"Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care," na Suzanne Gordon, Cornell University Press, 450 ʻaoʻao.
Nā kahu hānai. Nā kahu hānai. Nā kahu hānai. Ua hōʻoiaʻiʻo wau e ʻoi aku ka nui o ka poʻe e ʻike i kēia ʻatikala ma ka pūnaewele e ʻimi nei i nā kiʻi ponokala ma mua o ka poʻe e ʻimi nei i nā pane i kā mākou pilikia mālama olakino a i ʻole nā ʻike i kekahi o nā ʻoihana koi nui loa.
Ma waho aʻe o nā moemoeā moe kolohe, ʻo kā mākou kiʻi maʻamau o kahi kahu hānai he ʻānela. ʻO nā hoʻolaha o ka haukapila e hoʻopaʻa i nā kahu hānai hou e hōʻike ana iā lākou me nā ʻēheu. Hōʻike ʻia kā lākou hana me ka mālama a me ke aloha. ʻAʻole i ʻōlelo ʻia ʻo Skill, ʻike ʻia ka ʻike olakino, mālama ola a mālama ʻia ka ʻike a me ka ʻike.
ʻAʻole ʻike ʻia nā mea a nā kahu hānai iā mākou, ʻo nā mea maʻi, a me nā kahu hānai ponoʻī. Manaʻo mākou e pili ana i nā stereotypes o ke kenekulia 19. Ke kiʻi nei mākou i nā kahu hānai i nā pāpale i ʻaʻahu ʻole ʻia e kahi kahu hānai ola. Manaʻo mākou iā lākou he mau kōkua kanaka akamai ʻole i nā kauka e hana nei i nā manaʻo ʻepekema āpau. Manaʻo mākou he mau kahu hānai wale nō nā wahine - a ʻo nā wahine wale nō i nele i ka naʻauao a me ka makemake. ʻO ke kahu kahu, e like me ke kumu, ʻo ia ka lua o ka ʻoihana maikaʻi loa – no ka mea ʻaʻole ka holomua o ka ʻike ʻepekema kāna pahuhopu. Mai noʻonoʻo e hāʻawi nui nā kahu hānai e like me nā kauka i ka ʻike olakino a i ʻole he mau kumu i ʻoi aku ka hanohano o ke ola ma mua o ka hōʻiliʻili ʻana o ka ʻike.
ʻO ka puke a Gordon he hōʻike akamai a me ka nānā ʻana i kahi ʻoihana a mākou i ʻike ʻole ai, a ʻaʻole maopopo i nā hui mālama ola. Ma kēia ʻāina, hana nui nā kahu hānai i nā hana a nā kauka i kekahi mau ʻāina. Ke nānā mau nei lākou a me ka hōʻoia. 'Ōlelo pinepine lākou i nā hua'ōlelo e hāʻawi ana i ka mahalo i nā kauka no kā lākou hana, akā inā e kali mau nā kahu hānai i nā kauka e kālailai i ka ʻikepili maka a lākou e hōʻiliʻili ai, nui nā ola e nalowale. ʻO ke komo ʻana i kahi haukapila i hana maoli e like me ia e lawe i kahi pilikia nui i nā maʻi ma mua o ke komo ʻana i kahi kahua kaua.
Pehea ka mākaukau o kāu kauka, ʻo ka noho ʻana i kahi haukapila me ka ʻole o nā kahu hānai mākaukau ma nā kula e pili ana i kou maʻi ʻo ia ka pilikia nui i kou olakino. Pēlā nō ka noho ʻana ma kahi haukapila kahi e ʻae ʻole ai nā kauka e hoʻolohe i nā kahu hānai. ʻO nā moʻolelo a Gordon i haʻi aku ai no ka mālama ʻole ʻia ʻana o nā ʻōlelo aʻo a nā kahu hānai, a ʻo ka make pono ʻole ka hopena, he mea ʻeha a hoʻonāukiuki. ʻOiaʻiʻo, pono mākou e ʻoi aku ma mua o ia ʻano haʻaheo liʻiliʻi a me nā ʻokoʻa papa ma kahi ʻoihana i hoʻokumu ʻia e like me ka mālama olakino. ʻIke ʻia ʻaʻole mākou. Hāʻawi ʻo Gordon i ka hapa nui o nā ʻaoʻao 150 mua o kāna puke i nā pilina pili ʻole i ko mākou mau haukapila.
Hāʻawi ʻo ia i nā ʻaoʻao 75 e hiki mai ana i ka hōʻike ʻana o nā kahu hānai. ʻIke ʻo ia i ka hana a nā kahu hānai ʻaʻole i haʻi ʻia a ʻaʻole i haʻi ʻia nā kahu hānai ma ka pāpā e pili ana i nā pilikia olakino. Hōʻike ʻia nā kahu hānai ma ka nūhou i ka wā i nele loa lākou a me ka hoʻoikaika ʻana e kiʻi iā lākou, a i ʻole i ka wā e hoʻopaʻa ʻia ai lākou, a i ʻole ke aʻo ʻia ke kahu no ka make ʻana o ka maʻi. Hāʻawi ʻo Gordon i kekahi o ka hewa no kēia kūlana i nā kahu hānai. Peʻe lākou mai ka pāpā a me nā maʻi. ʻAʻole makemake pinepine lākou e hōʻike i kekahi i ko lākou inoa hope. Ma mua o ke komo ʻana i nā lole ʻoihana me nā inoa inoa a hoʻolauna iā lākou iho ʻo Nurse Smith a i ʻole Nurse Taylor, ʻaʻahu pinepine lākou i nā pajamas cutesie a kapa iā lākou iho ʻo Kimmy a i ʻole Nancy. Loaʻa iā lākou ka ʻike lapaʻau nui, akā ke hālāwai ʻoe me lākou ʻaʻole hiki iā ʻoe ke maopopo he kahu hānai lākou.
I kou hiki ʻana i ka ʻaoʻao 227 o ka puke a Gordon, loaʻa iā ʻoe kahi kiʻi pilikia loa o ka hānai. Me he mea la ua maopopo loa na kumu no ka hemahema o na kahu; Ke haohao wale nei ʻoe no ke aha i ʻoi aku ka koʻikoʻi. ʻO wai ka mea makemake e hana i kahi ʻoihana mahalo ʻole i loaʻa ka hewa, akā ʻaʻole e hōʻaiʻē ʻia, kahi mea maʻamau ka ʻōlelo a me ke kino a nā kauka, kahi e hui pū ʻia ai ka hana pelapela a me ka puʻuwai me ke koʻikoʻi a me ke koʻikoʻi, a me nā hana weliweli e like me ka hāpai ʻana. Ua hānai maikaʻi ʻia nā ʻAmelika mai nā papa ʻaina? No ke aha e hoʻomaʻamaʻa manawaleʻa a hoʻopaʻa ʻia e hana i kahi ʻoihana me ka nui o nā hōʻeha, koi ikaika no ka noʻonoʻo ʻana, a me kahi ʻano ʻano like ʻole o ke ao holoʻokoʻa o ka hoʻohaʻahaʻa, ʻoiai ma ke ʻano o ka mahalo i kou ʻoluʻolu a me ke aloha?
ʻO nā ʻaoʻao 223 aʻe e hōʻike ana i ke kūlana he 100 mau manawa ʻino. ʻO kēia ka moʻolelo o ka haukapila "hoʻoponopono." No ka loaʻa ʻole o nā mākau koʻikoʻi o nā kahu hānai, ʻike nā mea helu pīni HMO i ka loaʻa ʻana o ke kumukūʻai inā e ʻoki lākou i nā kahu hānai a hoʻololi hou iā lākou, e hoʻohuli iā lākou a puni mai kēia ʻēheu o ka haukapila a hiki i kēlā e like me ka mea e pono ai. Mai noʻonoʻo ʻole ʻaʻohe hoʻonaʻauao o kekahi o lākou ma kahi i hāʻawi ʻia iā lākou i kekahi lā. Mai noʻonoʻo ʻaʻole hiki i nā kahu hānai ʻewalu i nā lā ʻewalu ke nānā i ka loli ʻana o ke kūlana o ka mea maʻi e like me ke ʻano o ke kahu. ʻO ka mea nui ka mālama kālā. E kiʻi i nā poʻe maʻi ma hope a hoʻihoʻi koke iā lākou i ka home. Hāʻawi i kēlā me kēia kahu i nā maʻi hou aʻe i ka manawa, a mai noʻonoʻo ʻoe he maʻi koʻikoʻi nā mea maʻi a pau, ʻoiai ʻo ka hana a ke kahu hānai i hoʻokomo ʻia i kekahi mau maʻi e ola ana a nele i ke kōkua ʻuʻuku.
ʻO kaʻoiaʻiʻo, ʻo ka hapa nui o nā "hoʻoponopono" i kau ʻia ma kā mākou mālama olakino ua ʻoi aku ka maikaʻi o nā mea a lākou i manaʻo ai e kamaʻilio. ʻOi aku ka pōkole o ka noho maʻi maʻi, akā ʻoi aku ka nui o nā kumukūʻai. A ʻoi aku ka nui o ka hana a nā kahu hānai, akā ʻoi aku ka paʻakikī o ka loaʻa ʻana o nā kahu hānai e hele a puni. ʻO ka hoʻolimalima ʻana i nā kahu hānai manuahi a i ʻole "huakaʻi" mai nā keʻena maʻamau e ʻae i ka maʻalahi, akā uku nā halemai iā lākou i kahi kiʻekiʻe kiʻekiʻe e huhū pinepine ai nā kahu hānai i kā lākou mau hoa hana. I ka ulu ʻana o nā helu, haʻalele nā kahu hānai limahana i uku ʻole ʻia a hui pū me nā limahana hana. ʻOiaʻiʻo, alakaʻi kēia i ka liʻiliʻi o nā kahu hānai i loaʻa kahi kuleana i ka wā e hiki mai ana o nā haukapila kahi a lākou e hana ai.
ʻAʻole wale ka nānā ʻana o ka wā e hiki mai ana i nā kahu hānai ma ʻAmelika Hui Pū ʻIa (a ma nā ʻāina ʻē aʻe i kūkākūkā ʻia ma kēia puke), akā ke emi nei ko mākou manawa e lawa ai nā kahu hānai. Ke kamaʻilio ʻia nei ka hemahema o nā kahu hānai - ma ka liʻiliʻi loa i kēia manawa - e ka hoʻolimalima ʻana mai nā ʻāina ʻē, i ka manawa i makemake nui ai ka poʻe ʻAmelika i ka hana akā ʻaʻole makemake lākou e hana ma ke ʻano he kahu.
Hoʻokahi mea aʻu i manaʻo ai he hiki ke hoʻololi i nā kahu hānai a me nā ʻōpio i kēia manawa e heluhelu i kēia puke. Eia, ma ka hopena, he kiʻi o kahi ʻoihana hanohano e hāʻawi ana i nā hana koʻikoʻi a paʻakikī e pōmaikaʻi pololei a hiki ke uku ʻia me ka mahalo nui. ʻO ka heluhelu ʻana i kēia puke e kōkua pū i ka paipai ʻana i nā kahu hānai e ʻōlelo no lākou iho a ma ka ʻaoʻao o nā mea āpau e pono ai ka mālama olakino maikaʻi.
Hāʻawi ka ʻāpana hope o ka puke i nā ʻōlelo aʻoaʻo a Gordon. Ma muli o ka hohonu o ka ʻike a me ka ʻike i hōʻike ʻia ma kēia kikokikona, pono e noʻonoʻo koʻikoʻi kāna mau manaʻo. Hoʻokahi mea āna e kākoʻo ai, ʻo ia ke kau kānāwai i ka lakene o nā limahana palekana, i koi ʻia ma ke kānāwai ka helu haʻahaʻa o nā kahu hānai no kekahi helu o nā maʻi. Ua hoʻāʻo ʻia kēia ala ma nā wahi he nui, me ka mokuʻāina ʻo Victoria a me ka mokuʻāina ʻo US o Kaleponi. He kanakolu mau ʻelele mokuʻāina ʻē aʻe o ʻAmelika e noʻonoʻo nei i ka manaʻo.
Manaʻo pū ʻo Gordon i ke koi ʻana i kahi kēkelē ʻehā makahiki no ke kahu hānai, me ka hoʻopaʻapaʻa ʻana he nui loa nā mea e aʻo ʻia i ka manawa liʻiliʻi, a me ka haʻi ʻana i kahi haʻawina e ʻike ai i ka pilina ma waena o ka hoʻomākaukau hoʻonaʻauao o nā kahu hānai a me nā helu make.
Hōʻike ʻo Gordon i nā manaʻo hoʻopaʻapaʻa like ʻole no nā hola pōkole a ʻoi aku ka wānana i hui pū ʻia me ka uku maikaʻi aʻe a me ka leo ʻoi aku ka mana ma ka wahi hana. ʻO ia mau mea a pau: ka hiki ke hoʻokumu i kahi hui a me ka makemake e hana pēlā. Ma ke kahu hānai, e like me kēlā me kēia ʻoihana i ka US, ua hoʻokomo ʻia nā pilikia koʻikoʻi, i ke kānāwai a me ke kānāwai ʻole, i ke ala o ka hui ʻana. Eia naʻe, he nui nā kahu hānai e hoʻomaopopo pono i ke koʻikoʻi o kahi uniona e hoʻomaikaʻi i kā lākou kūlana hana. Pono lākou e aʻo e ʻae i kahi hui ʻaʻole e hoʻohaʻahaʻa akā e hoʻonui i ko lākou kūlana ʻoihana.
ʻO ka hope loa, inā ʻaʻole he mea kupanaha loa, ʻike ʻo Gordon i ka hoʻokumu ʻana i ka mālama olakino uku hoʻokahi e pono ai e hoʻoponopono i nā pilikia he nui i kā mākou ʻōnaehana mālama ola. Ma waena o nā haʻawina o kēia puke he mau hoʻohālikelike honua e hōʻike ana ʻo ka mea uku hoʻokahi wale nō, ʻoiai pono, ʻaʻole lawa i ka hoʻoponopono ʻana i nā pilikia e kū nei i nā kahu hānai.
Paipai ʻo Gordon i nā kahu hānai e pāʻani i kahi kūlana ʻoi aku ka maikaʻi ma ka hoʻopaʻapaʻa lehulehu e pili ana i ka uku hoʻokahi a me nā nīnau mālama olakino. Akā ʻaʻole kēia puke no nā kahu hānai wale nō. Pono e loaʻa i kēlā me kēia ʻoihana kahi puke e like me kēia. A pono kēlā me kēia o kākou e heluhelu i kēlā me kēia puke. Kūkulu ʻia ka lokahi papa hana ma o ka hoʻomaopopo ʻana i ka hana a ko mākou mau kaikunāne a me nā kaikuahine, a he kōkua maikaʻi kēia puke i kēlā hopena.
ʻO David Swanson he mea kākau a mea hana. ʻO kāna pūnaewele ʻo http://davidswanson.org. Hiki ke lohe ʻia ʻo ia i kēlā me kēia Pōʻakahi ma ka Thom Hartmann Show, http://thomhartmann.com.
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