Today's Women in the LDS Church

Background

An article I read this weekend has really had me thinking. I have read several articles about the Ordain Women movement the past few weeks. Many of them pro, and others against. It is an interesting topic to me, and I wonder about all of the drives for it and the intense anger against it. Many of the articles I have read have been kind. People are simply trying to express their views on one side or the other. Each side will give reasons for why women should be ordained to the priesthood, or why they should not. Although most of the articles are nice, the comments are often nasty and unbecoming of members of the LDS Church.

There are other feminist movements of the church, this just happens to be the one I have seen the most about. I believe it is simply because of the LDS Church's General Conference happening this weekend, and the Ordain Women supporters going to see if they can be admitted to the Priesthood Session. It makes this a very current issue.

But a further discussion on that topic can be held at another time. That is not what I want to comment on today. Today I want to comment on an article called "Why Aren't the Women Included in This?"It is from a website called rational faiths.com, which raises my eyebrows a bit. I don't believe that Mormonmism can really be called rational in many ways... Yet the article was still interesting to me. It can be found here.

Summary

The article highlights an interview from Sister Chieko N. Okazaki who has served in all three women's general auxilliary presidencies, most notably as the First Counselor in the Relief Society General Presidency from 1990-1997. The author highlights points of the interview where this highly ranked sister admitted that women of the church are often not consulted and sometimes not even informed about things going on in the general councils of the church.

For instance, the Relief Society presidency felt that a curriculum change needed to be made in Relief Society. Sister Okazaki worked hard, prayed, and put together a draft of a new manual that could be used instead. When she presented it, she was told that the brethren had already considered that a change needed to be made, and they were almost finished with the new manual for Relief Society and Melchizedek Priesthood quorums. Interesting that no one even in the General Relief Society Presidency knew that this was taking place.

A few smaller examples were also included, such as the fact that the Relief Society President at the ward level is only included in Ward Council meetings, while her presence in Bishopric meetings was suggested as a very needed and helpful possibility for change.

Also mentioned was the fact that The Family: A Proclamation to the World is often cited as doctrine, but the article argues that this is incorrect. Any new revelation that is truly doctrine should be canonized as scripture. The Proclamation has not. In fact, the official word on the document is that it is a "guide that members of the Church would do well to read and follow." (See "Cleansing the Inner Vessel" by Boyd K. Packer in the October 2010 General Conference).

The author then mentioned some of the movements within the Church, such as Ordain Women and Young Mormon Feminists. She pointed to some historical data that she feels proves that women's roles within the church have been diminished. For instance, when Joseph Smith, Jr. organized the Relief Society, they were much more autonomous and he referred to them as a "Kingdom of Priests." Women were also anointed with oil and provided blessings by the laying on of hands for those who were ill.

The movements mentioned above are defended as the sisters are explained to be faithful women who are aware of their history and simply want to be included in the church that they love so dearly.

My Two Cents

This article had a big impact on me. While I still would not wear pants to church in protest or affiliate officially with any of these organized groups, I have had my own moments of feeling down as a woman in the church. It can be very difficult. And I have seen it on so many levels- in families, in wards, as I have served in "higher" positions, from other things I have heard, and now at the general level from Sister Okazaki. The fact that I am a woman has probably tested my faith more than any other piece of doctrine or personal experience.

When I first read this article, I spent a day reliving some of the strong hurtful emotions I experienced as a youth. I still remember driving with my mom, telling her that I didn't understand why I couldn't have the priesthood. She told me that if women could have the priesthood, the men would become lazy and the women would have to do everything. That comforted me even though I knew that this could not be the actual reason. I had very low self-esteem as a teenager, and still struggle much of the time. When I was young, my female identity was one of the hardest things for me to accept. Somehow, though, I have been able to find a sense of worth as a woman in the LDS Church. That part no longer bothered me until reading this article.

The article was very well written. It actually made me feel bad about myself as a woman again for a day or so. I thought about some of the times that I felt I should have been listened to by my church leaders or even my dad or my husband and blamed it on my gender. I felt convinced that the Lord's Church should not be run in a way that causes this kind of inferiority.

Despite my initial reaction, I took a few days to think about it. I applied many of the General Conference messages to the thoughts running through my mind. I came to the conclusion that it is rather unfair to base such a widespread argument on a few examples. Yes, there may be times that women could have been included but were not. Yes, there are times when work is doubled because of lack of communication, times that women would have done things differently, and times that many people would feel that a woman's opinion and thoughts would have improved something. All of those things may be true.

But all we know on the topic is what the world has taught us. We live in an age when we have been taught to celebrate women's rights. We have been taught that we need to feel like we've been treated as inferior so that we can rise up and take what we deserve. We have applauded the "advances" that women have made in the world, and now want to apply those same principles to the Church. The Church of Jesus Christ. His Church. And I don't say that because Jesus Christ was a man. But because He knows much better than any of us do. The world has taught me that I am not good enough yet and need to keep fighting to get everything I deserve. But the gospel has taught me that I am a loved, cherished daughter of God and am already of infinite worth.

When we view the roles of women within the infrastructure of the church through the world's eyes, it looks unfair. It seems like things could be better. We feel diminished in our self worth because of our perceived diminished role within the church. It is easy to feel that way. But maybe we are just taking our worldly experiences and attempting to apply them to something that isn't as related as we think it is. Rather than being upset that the church is causing me to feel inferior, I am upset that the world would try to tell me that I am inferior because of the church I belong to.

I'm not necessarily saying that the way the LDS Church is run is perfect and how dare we ever question anything about it. I'm just saying that perhaps this shortcoming is not as big of a deal as we want to make it out to be. That we get distracted by specific follies and divert our emotions and attention to something non-docrinal that truly has no bearing on our eternal well-being. Maybe it is true that the Bishop of your ward should have listened when the Relief Society President recommended a name for a calling. Maybe it would have been wonderful. But no one is going to lose out on their eternal salvation because of it.

Now, I do not believe that women should just sit back and "take it," as it were. I have no problem with women politely brining such issues to their immediate leaders and kindly pointing out what could have been avoided or helped by involving women more. I think it would be very effective and needed for people who know each other to communicate this way. I hope that the highest levels of the Church were able to read Sister Okazaki's interview and made changes because of it. However, openly demanding or demonstrating to make a point just doesn't do it for me. I would never want to bring negative attention to the church I love so much.

The important thing for me is to know that Heavenly Father loves me, Jesus Christ atoned for my sins and was resurrected, and His gospel has been restored and can be found in the Church of Jesus Christ of Latter-day saints. Other things may not be perfect. I may not always agree with how things are ran. But my testimony does not depend on those details. If I spend too much of my time worrying and focusing on them, however valid my concerns might be, I will be an easier target for deception and distraction. As people we are not yet perfect in this world. And as we try to run Christ's Church on the earth, it will not be perfect either. I will not just sit back and take whatever is going on around me, but will share my feelings with patience, love, and forgiveness. Then I will return to my testimony as my focus whether a change is made or not.

If You Had to Choose, Would You Rather be Pleased with Customer Service, or Alive?

Background:

An article published on Medscape recently discussed some of the drawbacks of the new focus in healthcare. The government in America has decided that what healthcare providers get paid partially depends on how much their patients like them. It is their attempt to get rid of the "fee for service" type of payment that has ruled until now. According to them, the current system rewards for doing things. Thus, the onslaught of unnecessary procedures. It is thought that doctors and hospitals will order things like expensive MRI's when there really isn't a good reason for them just because they can bill for it.

So the new idea is that reimbursement should be based on how happy the patient is. If surveys show that your patients love you, a more substantial check is in the mail. If you happen to care for a more unhappy population, better start pinching pennies.

Summary:

This article was written by a physician who sees the problems with this arrangement. The article can be found here. However, you may be required to put in a username and password. Since most people probably don't have that, here is a quick summary:

The physician in the article had presented on RSV at a conference, emphasizing that antibiotics should not be given for this viral disease. The reasoning is that antibiotics don't attack viruses, they attack bacteria. Also, giving antibiotics for unnecessary reasons causes resistance for the individual and society. Later, he had conversations with multiple other physicians who stated that they knew this was true, but their patient's and the parents weren't happy unless they got antibiotics. Since reimbursement is tied to patient satisfaction, physicians felt that they needed to give out the antibiotics. One said his satisfaction scores rose 7% just by giving antibiotics to anyone who came in with some kind of cold or cough.

The author states "I believe that this little-known company, Press Ganey, [the company organizing the surveys] from South Bend, Indiana, has become a bigger threat to the practice of good medicine than trial lawyers." He argues that this system encourages healthcare professionals to provide care based on what the patient wants, rather than what they need. Often, these two things do not match. He also cites research that shows that the most satisfied patients get the most care and are the most likely to die. In other words, over-treating someone because they want it, just to make them happy is not beneficial. I might add, financially or physically. 

To prove his point a little more, the author tells of a time a woman came in asking for a medication for her prostate, just because he had a coupon for it. He also points out that it discourages physicians from approaching sensitive topics, such as obesity and smoking. A smoker doesn't want to be told that smoking is causing their illness. So if you want full reimbursement, don't address that. Just treat the problem without encouraging treatment of the cause.

Now I hope I have summarized fairly. Please don't get the impression that they physician was at all implying that the average patient is stupid and doesn't know anything. Simply that they don't have the training and background necessary to understand why they do and do not need certain things.

My Two Cents:

As I read through the comments, I saw mostly agreements to the fact that this is a problem. Granted, only medical professionals are allowed to comment. That does make the discussion rather one-sided. Being a nurse myself, I do very much agree that patient satisfaction truly has little bearing on whether or not good medical care is given. Some people say they would rather have a nice doctor who may not be as expert as another. In many serious situations, I would rather have a complete jerk of a doctor if he was the best in his field. But just because he isn't nice to me doesn't mean he deserves to be compensated less. In fact, if he does a better job, I would be willing to pay more.

From the hospital perspective, there are not many situations that someone is happy to be there. Perhaps if you have just had a happy healthy baby. But other than that, most people would rather not be in that particular predicament. That makes for sad, grumpy people filling out the surveys that determine pay. Pretty inaccurate and unfair in my opinion. Plus if even one thing is not up to par, say the food is bad, people tend to perceive that as being a total bad experience, and when given the chance to comment make it known. They often overlook the other great things that happened. (For instance, if their life was saved).

All that being said, I think some healthcare professionals take an approach that is unfair to their patients. For instance, the article stated that "Patients aren't the best judge of what is best for them." While that is often the case, I do not entirely agree. Every person needs to be heard. Every body is different. Because of that, no one prescribing or carrying out care for another person can assume that they are always right about what is going on or what the best treatment is. And I don't think that it is fair to say that the reason patient satisfaction shouldn't drive reimbursement is because patient's don't know what's best for them. In reality, it is simply not a measure of quality of care. But that doesn't mean your doctor is always right.

Here is one comment I especially appreciated:

"I agree that we should do what is right, but we must not forget to tell the patient WHY we made our decision."

THANK YOU. I simply think this is such an important point. Patient's may not have the training and background that physicians do, but most are capable of learning about their own specific ailments. In my opinion, providing health care is a partnership, not a dictatorship. Best results will be achieved if the provider of care explains what is happening, what the options are, and what each option would mean to a particular individual. Then a discussion can ensue where the patient can weigh the risks and benefits for them. It then becomes their own decision whether or not to take the medication, go through with the procedure, or begin the treatment. In fact, this approach may provide the best care for each patient while maintaining high satisfaction for most.

It is also something that rarely happens. I think there are a lot of things patients would not ask for or want if we were completely honest and upfront with them about the risks. I also think people have a false sense that everything that happens in healthcare is safe. Even if you do mention the fact that a procedure can cause severe infection, bleeding, loss of function or even death, people don't take you seriously. Better education on the part of the professionals would really help rather than hurt.

Just as an example, whenever I started a patient on a new medication,  I would print out a 3-5 page information packet on the new drug. I would highlight under "indications" the reason it had been prescribed for that patient. Then I would highlight other important information, especially potential side effects. There were so many times people were so surprised to hear all of the problems medications can cause. It was as if they never imagined that something prescribed by their doctor could hurt them in any way. But they can. I think if we were upfront about these possibilities, more patients would pay attention to what they are taking. Hopefully more would have a relationship with their pharmacist and always have him/her check their list of meds when a new one is added for possible interactions. This is just one example of an area where health care providers do not share enough information with their patients.

As another side note, physicians should not have to feel that they have to provide care they don't agree with. Patients should have a choice, and their providers should have a choice. If the two do not match, that partnership should end. It should be a kind and understanding separation, not one of judgement after a battle of wills. No doctor knows what is best for everyone. Their opinion of what is "best" will always be tainted by their own views of life, death, illness, and the social issues that surround these and similar topics.

Let us all show each other some respect and work as teams instead of competing against one another to see who is "right."

What Nurses Don't Say

I recently came across a blog article called "30 Things Nurses Almost Say, But Then Don't". The blog article can be found here, and I highly recommend you read it and a few of the comments before continuing. If you decide you don't have time, here is a brief overview:

Nurses are good people and want to help you. But their work is hard and frustrating at times. Sometimes, we just wish we could be more frank with our patients than we really are, even though shortly after thinking any of the thoughts we probably feel a little guilty about it. Here are a few of my favorites from the list.

4. I require nutrition to function. My taking lunch is not to punish you. I really need to eat.
7. I noticed you’re able to sleep, eat, and/or talk on the phone with that 10/10 pain. Interesting.
12. Don’t abuse the call light. It may disappear.
19. My feelings get hurt too.
22. Removing your oxygen mask doesn’t help you breathe better. You will die.
26. Just because I’m sitting doesn’t mean I’m not working.

I very much enjoyed the article. I thought it was fun and a lot true. I don't actually want to comment on the article itself, because I thought it was well-written without being mean. However, I was surprised by some of the comments. A battle began between people who had been hospitalized feeling upset about the call light remarks and nurses/the author defending the jabs. The author was clear that she was simply trying to be humorous, and not in any way wanting to downplay the importance of people using the call light when they need something. There were a lot of people expressing their views of poor service when they called and no one came for more than 15 minutes or people were rude to them when they called or that they never knew what to call about.

Here are my two cents on the issue, that is surprisingly more sensitive than I ever thought.

First of all, underutilization is a much larger issue than over-utilization. I would say maybe 20-40% of my patients would use the call light correctly. (I forgot to mention I am a nurse and worked on a hospital unit for 3 1/2 years. That's why I feel like I can comment on this). These are the people that call when they need something, and understand that it might take a few minutes to get something less important, but are also grateful when their request is fulfilled. 

More often than not, patients will sit in their beds waiting for someone to come in so they can ask for something. While that is okay for some things, many things people want are either easily granted or important enough that I want to know about it. For instance, I personally want my patients to be comfortable. So if you find yourself cold and want a warm blanket, just ask. If I am available, I will get it right away. If not, I will still probably get it to you sooner than if you just wait for me.

The other part to this that is not helpful is to send your family members out to the nurses station to tell me what you need. This plays into #26 above. True, I feel more obligated to get that cup of ice right now because you are standing there and your loved one might get it a whopping 3 minutes sooner than if you just requested it over the call light. But whether you mean to or not, you are giving off the impression that your loved one's ice is more important than the charting I am doing, the antibiotic that I need to hang, or the possibly life-changing results I might be looking up at the moment. I feel like you are assuming that I don't care. You think I am a bad, mean, lazy nurse. Because of those traits, you must stand there to babysit me and make sure I fulfill your request NOW. After all, I am just sitting at the desk. I can't speak for all nurses everywhere, but I personally will always try to get to the wants and needs of all my patients as soon as I can. And that almost always means that I need to prioritize and organize. It is not very organized for me to get up in the middle of typing something to grab something for your family member. Nor would you want me to stop in the middle of charing on said loved one to get someone else something. Common courtesy.

Now, please understand that if there is something that needs to be taken care of right away, I have no problem with a family member coming out to get me. If my patient is throwing up, seizing, has a sudden change in condition, or has diarrhea and really needs to get to the bathroom now, there is no problem. It's the other stuff that can wait 5-10 minutes that cause this issue.

But the thing that I think bothers people is when nurses complain about patients using their call light too much. For me I would say this happened only 5-10% of the time. We talk about it because it can be such a rock in our shoe. Usually these people just want attention, company, or truly think they are the only patient out there. There have literally been times I have gone in and out of the same room 4 times without any other stops to get things, only to have the call light ring again 30 seconds after I think I'm finally done. Most of the time it goes something like this: 

"I was wondering if you could refresh my water." I bring more water. "I forgot I also need a warm blanket. Or two." I get them a few warm blankets and tuck them in. "Could I actually have you fix this IV tape? It has been bothering me for an hour I just didn't think of it before." I get  another dressing, spend a few minutes fixing everything up, and think everything is good to go. I leave the room and before I can even sit down, hear the call and see the light go on over the door. I pop my head back in, and learn my patient also wanted a yogurt before going to bed. Keep in mind that every time I would get something, before and after would ask if there was anything else they needed. The answer was always no until each individual task was complete.

Now none of these things are bad in and of themselves. But it would be enormously helpful if people could make a list or let me do two things at once. I would much rather get you fresh water and a warm blanket, instead of water and then a blanket. I have never had this problem with a patient who is incapable of figuring this out. I would never be bothered if someone was in a mental state that made it impossible for them to understand what they are doing. But those aren't the people that do it.

So in my opinion, nurses complaining about abundant call-light use does not reflect on most people. I would bet the people that get offended by the comments would not be categorized in that group. The people that we do complain about likely don't even know it or don't care.

As a nurse, I want you to use your call light. I want to know what you need. I do wish there was a better system because there are times that whoever answers the call light doesn't tell me. Then you wait and wait and don't get helped. That frustrates me possibly more than it frustrates you. I don't know how to fix those kinds of problems. Just know that when nurses complain, it probably isn't about you. And if it is and you were reasonable, it just means your nurse needs to cut you a little more slack.