[ianyeh]

I live in Canada, and we have public health care.
Just wondering how health care systems work around the world.

What are your positions on privatization of Health care?

How does it affect the profession of nurses?

[fergus51]

I'm a BC born and educated nurse, currently working in the US. I DO NOT want to see a US style private system take hold in Canada. NO WAY!!! (Was that clear enough for you?). At the same time, I do not see a Canadian style system working here. Here's my main beef with the US system: People use the system and don't have to pay for it. Emergency rooms can't turn people away who need treatment, but no one is required to have health insurance, so hospitals get stiffed on bills pretty often. It is also very confusing for consumers. My plan covers 80% of this up to a certain limit, then covers 20% of that, etc.....

I don't think privatization is the biggest issue for nursing conditions. Here in the US, nurses still negotiate their rates, just like they do in Canada. The real difference is the prevalence of unions. I prefer a unionized position, so I had to look for it in the US, whereas I would be able to assume a job was with BCNU back home. I do think the US has more variety in working conditions. Some places are like palaces, others are not nice at all. That's usually determined by what hospital makes more money and serves a richer clientelle (course many in BC would argue that happens because of geography, that rural hospitals don't get the money cause Vancouver sucks it all up). I also HATE that patients here are refered to as customers. You'll hear nurse managers get concerned about customer satisfaction like we're a MacDonald's. My duty to my patients is on a deeper level than that.

I do love the fact that advanced practice nursing has been pursued to such a level here in the US. I suppose the drive to make health care cheaper and increase profits does encourage nurses to take over a lot of doctor duties. I think Canada could really benefit from that. We are decades behind the US in this matter.

[fergus51]

BTW, as soon as my fellow BCians vote Cambpell out of office, I'll be coming back. Until then, I'd rather live under Arnold Schwartzenegger and George W Bush (and anyone who knows me knows that's says alot about my feelings for Gordon Campbell!)

[ianyeh]

I just wondering how Canada can fix it's health care system, I bet privatization would make the problem worse up here. Since more money will be needed to convert the system from public to private.

[fergus51]

You can bet it will be worse. NAFTA requires that Canadian companies be treated the same as American companies, so you'd see American companies buying up healthcare services. There is no way we would be able to maintain what has made our Canadian system work. Have you read up on the Romanow report?

[ianyeh]

Also, you mentioned how nurses and doctor service differently in US.

In US, they approach clients more directly, does this affect how they care clients in a way?

[fergus51]

I don't think it does in a good sense. Nurses in general seem offended at the notion of customer service. But, there are a fair number of patients in the US who have the attitude of "Well, I'm paying for your services, so I'm the customer and the customer is always right and you have to do whatever I tell you to". Realistically nurses don't have time to grant a patient their every wish. But, if a patient complains, even if it is completely frivolous, a nurse gets to hear about it from management. Not helpful for creating a positive nursing atmosphere.

I don't see a big difference with the doctors though.

[apaisRN]

The customer service thing is bogus. First of all, most patients aren't paying for their care, at least not directly. Their insurance is, and insurance only pays for necessary stuff, not a nurse to bring ginger ale at the patient's whim. Or the patient isn't paying for the care at all, since the uninsured sure can't afford today's health care!

Also, our duty is to care for patients in their best interests. If the diabetic wants a dessert on his tray, or a patient on bedrest is crazy to go out for a smoke, they're going to hate me when I don't let them. Not good customer service, but I'd be in a lot deeper **** if I let that bedbound patient go outside and fall.

[Da Monk]

I heartily agree that the idea of "customer service" has been carried too far. I believe that it compromises the therapeutic nurse-patient relationship, especially in psychiatric nursing. When you are unable to effectively confront patient behavior due to fear of being chastized and the therapeutic relationship suffers because the nurse is hampered, the patient suffers in the service of the hospital's public image. Getting better is the idea, not simply being served. For "service", go to Jiffy Lube!