malamud69 10,071 Views
Joined May 10, '12.
Posts: 521 (61% Liked)
The problem with universal healthcare systems is they are abused big time.
ERs are full of non emergencies, who just love the free ambulance rides and the free sandwiches.
The Aus/NZ system is better, where patients pay an affordable fee, something like $25 for an ambulance, and then its refunded IF the ER doc says it was genuine need.
And those whose health is compromised by their lifestyle need to continue to pay. Why should taxpayers pay up for yet another failed detox, or their third asthma exacerbation of the week because they won't stop smoking?
Genuine healthcare should be available for genuine need.
I would have a free universal healthcare system in place like there is in England (the NHS - National Healthcare Service), but with good compensation packages for all staff. Funding would come from wages/salary and would be a % of income. No insurance.
It would no longer be a business, it would be a HEALTHCARE system. Top admin wouldn't be paid ridiculous amounts, but salaries more in proportion to realistic standards.
I would make sure every hospital was adequately equipped with everything it needs in terms of supplies and technology.
I would staff appropriately to improve patient safety and reduce nurse and doctor burnout and stress.
I would funnel money into preventative care programs.
I would funnel money into social services and provide family support from the ground-up, because a lot of the issue begin there.
I would provide adequate resources in schools to educate in health and wellness.
I would funnel money into mental-health because that is tragically understaffed and underfinanced.
(....and I would also like to dive out from behind the wall saying, "hi, I'm John Quiñones......"and this is "what would you do??")
Remove the insurance companies from the health care industry.
Insurance companies are becoming extremely invasive to the medical process and should not be allowed to dictate how the provider will provide care to their patients. Extensive office visits and unnecessary tests are acceptable to scrutinize by withholding payment. Denying procedures which have a proven medical benefit or determining which drugs will be covered is dictating how the provider will practice medicine and should be illegal. It's unethical and undermines the patient's health in the long run. Medicare operates more efficiently and with less overhead.
Eliminate the ability of pharmaceutical industry to determine the price of medications by lifting the ban on government pharmaceutical price bargaining. By allowing the government to negotiate Part D prescription drug prices. This would reduce the overall cost of prescription medications to the American consumer, tax payer, and increase access for people who cannot afford them. American pay some of the highest costs for prescription medications in the world, in spite of the US Government subsidies R&D for new medications.
I disagree with the previous posters. Nursing shortages and inadequate staffing is only one of the symptom of the problems in healthcare in the us.
In an unlimited, perfect world, I would Direct the budget towards primary health care - smoking cessation, proper nutrition, education, dealing with the social determinants of health to prevent health problems. Implement a universal health care model such as France. Change the model from a business centred one to one focussed on health and wellness of the individual.
Unfortunately, I think the US would require a lobotomy before that would ever go through
Yep, adequate staffing and everything else would fall into place.
So, my friend who was a nurse had a bipolar manic episode- came out of nowhere, she didn't know she was bipolar, it was totally unexpected, unplanned, obviously no one chooses to be mentally ill. She didn't show up to work because she knew she wasn't thinking clearly. Was reported to the board, her license was suspended, she wasn't allowed to return to work. She spiraled deeper, lost her health insurance because she lost her job, ended up homeless. While she was manic she was arrested when the police were trying to take her to a hospital for resisting arrest. When she was clear she was put on probation for practicing nursing while impaired- she didn't practice nursing, she intentionally did not go to work. She had to do drug tests even though she was not a drug addict. Her case was published online and published in a magazine that is distributed to all nurses- so, everyone she has ever worked with, gone to school with, basically ever met now knows she is mentally ill (which to me is a huge HIPPA violation). When she got a job offer she was banned from taking the job by the state who said that her incident had occurred too recently (a year had passed, she was medically stable and had been working a non nursing job for months). She ended up having to surrender her license because she wouldn't be able to log the hours needed to keep it active. So, now (she's pretty young by the way) her entire life is ruined- she can't go back to school because she won't be able to get any kind of state license after having lost her nursing one. She can't get most jobs because of her arrest while she was sick. I have friends who are school psychologists who are speech therapists who have suffered with addiction and who have suffered with mental illness and they have boards to report to as well- their personal problems aren't publicly published for everyone to judge, they're not forced to jump through hoops determined by their boards and they don't lose their livelihoods. Addiction is a disease- I'm not proud of what I did, none of us are- and mental illness clearly is an illness- no other field of work destroys people the way the nursing field does for being human. I understand that we have people's lives in our hands although, not all nursing jobs are as intense as say ICU nursing- but, when people do recover or they are stable they should be able to restore their lives. That's not possible for everyone that ends up on probation- a lot of us don't get second chances. Not everyone is able to find a job on probation and they have to leave the field and finding gainful employment as a failed nurse- people ask questions, look into it and go with someone else. Cats is upset because she has a mental illness and is having to run around disclosing that to people and is forced into a recovery program for drug addicts, spanked is upset because he made a mistake outside of work and our personal lives should be our own, my friend I mentioned is perpetually upset because her life is ruined, and I get that I did something bad, but, I don't agree with the way we're publically shamed for it. As if living with addiction or a mental illness isn't a torture in and of itself- we have to be shamed in front of our entire community as well? That helps no one.
In my opinion it still circles back to the role of the programs being to monitor/ensure safe practice. Instead they now have all of these mandates that have zero to do with safe practice. Even if I actually had a substance problem (and not a diagnosis invented by some sleazy half arsed "approved evaluator" who thinks the whole "do no harm" thing is merely a suggestion) then how is attempting to control nearly every waking hour of my day by forcing me to go broke attending the rehab of their choice (even if it is totally ill suited to my needs and costs me an arm and a leg), sitting in constant meetings of an organization that itself states that it's requirement for membership is to want to be there and to force me to be obsessive over every drop of salad dressing, hair product or soap that is near me for the foreseeable several years going to accomplish that?. Oh and let's not forget embarrassing the beejeezus out myself just trying to nail down a job. None of that has a darn thing to do with making me a safer nurse. All of this does nothing for advocacy or support and simply punishes. Who elected this clown car to be judge jury and executioner? I'm not sure any of us did anything wrong that it is these people's place to "punish" us for especially under the guise of advocacy.
I might go so far to say that as the shennanagins of these programs thus far have forced me in to an area of nursing that I have zero experience and background in, it's conceivable that it has quite done the inverse of ensuring my safe practice.
I read two interesting studies lately. In the first study participants were told to take a daily placebo because daily administration of this pill was thought to lead to better health. In the second study menopausal women were told to take a daily dose of estrogen (later actually determined to be arguably bad for them) as this would lead to better health. In both studies the participants who took the pills daily were healthier than the non-complaint participants. Is this because of the wonder of the sugar pill or additional hormones that either did nothing at all or in fact caused actual harm? Of course not!!! It's because the type of person who is willing to take daily meds to help him / herself is more invested in being healthier and is willing to do what it takes to get results.
The few studies I've read on the effectiveness of rehab indicate that people who go to rehab, get counseling and attend meetings are somewhat more likely to maintain sobriety over the long haul (the number are still dismal). Is that because the rehab, counseling and 12 step meetings actually help or is it because the people who do all this are determined to stay sober. Is it the commitment of the people to change their lives or all this other "treatment"? I think the rehab industry, counselors and 12 step apostles are like the Rooster taking credit for the sun coming up in the morning. None of these have anything to do with my sobriety. I don't drink now because I choose not to in order to save my career PERIOD!!! Inpatient, Outpatient, Counseling, 12 step babbling has nothing to do with it and in fact I'm never closer to a drink then when I leave my weekly "support" group when I have to listen to rehab nonsense from a "professional" for 1 1/2 hours ever week
I'd like to see these "studies" too. I'm not holding my breath because such a thing doesn't exist. 12 step has infected the rehab/recovery (and more specifically the peer assistance program) business, to the exclusion of nearly anything else. The whatever-anonymous organizations themselves, as they do not keep records cannot claim relapse rates or lack there of.
In regards to using these this very massaged and basically useless data to justify a certain length of contract is pure BS. I am pretty sure there is no connection whatsoever. These programs pretty much try to do whatever the heck they can get away with.
And while we are taking statistics, where did sexual abuse come into play in determining length of contract. That’s like pouring gravy on a hot fudge sundae??????
I also want to tell you a little more about SMART meetings and how they differ from AA. Like I said, they're secular. The framework is based on Albert Ellis's Rational-Emotive Behavioral Therapy; so, it focuses on changing negative and unhealthy thoughts into positive alternatives and adapting good coping skills. Where AA tells people they are powerless over their addictions and they have to turn this over to a higher power, SMART teaches people that they do have power over their behaviors and shifts responsibility back to the person, which is empowering. SMART stands for Self-Management and Recovery Training. It embraces psychology, psychotherapy and science where AA is like a cult with a spiritual foundation. SMART instructors receive training before they are allowed to facilitate a meeting or hold their own group meeting so there is a standard of quality control to the SMART meetings. SMART does not push a one size fits all approach to recovery, people map out their own path to recovery- there are no 12 steps and people aren't pushed to do things they're uncomfortable doing because they're told "it's an essential step." No one is labelled "powerless" in SMART, because like I said, it's about recognizing that it is up to you, recognizing that you are not powerless. There is cross-talk among participants in SMART meetings, so people are talking with one another instead of at one another- so, it's more therapeutic. I don't want to sound anti-AA, it's great that it works for some people but, I don't understand why it's the gold standard when science has proven that their approach is ineffective. Do you think it's because it keeps people running back to a rehab facility every time they relapse because they have committed such a horrible sin and are powerless to regain control on their own? Having people realize the power they do have over their addiction is not profitable... I wish I had some power over my career though, this is such a nightmare. No other field, none does this to people who are struggling with addiction or mental illness- every other field is so much more forgiving and understanding. I never would have imagined that a field that is based on caring for people who are sick or wounded just destroys anyone in the field who becomes sick or wounded. If we had done anything else with our lives none of this would be happening- we wouldn't have lost everything and been publicly shamed- a shame we have to carry for the rest of our lives. It's so terrible, if you leave nursing good luck working anywhere else and if you stay in nursing good luck getting a job- it's just... I have no words to describe my disgust.
The essential argument has been that the monitoring programs were originally (and to a point still are) suited for a particular sector of people. For that particular sector, they can be a wake up call, a very good thing and an avenue back to practice in a way that is safe to both themselves and their patients.
The problem that so many people (my self included) are so angry about is that the programs have become an expansive money generating monster full of conflicts of interest. People who do not belong here at all, people who's "crime" has nothing to do with nursing practice what so ever, people who's "crime' was reaching out for help, mistakenly thinking that we nurses are a caring profession. We are all swept up in this and broken mentally, emotionally and financially.
Maybe in the distant past, these were not "mean ole monitoring programs" but i assure you, today...in many if not most states they are broken, punitive, expensive nightmares for the majority of the nurses are that unfortunate enough to wind up in their clutches warranted or not. Their net has been cast far and wide so that people without substance use issues, with mental health issues, with issues that have nothing to do with nursing practice, with issues that happened years before they even thought of going to nursing school, things that they've already paid for via the justice system get slammed with contracts that have stipulations that have nothing to do with ensuring safe practice, but more to do with power and control.
Tell me again how rewarding this is.....I'll wait......
I think the reason why you are in your program and at what point in your nursing career you were forced to enter will determine your life after monitoring.
Me personally, as you probably already know, am on probation due to a DUI that occurred while I was still in college. As a 25 year old, I'm at that stage of life where weddings, parties, and other events that involve alcohol are common. Yeah I enjoy drinking but does that one DUI truly make me an addict? I don't think so, it was a one time mistake. A mistake. Nothing more or nothing less. My only other criminal conviction is for petty theft when I was back in high school. This program has (and is) literally taking my life away from me. I don't mean just with drinking. Can't travel out of the country, if it's in the states I have to make sure there's a collection site. We recently had a family trip to see the solar eclipse in person, somewhere on the border of Utah and whatever state, but I couldn't even go to that because there was no collection site. My parents are getting old, I want to take them out to travel but can't, I have student loans to pay that I could be paying with my drug testing. This whole program is a scam I don't know how else to put it.
To sum it up, I'm going to be the same person I was before this whole monitoring BS started.
Not saying that it isn't helpful for others but they really need to individualize each persons case and not just lump us all into one box. As a new grad, I wanted to really get my acute care experience and then transition into public health but right now I'm about to start working in psych. I'm grateful for the opportunity but there's really no correlation with that DUI and how I will perform as a nurse. To be completely honest, if I knew a single DUI was going to land me in this predicament, I would've chosen a different career altogether.
Oh I absolutely agree. I think someone switched my urine at my monthly addictionologist appointment...it came back positive, so I scheduled myself one through my monitoring program an hour later and it came back negative...as did their extra ordered hair test just to make sure I wasn't lying...even after all that evidence of my innocence, I'm coming up on 2 months of Observed urines. That line in the handbook about us having a right to dignity is pure garbage.
Prescisly . So far as these programs go. Appropriate would be DAU. You pee clean. You work. You don’t. You’re off work until cleared by YOUR (not chosen by program) doc/shrink/addictionologist. If you get written up or fired at work, that’s your problem. Program notified. Happens X number of times, BON notified, appropriate action taken.
All this forced voluntary meeting attendance, forced rehab attendance, forced employment loss, forced financial ruin, forced loss of dignity.....has nothing to do with ensuring safety in practice.
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