Flying Voter

        

image from thebloggingjuan.blogspot.com

              It has been two weeks since I flew to Iloilo so that I can exercise my right of suffrage. I was too busy during the registration period last year that I was not able to transfer to a voting precinct nearby. Besides, I have four relatives and a friend running for local government positions and I would like to add one vote -- my vote -- to each of them. I also wanted to support my partylist and senatorial candidates. These points and my desire to visit my aging parents who have been living on their own, without any house help, I thought were good excuses to be a flying voter.

         Taking the bus to Passi is always relaxing. In this trip, I was on the lookout for the sunset. It didn’t show itself that long because of the clouds but I was still able to feast on its beautiful colors.  Since the province has vast farm lands, I also liked the smell of farm soil from rice paddies and the sweet scent of the sugarcane plantations. It indeed brought in clean air from my usually pollution-irritated lungs. It is dark as we near Passi and it also began to drizzle. Closing my eyes, I enjoyed the feeling of cool air and bits of rain shower touching my face. It is good to be home! Except for a brief moment, I didn’t pay much attention that the trip home took much longer than usual.

            Monday, May 13, I cast my vote for my favored candidates. Fifty percent of those I voted made it to both the local and national positions. As I listened to and read people’s reaction to the proclaimed winners, I made my own considerations:

• Personal dealings is still more effective than virtual. Many people still vote because a candidate did a specific personal act to them – a smile, a wave, a handshake, a hug, a photo op can win you votes sometimes more than your qualifications
• Utang na loob has more influence than the integrity and honesty of the politico. 
• There is still a lot of work to be done in educating the voters so they choose candidates according to principles and their conscience and not just because of popularity or worse, because of their notoriety, or because their amo told them so.
• In politics, it is not enough to have the best qualifications, intention and spirit of service. One needs to have enough machinery and the cunning to fight for a post.
• Money still talks. It is disheartening to note that corruption continues.

            At the end of the day (senator elect Nancy Binay’s favourite line. hehehe), the truth is, our newly elected leaders will be running the country for the next 3 to 6 years. Thus, I hope and pray that our leaders fulfill their promises. For the incoming provincial, district and town officials of my palangga nga Iloilo and Passi, I just have three requests:

1. Please work on the roads and bridges faster. The trip from Passi to Iloilo is taking us forever because of the re-routing and the rough roads. Despite at least 3 hours of lead time travelling, I still feared that I’d be missing my plane back to Manila because of the roads and unfinished bridge.
2. Please solve the problem with floods. I spent a good part of my short Christmas trip last year cleaning our house because water now enters it when there is flood. Think about the loss of property and the fear for our lives every time it rains heavily. Don’t use the calamity to gain pogi points and gain utang na loob from your constituents through the relief goods and funds that you will be distributing.
3. Those first two requests, I know, are quite gargantuan. That is why, my third request is that you cooperate and work together. Such huge projects need a concerted effort from each one. Please don’t block or make it difficult to carry out, noble projects initiated by another official simply because you are coming from opposing parties or you didn’t get his or her support during the elections. Enough of these nonsense and prove to us that you deserve being in your position. 

Of Sacred Cows and Evidence-Based Practice

I wrote this for my synthesis paper in one of our PhD subjects

                Ever since the ancient times, people have realized and accepted the fact that there is nothing permanent in this world but change. One of the ancient philosophers, Heraclitus (500BC; Graham, Summer 2011) compared existing things into the flow of the river: ”Into the same rivers we step and do not step, we are and are not."  This illustrated how change happens constantly. Man, being part of this world, is also affected by change. “All good men desire to change.  He longs to develop and to perfect himself” (Von Hildebrand, 1990). Under this line of thinking, nurses try to improve their Nursing practice. And since Nursing is a science, Nursing Practice should be based on science, wherein research is used to answer questions, establish protocols, and promote critical thinking and decision making at the bedside (Rauen, Chulay, Bridges, Vollman, & Arbour, 2008).

            Many new ways of practice had been introduced based on evidence – that is, research findings that are relevant and applicable to clinical situations with the aim of better outcomes for the patients. This is referred to as Evidence-Based Practice. The Institute of Medicine defines evidence-based practice (EBP) as “the integration of best research, clinical expertise, and patient values in making decisions about the care of individualized patients (Rauen, Chulay, Bridges, Vollman, & Arbour, 2008). More accurate measurement of blood pressure (Rauen et al, 2008), less- restricted visiting policies (Makic, VonRueden, Rauen, & Chadwick, 2011), unit guidelines for urinary catheterization (AACN Bold Voices, 2012) and the development of the seven domains and associated quality indicators for End-of-Life (EoL) care in critical care  (Efstathiou & Clifford, 2011) are among the results of the nurses’ efforts to discover better and safer ways of doing things.

            However, one irony about change, although constant and good people desire it, is that people also tend to resist it.  Change requires willingness and ability to change practices, regardless of the tradition and commonly held beliefs (Rauen et al 2008). Sometimes, though, it is not easy to leave tradition and one’s “security blanket” that were referred to by Rauen et al as sacred cows. John Maxwell (2011) describes this process   as the “pain of change”. It is painful to break the habit of doing things. It can be tiring and toilsome work, requiring persistence and resourcefulness (Sanborn, 2008). It is especially difficult if one's opinion or beliefs very much differ from the new evidence being presented. Several studies support positive outcomes for on-duty napping (Fallis, MacMillan, & Edwards, 2011). The authors noted that in nurses working either 8-or 12-hour night shifts, sleep deprivation increases the risk for patient errors, near misses, and personal injuries on shift and while driving home. Furthermore, the authors also concluded that sleep deprivation, sleep disturbance, and fatigue are also significant contributing factors to impaired personal health. They thus broached into the idea of restorative naps within work to address these problems. This proposal may be a welcome practice to many night duty nurses, but one can meet resistance among the traditionalists.

            More resistance can be expected to Daly’s (2008) proposal to withhold cardiopulmonary resuscitation unless there is prior order from the physician. She recommended  “to restrict use of CPR to those patients who provide adequately informed consent and for whom CPR has a reasonable chance of success” (Daly, 2008). This revolutionary idea based on research may not have many takers but this and the other new discoveries (too revolutionary or not), give growth and development to nursing science and consequently, to practice. Because of EBP’s, more specific and clear guidelines are present, that can signal to the staff the orientation of the goals of care and the interventions to be provided (Ells, 2010).

            EBP can further grow if there is a unified research agenda among muti-disciplines in health that are based on the assessed needs of a particular place. The effort to do this was shown by the multisociety task force for critical care who came up with a comprehensive agenda for critical care research using input from a broad range of stakeholders to serve as a blueprint for future initiatives (Deutschman, Ahrens, Cairns, Sessler, & Parsons, 2012).

            In summary, evidence-based practice has shown many ways of having a deeper knowledge about the patients, families and about the processes followed by the health team so that there is improved efficiency and safety in practice that would bring about better outcomes of care. Although resistance to change due to traditonal beliefs and practices may be encountered, these traditionalists who resist “putting their sacred cows out to pasture” will eventually be convinced if better outcomes are consistently manifested. With a concerted effort from the members of the different health disciplines who pulls the cart together in one direction based on one research agenda, we can expect greener pastures ahead. 

Holy Week

Holy Week

    
           It has been more than a decade (17 years to be exact) that I have attended the Holy Week services in my hometown, Passi. But I can still recall and appreciate those childhood memories wherein everyone tries to come home and be with their families during this time of the year. Life is a lot simpler then but I didn't find it boring at all. Holy Week begins today, Palm Sunday.  Radio stations, TV Networks (we only had Channels 4, 8, 10 and 12 then) and everywhere you go remind you that it's Holy Week. Bombo Radyo had Holy Week specials. You don't hear the usual "Sin-o ang May Sala" radyo drama. Instead, they're replaced by the Seven Last Words and other inspirational dramas. I also remembered crying over the characters portrayed by Tito, Vic and Joey and their entire Eat Bulaga troop. They don't do game shows on those days. Instead, they play serious characters and teach lessons of forgiveness, love, etc.

    But the highlight is the Easter Triduum - Holy Thursday, Good Friday and Easter.  Having studied and learned more about our  Christian faith, I am amazed at how great a teacher our mother the Holy Catholic Church is. The Bible characters come to life during those days and the entire town participates.  The 12 Apostles come from the different parts of the town. They also went by pairs to the houses, in their costume and sash to identify which Apostle they play. Oh, and they carried a coin purse too. When they come to your house, just like in the Gospels, after locating where the Sacred Heart image is, they start praying for peace and blessing for the entire family. We were welcoming, I think, so we didn't witness any of them brushing dust off their feet and getting back their prayers for peace. The 14 stations of the Cross is spread all over town that during the procession, you will have walked around the entire town to complete the 14 stations. The walk was quite tiring that I remembered cheating when I was a little younger. Our house is located towards the end, so instead of completing, we stayed at the street corner and just watched people and images pass. When I became a teenager, I was distracted with people watching. During the procession, you will see who is courting who or who is officially together. I also remembered watching out for my crushes  and wondered when I will ever be noticed.  But the procession and the Way of the Cross, I now realized, is a great catechism. Through the images, we get to know more the characters in the Gospels. Below are my considerations on these images:

     My Lola Esther's family is in charge of Mary Magdalene. Her image had nice curls and long lashes and rich clothes and she always carried a bottle of perfume. As a child, it was explained to me that she's quite vain that's why she's represented that way. But as you check out her character in the Gospels, you will realize that she's that lady whom Jesus expelled 7 devils. She lived a sinful life but after being forgiven, she learned how to love greatly and be most generous. She was that lady who didn't skimp on an expensive perfume (a whole year's laborer's wage worth) by breaking the bottle so all gets poured to anoint Our Lord's head before his Passion. 

     One image I didn't quite like was Martha's. She wore a very simple dress and carried a walis tingting. Why did she earn a place in the procession? Well, this lady taught us the value of domestic work. If Mary taught contemplative life, Martha teaches us the importance of taking care of the work of the home. It is such an important but unrecognized job. Without a lady taking care of a home, it will just be a house. But the home is where life and values are first learned. The love and care of a mother and wife will produce happy and contented and inspired husband and children.

      St. John. This young man became an Apostle when he was a teenager. He was the only unmarried among the Apostles. His life teaches us that chastity and total self-giving is possible and noble. Who was that apostle who kept reminding the early Christians to love one another even at old age?  It was John. Why was he able to speak about Love? Because his total self-giving taught him Love. 

      St. Peter with a cock. "Before the cock crows twice, you have disowned me three times" Jesus told Peter. Peter had a lot of faults but he said sorry and rectified. This impulsive guy truly loved Our Lord. That is why despite his weaknesses, he was made the "Rock" where Christ built his Church. He became the first head of the Church and he died a martyr trying to spread the Christian faith. He felt not worthy to die the way Jesus did so he asked that he be crucified upside down. 

      Jesus' agony in the garden with an angel holding a chalice. "Father, if you will, remove this cup...But not my will but yours be done". Suffering is never inviting. Even Jesus, in his human body, did not want it. But that suffering was our Redemption. So, in the end, Jesus followed The Father's will. We too should embrace our little and big crosses. The hurt are like the chips under the jeweller's hand.  Without being cut, we won't shine as the diamonds that we are meant to become. 

      There are a lot more images to consider and events in the Easter Triduum to comment on but it is time to end so I'll end... You may add your thoughts on the Last Supper, the Visits to the Monumentos, the kissing of the cross, the Easter vigil with the blessing of the seed of the farmers, the 7 Dolorosas, the meeting of Jesus and Mary at Easter morning...