Mar 29, 2009 fifth sunday of lent

Thommy and John

Good morning
I love you

Happy Sunday -
Sunshine and wind in Greensboro; three inches of snow [so far] in Chicago.

How are you? How ya doin? What’s up? What ya doin? With whom? Why?
Who’s important these days? Including John Hope Franklin? If you haven’t read his From Slavery to Freedom, do it. You may have my copy if you like. [I was introduced to this book, this man, in 1970 by a friend of mine who was then a ‘black studies’ major: and she, a white Jew from Montgomery. It’s a 1947 book - imagine that. Not only the book, I suggest you get a piece of the man’s biography, if only from today’s Times. There was also a blurb in the news-record this week.]

And all the dad questions….

Yesterday, I half believed in horoscopes. I had a call out of the blue from a friend. Hadn’t heard from her I a while. We’d worked together in Columbus and have stayed in touch about work and family developments on and off. The horoscope said explicitly that I’d be getting an unexpected call from a friend whom I hadn’t heard from in a while. Go figure….

Angela’s call was to ‘get some wisdom’ and ask me ‘an ethical question.’ A high honor to be considered a source of wisdom or possessor of ethics. But, for her, I am. A reaffirmation of my self beliefs….

The specifics, after catching up on family stuff and a little bit about work, kept us going for a half hour. A licensed person, supervising unlicensed persons, was having the secretary use the licensed person’s password to get into the electronic medical record and sign his name to the unlicensed people’s notes. So wrong on so many levels. The good news is that ‘the system’ caught it; and the person in charge of the system has the courage to act on it.

Of course this isn’t just any licensed person [LP]. Ole LP is a favorite of the owner of the organization: an apparent untouchable. Angela is, justly, outraged that LP would even dare do this but wonders how best to present this to LP’s boss, knowing that the owner will be involved in both the personnel matter as well as the regulatory and legal and professional matters that necessary flow from this transgression. For this owner, “it’s the policy” is not sufficient to take action against a favorite.

Makes for a great case study on many levels. How about a moment with the secretary [S]. When asked by LP to do this, S should have said not only no but hell no. And then S should have reported the request to the company’s compliance hotline or to LP’s boss or to the person in the organization who takes ethical/compliance questions. So what do you do about her?

S is an inexperienced and not particularly competent secretary. The decision to fire S was made before finding out about LP’s transgression. S said that she did not know that she shouldn’t do such signing as her supervisor, LP, directed her. [with electronic medical records, each person has their own password. It is unlikely that S did not have access to the medical records at all so S had a password for S’s access.] Let’s uncloud the case - assume that S was an averagely competent secretary and did what LP asked/directed her to do.

How do you proceed? What questions do you ask? Of whom? Of course, this scanty amount of information presumes you know something more about healthcare operations. It’s a good case because all of the crucial principles are not only general business but common sense.

How would you approach LP’s supervisor and the owner about LP? Being righteous about ethical practice of professionals is not the road to take; albeit, use the righteousness as energy for pursuing the correction of the transgression….

And question how much of this circumstance is idiosyncratic to LP and how much of this is symptomatic of systemic decay.

This is what makes my work fun!



I was at a state hospital last week talking with them about the patient advocate’s role - and patient advocacy in state hospitals in general. NC psychiatric hospitals are in crisis. Horrendous patient events; loss of Medicare/TJC certification [to the cost of $1m+/month]. “Patient Advocate” is a job in the state hospitals. There’s a nine page, single spaced job description. In the private sector, the role is usually called ‘patient representative’.

Based on my study of the situation at this hospital, I am sure that it is not clear to any of the stakeholders in inpatient psychiatric treatment at state hospitals what the role of the advocate is; what is the place of ‘patient advocacy’. You see, by definition, every licensed person is a patient advocate. The job description of the non licensed persons includes their to being patient advocates. There are organizations galore - from NAMI to MHA - who declare that they are patient advocates. Patient advocacy in state psychiatric services is mandated by federal and state laws and regulations.

Patient advocacy is suppose to assure that all patients are accorded their rights at all times. And, in this system, when a patient or other stakeholder complains that rights are violated, the patient advocate investigates the complaint and pursues individual rectification and systemic improvement.

How does this function fit with Risk Management, Performance Improvement, Compliance?

Take a look at the publicly available reports - e.g., Medicare - and the hospitals’ responses to them and tell me where you see the role of Patient Advocacy. Look at the job description and tell me how patient advocacy means unannounced monitoring of the units - or how this is different that the nursing supervisor and unit managers making rounds…. A convoluted system and a half.




Sunday March 29
Fifth Sunday of Lent

No biggies today. Instead my comments about the readings….



Reading 1
Jer 31:31-34

The days are coming, says the LORD,
when I will make a new covenant with the house of Israel
and the house of Judah.
It will not be like the covenant I made with their fathers
the day I took them by the hand
to lead them forth from the land of Egypt;
for they broke my covenant,
and I had to show myself their master, says the LORD.

Jeremiah is worth the read. Straight talker. Honest reporter/broker. His bio gives him credibility.

A new covenant because the old one has been broken so often. Not only has God kept his part of the bargain from the beginning of time, not only has he kept coming back, staying steadfast, regardless of what we have done vis a vis the original covenant, but He gave us a New Covenant, a better covenant. …. Not unlike a father to his sons. The secret of a father’s love - no matter what. … On the flip side. On the heart of each of us is written the Law of God, which includes, ‘I will honor my father.’ What does it say about the son who decides, I do not have to honor my father. Or the child who decides I do not have to obey my father? Or the people who tell the child, that he does not have to obey; and those who reinforce disobedience? How does such a son become a father? A husband? What kind of wife will such a son select? And the implications for their children?


But this is the covenant that I will make
with the house of Israel after those days, says the LORD.
I will place my law within them and write it upon their hearts;
I will be their God, and they shall be my people.

Simple enough, don’t you think. Look on your heart. Unlike in Caesar’s world, God’s law is not capricious, it is truth. God’s law is our covenant of love. How often have you asked - what do I have to do to show that I love? God’s law, written on our hearts, tells us how to know Him.


No longer will they have need to teach their friends and relatives
how to know the LORD.
All, from least to greatest, shall know me, says the LORD,
for I will forgive their evildoing and remember their sin no more.


We will know God, our Lord, because He forgives our sins. And, being created in his image and likeness, we too have at our essence the obligation to forgive sins. … Growing up, I went to confession every week. In the novitiate, I learned to do an examination of conscience three times each day. And whenever I got further from these practices of my asking forgiveness, it became more difficult for me to forgive. That’s one reason I taught you that the response to “I am sorry” is “I forgive you”. The best way to learn forgiveness is to seek and receive forgiveness. And the greatest source of that blessing is the sacrament of reconciliation. … I know it’s hard to come back to that sacrament in particular - and the harder it is to seek forgiveness, the harder it is to give forgiveness. Once the cycle is broken, once you meet with the priest, confess, and offer sorrow and penance, and receive forgiveness, the outpouring of grace experienced then will make giving forgiveness and freeing yourself from so much more easy and joyful. And the return to the sacraments, and the reception of the blessings and joy, will become the new cycle….



The new cycle is to ‘harden not your heart’ … or to pray the responsorial psalm…


Responsorial Psalm
Ps 51:3-4, 12-13, 14-15

R. (12a) Create a clean heart in me, O God.
Have mercy on me, O God, in your goodness;
in the greatness of your compassion wipe out my offense.
Thoroughly wash me from my guilt
and of my sin cleanse me.


Start with God. He has already promised you forgiveness, reconciliation for the asking. As I too hold my arms out for our reconciliation, our embrace of our pater filiique.


R. Create a clean heart in me, O God.
A clean heart create for me, O God,
and a steadfast spirit renew within me.
Cast me not out from your presence,
and your Holy Spirit take not from me.


In God’s presence, with the Spirit of our confirmation, we are new men, Christian men, full of the joy of our freedom, the joy of His love.


R. Create a clean heart in me, O God.
Give me back the joy of your salvation,
and a willing spirit sustain in me.
I will teach transgressors your ways,
and sinners shall return to you.
R. Create a clean heart in me, O God.


Try the entire 51st psalm. Take your time to read all of the psalms. Another way to get to know God. To get into the head of David and see how his life, his faith, his love and charity is an inspiration for yours.

We each have a willing Spirit within us. It is sustaining that Spirit to remain in God’s grace. And we cannot do that alone. We do that with God’s grace. Give me back the joy of your Love.



Reading II
Heb 5:7-9
In the days when Christ Jesus was in the flesh,
he offered prayers and supplications with loud cries and tears
to the one who was able to save him from death,
and he was heard because of his reverence.


Why pray? Prayer is the joining of Father and Son. Jesus prayed. All types of prayers. And all of our prayers are heard just like Jesus’ were, because of Him. Morning, noon, and night. Let every action be our prayer. “I offer you my thoughts words and actions of this day….” When our actions are our prayer, imagine what actions we will take - and equally, what actions we will no longer do….


Son though he was, he learned obedience from what he suffered;
and when he was made perfect,
he became the source of eternal salvation for all who obey him.


Jesus learned obedience from what he suffered. If any Son had the power to disobey, if any Son had the foresight of his suffering for obeying, Jesus did. “not my will but thine be done.” As we come upon Psalm Sunday, the triumphant parade into Jerusalem - the pinnacle of time to be God’s Son, to be the fulfillment of God’s covenant: but not. Jesus’ triumph, in obedience to God, the Father, is the Triumph of the Cross. It is obedience in times of trial that we strive for…. And it is the covenant of Love that makes that obedience both desirable and possible.



Gospel
Jn 12:20-33

Some Greeks who had come to worship at the Passover Feast
came to Philip, who was from Bethsaida in Galilee,
and asked him, "Sir, we would like to see Jesus."
Philip went and told Andrew;
then Andrew and Philip went and told Jesus.


How do people come to you to see Jesus?


Jesus answered them,
"The hour has come for the Son of Man to be glorified.
Amen, amen, I say to you,
unless a grain of wheat falls to the ground and dies,
it remains just a grain of wheat;
but if it dies, it produces much fruit.


How are you the grain of our faith and love? To die to oneself, to do the Father’s will….


Whoever loves his life loses it,
and whoever hates his life in this world
will preserve it for eternal life.


Again, Monsignor hit a homerun with his homily. How many teenagers [and others] wail that “I hate my life!” I wish I could transcribe what our pastor said from there on. I was distracted by the father/daughter sitting in front of me - their shared look and warm embrace. It is God’s life that we embrace, it is God’s love we take hold of, it is this life we take into eternity. Even when the path takes us to the pinnacles of psalm Sunday and the triumphs of Calgary.


Whoever serves me must follow me,
and where I am, there also will my servant be.
The Father will honor whoever serves me.


We are one in the Lord. He is here with us always. Where two or three are gathered in My Name…. How are you His Servant… Honor the Father by serving the Son. And so the Father will Honor you.


"I am troubled now. Yet what should I say?
'Father, save me from this hour'?
But it was for this purpose that I came to this hour.
Father, glorify your name."


In times of trouble, Mother Mary says to me…. Beatles. In times of trouble, say Father, glorify your name in me. Especially in times of trouble, see God’s Word as the Way through….


Then a voice came from heaven,
"I have glorified it and will glorify it again."
The crowd there heard it and said it was thunder;
but others said, "An angel has spoken to him."
Jesus answered and said,
"This voice did not come for my sake but for yours.


God speaks for our sake, listen, seek a clean heart, serve….


Now is the time of judgment on this world;
now the ruler of this world will be driven out.
And when I am lifted up from the earth,
I will draw everyone to myself."
He said this indicating the kind of death he would die.


Holy week starts Sunday. Easter holidays, the Triduum, retreat a moment into God’s embrace….



I love you
dad