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AAR Patient Safety (NursesTakeDC) Conference, Alexandria, VA 4 May 2017






 
WAY OVER DUE!
 
My own After Action Review (AAR) once again, as there were no attendee evaluations, for the conference presentation titled “MAKE HEALTHCARE GREAT AGAIN!” This time in DC (4 May 2017). However, several attendees, like conferences before did provide compliments.
 
What was supposed to happen (GOAL)?
1. Bring Awareness 
2. Recruit Companions 
3. Arouse Change
 
What was the plan to achieve this? 15-minute podium presentation without Q and A. Presentation slides included links to the book’s web and Facebook pages, to include at the end of the presentation a slide that directs those interested to follow-up via those page links. Unlike the previous presentations of the same content this time I left out the following words at the end of this presentation, “To those interested, I will send you a FREE PDF copy of the book if you ‘LIKE’ the book’s Facebook page.” Words with the intent of getting eyes to the Facebook page, the blog and the book. However, because of time constraints those words were excluded. Although, I do not believe those words moved anyone to follow the links.
 
How did the plan change as it progressed? There was no change to the plan during its execution. That is always because of my inability to present without reading and unable to make changes on the fly. That said, by reading not only do I stay within the allotted time but it ensures I do not leave out vital points from a conversation that matters.
 
Although the following might sound as minutia it is ONLY to point out as part of the AAR and NOT to complain, apologize or documented because of insecurities but instead for my assessment to point out the good, the bad, and/or the ugly and even the simple minutia, the latter which can cause much unneeded anxiety.
 
With that said, because I need access to the notes the conference organizer’s equipment was a bit challenging. No fault of the organization as I and others are their guest and it would not be possible for organizers to accommodate each presenter. Thus, it is each presenter who must adapt to the equipment available. In this case, having to hold the mic in one hand, the notes in another hand, and advancing the slides was challenging initially. Once I found a spot to place my notes I did so freeing one of my hands to forward the slides. However, it was not how I had practiced forwarding the slides thus finding how that worked became another challenge. Next was holding the mic, also something I had not done before and it was the most burdensome as I did not appreciate the mic having to be so close to my mouth. And then, as soon as I got going with the presentation I got distracted of the mic and the mic would drift away from my mouth. My voice’s volume lowering in the audience before I would notice and I would have to accommodate the mic close to my mouth again.
 
Because of the presentation time being so tight to the allotted time that is what I rehearse the most. However, something I have not experienced before and had to adjust to was the audience clapping and cheering. That excitement at times lasting to the point I would have to pause and wait for the it to calm before I could speak again. Most definitely NOT complaining about the audience’s positive reception but simply answering the AAR question. Again, questions intended to assess and recognize the good, the bad and/or the ugly of the activity while also insuring denial or neglect of the minutia is not overlooked.
 
Another distraction was the stage spot light. Its overwhelming brightness a greater distraction than those mentioned above as a conscious effort had to be made to avoid the light. Again, minutia but a learning point for the future.
 
What actually happened? First and foremost, I HAVE FINALLY FOUND MY HOME! WOW! This audience was what I been looking for—tired of the status quo, crazy energy and MOST SIGNIFICANT and APPRECIATED an audience determined to make a DIFFERENCE! More audiences like this one needed!
 
I delivered the presentation as intended but longer than the allotted time as I had to make up for the above-mentioned adjustments. However, I do not believe the audience noticed I had passed the allotted time and was cutting into their lunch time. That aside, based on the audience’s excitement during the presentation I would say it was, HANDS DOWN, the best reception by far, this being the sixth presentation. That perception quantified and qualified even more by the number of persons who later expressed their content and appreciation for the presentation. That one-on-one acknowledgement and appreciation being most significant and rewarding as I take those compliments humbling and encouraging that I am on the right path with the goal of taking healthcare back to MAKE HEALTHCARE GREAT AGAIN!
 
This audience’s reaction during the presentation was significantly different from previous audiences. With previous audiences, I found it difficult to assess the impact of the presentation as those audiences remained unemotional and NOT participatory. Unemotional to the point of blank facial expression to include the absence of reassuring nods and even the presence of pseudosmiles among them from where I was standing.
 
This audience, on the other hand, was significantly larger and despite the stage spot light impairing my appreciation of the audience’s body language it was obvious they were enjoying the presentation. Not to mention, previous presentations were not only in front of smaller groups but the space was also limited to where the audience was and much closer than this audience.
 
That said, for this audience I had a difficult time assessing the reactions to the comic relief mentioned. Comic relief I added after previous evaluations stated the comic relief was missing from presentations before. However, I would submit there was NOT a lack of appreciation from this audience. As this audience was significantly engaged and it was more the fact that I simply could NOT discern which, which, was which [sic], the facts or the comic relief, for ALL the excitement.
 
In the past, I mentioned my lack of deciphering or appreciating the meaning of the blank faces from the audience and instead concluded that I had NO idea how the presentation went or even what happened as it was hard to assess the audience’s reaction. That said, with previous presentations, one thing was for certain despite the blank faces the presentation captured the audience’s attention. However, for the first time, of six, I MOST definitely have NO doubt this audience really appreciated and enjoyed the presentation.
 
This AAR, although like some before lacked formal evaluations, there were many more one-on-one interactions this presentation who mentioned they enjoyed and appreciated the presentation. Some of them sharing with me their business card, something else I believe was a first of six.
 
Also, unlike previous audiences, which had no more than 50 attendees, this presentation had close to 200, if not more in attendance. The audience size I been craving. Another plus, the presentation was not competing with any other session as in conferences before. However, after the presentation I was told by some who missed the presentation, because they were outside the conference room, that they had heard that during the presentation “[I had] lit up administrators in there” or that it was “AWESOME”.
 
Unlike some conferences before there were NO questions and answers after the presentation. That said, I did have individual questions and conversations, which included accolades later when stopped in the convention center by some, ALL welcomed and much appreciated. Again, some sharing their business cards.
 
Lastly as to what actually happened, this presentation did bring MUCH awareness, one of the intended goals, but as for recruitment of companions or arousing change I could NOT decipher either. Part of that lack of recruitment and change arousal could be the conference already had a momentous task at hand, the charge and change of nurse:patient ratios. Thus, my opportunity to present was more as a guest, which I much appreciated and even voluntarily debt myself for, as the organization placed NO such expectations on me AT ALL! However, seeing the bigger picture I am willing to advocate for their agenda and without expectation as well.
 
As mentioned, I did receive 8 business cards and although not a significant number it was a lot MORE than previous. That said, I am not sure what the intent or significance of business cards are. I have been given 1-3 business cards at each previous conference but neither of them lead to anything. Because of that, I DO NOT put any meaning to business cards.
 
When I give someone a business card the intent is that they look up the book, the web page and/or the Facebook page/group of their own interest and without other influence. The hope is either or ALL those sources will spark interest. Other than that, I DO NOT engage in purposeful intent to recruit anyone as I know pushing back is NOT easy and comes with a LOT of risk of losing one’s job. I believe, if anyone wants to get involved they will. Only time will tell.
 
On that note, two administrators have given me their business cards and asked me to contact them for assistance. Yet, when I reached out to each of them, at least twice, neither of them, EVER, returning a reply. Thus, I DO NOT put too much weight on how business can help. But I will look over the new ones and see if there is anything I could benefit from and if so I will try to post those as well.
 
However, I believe that my hope of others joining to push back for this change will evade healthcare for more decades to come. That said, yes, awareness was made, however, with little, if any, impact. However, for this audience, unlike others, I am convinced this group lack of interest is NOT lethargy or disinterest but more about them already having a momentous task at hand and for that they CANNOT take on another momentous task which would be overwhelming. And I agree. Thus, as for the significant goals of recruitment and change nothing was accomplished. Again, NO fault of this audience or organization as they ALREADY have their plate full and MORE reason I appreciate them. NOT for only giving me a platform to share mine but MORE so that they MADE the time and afforded me the venue to do so when so many before have said NO! Thank you, ShowMeYourStethoscope! Thank you! Very much. I wish you success with your crusade.
 
Why were the differences between the intent and what happened? I set out to bring awareness and change to this silent national crisis knowing one person can do neither and why I need companions. I did so by jumping into this without any idea on how any of that gets done and how time consuming it would be. Because of that, I have accepted I am going to trip, make mistakes and/or not hit the mark every time or at all. I realize my Knitted Brow and my “matter of fact” and inflammatory delivery are not the best as far as any of this goes, although I believe this audience appreciated all three. However, as stated in EVERY AAR before, right now there is no one else. And healthcare’s submissive nature does not help, although this audience was as far from submissive as one can be, at a minimum, they were SUPER vigorous!
 
That said, describing other audiences is not redirecting blame or an excuse as to why I am unable to obtain the other two goals, recruitment and arouse for change. But simply pointing out that the battles are going to be tough and long with only one of two choices, keep trying or canceling the crusade of taking healthcare back to MAKE HEALTHCARE GREAT AGAIN! That NOT a fancy pitch, although it really is, but in this content more of just being factual as to what there is to gain from pushing versus losing because of apathy.
 
On top of that, and likely the single most significant factor in all of this, who wants to be unemployed, a point made during the presentation and shared with some of who I spoke with later privately. That said, because of those, especially the fact that no one wants to be unemployed, and who can blame them, I realize that I am asking a lot from anyone to cross to my side and help to push back. That said, this audience significantly more receptive than ALL groups before combined, if measureable in that manner.
 
That said, I really have NO idea why this group was SIGNIFICANTLY more receptive and emotionally charge than others as the presentation content was the same for ALL, with very minor changes intended to target each audience. Although already mentioned I have NOT been able to decipher any audience’s triggers. However, it could be this audience was already SUPERCHARGED related to their agenda of seeking HISTORIC and MEANINGFUL change related to nurse to patient ratios.
 
What worked and why? The presentation content and context were received well as documented above regarding the audience’s reaction and the many one to one thank yous. One gentleman, in particular, saying to me, “You lit up administrators in there.”
 
Regarding the goals only awareness was achieved, as said so many times before, that is because although everyone in healthcare is aware of this problem NO one want to talk about it in public. Other than that, despite ALL the excitement, not much more was accomplished regarding the other two goals, recruitment and change. That said, in NO manner is this audience at fault for that as their plate is significantly full already with championing nurse to patient ratios, which is also an uphill battle and I wish them well.
 
As mentioned early in this AAR, at the suggestion of someone in the past I added comic relief I had taken out. However, I was unable to decipher the impact with this audience for the reasons already mentioned. That said, as before, despite unable to specifically appreciate the comic relief I believe it was a hit and despite not specifically assessed it will be kept permanently.
 
To those I mentioned the FREE PDF copy available for download the response was overwhelmingly positive. However, I cannot assess if the file is downloaded at all or downloaded a million times and something I should try to find out if such data is obtainable from the site.
 
Different from before this time I use the iPhone to access the notes and it worked better than the tablet but not better than the laptop, which by far is the best, and here the laptop would have been just fine with the handling of the loose mic. Unfortunately, the laptop was too large to share the podium with the equipment already there. But the loose mic made it difficult. Otherwise, the iPhone, as with the tablet/laptop before, it helped with staying on time and on message thus that too stays.
 
During the past five AARs the following was the same, the tablet and the humor were the only two components of the presentation which I was convinced were effective but nothing else with regard of reaching the goals of awareness, recruitment and change. However, I believed both the content and context of the presentation were on the right path despite not obtaining the goals of recruitment and change. Because of that I will hold on to the content and context as being on the right path. Especially, after the reaction from this audience, for the first time of six, which confirmed for me that I am on the right path.
 
What didn’t work and why? Specific to the presentation content and context more difficult to assess on my own. However, from the audience’s reaction described above little of the presentation didn’t work.
 
As for the mechanical portion of the presentation, having to juggle the iPhone, the mic and advancing the slides was a bit challenging. However, those are circumstances that are unpredictable and for which one can only adapt to and overcome once at the podium.
 
Regarding the goals of recruitment and change not being obtained mostly falls on the fact the audience already had an agenda, and a good one at that of nurse to patient ratios. Nonetheless, an audience with an agenda already is a difficult crowd to get to change to yours. On top of that, I would say there is a greater and VERY REAL risk of being unemployed from pushing back against customer satisfaction in healthcare than any other issue and likely another reason for not gaining companions. For example, nurse to patient concerns to be chalked up to patient safety. Something a discontent customer can NEVER be deflected to.
 
That said, there could exist other variables that I am not able to appreciate as to what isn’t working or why. However, overall, I see what I am doing as being on the right path. Now more than ever based on this audience’s positive reaction and those who have commented that I am a voice for many. Of course, that challenged by those who have described the content and context as inappropriate previously still casting that doubt despite no one in this audience made those negative comments of discouragement.
 
Nonetheless, the day after numbers: -Facebook New Likes: EIGHT specific to those met at conference (By FAR, the most ever of the six presentations thus far. The most EVER previously being ONE and only once in six presentations.) One person did load up a picture on to their Facebook page with the caption, “Thank you!!!” But that person not specifically “Liking” the page. On that, I am still trying to figure out ALL this social media and its worth versus time invested and keeping up with it. Facebook Group joined (NEW metric): FOUR specific to those met at conference. -LinkedIn Profile views: ZERO -Website views: A whopping 287 viewer spite after the presentation then sudden drop to previous trends the following day. Because of that obvious spite and drop the spite more likely related to the posting of the presentation transcripts and not related to the presentation itself. Thus, ZERO impact as well. -Amazon: The book rating did raise from 3+ million to 200+ thousand. But that rating difficult to discern as the book has been discontinued at Amazon and others. And although book sells have never been a goal it was another metric. Twitter (NEW metric): Since the presentation another NINE followers were gained but not sure related to presentation. Again, social media NOT understood well. -Hearts and Minds changed: Hard to assess but looks like at least EIGHT interested! Although those numbers paint a better picture than previous I am not sure an accurate one of not much accomplished. However, and a HUGE however, despite those anemic numbers I would say this was the most rewarding presentation thus far and still encouraging as the previous in Hawaii also was encouraging. That would be two in a row.
 
Now, although a self-AAR does not permit an appropriate evaluation of the differences between the intent, what happened, why what worked or didn't work the numbers are still the numbers. And although the numbers are NOT encouraging for ALL the time and effort it seems overall the ball is rolling in the right direction as far as the content and context.
 
What could have gone better? More than ever this audience confirmed the message is the right message reinforcing that those who agree are more in numbers than those who have expressed dissent. This audience’s positive feedback is the sign that I am on the right path. Although the path is a VERY LONG haphazard mountainous road of exhausting climbs and sudden drops it is the right path. Not a pleasurable path by any means but instead a tiring and punishing climb. Despite the hardship, it is the right path to be traveled to get to the goal, taking healthcare back to MAKE HEALTHCARE GREAT AGAIN! But, despite that encouragement, without more input from others it is hard to access if any of this is correct or not or even worth anything.
 
Thus far, the only ones who have told me to tone down the message have been healthcare administrators and those despite they agreed with the message. At this event, no administrators identified themselves. Not that it would matter as I have reached out to those administrators, who asked me to tone it down, via email after previous conferences and NONE, ZERO, have replied. However, it seems this audience had no issues with the tone either.
 
That said, as mentioned in previous AAR’s, regarding the message’s tone, I get it. But it is hard NOT to point out that the root problems of ALL this chaos in healthcare are healthcare administrators who have sold their soul to outsiders with any other tone. But, again as said in previous AAR’s as well, I know the spokesperson for this message could be better and should be better than what I can deliver but for right now there is only me. Believe me when I say no one is asking for a better spokesperson than I as I rather not be on stage, just not my personality.
 
For this audience, a fifteen-minute presentation was more than enough to get the message across. That mentioned as I have gone back and forth as to what was adequate time for such a large and complicated problem that requires a complicated and multifaceted solution. As I have stated before and as this audience proved fifteen minutes is more than enough time to get someone to look in your direction if they are interested.
 
Granted the sixty-minute presentations allow for more elaboration of pertinent and convincing information. However, although the longer time brought awareness, one of the goals, none of the longer times presentations brought change or companions (the other goals), or changed the numbers related to FB “Likes”, pages viewed, etc..
 
On that note, I have thought, over and over, about developing a 6-8 hour program to present as Continued Medical Education (CME). However, that is a huge project as far as I am concerned and I am not sure I am up for it as these presentations already take up enormous amounts of free time for which I am not compensated. And although ALL of this began to channel my frustration with the current healthcare system as related to chasing satisfaction scores it has not accomplished anything for anyone else, myself included, and much less for healthcare. The one ABSOLUTE accomplishment it has made is burn LOTS and LOTS of my free time. Free time I can better spend with my three loves!
 
Also, I have considered that maybe a poster presentation would be a good idea but after this presentation I am going to skip that idea as well. If this presentation in front of this lively audience did not move the metrics mentioned above, how would a poster sitting there passively accomplish more. Thus, another idea out the window.
 
I did pass out a few business cards, about five, and collected another six. I know both quantities are insignificant but scholars of these social adventures say all that is needed is only one to the right person to take off. Not to mention, both, five distributed and six received, are exponentially more than ever before. I did hear someone say to me, “After that performance you are going to get a lot of calls.” Not sure what that means but nonetheless that is what I was told by one person. Otherwise, it is hard to tell what the outcome of any of this will be, whether in the short or long run.
 
In the past I had forgotten the business cards but this time I made sure to bring them. On that note, interestingly, because of plans to attend the rally on Capitol Hill, as part of the conference, I made information sheets to pass out in case I ran into a legislator. But because the rally was the following day I left those sheets in the hotel room during the remaining of the conference, putting them away during lunch, which was just after I had presented. Unfortunately, one of the afternoon speakers, right after his presentation, mentioned he was leaving the conference to meet with Health and Human Services Secretary Tom Price and I missed the opportunity to share one of those information sheets with the speaker who could have shared it with Secretary Price. Damn!
 
Secretary Price being one of the persons I have sent letters to about abolishing the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys without a reply. Here was a HUMONGOUS opportunity of possibly getting that information sheet to Secretary Price but I missed out. DAMN! I REALLY SUCK(!) at networking and all the social Kung-Fu that goes along with it.
 
That said, I also missed out on pitching an emergency department survival television show idea with a television personality who was also a speaker at the conference as well. A television idea that has been running through my brain for the past fifteen years and when an opportunity to pitch it the idea was nowhere to be found until I was on a plane heading home. DUH! Again, networking NOT MY THING!
 
I was asked if I had any book copies with me, the answer, “No.” Not that it matters as the book is no longer available from the publisher. Maybe I need to add the PDF offer again. That said, later that day I did share a PDF copy with the one person who showed interest by “Liking” the book’s Facebook page. However, I have done that before as well without any feedback. But only time will tell where that will lead as well. I also offered to send one person a signed copy of the book. That said, I did not have any books to share but I have shared several books (50-60) thus far without feedback. So, not sure that would matter either.
 
Not kept due to time constraints but likely would have been beneficial with this audience I did not get to mention the book’s PDF version being available for download. However, I have NOT been able to decipher which audiences would appreciate what content. For example, I thought the presentation would have been most appreciated at the violence conference, however, that was not the case. If anything, the reception at that conference was luke warm, if that.
 
That said, unlike previous presentations of the same content this time I left out the following words at the end of this presentation, “To those interested, I will send you a FREE PDF copy of the book if you ‘LIKE’ the book’s Facebook page.” Words with the intent of getting eyes to the Facebook page, the blog and the book. However, because of time constraints those words were excluded. Unfortunately, if any group this would have been the group to share those words with.
 
So, what could have gone better? I must keep practicing my words and their delivery. I need to improve networking. I need to work on being faster on my toes for when opportunities present themselves. Maybe have a few thumb drives with the PDF version on them to give to those who ask for a book. The thumb drives are much lighter than the books to carry. However, thumb drives can get costly.
 
What advice would you give yourself if you were to go back to where you were at the start of the project? I am not the right spokesperson, period. I realize and honestly believe a different spokesperson would be a significant game changer. However, right now there is no one else. Can the tone, especially regarding administrators, be minimized? Anything is possible, however, I find it hard to convince myself of minimizing the tone directed at healthcare administrators and outsiders as I fully blame them for where we are in healthcare today. It is healthcare’s altruistic, submissive and accommodating culture which has allowed others to not only walk all over us but to wipe their feet on us as well. Because of that, I cannot convince myself that lowering the tone will get us to taking healthcare back or MAKE HEALTHCARE GREAT AGAIN. I truly believe that pulling back on the tone only takes the heat off those who have taken us down the wrong tracks, which is why administrators have been the only ones to point the tone out. That said, I believe a more articulate spokesperson could deliver the message better despite the tone.
 
I have watched LOTS of TedTalks presentations, LOTS of them, including Fred Lee, and many others speaking but I cannot find myself among those individuals and much less possess their talent to deliver their message, whatever their message is, so effortlessly. I just am not a spokesperson, PERIOD. But, again, there is no one else. And, again, as pointed out so many more times before, I have but two choices. One, continue until a better spokesperson appears or, two, cease in trying to bring awareness, recruitment and change that is so desperately needed.
 
On that note, despite the already manifested likeliness of a poster presentation and/or a 6-8 hour program being a big waste of time and effort, just keeping it honest, most definitely there is no sense in pursuing a poster presentation. However, as for the 6-8 hour program there is still a honest consideration to consider such.
 
Since the last AAR, when I mentioned reaching out to Senator McCain being of greater perseverance that perseverance accomplished NOTHING! That mentioned, as another presenter at the conference mentioned a similar dead end journey with her legislator ONLY to gain that attention after writing a check, as a donation, to the legislator’s campaign. A line I refuse to cross as I see that as part of the problem, another industry, without fixing the problem, that being another conversation.
 
However, since NOT getting anywhere with Senator McCain I reached out to Senator Jeff Flake, also from Arizona. Yet, despite actually speaking with someone on the staff not much was gained either. Senator Flake’s staff pointing out that ABOLISHING HCAHPS has NOT been mentioned before as an issue. Which likely was true, however, something Senator Flake can NEVER say again as I have NOW brought it up and will continue to do so.
 
Aside contacting Senator Flake, I also sent a letter to Human and Health Services (HHS) Secretary Tom Price Jan 2017 but also no return correspondence since. One minor detail I left out of that letter, which came to mind while at the conference, was President Trump’s intent that for every new legislation that two must be removed from the books. With that in mind, another letter to Secretary Price is due with that approach. That HCAHPS be ABOLISHED as one of two legislations needed to be removed from the books in place of the new American Healthcare Act being implemented.
 
To those I mentioned the FREE PDF copy available for download the response was overwhelmingly positive. However, I cannot assess if the file was downloaded at all or downloaded a million times and something I should try to find out, if such data is obtainable from the site.
 
That said, I need to somehow reinstate the PDF offer during the presentation so that everyone is aware rather the few spoken to individually. Something else, I need to figure out how to convince others to follow the blog, “LIKE” the FB page and join the FB group.
 
Maybe I can find a way to pass out USB drives with the PDF already loaded. Not sure that cost but worth looking into it.
 
What are the key lessons to share with others? (1) This audience most definitely confirmed the heart is in the right place. (2) The message is the right one and this audience liked the tone. (3) Comic relief is effective. (4) With that said, the greater need and importance of ALL of this is to bring awareness, recruit companions, and arouse change. Without those this is nothing more than talk without accomplishment.
 
What next? Another 15-minute podium presentation on the same subject is scheduled for 13 Jul 2017 at STTI Conference in Vancouver, BC, Canada.
 
On top of that, another abstract submission is pending approval and another one or two are likely to be submitted. However, again, when it comes to submitting more abstracts time is a huge lost luxury. Nonetheless, the intent continues to be the same: awareness, recruitment and change. As mentioned in previous AARs, more, in many forms, is needed under the belt to get the foot in the right doors thus submitting more abstracts. Despite most have been rejected and a huge loss of time more will continue to be submitted. At least until I tire. With this audience’s enthusiasm getting tire might take some time.
 
As already mentioned other vehicles to consider would be the class presentation format despite not appealing to me because of time wasted. And of course, continue to reach out to now Senator Jeff Flake (AZ) and HHS Secretary Tom Price as well with greater perseverance about abolishing HCAHPS, as either in our corner will MOST definitely turn heads. As for Senator John McCain (AZ), he has been of NO help thus written off.
 
Maybe rewriting the book and republish since the publisher canceled its publication.
 
What should be expected in a year from now? Hard to say, as the book was out for 4 years, before it was cancelled and this was the sixth attempt to gain companions without gaining any, again. Although getting Senator McCain’s would have been a HUGE game changer he was of no help; he didn’t even try. Senator Flake’s and/or HHS Secretary Price’s attention would be HUGE game changers as well despite right now more a fantasy than obtainable and the same goes for trying a class of the same theme/intent. But I am willing to try despite another side of me is convinced that with the book cancelled and the needle not moving thus fur it might just be time to move on. But only time will tell.
 
Any personal lessons? I never thought this was going to be easy. But I never thought it was going to be so frustrating either and even worse so much time wasted. And why, after not moving the needle, again, like so many times before I considered putting down the guidon (flag). However, at this conference I was given even more energy to press on than ever before. In the past I have had to remind myself that although these writings began as therapy it has evolved into something else and not about me any longer but about taking healthcare back. But if not me who? My bridges are already burned thus I have nothing to lose other than time, and a LOT of time it is and a LOT of time has been wasted thus far. Time during which I could be doing LOTS of something else for a LOT more other reasons. However, none of those reasons are what any of this is about.
 
In the past, and once again, I find encouragement in Thomas A. Edison’s words, “Many of life’s failures are people who did not realize how close they were to success when they gave up.” As encouraging those words might be there has never been anything for me to gain by succeeding here either. However, I truly want to take healthcare back and MAKE HEALTHCARE GREAT AGAIN! Not for me, as that time has long passed, but for others.
 
However, the bottom line is time. And does it take a lot of time. It does! Time during which I could be doing, as already said so many times before, LOTS of other things! Additionally, at some point I might realize “what is the point?” But until then I will continue to submit abstracts and pursue those mentioned hoping that at some point I will capture someone’s attention. Until then!
 
Conclusion: Other than myself being my harshest I have to remind myself of Nelson Mandela words, “You don’t make peace by talking to your friends (the choir); you have to make peace with enemies.” Got it. However, healthcare DOES NOT have enemies. Instead, healthcare’s problem are healthcare’s workers and healthcare’s culture. And until those changes NOTHING will change in healthcare.
 
By the same token, while being my own harshest critic I am also the biggest hindrance to taking healthcare back as I am NOT a good spokesperson for any of this. That’s not but facts. Having said that, criticism of myself or from others I can handle but finding another spokesperson is going to be quite the challenge as no one wants to be without a job. Yes! I get it. But then a little voice inside my head reminds me, “Warriors are not the ones who always win, but the ones that always fight.” -Unknown
 
Again, a lot of time and effort goes into these presentations for nothing to be accomplished. Also, as already mentioned, the book has been cancelled, and although I realize my writing sucks I counted on the intent of taking healthcare back to make healthcare great again as being the only message and goal of ALL of this, yet, I have gotten nowhere.
 
I realize Florence Nightingale didn’t change nursing overnight either. And before the emails from critics, in NO manner am I comparing myself to Florence, oh no, but instead just reminding myself that change is never accepted or so easy. And why the underlying message is to press on! The more exposure the more exposure, I guess. Most definitely, reaching out to Senator Flake and Secretary Price, although a fantasy, a HUGE game changer and nothing to lose by doing so but more time.
 

THANK YOU to everyone who attended the presentation, especially those who “Liked” the book’s Facebook page, joined the Facebook group, and those who encourage me to press on!

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