Talking to patients about the health care debate - page 2
Today I took a triage call from a patient, an active lady in her late 60's. She's been taking a beta-blocker for years to regulate her heart rhythm. This month, her insurance company took it upon... Read More
Jun 13, '09Quote from multicollinearityWhy unwise to speak the truth? Why are all of you reluctant to speak the truth to your patients?Yes, it would be tempting but unwise to issue this retort: "So why do the Canadians live several years longer than we do...?"
I like Elkpark's response, as usual.
Jun 13, '09Quote from delana_rndo it, do it right now.perhaps some health care does need to be rationed; based on what? on your friend's behavior toward her fil?
how about my friend's fil, an 89-year-old advanced alzheimer's pt (bedridden, nonresponsive) who is slowly dying under the substandard care of his daughter who rarely turns him but refuses to have him in hospice care. she does not pay for any of his care, including frequent hospitalizations for aspiration pneumonia, but continues to collect his social security and pension checks (could this be the reason why she refuses to let him die with dignity?) you need to report this at once. you are liable if you do not report this to the elder abuse and neglect hotline or to the police.
Jun 13, '09Quote from Vito AndoliniIt would be unwise (and unprofessional) to open the door to a political argument with a patient. To put it in academic terms, it would not be a patient-centered therapeutic communication.Why unwise to speak the truth? Why are all of you reluctant to speak the truth to your patients?
Jun 13, '09Quote from Vito AndoliniI am afraid because I don't have accurate answers and I don't want to add fuel to the stress because of my lack of knowledge. I am also VERY unfamiliar with insurance plans, and refer them to managed care or our financial counselors. Maybe we should receive more of an explanation of these benefits to better educate our patients, but until I know for sure, I don't feel comfortable discussing it. Maybe if I were more well-versed on that subject, I would be less hesitant to broach the subject.Why unwise to speak the truth? Why are all of you reluctant to speak the truth to your patients?
Jun 13, '09"Who the heck is putting this nonsense into peoples' heads?"
You might want to be certain that this rationing is only a "myth" before you go about discrediting these fears to senior citizens in your professional position.
You may want to read Sen. Tom Daschle's writings on his vision of healthcare for our nation. Daschle was Obama's first pick to head up Health and Human Services. You may find out where this "nonsense" is coming from.
Look it up for yourself. Do not rely on others for information. Make up your own mind.
Jun 13, '09Quote from jRN2beI just don't understand this line of thinking...and the patient that the OP encountered...opinions like that are horrifying, acidic, disgusting, and sets this country back decades.That is socialized medicine. That is what Obama is shooting for.. Nurses will be sitting in hard back metal chairs, no tile floors, and no computers. That 70 year old that needs a heart cath, the one that is not long for this world anyways, will be put to the back of the line... its a shame.
Could someone site a source directly from President Obama or his administration that says anything that warrants the above quote or the patient that the OP had the pleasure of encountering? From all of the information I've read on the President's website http://www.barackobama.com/pdf/issue...reFullPlan.pdf, I haven't read anything that would support those fears. I'm amazed when I hear comments such as the ones above because I haven't heard either party-Republicans or Democrats-that have come up with anything better than what President Obama has proposed.
For all of the people spewing venom onto the proposed health care plan: Do they realize that the United States is the only developed nation without some sort of national health care plan. Infant mortality rates are used to judge the health of a nation and we, the United States of America, one of the most powerful nations in the world, rank # 29!
So, as you can see, I took the long route to answer the OP's question. When I'm asked about how I feel about President Obama's plan, I use the facts to back up my opinion on the state of our nation's current health care plan. How can you argue with the facts?
Around 46 million are left uninsured in this country, at this time. We rank #29 in regards to Infant Mortality. There are elderly people who have to make the choice of whether to eat or buy their medication. People have died while trying to convince their insurance companies to pay for a life-saving procedure (source: Frontline, episode can be found on NPR's website).
Is this ok? Is our current system working?...just look at the facts.
Jun 13, '09Seems to me the topic of this thread was what to do when a patient brings up such issues, not a debate among ourselves about what we believe.
Jun 13, '09Quote from multicollinearity"So, as you can see, I took the long route to answer the OP's question. When I'm asked about how I feel about President Obama's plan, I use the facts to back up my opinion on the state of our nation's current health care plan. How can you argue with the facts?"Seems to me the topic of this thread was what to do when a patient brings up such issues, not a debate among ourselves about what we believe.
As you can see, I addressed the OP's question...but I also took the liberty of throwing in a little extra ; )
Jun 13, '09Quote from Spidey's momThe pt should be known to "the system", after all he receives home health care (but not hospice care) three times a week and is in the hospital every few weeks; meanwhile, his decubs keep getting bigger and the daughter (who is a friend of mine's SIL) is now taking him to a woundcare center weekly. She must tell social workers and nurses that she cares for him better than she obviously does and they can't remove him, I guess, because there is no obvious "abuse" (although clearly neglect - he resembles a skeleton).Has Adult Protective Services been notified?
It's a sad situation.
Jun 13, '09Quote from multicollinearityYes, but unless you avoid the issue by changing the subject, your personal beliefs be the basis for your response.Seems to me the topic of this thread was what to do when a patient brings up such issues, not a debate among ourselves about what we believe.
For the near future (i.e., affecting our current pt's who are 70+) nothing like rationing is likely to happen soon enough to make any difference to them. I would therefore reassure them. In a discussion with younger pts, however, I might mention some examples, such as terminal pts who use up scarce resources without any apparent benefit to themselves to put things in perspective. I don't foresee a future where a 70-year-old who would clearly benefit from it would be denied a CABG; but perhaps a 90-year-old advanced Alzheimer's pt would not be able to get every possible expensive tx. If pts want to talk about this, I don't see anything wrong with discussing it with them (however, if they make racist or otherwise out of line comments as in the case OP describes, I would immediately change the subject).
Jun 13, '09Quote from Vito Andolini1) Not all patients can actually handle the truthWhy unwise to speak the truth? Why are all of you reluctant to speak the truth to your patients?
2) Management does not want nursing staff to tell the complete truth. For example, one of my former nurse managers used to tell the staff to never divulge to patients and family members about how many other patients you have, because this information might be "depressing" to our clients.