June 23

I've re-affirmed my decision to focus on pediatric rather than adult nursing. I'm not changing my "family" nurse practictioner program to a "pediatric" program, but I would certainly like to stay in peds when I graduate in May.

I got my nursing degree in 1993 and have done nothing but pediatrics since. I've worked in general pediatrics and pediatric intensive care. Since January, as part of my NP education, I've been doing clinicals with family practice doctors seeing mostly adult patients. It is SO frustrating to see patient after patient after patient with the same issues: "I smoke, I drink, I eat bad food and I sit on my butt all day. I have high blood pressure, type 2 diabetes, heart problems, sore knees and swollen ankles. And now I want you to fix me."

So I tell them, "Quit smoking, quit drinking, eat healthier and exercise." And they laugh at me. Like it's some kind of joke!

Everyone wants a magic pill. There are some magic pills out there, but people don't want to pay for them. Chantix -- the newest anti-smoking drug -- is working wonders. For people who really want to quit, Chantix is a miracle drug. I've seen folks who've smoked for 40 and 50 years quit in 3 or 4 months -- without turning into raving lunatics from nicotine cravings and withdrawal.

So, why aren't people standing in line to get this drug? Because it is not covered by most insurance plans and people are not willing to pay the $130 or so that drug costs per month. Simple math shows that a pack-a-day smoker will pay about $90 a month for 3 cartons of the cheapest cigarettes. In four months' time, the Chantix expense is gone and so are the cigarettes. That's an extra hundred dollars or more in their pocket not to mention the savings on doctor visits, medicines, etc. While I agree that Chantix should be covered by insurance plans, I can't see why people wouldn't at least try it.

Then we talk about drinking. "How much do you drink?" I ask. "Too much" is the most common reply. "Really. How much is 'too much'?" The most common answer is about a case of beer on the weekend and one or two every day during the week. I immediately add about 50% to that because if you're admitting to a case, it means you're drinking a case and a half. And "one or two" a day is really more like three or four. So we're looking at 36 on the weekend and 15 through the week. That's 51 beers a week. Once again, you've got the expense to say nothing of what it's doing to your liver, your brain, your heart, your kidneys and your children.

Next comes the diet. "Well, I eat a lot of vegetables," they say. But only in the South are "vegetables" cooked with bacon grease, ham hocks or fat back (I don't even know what that is...nor do I want to). Those are no longer vegetables, they are cholesterol carriers. And more than half of what we consider "vegetables" are really starches: corn, peas, butter beans, potatoes. All starches.

Then there are the lovely "coffee" drinks everyone is addicted to. A Starbucks strawberries and creme frappuccino has 570 calories! A McDonald's quarter-pounder (no cheese) has 410 calories. Nobody in their right might would eat a quarter-pounder everyday (sometimes twice a day), but a Starbucks frappuccino every day doesn't sound so bad! We're even getting our kids hooked.

And exercise?!? Forget it. The most exercise the majority of people get is RUNNING their mouths, JUMPING to conclusions and DANCING around the truth!

I guess I need to take some comfort from the fact that I will always have a job because people keep insisting on killing themselves slowly, so I guess -- for ME, at least -- it's a good day.