My 2 Hour Talk at Apollo College of Nursing

(The following is cross-posted at my blog with the Archimedes Movement)
Since the community presenters training last spring I’ve been lucky enough to give a few presentations. The most recent was last Tuesday the 4th (election day!) for a class of nursing students at Apollo College of Nursing. I gave an hour long presentation to a different class at the same school in late August, but I had technical problems and scheduling difficulties, so I didn’t fee terribly successful. I was invited to come back though, this time for a 2 hour lecture on Health Policy, The Archimedes Movement, and Leadership in the health professions.

My powerpoint slides are based on the draft generic presentation that Liz gave us at the speakers training, but pretty extensively modified. Here are a few major differences.

1. I re-arranged the order of the slides so that it all fits into three questions. At the bottom of every slide I indicate which question the slide is addressing, to help them keep track of the overall scheme of the presentation

    How did we get here (the broken system)?
    What do we really want (our needs, what would a new system look like)?
    How do we get there (agree on vision, political tension)?

2. To start, I ask them to give me a list (I wrote it on the white board) of why they want to be nurses. Throughout the presentation I continually refer to these motivators, how they are affected by each issue I talk about (e.g. cost-shifting). A major theme is that EVERYONE has their own unique list of motivators, and we have to understand that whatever solution we come up with WILL be the best compromise of everyone’s motivators, otherwise it won’t be a solution at all. I think this is more personal, and easier for them to apply in their lives than the “I commit to be a citizen first and stake holder second” idea.

3. I use funny pictures of Dr. Quinn medicine woman (from an old TV show), and an old french TB poster to introduce the infectious disease model of care.

4. Dr. Kitzhaber uses an analogy where the delivery system is like a car, it’s top speed is a product of the car, not how you “finance” the car. I’ve switched to a hover craft analogy. I say:

    I just finish talking about the American frontier in which the infectious disease model of care was established

    I transition by saying imagine an American frontier without roads. Without roads, a hover craft would be great – you can go 30 miles per hour over all kinds of terrain.

    Now imagine an America with roads – on the highway your stupid hover craft only goes 30 miles per hour, it doesn’t have a sharp enough turning radius, stop time, or covering/protection on the top to even be safe when all the traffic is concentrated on these roads.

    What we really need is cars that can go fast, stop quickly, turn quickly, and have protection and padding in the case of these new kinds of accidents (like colliding with other vehicles) that only happen in a world with roads.

Here’s why I like it better:

    It’s comical – everyone laughs but I think the hilarity of saying politicians are calling for “universal hover crafts” when they should call for electric cars is instructive.

    It emphasizes that the reason our health system has become inefficient is that the context of care has changed – we now can and do treat chronic diseases etc.

    It emphasizes that the infectious disease model (hover crafts) is qualitatively different than a chronic disease model (cars). The hover crafts (infectious disease) are so different from what we need today that they aren’t even safe anymore.

    It makes a solution seem more tangible. Switch from hover crafts to cars jives better with switching from infectious disease model to a triple aim-centric chronic disease model better than thinking about a car that just needs to go faster.

5. I included slides on Barack Obama’s and John McCain’s health care plans, emphasizing that both are talking mainly about financing rather than changing delivery models (I base it on Dr. K’s October 16th video). I also include a quote by John McCain saying that the solution to lowering costs is to deregulate health care like we did with banking (because it turns out banking isn’t doing very well with extreme/radical deregulation in the long term).

6. Finally, this lecture introduced these nursing students to a whole semester on the topic of leadership, so we discussed specifically how health care providers can be leaders. I was pleased that someone had said a motivator was “scrubs = respect.” I argued that the reason people respect professionals who wear scrubs is that they expect them to take responsibility in difficult situations. I even encouraged them to show up to a town hall or the capital in Salem wearing scrubs; it’s harder for legislators to ignore advice about our health system if it comes from someone wearing scrubs.

Some of the slides won’t make very much sense without me explaining them individually, and my notes are certainly incomplete, but I would be happy to answer an email if you have any questions.

I’m getting to the busiest part of my semester now, so I don’t know if I’ll be doing any more presentations until late December. I’ve really enjoyed them though, and I’m excited to have two more talks schedules for January. Let me know if you find any more opportunities!

cheers
Isaac

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