled by Karen Buley, RN, BSN and published by Dog Ear Books. Nurses on the Run is available on Amazon, and is also now listed on Google Books. If you happen to purchase a copy, please consider posting a review on Google Books.

My thanks again to Karen for including me in this exciting project, and please consider ordering a copy or asking your local library to do so!

Sunday, May 16, 2010

New York City Is Now a Home Birth Backwater

After the closing of St. Vincent's Hospital in New York City on April 3oth, the thirteen midwives who have provided home births to women choosing this option in this city of 8 million people can no longer do so legally. New York law requires that midwives have an obstetrician or hospital as backup when providing home birth services, and the American College of Obstetricians and Gynecologists has stridently opposed home midwifery and home births for years, discouraging their members from supporting or providing medical coverage for midwives.

With one third of all pregnancies in the United States now ending in Caesarean Section, many midwives and supporters of natural childbirth feel that birth has become yet another cash cow for the American medical industry, with home birth becoming more rare (and less legal) as the decades pass. Some American cities and towns have even made public breastfeeding a crime, adding further insult to injury for women who choose natural childbirth and breastfeeding as a lifestyle choice in the interest of the health and well-being of their baby.

Despite the fact that home birth and midwifery are quite popular in other industrialized nations with advanced medical infrastructures (30% of babies in the Netherlands are born at home), the United States medical establishment still vilifies home birth as foolish and dangerous. In fact, the US has one of the highest rates of maternal mortality in the industrialized world (16.7 per 100,000 live births) as compared to The Netherlands' maternal mortality rate of 7.6% or Italy's rate of 3.9%. Amnesty International has even called the United States' childbirth track record "a human rights crisis".

With the current situation in New York City, home births are now illegal and midwives providing maternal care in the home do so at their own risk and without legal or medical support. As one of the most famous and progressive cities on earth, New York City has now become a home birth backwater, creating a crisis for the midwives and families who choose this natural alternative to the American medical industry's industrialization of childbirth.

Thursday, May 13, 2010

Everyone's Going to Nursing School

Just today I learned that one of my cousins is getting ready to enter nursing school. With three aunts who were nurses (one of whom served with General Patton during World War II), there is certainly a precedent in our family for some of us to pursue a career in nursing, and a laudable precedent at that. My cousin is yet another person realizing the potential economic benefits of being a nurse at a time when many Americans are searching for a new recession-proof career.

As older nurses continue to retire and the Baby Boomers enter their golden years, the demand for nurses certainly seems to continue unabated. Recent reports, however, indicate that a strained economy is forcing many nurses who used to enjoy part-time or per diem work back into full-time positions, making competition for jobs more challenging for new nurses entering the field. And with nursing schools overwhelmed with applicants and short on professors to teach those fledgling nurses, many would-be nursing students may turn to other allied health professions like Occupational, Physical, or Speech Therapy.

A recent article published in the South Florida Business Journal cites a new study by The Florida Center for Nursing which concludes that attrition from the nursing profession is far greater than the influx of new nurses. For example, in the last two years, the number of nurses in Florida increased by 27,000, however more than 50% of that gain was offset by nurses leaving the field, making the net gain of nurses around 11,000.

With more than 3 million registered nurses in the United States at this time, it's clear that the profession is still holding its own as one of the backbones of the health care industry. Still, with a shortage of qualified professors due to a large wave of retirements and few willing to replace them due to better salaries for clinical positions, all signs indicate that the overall shortage of nurses will continue to plague the United States---and most of the world---for some time to come.

In my view, geriatrics and long term care are sure bets for future nursing job opportunities, and those who are willing to pursue an advanced degree as Nurse Practitioners specializing in geriatrics will likely be readily employable in most regions of the country, especially those areas most popular with retirees.

I am thrilled that my cousin is pursuing the family legacy of a nursing career, and I pray that she will be accepted to the school of her choice and be readily employed upon her graduation. Still, one must be realistic that the calculus of the nursing shortage and the opportunities for employment have indeed changed since the days when new grads waltzed into jobs demanding any salary they pleased. Despite the shortage, competition for jobs is stiff, and the competition to get into nursing school equally as difficult.

For myself, having taken almost a year off for travel and writing, I am readying myself to look for a job in the Santa Fe area where my wife and I plan to spend the summer, if not the next year. While I may be fluent in Spanish and have a relatively impressive resume (home health, community health, hospice, and public health), I have never worked in a hospital and thus am somewhat limited in the type of nursing jobs I can pursue. I do not anticipate finding work to be overly challenging, but in the current climate, I realize that it may not be as simple as it once may have been. And with new grads flooding the market and willing to work for less than seasoned nurses accustomed to higher wages, perhaps finding the perfect part-time nursing job may be more challenging than I originally anticipated.

There's no question that nurses are highly trusted professionals who are sorely needed by an aging population. But in the current economic climate, can enough well-paying jobs be created for the seasoned nurses and new grads who are more than willing to don their scrubs and get to work? Only time---and economic forces---will tell.

Monday, May 10, 2010

Some Notes During Nurses Week

With Nurses Week happening this week, there is a great deal being written and said about nurses in the media. We are indeed one of the backbones of the medical establishment, and while Nurses Week is often glossed over with trinkets, flowers, Hallmark cards and other ephemera, it is indeed helpful to be appreciated and acknowledged from time to time.


During Nurses Week, Dr. Dean over at The Millionaire Nurse Blog is running a 100% anonymous survey with the goal of gathering data on nurses' salaries, investment habits and savings habits in order to help him develop products and services to benefit nurses financially. You can take the survey by clicking here. Everyone who completes the survey will be entered in a drawing for several prizes, so why not give it a try?


Also, coinciding with the 100th anniversary of Florence Nightingale's death, Black Dog Publishing is releasing Nurse: Past, Present and Future---The Making of Modern Nursing, edited by Kate Trant and Susan Usher. This new book examines the evolution of nursing internationally, and readers of Digital Doorway have been offered 40% off the purchase price. If you would like to take advantage of the offer, please email and mention Digital Doorway, or simply email me directly.

Here is a description of the book from their website:

Nurse: Past, Present and Future: The Making of Modern Nursing examines the culture of nursing on all levels, from its historical development to its status today. The book highlights the power and value of nurses worldwide, and traces the evolution of nursing as a career.

Nurse: Past, Present and Future discusses the importance of nursing to economics across the world, the impact of nurse migration patterns. The book traces the evolution of the nurse’s social standing, appearance, education and skill set, and examines some of the key debates now underway. These are put into context with a look at how nursing has progressed through the twentieth century in response to changes in medicine and society.

Includes essays from key figures in nursing and first hand accounts from nurses working today. Thoroughly illustrated, comprehensive and global in scope, Nurse is the first book of its kind, dedicated to the past, present and future of the culture of nursing.


Happy Nurses Week to all, and remember that every patient deserves a nurse!

Sunday, May 02, 2010

101 Blost Posts Every Nurse Should Read

On the blog known as "Online Nurse Practitioner Schools", a new post entitled "101 Blog Posts Every Nurse Should Read" is now published and available. I am humbled that my post, "The Nurse As Sisyphus", is included as #4 on the list. My gratitude to the publishers for this honor.