Hospitals: The Good, the Bad and the Ugly
I recall the hospital in my small town during the time I was growing up. It was St. Joseph's Hospital. The nurses were nuns and from what I could tell in the short time I stayed there after my double hernia operation, they were close to God.
St. Joe's (local name), like all the hospitals of its time, had a unique smell. The hospitals always had a smell that separated them from the real world that I lived in. Back then it was the smell that only comes from something that emits its character in an odor. It was an antiseptic smell. It was a quiet smell. It was a smell of respect in the neighborhood of disease. The focus of the hospital was the care of the patient at all cost. A unique focus. A focus that emitted a unique smell.
The smell of hospitals today is indistinguishable from any strip mall located on a turnpike in New Jersey, Illinois, or California. I've tried to figure this out over this past year in my travels. Not only do I admit patients to my own hospital, but because some people think I have some interesting things to say (fools are everywhere), I get to travel and visit a number of hospitals across the country.
At first, hospitals appear to have no smell at all because there are thousands of special interests within a hospital that emit so many odors that they cancel each other out. By the end of last year, they just smelled like crap to me. Hospitals spend their waking days preparing for yearly inspections from agencies created to survey, approve and accredit hospitals. Unfortunately, dotting the i's and crossing the t's on all the survey points has little to do with patient care.
What I See
Hospitals seem to only care about profitable diseases. One would think that this entire country is filled with only three types of people:
First, I look for what is called the Med-Surg floor. This is the floor where people with all kinds of other diseases go. What I usually find are dirty floors, linens piled outside rooms in overflowing bins, nurses who are tired and ignored and patient-to-doctor nursing ratios that approach the population base in the largest province in China.
In one hospital I recently went into, the Orthopaedic Floor had an inadequate number of pain pumps, older continuous passive motion machines, and an anemic physical therapy section that looked like a public toilet in a NYC subway.
In college sports there is a program called Title IX - this means that men's sports cannot get more funding that women's sports. We should have this in hospitals. If funding is given for a particular disease then a percentage must go to the rest of the hospital as well.
Medicine is not a business; Hospitals are.
Hospitals are run by Boards, administrators, and professional businesspeople. Doctors are not businessmen. We all seem to know this. Here's the 411 on something you don't know - medicine is not a business. That's right. You will probably hear every freaking "expert" in the country banter all day long that medicine is a business. No way.
Hospitals are businesses; medicine is a calling. Medicine - which includes doctors, nurses, respiratory therapists, physical therapists, unit clerks, radiology technicians and more - is a world that defies all the rules of economics. Applying the rules of economics to medicine leads to "acceptable" loss of life.
I recall that a number of military strategists used to talk about "acceptable" losses in nuclear warfare. What a concept. Businesses like Pepsi and Microsoft understand acceptable losses. If Pepsi has a division that they spent a lot of money on but is not working, they will sell or close the division. An acceptable loss. In medicine, the acceptable loss rate is zero. The acceptable complication rate is zero. The acceptable death rate is zero.
This does not mean that these things don't occur. It means that, as medical people, we refuse to accept it as a way of life and work to the end to prevent these things from happening.
Businessmen running hospitals accept complication rates. They accept infection rates. They accept death rates. Most of the time it happens way before anyone can figure out it was their doing.
A True Story
I was called recently about a problem in a mid-sized community hospital and asked to give an opinion on the situation. It appears that in this hospital there was a growing joint replacement program and the surgeons were concerned about a large transfusion rate as compared to a neighboring hospital.
After some simple research they found that the other hospital had implemented a product called an OrthoPat. This is a product that allows for the salvage of blood during the hip replacement operation and after hip and knee replacements. This meant that during a hip replacement case blood lost during that surgery was able to be put back into the patient. Over the course of a year this product would save almost 150 blood transfusions over the previous system.
What Happened?
This is remarkable. A product, known to prevent the need for unnecessary transfusions, was simply not implemented because a single hospital administrator did not want to assign one of the nurse practitioners in the hospital to manage the tubing. I can only assume that he felt that the potential disease transmission that could occur from 150 unnecessary transfusions a year was an acceptable loss. It was acceptable only because it was not in his own operation or in his own family.
I am sure someone who contracted Hepatitis C from one of these transfusions wouldn't think it is very acceptable. I wonder what the hospital will say when a patient who gets sick from one of these unnecessary transfusions, gets an attorney, and sues all of them for this grossly irresponsible behavior.
Not convinced yet?
Is there another side? I am sure there is. I am sure across this extraordinarily large country there are hospitals driven to the care of their patients and the communities they serve. Unfortunately, you don't get recognition for doing something right unless you also have an extraordinary Public Relations department.
Hospitals will go out of their way to pass all kinds of state regulatory surveys and parade around their success. All they did in these surveys was dot the "i's" and cross the "t's." Stay out of hospitals if you can. You will probably live longer.
Dr. K.
Related Topics:
Technorati Tags: hospitals, health care, medical practice
St. Joe's (local name), like all the hospitals of its time, had a unique smell. The hospitals always had a smell that separated them from the real world that I lived in. Back then it was the smell that only comes from something that emits its character in an odor. It was an antiseptic smell. It was a quiet smell. It was a smell of respect in the neighborhood of disease. The focus of the hospital was the care of the patient at all cost. A unique focus. A focus that emitted a unique smell.
The smell of hospitals today is indistinguishable from any strip mall located on a turnpike in New Jersey, Illinois, or California. I've tried to figure this out over this past year in my travels. Not only do I admit patients to my own hospital, but because some people think I have some interesting things to say (fools are everywhere), I get to travel and visit a number of hospitals across the country.
At first, hospitals appear to have no smell at all because there are thousands of special interests within a hospital that emit so many odors that they cancel each other out. By the end of last year, they just smelled like crap to me. Hospitals spend their waking days preparing for yearly inspections from agencies created to survey, approve and accredit hospitals. Unfortunately, dotting the i's and crossing the t's on all the survey points has little to do with patient care.
What I See
Hospitals seem to only care about profitable diseases. One would think that this entire country is filled with only three types of people:
- Very healthy women having babies
- People with cancer that need chemotherapy or radiotherapy
- People with heart disease that need a stent procedure.
First, I look for what is called the Med-Surg floor. This is the floor where people with all kinds of other diseases go. What I usually find are dirty floors, linens piled outside rooms in overflowing bins, nurses who are tired and ignored and patient-to-doctor nursing ratios that approach the population base in the largest province in China.
In one hospital I recently went into, the Orthopaedic Floor had an inadequate number of pain pumps, older continuous passive motion machines, and an anemic physical therapy section that looked like a public toilet in a NYC subway.
In college sports there is a program called Title IX - this means that men's sports cannot get more funding that women's sports. We should have this in hospitals. If funding is given for a particular disease then a percentage must go to the rest of the hospital as well.
Medicine is not a business; Hospitals are.
Hospitals are run by Boards, administrators, and professional businesspeople. Doctors are not businessmen. We all seem to know this. Here's the 411 on something you don't know - medicine is not a business. That's right. You will probably hear every freaking "expert" in the country banter all day long that medicine is a business. No way.
Hospitals are businesses; medicine is a calling. Medicine - which includes doctors, nurses, respiratory therapists, physical therapists, unit clerks, radiology technicians and more - is a world that defies all the rules of economics. Applying the rules of economics to medicine leads to "acceptable" loss of life.
I recall that a number of military strategists used to talk about "acceptable" losses in nuclear warfare. What a concept. Businesses like Pepsi and Microsoft understand acceptable losses. If Pepsi has a division that they spent a lot of money on but is not working, they will sell or close the division. An acceptable loss. In medicine, the acceptable loss rate is zero. The acceptable complication rate is zero. The acceptable death rate is zero.
This does not mean that these things don't occur. It means that, as medical people, we refuse to accept it as a way of life and work to the end to prevent these things from happening.
Businessmen running hospitals accept complication rates. They accept infection rates. They accept death rates. Most of the time it happens way before anyone can figure out it was their doing.
A True Story
I was called recently about a problem in a mid-sized community hospital and asked to give an opinion on the situation. It appears that in this hospital there was a growing joint replacement program and the surgeons were concerned about a large transfusion rate as compared to a neighboring hospital.
After some simple research they found that the other hospital had implemented a product called an OrthoPat. This is a product that allows for the salvage of blood during the hip replacement operation and after hip and knee replacements. This meant that during a hip replacement case blood lost during that surgery was able to be put back into the patient. Over the course of a year this product would save almost 150 blood transfusions over the previous system.
What Happened?
- The surgeon presented the product with all the data to a committee made up of a general surgeon a nurse, and three hospital administrators
- The committee approved the product
- The Chief Financial Officer of the hospital unilaterally vetoed the purchase of this even though he did not have the authority to do so.
- The surgeon spent 3 months complaining to administration about this situation.
- Finally the system was reapproved.
- Two weeks before implementation of the system the surgeon got a call the system could not be implemented.
- The reason for not implementing the system was that the hospital across town that used the system had hospital-based nurse practitioners manage the tubing on the ward.
- Even though this surgeon's hospital has nurse practitioners on staff in multiple capacities in the hospital the Executive Vice President of the hospital, actually an MD at one point in his life, refused to assign this responsibility to one of these nurse practitioners.
- When the surgeon inquired why this could not happen, he only received an e-mail reply saying "this service is not available at this time."
- The product designed to save unnecessary transfusion was stopped from being implemented - again by an administrator.
This is remarkable. A product, known to prevent the need for unnecessary transfusions, was simply not implemented because a single hospital administrator did not want to assign one of the nurse practitioners in the hospital to manage the tubing. I can only assume that he felt that the potential disease transmission that could occur from 150 unnecessary transfusions a year was an acceptable loss. It was acceptable only because it was not in his own operation or in his own family.
I am sure someone who contracted Hepatitis C from one of these transfusions wouldn't think it is very acceptable. I wonder what the hospital will say when a patient who gets sick from one of these unnecessary transfusions, gets an attorney, and sues all of them for this grossly irresponsible behavior.
Not convinced yet?
- Hospitals are owned by stockholders.
- Hospitals judge their quality by standards that have nothing to do with health.
- Many hospitals no longer care for the poor and the underprivileged.
- Hospitals reward physicians that save money at the expense of patient care.
- Hospital administrators have no clue concerning their infection rate.
- Hospitals only order equipment if they either need to market a procedure or are embarrassed into it.
- Hospitals are political in the way they deal with staff. Congress is political. Need I say more?
- Doctors within a hospital have little say or power to bring about change. Patients have no say.
Is there another side? I am sure there is. I am sure across this extraordinarily large country there are hospitals driven to the care of their patients and the communities they serve. Unfortunately, you don't get recognition for doing something right unless you also have an extraordinary Public Relations department.
Hospitals will go out of their way to pass all kinds of state regulatory surveys and parade around their success. All they did in these surveys was dot the "i's" and cross the "t's." Stay out of hospitals if you can. You will probably live longer.
Dr. K.
Related Topics:
- Hospital Care Quality Web Site Debuts
- Taking Charge of Your Hospital Stay
- WebMD Video: High-Tech Hospital
Technorati Tags: hospitals, health care, medical practice
24 Comments:
WOW!! What a fantastic exposition of the reality of contemporary health care delivery in the hospital setting. I don't recall ever having read anything as penetrating as this post. Clear, concise and to the point. I will be sure to circulate it among my colleagues at the National Institute for Patient Rights. Hope you don't mind if I cite it on our blog.
Our biggest beef is miscommunication or a failure to communicate resulting from the fragmentation of care or the lack of coordination among specialists in the delivery of patient care.
A failure to communicate among specialists and, as a consequence, between the "team" and patient/family leads, in turn, to unnecessary confllict, and, ultimately, to medical error.
It also entails the gross and widespread violation of THE most fundamental right patients/advocates enjoy in this country (since we don't have a right to health care), i.e., the right to informed consent.
I wonder if you might turn your penetrating eye toward the issue of a failure to communicate. In your view, what are the causes?
Thank you again for an extremely valuable post!
Dr. Mark E. Meaney
President and CEO
National Institute for Patient Rights
empowerpatients.com
empowerpatients@gmail.com
The health care posts about hospitals is right on. I have waited to see if doctors would come forth and admit the flaws that are in our hospitals. My one and only hospital experience has left me in disbelief, traumatized and in shock.
My mother went into the hospital for a procedure to have a dialysis access placed. The specialists persuaded us to have her stay for more procedures. While waiting for those procedures, horrible things occured. As you stated on the med surg floor, it was filthy and linens were piled up in the bathroom and trash flowed into the floor. We the family cleaned the room.
The nurses would leave food trays
untouched in my mom's room, she was blind and needed assistance.
So she never got fed. They didn't turn her every two hours and she
got stage IV bedsores. She got pneumonia and numerous other ections. Safey accidents occured.
When I would tell the doctors about
these occurances, they brushed it off. There was absolutely no commnication between the doctors and nurses. Orders didn't get followed and we the family was left in the dark. There was never a plan of care discussed.
Needless to say, because of this
neglectful type care and mis communication, my mother went
into cardiac arrest. Was it from
malnourishment,pneumonia,nfections we will never know.So now we have a legal claim against the hospital. This is what happens. A family is left devastated without answers and no one cares. The hospital conntinues to ignore us and thus we have a lawsuit.
Thanks for realizing what is happening in modern big city hospitals. There needs to be
patient advocates for patients,especially the elderly.
My mom was not only neglected but
treated like she was invisible.
After the poor treatment that I got today at the Hospital, I just got up and left.
No, the problems are not only with the administrators. The Doctors, and staff DO NOT CARE about the PEOPLE that they are there to help. To them you are nothing but a piece of meat!! I think that it is time that we, the victoms, start DEMANDING that they treat us PROMPTLY, PROPERLY, and with RESPECT!! From now on, I give them 15 minutes grace from the time of my stated appointment. THEN I WILL LEAVE!!! And if one of my loved ones are in their clutches, I will ride them to make sure that they are treated properly!!
About the above post:
I agree with some but not all of the comments. The Blog was not designed to be a complete total essay on all that is wrong with healthcare and hospital but to point out an important aspect of it- the role of management and who actually controls decision making.
It is not even remotely possible to take seriously such a global statement that doctors and nurses do not care and that patients are a piece of meat. Most doctors care. Most nurses care. The reality is that any organization, though, is successful or fails due to management. The workers at the best car manufacturer are not more qualified than those at the worst but management of these factories is radically different.
Specifically with hospitals, this MANAGEMENT of a hospital- whether invested in a group of doctors, a Board of Advisors, or a group of administrators controls the situation that a patient is in. The management can free the doctors and nurses to deliver good care or by design put up road blocks.
Dr. K.
Well Dr.K, being that I am an autoworker I can state that no matter how incompetant the management is, I do the best that I can to provide the best parts that I can. I will go beyond what they tell me that I can do. If they don't supply the tools necessary, I provide them. But what I bring that is most important is a moral obligation to do my job well. My statement above stands, until those in the medical practice show me the same moral obligation, and care about the people that they are careing for. I am sure that there are some in the medical field that actually care about what they are doing, I'm just having a very hard time finding them.
Quote:
I agree with some but not all of the comments. The Blog was not designed to be a complete total essay on all that is wrong with healthcare and hospital but to point out an important aspect of it- the role of management and who actually controls decision making.
No,the title of this blog is Hospitals: The good, the Bad and the Ugly.
Not, were onlt talking about what is wrong with management. Its the same finger pointing that you see in every business, its management, not me. If you turn, and look the other way, you are just as guilty as them.
WOW! I don't know where everyone else comes from or which hospitals you are talking about or the size of them, but I come from the Midwest and I go to the Twin Cities for most of my medical care. I have never been treated badly in the hospitals that I have been in for any of my surgeries, 2 in the Twin Cities and one in the small town close to where I live. I have always been treated with respect, my doctors have always spent time with me after a surgery explaining the situation,checked on me every day I was in the hospital, answered all my questions, if I had other problems had them taken care of even if they weren't from that surgery. The nurses have all been polite, friendly, helpful and wonderful. I don't have one complaint. I've never been in a dirty hospital. I've been in a hospital that was under construction, but that couldn't be helped. I guess I have alot to be grateful for from what you all are talking about. I think I'll stay where I'm at and not worry about moving to a big city. I have everything I need here. Good health care, excellent doctors, excellent hospitals and good living and good clean air! Thanks for reminding me how lucky I truly am. Linda Kennedy
I'm in agreement with the previous poster. I live north of Atlanta just north of some wealthy suburbs. And while there isn't a hospital in my town, there are several in neighboring counties. A couple of these hospitals are competing heavily with each other. This has been great for the patients. I have received great care in these hospitals from the management on down to the medical team in charge of my care. Only the night staff at one hospital had a squirrelly nurse with an attitude.
The one time I had an extended stay at a hospital in Atlanta I also had great care. My surgeon was excellent for starters. But I had a doctor in charge of my stay that checked on me twice a day. I had another doctor in charge of my pain management that also checked on me twice a day. And a head nurse for each shift that checked on me. All of them were compassionate and caring.
But I also know that there is a shortage of nursing and as such many of them are overworked and stressed. After a recent surgery I ended up spending several hours in recovery. I wake up fast from anesthesia anyway but I was in there so long that all cobwebs were gone. I was antsy, in pain and wanted to get to my room where they would attach my PCA pump. I heard the nurses in the background cussing and complaining because they were shorthanded and couldn't get people moved. The nurse in charge of me was young and not used to stress. She got a little nasty when I asked when I could go to my room. When I later had a chance to talk to someone from management she apologized profusely, told me it would never happen again and then proceeded to tell me how they were working to remedy the situation. I was impressed about how it all was handled. The rest of my stay went off without a hitch. Sometimes I thought my room was too crowded with nurses, doctors, physical therapists, etc.
I am with Dr. K that many of the problems in hospitals today stem from management. As a critical care nurse, I KNOW that my colleagues and I care about the care we give our patients. Staffing, equipment, and having ancillary help like aides,lab techs, etc., can make our jobs easier and give us much more time to spend with our patients and attending to their needs. What I have observed in the last ten years or so is that, more often, shrinking money and reimbursements from Medicare, Medicaid, and private insurance companies & HMOs are what drive management. The shrinking pot of money to pay for the increased services we all want pushes administrators to trim staff and equipment to the bone. The result of this is stress on the existing caregivers and inadequacies in services. Doctors don't have as much time to spend with individuals because they have to pay their bills too, and the more patients they see, the more reimbursement they get. So you'll only see your doctor in the hospital for 5 minutes a day (if you're lucky) because they have to get back to their office and see people there where their reimbursement is better.
Are hospitals driven by the accrediting agencies? Yes, because that's where consumers look to find the "good" hospitals. All those "good" ratings come at a cost. It appears to be a no-win situation for hospitals---to keep their good ratings and attract the
consumers they need to provide good services and adequate staff to provide those services, they need more money. To get money in the age of decreased reimbursement (instigated by consumer complaints regarding high healthcare costs), they have to cut back on staff and services. And all those workers still expect raises! I would not want to be a hospital administrator in this day and age...
Hospitals are dangerous places. No one should enter a hospital without someone to advocate for them. Not only do I believe this, so does every nurse I've ever spoken to.
The patient IS just another body.
Never trust the opinion of any doctor, ask for a second, third, fourth opinion, preferably from a team.
If you are on Medicare, it will pay for several opinions. Take charge of your life and healthcare.
No doctor will ever be as concerned about your health as you are.
A few comments so far:
Concerning the hospitals in Minnesota and Atlanta- then you are blessed that the very serious cutbacks hospitals have been forced to do bedause of decreased Medicare reimbursement has not hit you.
In most other urban centers where rent is high, personnel costs are high, it is a different story.
Hospital care is very fragmented.
As a doctor I disagre with the last post that a doctor will not be concerned about your health as much as you are. Many doctors and urses care a lot more than the public seems to give credit for. What can be said is that your insurance company REALLY is not concerned for you.
Dr. K.
Dr. K,
I wasn't really speaking about the hospitals inside Atlanta. I only spent time in one and that was on an OB/GYN floor where life is a little different. But my husband spent a few days in a prestigious teaching hospital inside Atlanta. If I hadn't been there to feed him he likely would have starved to death. He had two nurses that cared about him but when they left he was on his own.
I was speaking more about the hospitals in the wealthier suburbs. The competition is tight and the care is topnotch. Not to mention, the nurses and doctors are a lot happier.
I won't be using any hospitals in urban Atlanta if I get my way.
I'm sticking by my comments. Although I do have to say I have only been in one hospital in St. Paul and one hospital in Edina, MN (suburb of Minneapolis). There are many more hospitals in these 2 cities. And I am on Medicare although I do have private insurance through my husbands job. I think I have been lucky because I have never been denied a surgery by my insurance or had any problem getting anything paid. My daughter just had her tonsils taken out in a surgery center (new to this town) a town of about 50,000 people about 40 miles from here owned by the doctors who own the clinic there. She got excellent care and everyone was so nice. It is only for same day surgery. She had to go back for emergency surgery 9 days later as she hemorraged and she had to go to the hospital and she still had excellent care. I needed to be taken around in my wheelchair because of my knees and back and they were happy to accommodate me as well as my daughter. I understand the problems that you are talking about but it seems around here they go out of their way to make you comfortable, happy, etc. I am having hand surgery tomorrow and I called the hospital today to pre register and requested the anesthesiologist that I had at my May 17th foot surgery and they are going to get him for me. This is in the Edina, MN hospital. I think I just live in a good area, huh? I'm not saying I couldn't go down to Des Moines or to Iowa City or some other place in Iowa and get the same result. I just haven't been to those places. I'm just reporting on the places I've been. But, so far, so good! Linda Kennedy
The above comments are important. There are many hospitals in this country that give remarkable care as Linda Kennedy points out.
The travety is that since these great hospitals exists and have been shown to give exceelent care, why are we not using these as a model for other hospitals. Instead of the lame health grading companies that "review" hospitals using ridiculous criteria, why don't we model the lesser hospital on the better ones.
Dr. K.
Dr. K.-
I couldn't agree with you more. Any plans to see Michael Moore's movie "SICKO"? I'll be first in line for tickets. Anyway, is it me or does it seem that hospitals put more focus on visually appealing aspects such as glorified lobbies that look like bird sanctuaries (trees, fountains, etc.) rather than addressing the medically & ethically necessary issues you mentioned in your post. The term 'healthcare' no longer represents HEALTH CARE.
on the side
bonoit the WWW has any one conisder residuals from closed head injuries sustained over time that did affect multitude of brain functons and behavorial interactions....i would believe there is a better than fair chance that he did suffer numerous closed head injurires in his career and the cumlative effect , as we know, is this horrific outcome
petemoughanjr@gmail.com a tbi survivor
What happens if you get a flash of blood back in the syringe when youre getting a vaccination and feel it going down youre arm like when you get an iv?
I am a nurse at a teaching/county hospital. When Dr. K mentioned "crossing the t's and dotting the i's" for surveys...he's 100% accurate. There have been staff members that were coming in for overtime to "audit" charts whenever the hospital knew that the joint commission was coming. If hospital management would allow us to have a smaller nurse/patient ratio then the i's and t's could be taken care of at all times. Not because some agency is coming to survey us.
Now my hospital is going for another accreditation, Magnet Status. The administrators think they want Magnet, however, they are far from accepting the Magnet principals. Magnet is about staff at the patient care level having some decision making authority and the responsibility that goes with it. That doesn't happen. We just found out the other day that the CNO wants to tell us what color uniforms to wear. The color of our nursing scrubs have no positive effect on our nursing care. Plus, our hospital was recently under investigation because the previous CEO is suspected of being involved in giving large contracts to his "Good old boy" friends and not getting the service for those contracts. He was "let go" by the county a few months ago, and apparently being investigated by the FBI....seems he might have done the same thing in another state....Background check anyone??
Anyway, back to the uniforms. I wear solid colored pants and a variety of cheerful colorful scrub tops. My patients comment on how nice my scrubs are. I don't want to be told that I can only wear blue and white. The only affect that will have on my nursing care is negative. My co-workers and I have spent $100's of dollars on uniforms. We have holiday scrubs, cartoon character scrubs, floral scrubs, etc. There may be a few bad apples out there that wear what may be considered inappropriate scrubs. However, the management should speak to those individuals, not punish the rest of us. Also, if the hospital dictates the uniforms we wear, then according to a state law that some of the nurses have discovered. The hospital, therefore the county, will be required to pay for our uniforms and the washing of those uniforms. Hey taxpayers...we are already millions of dollars in debt...do you want to pay for the uniforms that we DON'T want to wear. We've already spent our own money on uniforms that we are happy wearing.
Healthcare workers go into healthcare because we want to help people. We care about people. It's a calling and a profession, not a job. However, with cutbacks and management giving us form after form to fill out...the hours of paperwork take us away from our patients. Management doesn't care if we've cleaned an incontinent patient 5 times in a shift. They want to know why the paperwork wasn't done and why you can't be done at the change of shift. The fact that we have to put on a gown, gloves and mask everytime we enter a room (isolation patients) shouldn't take any extra time. Taking care of patients that are vent dependent, tube feeding dependent and have skin breakdown that you can put your hand into (usually transfers from nursing homes...that's a whole different topic) ...none of that should take any extra time....sure throw one more patient on my load. I can take it.....I'm just waiting for a lawsuit.
OK....I've said enough. Can you tell that my 12 hour shift turned into a 13 1/2 hour shift because I couldn't keep up with the paperwork .... I actually took care of my two patients going thru DT's from ETOH withdrawl and had to clean up their "finger painting", tie them to the bed (which I hate to do because it's barbaric....however, sometimes necessary for the patient's safety), etc.
Anyone who thinks healthcare workers make lots of money....I invite them to walk in my shoes for a day. Just make sure they are ready to only wear white shoes and blue and white scrubs.
As the husband of a critical care nurse, I know of the frustration on BOTH SIDES! To say that Doctors, Nurses, and staff doesn't care blanketly is a crock! Too many people think that a hospital stay is a stay at the Hilton; or some sort of entitelement program. The staff is tired of working understaffed, underpayed, and underappreciated!
I have been in health care in one way or another for many years. I'm currently employed by an architecture firm as a consultant for new hospital construction, worldwide but primairly in the US. I work with ALL staff members of a hospital, administrators,doctors, nurses, technicians, maintenance folks...everyone! And yes, Dr K is correct with most of his complaints about our health care system in this country. Hospitals are businesses, your health and care are taken into consideration, of course, but this is only secondary to...PROFIT....money is the first and foremost reason for their being. If you don't believe this, come travel across the U.S. with me for 1 year, visit hosptials and sit in on meetings for every department. Money drives our country, and healthcare is a very profitable business now days.
The above comment is excellent. Let me quote:
"Money drives our country, and healthcare is a very profitable business now days."
We all talk about the high cost of healthcare. healthcare is not costly- someone is always making money in healthcare. It is brutally profitable for pharmas and private equity.
Dr. K.
All the docs I talk to would like medicine to be a business. This calling is killing them.
This was a good commentary on the state of today's hospitals. As was mentioned, hospitals are in the business of making money and alot of it. This is forcing some people, even those with insurance, into bankruptcy.
What is ironic is the number of hospitals that state they are non profit so could they not even be paying their share of taxes?
And they state they are non profit (or not for profit,what is the difference?) and then refuse to treat patients who are low income, then build offices and wings that rival the Hilton.
They are non profit and then charge 200 to 1500 times what it costs for services and don't provide some life saving services because of the costs.
They don't have to disclose their costs for procedures or failure rates or infection rates.
It costs more to have something done by someone with little training working in the hospital than it does to go to the doctor.
It is all very political.
Many of the people who work in the hospital are trying to do a good job but when profit is the motive then there isn't enough help and some workers are on government assistance.
It is a very sad situation of which most people are unaware.
Most likely, in the future, only the very rich will be able to afford health care in the US and they will take all your money and then you will die. The rest of
us will have to go overseas or die here.
It's good that I've been confined to hospital once. Based on my opinion or observation some hospitals or even some doctors or nurses when the patient has no money, they don't pay too much attention. Hospitals need to treat equal both patients, the higher level and lower level. that's all.
I must say I agree with Dr. K but he did leave out all the building and remodeling for cetain conditions because that's where the money is paid. Most of these are in the millions and where do you think this is coming from.
I also know for a fact Drs. that are thru hospitals and or certain clinics are required to see a certain number of pts a day that they they are to push certain tests in their fields in their areas and whatever drug companies that are in the top ten.
And yes there is medical people who are not in it for the care of the people but to make the dollar and pts are something to put up with and they are quite verbal about it as are some Drs.
I also want to commend the real Drs. nurses and techs that are there for the pts because they are the ones that have to pick up the slack and become overloaded.
I agree that until Drs. start taking back the practie of medicine that money and politics will always be there and as a person with a chronic disease I get to see all these sides and come away mostly sad and depressed with very few times thinking that I and my Dr. really have a hand in my health care.
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