Sunday, November 27, 2011

value matters

There are many ways to value “things”.
Things might be worth 
  • what it cost to design/make/market and deliver them; 
  • what it cost to buy them; 
  • what we are prepared to pay for them; 
  • how much they have deteriorated or been superseded; or 
  • what someone is prepared to sell them for. 

All of these possible valuations will differ depending on such variables as how scarce they are; whether we can afford them, or how useful they might be in the long term.

Then there are things which might be precious simply because they mean a great deal to us.
Can we judge what a society values most by what it is prepared to pay for different assets and services? 
By this measure it seems the Occupy Movement has a reasonable axe to grind. 
Is a woman who is ludicrously rich because her father had the vision to dig holes in the ground really worth so much more than everyone else in the country? Is a woman who spends 120 hours a week doing piece work on a sewing machine really worth so much less?

Of course, our intangible values are more difficult to measure in terms of money.
Government budgets or even legal decisions can reveal something about what we value, but not everything.
We might quibble about the details, but we value the environment and pass laws to protect it for the future.
As a predominantly omnivorous nation, we have legislation reflecting our belief every animal deserves a clean life and a clean death.
We have many laws [perhaps too many] reflecting our belief that we should respect or care for each other, even strangers.
We have a free, universal health care system built on the notion that if we encounter someone in distress our first instinct is not to ask if they have insurance, but to ask what we must do to keep them alive.

We can walk into the emergency department of any hospital and see the values of doctors, nurses and allied health workers in action: A throng of people – washed and unwashed, whiney or stoic, weak or strong in character, victims of chance or those who are the causes of their own suffering – are all treated equally. For most people who work in medical fields, life itself has a greater value than the temptation to pass judgment.

No person can survive for long in any job that challenges their core values and convictions, or where they are under-appreciated. The few who are judgmental are statistical outliers, or jaded after years of working in a system that is not built on the values it should be.

The current campaign by Victorian nurses for better pay and fixed nurse:patient ratios is not driven by greed, it’s a reaction to the long term, ongoing neglect of the health system by governments whose budget priorities are out of sync with what I hope we value most as a society – life.
The value we place on life and its quality is not being pooh-poohed by nurses, but by those directly responsible for a scarcity of health resources.

Our reasonably free market economy is fuelled by demand; by the notion that when we value a resource this value will motivate others to provide it. We might think of democratic governments as entities we buy with votes, but it seems our democracy is a “free” market place where none of the usual rules apply. For example, 
  • We are ruled by an oligopoly, for there are few political brands to choose from and they are not very well distributed.
  • When the promises we buy are defective; when our governments let us down, we have no consumer affairs organisation which will refund the vote we paid.


The Baillieu government insists nurses cannot have pay rises unless they deliver an increase in productivity. 
If the question of nurses’ pay is nothing more than an exercise in sound budgeting, then it is fair to assess what government – the nurses’ bosses and business managers – are themselves contributing to productivity levels.

Would we expect printers to churn out magazines or books without paper or ink? Similarly, should we expect hospital staff to be productive when our hospitals do not have enough beds, or enough equipment to cope with demand? 

What equipment they do have is in a poor state of repair and in short supply.

When Mother Other was finally placed on a special emergency room cardiac bed – after three hours in a queue – absolutely none of the equipment needed was functioning, with some missing altogether. 
The Other herself once spent hours in agony experiencing a full blown heart attack in a hospital corridor. The corridor space was only available because she has connections. Such was the demand on resources that other, more life threatening cases were attended to first, on the understanding The Other would survive and could be helped once the attack was over.

These two situations did not arise because of industrial action, they arose at times when it was ‘business as usual’ in Victorian hospitals.

The Baillieu government claims the system has enough nurses; that some of the traditional nursing tasks could be handled by ancillary staff. Today, certificated PSAs strip, wash and disinfect every hospital bed then make it up with fresh sheets, after use and before a new patient takes over. In practical terms, what should nursing staff do when a patient soils themselves, or is bleeding profusely – press a buzzer and wait for a free PSA to arrive? 

If a patient’s head must be elevated to keep their airway open, who is the best person available to immediately prop up the head and provide jaw support? If a patient needs jaw support – which might mean physically lifting someone’s head and holding it in the correct position for an hour or more – how many patients should one nurse be expected to care for? Even with a one:to one nurse:patient ratio, where does the help come from if the bed of a jaw-support patient needs changing, or drugs must be fetched, or a doctor called?
A printing press uses floor space. Floor space is also required for storing paper and ink, for a guillotine to cut the paper to size, a place to store finished product before it is trimmed, and somewhere for a printer to stand or move backwards and forwards.

Similarly, in a hospital emergency department space is required for a bed, up to three or four nurses or doctors at a time for each bed, an equipment cart, privacy and more. But space is something in very short supply in hospitals.

If our economy requires an investment in resources to provide the services we need, it also requires incentives to attract workers into service industries. If someone chooses to become a nurse, what’s in it for them? What’s the reward at the end of an expensive university degree?

Under the 2010 award, these are the weekly wages of a Div 1 nurse with a 3 year degree:

Level 1
Pay point 1
Pay point 2
Pay point 3
Pay point 4
Pay point 5
Pay point 6
Pay point 7
Pay point 8

This makes an entry level rate of $35,000 rising to $44,000 over 8 years.

The average minimum graduate entry salaries [per annum] for other career paths are:

HR & Recruitment
IT & Communications
Trades & Services
 [Nov 2011]

Economists have long acknowledged that all wages or salaries contain a ‘transfer’ component. As an example, this means that someone who enjoys a great deal of job satisfaction in their current position would need an irresistible increase in salary to be lured away by a new employer.

Hospital staff – especially public hospital staff – deal every day with 
  • verbal abuse, 
  • threats of physical abuse, and 
  • real physical abuse. 

The small proportion of patients who are feral or aggressive might 
  • be suffering a psychosis over which they have no control, 
  • be under the influence of some very heavy duty drugs, 
  • feeling they need to compete for medical attention, or 
  • simply antisocial. 

Nursing staff often lift people far heavier than themselves, deal with unpleasant bodily functions, and accept responsibility for making life or death decisions all day every day. 

They deal with death, the grief of relatives and friends of patients, and their own grief. Theatre staff, and in particular recovery staff, are often punched or kicked by people coming out of an anaesthetic and desperate to remove tubes and lines from their face and arms. Some of them even lash out simply because they can [until someone calls their bluff].

The Baillieu government claims nurses were placing the welfare of patients at risk by closing beds; by excluding cases of elective surgery.
The system which has evolved for prioritising surgical cases is, in itself, an indication that the system is under-resourced.

Elective surgery is surgery that can safely be delayed for more than 24 hoursThe term ‘elective’ is used only to distinguish it from emergency surgery, which is required within 24 hours to save a life. 

Elective surgery does not mean that the surgery is optional – elective surgery is often life saving (for example removal of a tumour) or very important to a patient’s health and well-being (such as a hip replacement). It is also known as planned or booked surgery. Elective surgery can be postponed and, unfortunately, too often is postponed for far too long.

But there are different categories of elective surgery. What has not been made clear in the government's criticism of the nurses' industrial action is which category of elective surgery is on hold, and how often exceptions to these bans are being made.

Cat 1
Admission within 30 days desirable for a condition that has the potential to deteriorate quickly, to the point that it may become an emergency
Cat 2
Admission within 90 days desirable for a condition causing some pain, dysfunction or disability, but which is not likely to deteriorate quickly or become an emergency
Cat 3
Admission within 365 days for a condition causing minimal or no pain, dysfunction or disability, which is unlikely to deteriorate quickly and which does not have the potential to become an emergency

With the current state of affairs in our public hospitals, one in ten patients do not receive their surgery within the recommended time frame, and 3 quarters of these are people living in Qld, Vic and Tas. 
[The Tasmanian figures should not be surprising as even Hobart is classified as “Inner Regional” as it is so short of essential services - usually provided to Tasmanians by Victoria].
Nurse patient:ratios have an impact on these delays.
The Baillieu government has recently closed 100 hospital beds.
Victoria is struggling to hold on to paramedics.

Churn numbers relating specifically to nursing are hard to find, but a 2008 paper makes the following quite plain:

There is currently a severe shortage of experienced nurses in Australia, as in many other developed countries. This is considered to be the result of both decreasing enrolments in nursing education, and poor retention rates of those in the nursing workforce. Retention rates are generally thought to have worsened over recent years. There is also concern over the ageing of the nursing workforce since this will cause critical shortages in the future as greater proportions of nurses reach retirement age.

I do hear plenty of anecdotal evidence that a large number of nurses desert the hospital system within 6 months of graduating.

When it comes to government priorities, health, child protective services, aged care and education are all competing with everything from transport and other infrastructure to motor or horse racing for funds.

I am hopeful that the yartz will obtain continued support, and that Flinders St Station will be preserved and revitalised. I am also aware that as much as a couple of months in Europe would add to my quality of life, I have to sacrifice or postpone some things in order to pay for other priorities in my own life. 

When it comes to the wages of nurses, the usual government tactic of shifting the blame is not a very productive solution to a systemic problem. Blaming nurses or letting their "accounting value" further behind will do nothing to increase productivity.

Saturday, November 26, 2011

sibling saga episode 666

Fear not! Football may have been ditched by fickle fans in favour of cricket as the weather warms up, but the sororal competition continues unabated.

Followers of this blog may be interested to learn the pathology report for The Other’s recently removed knob-oma came back with a disappointingly indeterminate ‘envenomated’. The absence of proof that The Other’s bite was definitely caused by a redback may not entitle The Other’s sister to her husband’s Ka-Ching, but it has still left her with a wide but knowing grin on her dial.

My lovely Aunt Fruitcake has made her annual trip south for the summer, arriving in Frankston today. Coincidentally, The Other’s sister is also at Frankston while her hubby –aka Spiderman – recovers from knee surgery in a local horse’s piddle.

Naming names – while changing names to protect the innocent – let us now christen The Other “Daisy” and her younger sister “Geranium”.
Aunt Fruitcake’s two daughters are, in a different order of preference, named “Geranium” and “Daisy”.

Tonight, Geranium Other suggested to Aunt Fruitcake that Geranium must be Aunt’s favourite name if she named her first daughter Geranium rather than Daisy.
To this, Aunt Fruitcake replied that it was Uncle Fruitcake who had liked the name Geranium, while she had given her favourite name – Daisy – to her second daughter.

What’ll it be customers, KA-CHING or OUCH?

Wednesday, November 23, 2011

food glorious food

 Sometimes it’s hard to remember that Australia is no longer the cultural backwater it once was:

Back in the day - so long ago it was even before my time - while billies boiled and damper cooked on the campfire, old swaggies swapped recipes. To them we owe details of the best way to cook a galah:
  • Place galah in large pot with 2 quarts of water and 3 large rocks;
  • Boil for two hours;
  • Drain pot, dispose of galah, eat rocks.

Wood stoves might be efficient for heating hot water and warming houses as well as cooking, but trees are now sacred and firewood is expensive.

The 1950s and 60s gave us electric frypans, and Sunbeam Mixmasters, along with migrants seeking a little more variety than mutton with 3 veg;

We stopped taking our saucepans to “the Chinese” when fast food franchises arrived in the 70s, and in this new millennium we can eat at restaurants serving food from every conceivable cultural tradition.
Why, Australian cooking has even been paid the ultimate compliment by providing fodder for a whole swag of reality TV shows.

But since 1940, William Angliss institutes in one form or another have quietly worked behind the scenes, training people to produce reliably good, nutritious, tasty and attractive traditional grub.

The government people for whom I currently work are very big on team building. They care more about bonding than the people at Tarzan’s Grip, and so today I went with my ‘team-mates’ to lunch at the William Angliss Institute of TAFE Bistro.

The buffet offered soup and pasta as entrees, a range of salads, vegies cooked in different styles, rice, sweet and sour pork, cantaloupe with prosciutto, asparagus with beef, roast beef, roast pork, cheese and fruit, more fruit, and pastries.

Although short for my weight I am a rather fernickety eater; don’t much care for roast beef, don’t do pork, and assiduously avoid any food tainted with bacon, basil or parsley. For all that, I had so many little bits of this and that for my $22 that I came away in need of a good sleep. 

Thinking it would be a bit rude to knock off a linen napkin I decided against wrapping up one of the massive great hunks of cake as a treat for The Other while sampling some of the desserts. 
Fruit platters always call to me, because it’s just impractical to buy honeydew melons, cantaloupes, watermelons and a heap of other stuff for home without a starving horde to make sure it doesn’t get wasted. 

Some of my work buddies were happy to divvy up profiteroles, brandy snaps and the like so we could just have a taste of everything without making ourselves sick.

One or two had a wine or beer [not too expensive] while I opted for a post-prandial coffee [which, I later discovered, was covered by my $22].

Many years ago someone gave me a William Angliss plum pudding and it was yummy, so I dropped into the bakery to ask if they still sell them. For thirteen dollars I put in my order for 6 small puds and some brandy custard which I can pick up in mid December.

The bakery, I discovered, sells some rather fancy and expensive looking cakes for $10... so if you are in town and need to buy a birthday cake, this might be the 'shop' for you.

To cap off all of today’s treats, I worked out how to take a photo with my phone AND how to download it so I could upload it for my salivating friends in blogland.

Saturday, November 12, 2011

about the shape of it

The 2010 theme for sand sculpting on the Frankston Foreshore was
‘Events that have changed the world’

The theme for 2012 will be ‘Toytopia

After living in Frankston for more than twenty years, The Other announced she wanted to see the McClelland Sculpture Gallery. The weather today was perfect, so we got in the car and drove off, arriving about six minutes later.

The Sculpture Park and Gallery’s 16 hectares – situated on McClelland Drive – were once home to Harry McClelland (1884-1954), local artist and philanthropist. 
In 1971 the gallery was established under the terms of his sister’s will, growing over the next 40 years with the support of several government bodies, and some private foundations including the Elisabeth Murdoch Sculpture Foundation.

Large sculptures – a mix of both classical and more contemporary works – are scattered across the site. 

Some of the works sit in carefully landscaped and quite formal gardens, while others are waiting to be found in native bushland settings. 

No, they aren't the work of Mr Curly

I don’t believe I’ve ever heard bellbirds anywhere but Sherbrooke Forest before today, but bellbirds there were!

Some parts of the gallery invite visitors to go on a
journey of discovery

There are indoor exhibitions as well but, following some recent heavy storms, parts of the ceiling in the gallery centre caved in leaving a dreadful stench of mildew, and no hope of exploring indoors today. 

We spent more than two hours exploring outside, and also visited the gallery café which – surprise, surprise – had a rather arty farty ambience with matching menu and prices.
There is one review on-line somewhere suggesting the service in the café was a tad snooty, but the woman who took our order was quite pleasant. 
Unfortunately, the waitress has a severe problem with anorexia. This did not put us off our tucker, but it does give one pause. I looked around the room and saw that everyone else was of a reasonably average weight – healthy or larger. The Other commented that the young lady probably weighed 30 kg and probably wouldn’t live to 30. 
It’s a tragedy because she would have quite a pretty face if it wasn’t so gaunt. I don’t know what causes such self-loathing, and I’m not sure what I would do if I managed a café and she asked me for a job. I would probably stick my neck out and risk handing her a card with the name of a counselling service on it, though I doubt it would help.

On a happier note, other gallery visitors today included a family with a Jack Russell [on lead], a couple sharing a blanket under the shade of a tall gum, and another family who had brought their own picnic.
One chappy with a ginormous camera round his neck [and partner several paces behind] seemed inspired and excited by the whole place, taking more pictures than steps and sometimes causing his respectful partner to bump into him.

It would be wrong of me to include too many photos, because part of the fun is being surprised and some of you may want to visit the gallery yourselves one day. You can check out the hours and details of free entry at the gallery website.
In a spirit of full disclosure, I should point out the gallery is on the Langwarrin side of McClelland Drive, not the Frankston side.

Recent news articles about a couple ‘from Frankston’ who were not so much ‘missing persons/ feared victims’ as ‘on the lam’ do not mention that they are actually from Langwarrin, so goshdarn it all, if it’s good and it’s in Langy I’ll claim it.
If the gallery is 6 minutes from home, it’s only 4 minutes to Dame Elisabeth Murdoch’s Cruden Farm. The next Open Garden Day is on the 20th November, and if life doesn’t get in the way it sounds like a good way to pass an afternoon.

Tuesday, November 8, 2011

operation ka-ching

The Other has requested I provide a score update in the great spider bite competition of 2011.

Approximately 2 weeks after she was initially bitten by a red back, the swelling from her forearm to fingers subsided, but a large infection remained above one knuckle. A lovely GP lanced it and prescribed a course of strong antibiotics. Although the infection has cleared, a granuloma now remains. This photo really does not do justice the size of the lump. But... at least I worked out how to turn the camera flash off.

To oversimplify, in this instance the lump [oma] is most likely made up of dead macrophages [biological goo-munchers] which gave their lives that The Other may live.

The Other believes the lancing deserves a point but I disagree. Pus, after all, is common as muck. I will, however, award a point for the gross inconvenience and discomfort the granuloma is causing.

Patients recovering from surgery, when they come out of anaesthesia, like to grab hold of something. [In the case of male patients, they like to grab something specific first, just to make sure their greatest nightmare has not been realised. Then they grab at the limbs of recovery room nurses. Recovery room nurses often go home with thumping great bruises.]
Thus, at work, both surgical gloves and patient activity have been exerting pressure on The Other’s knob-oma, in turn putting pressure on nerves and tendon.

I’ll also award another point [ka-ching] for the appointment with a plastic surgeon next Wednesday a.m. to remove the thing.

We haven’t heard in recent days of how the Bro-in-law's bite site is progressing, but he will be here later this month to have a knee replacement [ka-ching] so I guess we’ll learn more about it then.

This sibling rivalry is serious, but began with no book of established rules. Should The Other’s sister be awarded points because of her husband’s bite, or should she earn points on her own merit?

How far back should we go – is this to be a life-long competition, or a series of games, sets and matches?
Does The Other score points for having surgery on her Morton’s Neuroma before her sister had surgery on hers? Does the sister earn an extra point for unsuccessful surgery, then an extra point again for needing surgery to correct the surgery, or does she lose one for not going to The Other’s recommended surgeon in the first place?

Whenever a medical issue arises The Other simply discusses it with this or that person at work, and has it dealt with as casually as one might borrow a pen. This adds a whole new dimension to the idea that people with private health insurance are free to choose their own doctors and surgeons. Since I can't work out how to keep score, I've decided to disqualify The Other for insider trading.

Sunday, November 6, 2011

no point arguing with logic

It seems a neighbour has a family of black cockatoos making babies in his grevillea. I hadn't heard cockatoo-like noises, but then, before moving back to Melbourne I was used to having two or three hundred settle down in my gum trees every night at dusk. It's the sort of noise I'd learned to block out.
The Other, on the other hand, has been gardening and mowing and making hay before the cool change, and always has an ear cocked at this time of the year, because rainbow lorikeets love trees full of green almonds.

Around lunch time the cockatoos had moved to the other side of the court and into a tall gum, so everyone emerged from their homes in stages to check them out. Funny how babies can bring people together.

Armed with nothing but my "this'll do til I find the good one somewhere in a box somewhere in the shed" camera,  I was lucky enough to snap one clearly enough to identify it properly. 

Seems they are yellow-tailed black cockatoos. While I had long believed black cockies were, like black swans, a WA thing, surprise surprise I was wrong! [Who'da thunk!] 

A neighbour told us black cockatoos are a sign of bad weather to come. If this is true, then we have had bad weather for as many years as black cockatoos have been around. I personally thought the gathering clouds, the change in temperature and the few drops of rain were a sign of bad weather to come, but I think she was talking about global warming and the way Melbourne's climate is getting more like Queensland's. 
At the risk of offending the 6 million followers of this blog, all I can say is "tosh".

Some websites provide lists of widely accepted beliefs about weather. 'When spiders come inside, bad weather is on its way". In the summer, huntsmen do seem to move indoors when the barometer climbs, but this might mean that it's breeding season and a house seems like a pretty good tree.

Another good claim is that 'when worms come out, the rain has stopped'. I think it would be easier to just stand outside and see if you get wet than to carry around a worm farm. It's a bit like people who have been looking everywhere for something and then say they only ever find things in the last place they look. Well... yeah!

Friday, November 4, 2011

words’ worth

Words [of any language or dialect] are one of mankind’s greatest inventions. The strengths of English, and its position as lingua franca is due, ‘they’ say, to its adaptability and its incorporation of useful words from other languages.

This has led to – amongst other things – the useless abomination known as International English: A type of jargon in which each word or sentence makes total sense but which, in total, leads to paragraphs and speeches which are ultimately meaningless.
An example lifted from Wikipedia goes something like this:

“In order to solve the stress that international students have, some scholars gave some suggestions, including deal with the problems with a positive attitude and educate international students to use various ways to help them solve their problems…”

[If you need further examples of correct but meaningless English, please see any scuzei bog.]

Whether the need for an international language or simply an increase in levels of mass communication is to blame, the English language is being bastardised by unnecessary changes in otherwise adequate words and expressions, so that ‘sign’ has become ‘signage’ and to increase the value of an asset is now ‘to grow an asset’ – as if all we need do is add water.

One source of fascination for me is the way speakers of English as a second language might misinterpret an English word and rework it so that it makes more sense today than the original English.
For example [before built-in-robes became standard in new houses] a friend increased her English vocabulary with the word “walldrobe”.
This improvement now lacks a reference to the origin of the original word – ‘keeper of the robe’ – but I’m not sure it matters.

Many speakers of English as a first language have completely lost the plot, believing, for example, that the person who hires and fires in a company is the ‘Personal” manager. No doubt if the mistake were pointed out to them, many might reply “I could of got that editing job if only I’d of known’.

In the 1960s a series of books written by Alastair Morrison were published, the first volume of which was Let’s Talk Strine. The pen name adopted by the author provides a clue to the idea behind the books– Afferbeck Lauder [for Alphabetical Order] – that idea being to help English speakers understand what Australians are really saying.
One favourite piece of Strine [Australian] which many my age still tend to use and understand is ‘Emma?’, from ‘Emma Chisit – an inquiry about the price of something’.

Portmanteau words were first explained by Lewis Carroll in 1871, in Alice Through the Looking Glass, where he uses the word ‘slithy’ to mean ‘lithe and slimy’.
Modern portmanteau words include ‘globish’ [global English] and ‘Brangelina’.

Perhaps the greatest contribution to English was the book by Douglas Addams and John Lloyd, The Meaning of Liff. Using nothing but genuine place names, they came up with words to describe those situations and things for which no word yet existed, e.g.:

Cromarty (n.): The brittle sludge which clings to the top of ketchup bottles and plastic tomatoes in nasty cafés.

Dalmilling (ptcl. vb.): Continually making small talk to someone who is trying to read a book.

Which brings me to what prompted this pompous post: When trying to explain the steps involved in using a computer program, unbearable frustration makes you want to just take over and do it yourself. For this, a workmate invented the word ‘mouseturbation’.

a man of vision

Some favourite bits [Fit the Second - The Bellman's Speech] from a favourite work [The Hunting of the Snark] from a favourite author [Lewis Carroll]:

The Bellman himself they all praised to the skies--
Such a carriage, such ease and such grace!
Such solemnity, too! One could see he was wise,
The moment one looked in his face!

The Bellman

He had bought a large map representing the sea,
Without the least vestige of land:
And the crew were much pleased when they found it to be
A map they could all understand.

"What's the good of Mercator's North Poles and Equators,
Tropics, Zones, and Meridian Lines?"
So the Bellman would cry: and the crew would reply
"They are merely conventional signs!

"Other maps are such shapes, with their islands and capes!
But we've got our brave Captain to thank:
(So the crew would protest) "that he's bought us the best--
A perfect and absolute blank!"

The Map

This was charming, no doubt; but they shortly found out
That the Captain they trusted so well
Had only one notion for crossing the ocean,
And that was to tingle his bell.


Tuesday, November 1, 2011

all saints day

It’s official: The Other has been having fun for 23360 days now [plus a couple of Feb 29s]

Happy Birthday!