Adonis Diaries

Archive for December 17th, 2011

Daydream project: Restructuring medical  profession and health care providers systems

My daydreaming started by recollecting that nurses are the ones who took care of me, smiled to me, and had compassion to my predicament after each surgery: Surgeons spent less than a minute after their job was done, if they ever found it necessary or had time to visit their patients.  The entire health care system is fundamentally run by nurses, carried on the shoulders of nurses…Philippina nurses in the US (at least a decade ago).

Eduardo Galeano wrote this story: “It is 1984, in the prison of Lurigancho at Lima (Chili).  Luis Nino is inspecting the prison for the count of a human rights organization.  Luis is crossing sick prisoners, vomiting blood, agonizing, open wounds, with fever…Luis meets the chief medical staff and ask why the physicians are not making any routine health rounds…The physician replies: “We, physicians, intervene at the calls of nurses…”  And where are the nurses? The chief retorts: “The budget for the prison didn’t allocate funds for nurses…”

I got into thinking: “If I ever come into big money, or get in a position of power, I will take care of the nurses, better their standard of living, extending material values and dignity to their hard work, get engaged with Occupy Health Care protests…I will rent buildings close to hospitals and rent rooms very affordably to nurses, and let the nurses run the building…and installing a modern facility in the building for continuing education and providing vans and affordable transport system for the nurses who can barely make ends meet…”

My ideas went wild and I got into thinking: “The entire medical system and health care providers need restructuring in order for nurses to receiving their fair share in the gratitude of patients and return on the huge profit and…”

I saved the post as a draft, with the intention to publish as my daydreaming project is complete, and then I said: “This project is hardly ever going to be complete. Publish whatever you have and let readers be inspired and finish it for you…”

The project is not meant to abolish current health institutions, medical schools and health services, but to establish an alternative system, funded by States until the new alternative institutions start generating followers and fund-raisers and…

The idea is that students in all medical fields (nurse, dietetics, massage provider, biologist, veterinarian, dentist, Red Cross volunteer, hospital administration, hospital manager, pharmacist, psychologist, psychiatrist, medical students, Ergonomics designers, medical equipment designers and operators…) share nursing practices in the first couple of years, get paid from year one, and are of practical service to the communities, particularly in rural areas, poorer districts, and in time of catastrophic events.

The University program and curriculum are reviewed so that practical initiations with patients and health institutions are offered in tandem with theoretical and general knowledge are focused on.

All students enrolled in one of the medical fields mentioned above have to learn and work as nurses for the first two years, and earn their living.

Year One:  Medical students, in all fields mentioned above, work in hospital and learn to deliver first aides services (like Red Cross volunteer courses), communicate with patients, get initiated with hospital administration and procedures…

Practical initiation: trauma cases, drug cases, vaccination procedures, types of contagious diseases, curable diseases

Formal courses: Physiology, musculo-skeletal disorders, introduction to Human Factors issues, heath and safety in hospital and workplaces, experimental design, statistical analysis…

Year Two: Medical students learn to be exposed to surgery room practices and procedures, anesthesiology room, pharmacy section, and hospital administration…

Practical initiation: blood testing procedures, urine testing procedures, tropical diseases diagnostics, injection, administering medication,

Formal courses in Anatomy, designing surveys and collecting data, analysing and interpreting peer-reviewed scientific research and sorting out valid experiments, introduction to pharmacology,…

Year Three: Students targeting fields in (medical equipment design and operation, hospital management and administration, dietetics, massage provider, biologist, and psychology) part from the other students into specialized universities and sections.

The remaining students get skills in small skin surgery, dialysis procedures, intensive care units, hard to cure diseases…Formal course in neurology, in-depth reading of peer-review scientific research articles, designing and performing controlled experiments,…

In year four, the students in the medical fields part ways.  Except for the general physician practitioners, dentists, pharmacists, psychoanalysts, the other students should be ready to graduate in their preferred subject of interest.  At worse, a couple of courses might be needed to achieve their requirements.

Rationales for this alternative system:

1. The “psychological” divide between physicians and nurses is “physically and mentally” reduced

2. Physicians will be readier to empathize with patients

3. Physicians will be initiated with the “physical understanding” of the job of nurses, and will feel readier to support nurses demands and syndicates for continuing education and resume the study to becoming full-fledged physicians…

4. Communities will enjoy a much larger pool of health providers in the events of catastrophes, war, economic downturn…

5. Earning a living from year one and feeling confident as a valued citizen

6. Efficient interactions and interrelations among health institutions

7. Nurses playing vaster roles as communicators and transmitters link among patients and specialized physicians, particularly for remote patients, neglected patients in residences, uncovered patients with any health insurance…

8.  How about you forward me with all your rationales, suggestions, and developed comments?

Note: It is becoming evident that modern schooling system is principally a big detention center for the youth in order to keeping them “away from the streets”.  Kids do not need 13 years of formal schooling before going to universities or learning practical skills and talents to earning a living by the age of 15. It is not knowledge that they are learning, but regurgitation of consensus information.

Reflective learning and self-learning are not appreciated on the ground that kids are not “ready to discuss, ponder and ask the right questions…”  Kids have to earn a living from skilled maintenance professions before considering higher education in fields of their interests…

In general, in almost every society, you have about 15% of the population deemed unnecessary for producing and contributing to the development of the” system”: They are confined in ghetto quarters to fend for their survival and are basically the ones incarcerated in order to show “statistically” that the police force is doing its job…

Intelligence Quotient IQ test: Is it valid, unbiased, ethical, accountable…? Occupy IQ revolt in New York State school principals

I recommend reading this link prior to resuming the current article on Intelligence Quotient (IQ) https://adonis49.wordpress.com/2011/01/13/low-iq-prisoner-studied-and-raised-the-score-found-eligible-to-death-row/

A member of the school board of one of the largest school systems in America voluntarily submitted to an IQ test for 10th  graders.  He said:

“I won’t beat around the bush. The math section had 60 questions. I knew the answers to none of them, but managed to guess ten out of the 60 correctly. On the reading test, I got 62% . In our system, that’s a “D”, and would get me a mandatory assignment to a double block of reading instruction. It seems to me something is seriously wrong. I have a bachelor of science degree, two masters degrees, and 15 credit hours toward a doctorate.

“I help oversee an organization with 22,000 employees and a $3 billion operations and capital budget, and am able to make sense of complex data related to those responsibilities.  I have a wide circle of friends in various professions. Since taking the test, I’ve detailed its contents as best I can to many of them, particularly the math section, which does more than its share of shoving students in our system out of school and on to the street. Not a single one of them said that the math I described was necessary in their profession.

“It might be argued that I’ve been out of school too long, that if I’d actually been in the 10th grade prior to taking the test, the material would have been fresh. But doesn’t that miss the point? A test that can determine a student’s future life chances should surely relate in some practical way to the requirements of life. I can’t see how that could possibly be true of the test I took.”

“If I’d been required to take those two tests when I was a 10th grader, my life would almost certainly have been very different. I’d have been told I wasn’t ‘college material,’ would probably have believed it, and looked for work appropriate for the level of ability that the test said I had.

“It makes no sense to me that a test with the potential for shaping a student’s entire future has so little apparent relevance to adult, real-world functioning. Who decided the kind of questions and their level of difficulty? Using what criteria? To whom did they have to defend their decisions? As subject-matter specialists, how qualified were they to make general judgments about the needs of this State’s children in a future they can’t possibly predict? Who set the pass-fail “cut score”? How?”

“I can’t escape the conclusion that decisions about the [State test] in particular, and standardized tests in general, are being made by individuals who lack perspective and aren’t really accountable.  I can’t escape the conclusion that those of us who are expected to follow through on decisions that have been made for us are doing something ethically questionable.”

Marion Brady, a veteran teacher, administrator, curriculum designer and author wrote:

“A longtime friend on the school board of one of the largest school systems in America did something that few public servants are willing to do. He took versions of his State’s high-stakes standardized math and reading tests for 10th graders, and said he’d make his scores public.

By any reasonable measure, my friend is a success. His now-grown kids are well-educated. He has a big house in a good part of town. Paid-for condo in the Caribbean. Influential friends. Lots of frequent flyer miles. Enough time of his own to give serious attention to his school board responsibilities. The margins of his electoral wins and his good relationships with administrators and teachers testify to his openness to dialogue and willingness to listen.

He called me the morning he took the test to say he was sure he hadn’t done well, but had to wait for the results. A couple of days ago, realizing that local school board members don’t seem to be playing much of a role in the current “reform” brouhaha, I asked him what he now thought about the tests he’d taken. (Read the answer in the beginning section above)

A concise summary of what’s wrong with present corporate driven education change: Decisions are being made by individuals who lack perspective and aren’t really accountable.  Those decisions are shaped not by knowledge or understanding of educating, but by ideology, politics, hubris, greed, ignorance, the conventional wisdom, and various combinations thereof. And then they’re sold to the public by the rich and powerful.

All that without so much as a pilot program to see if their simplistic, worn-out ideas work, and without a single procedure in place that imposes on them what they demand of teachers:  Accountability.

As I write, a New York Times story by Michael Winerip makes my day. The stupidity of the current test-based thrust of reform has triggered the first revolt of school principals.

Winerip writes: “As of last night, 658 principals around the State of New York had signed a letter — 488 of them from Long Island, where the insurrection began — protesting the use of students’ test scores to evaluate teachers’ and principals’ performance.”

One of those school principals, Winerip says, is Bernard Kaplan. Kaplan runs one of the highest-achieving schools in the State, but is required to attend 10 training sessions.  Kaplan said: “It’s education by humiliation. I’ve never seen teachers and principals so degraded.”  Carol Burris, named the 2010 Educator of the Year by the School Administrators Association of New York State, has to attend those 10 training sessions.

Katie Zahedi, another principal, attended the sessions ans said:  “Two days of total nonsense. I have a Ph.D., I’m in a school every day, and some consultant is supposed to be teaching me to do evaluations.”  A fourth principal, Mario Fernandez, called the evaluation process a product of “ludicrous, shallow thinking. They’re expecting a tornado to go through a junkyard and have a brand new Mercedes pop up.”

What they’re being made to do isn’t ethically questionable. It’s ethically unacceptable. Ethically reprehensible. Ethically indefensible.

How many of the approximately 100,000 school principals in the U.S. would join the revolt if their ethical principles trumped their fears of retribution? Why haven’t they been asked?

QUIZ: How would you do on this same test taken by a school board member? Find out: Reading Quiz | Math Quiz. Questions come from the Florida Comprehensive Assessment Test (FCAT) for 10th grade. Or try your hand at questions from the National Assessment of Education Progress for fourth and eighth graders.

Follow The Answer Sheet every day by bookmarking http://www.washingtonpost.com/blogs/answer-sheet. And for admissions advice, college news and links to campus papers, please check out our Higher Education page. Bookmark it!


adonis49

adonis49

adonis49

December 2011
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