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| No. 40 | 
Oct 28, 2009, 01:20 PM
 Re: ICU stay before death common in the U.S. Originally Posted by geekgolightly  So, hospitals in UK, and professionals in UK aren't worried about getting sued... why is that? And what will it take to get USA on the same page?
Good question. I think malpractice laws are very different under a national health system. Someone else here knows much more about it than I do. I'd like to know more about this, too.
To semi-quote my hospice social worker friend--
Trach me home
Country roads
To the place
I don't belong....
 | | Advertisement Sponsored Links | | | | No. 41 |
Oct 28, 2009, 02:51 PM
Re: ICU stay before death common in the U.S.
As a new nurse I cannot say I've had extensive experience with this topic however I feel I've got to put in my two cents. And hey, I did my preceptorship in the ICU so I have a tiny taste of ICU experiences.
My Grandmother died last fall at 83 years old...after spending months in the ICU, with a broken back, on and off the vent, having bowel resections (yes, multiple), invasive devices everywhere and DIC. Unfortunately I wasn't far enough along in school or near enough in physical location to help guide my family with less traumatic options. At the same time, my Grandmother had always been afraid of dying and requested prior to her deterioration that everything be done.
Contrast that with ICU patients I worked with who had told their families they didn't want extensive measures taken but had family members who simply could not let go and allowed their relative to be kept alive artificially. The specific one I'm thinking of had nothing in writing and was unable to state their wishes and so their care was based on familial decisions.
If I have learned anything in my first year of hospital experiences it is how my who-would-want-to-live-like-that worldview is not held by everyone. It is multifaceted as someone else said; it's legal BS, it's misinformation, it's politics. On the other hand, there has to be some sort of change that benefits the greater good in the political sense, monetarily, and yet still allows for patient autonomy. I wish I knew what that solution was. Maybe a government requirement that everyone has advance directives would be a start. I don't know. As for right now, I'll just keep pressing my family and friends to get AD's.
| | No. 42 |
Oct 28, 2009, 04:04 PM
Re: ICU stay before death common in the U.S. Originally Posted by tewdles I am so sick of hearing about OBAMAcare. Talk about a bunch of political crap.
And what does that have to do with the discussion.
As yet, there is no "Obamacare", just as there never was "Hillarycare".
I will say that I am sick of political "crap", much of which has no basis in fact, no basis in written policy, and basically is two partison groups trying to fight it out, based on innuendo, presumptions, deliberate misinterpretation.
And destroying our country with their fighting.
| | No. 43 |
Oct 28, 2009, 04:29 PM
Re: ICU stay before death common in the U.S. Originally Posted by elkpark Hospitals and physicians today (in the US) could refuse to admit people to ICUs and refuse to code people (and refuse to do lots of other things) -- they just don't.
Yes, but the PR is also as daunting as getting sued.
No one wants to be on the front page of the "X Union Times" w/a story about how someone's beloved grandmother was denied ICU care and the hospital "murdered" them.
Does anyone remember the infamous "high dose chemo with bone marrow salvage for breast cancer fiasco" of the 1990s. The public was beating up on insurance companies that would not pay for this procedure...trotting 35 year old mothers of small children, talking about how this experimental was their "only chance" at life. The PR was devastating, thus many paid for this highly expensive and dangerous procedure. Only to find, that when the test results were rechecked, the procedure really did not help in many cases and may have actually shortened lives, plus contributed disproportionately to poorer quality of life.
The issue with the UK, I really believe that Americans have an unreal idealism about "life", compared to many other nationalities. I have been overseas, and the idea that one would spend huge amounts of money on one case, such as the costs of separating some conjoined twins, when that money could be used to improve many more lives with basic care, tends to be an American idea. NonAmericans tend to be more rational about the fact that death is a natural part of life, that one can't "cure" death and that we should plan on ways to handle that.
I was watching a highly conservative news channel, and several different commentators were complaining about "death counseling", about how unAmerican that it was, because "we are Americans, it is part of are culture to fight to live and not "give up". I have to wonder how they will feel when they or a loved one is being brutally forced to live, because no will let them "give up".
| | No. 45 |
Oct 28, 2009, 07:53 PM
Re: ICU stay before death common in the U.S. Originally Posted by caroladybelle Yes, but the PR is also as daunting as getting sued.
No one wants to be on the front page of the "X Union Times" w/a story about how someone's beloved grandmother was denied ICU care and the hospital "murdered" them.
Does anyone remember the infamous "high dose chemo with bone marrow salvage for breast cancer fiasco" of the 1990s. The public was beating up on insurance companies that would not pay for this procedure...trotting 35 year old mothers of small children, talking about how this experimental was their "only chance" at life. The PR was devastating, thus many paid for this highly expensive and dangerous procedure. Only to find, that when the test results were rechecked, the procedure really did not help in many cases and may have actually shortened lives, plus contributed disproportionately to poorer quality of life.
The issue with the UK, I really believe that Americans have an unreal idealism about "life", compared to many other nationalities. I have been overseas, and the idea that one would spend huge amounts of money on one case, such as the costs of separating some conjoined twins, when that money could be used to improve many more lives with basic care, tends to be an American idea. NonAmericans tend to be more rational about the fact that death is a natural part of life, that one can't "cure" death and that we should plan on ways to handle that.
I was watching a highly conservative news channel, and several different commentators were complaining about "death counseling", about how unAmerican that it was, because "we are Americans, it is part of are culture to fight to live and not "give up". I have to wonder how they will feel when they or a loved one is being brutally forced to live, because no will let them "give up".
Many families won't give up. They want everything done. We treat our animals better than we do our families.
| | No. 47 |
Oct 28, 2009, 09:36 PM
Re: ICU stay before death common in the U.S.
Originally Posted by tewdles
I am so sick of hearing about OBAMAcare. Talk about a bunch of political crap. Originally Posted by caroladybelle And what does that have to do with the discussion.
As yet, there is no "Obamacare", just as there never was "Hillarycare".
I will say that I am sick of political "crap", much of which has no basis in fact, no basis in written policy, and basically is two partison groups trying to fight it out, based on innuendo, presumptions, deliberate misinterpretation.
And destroying our country with their fighting.
Obviously you did not read the post prior to mine...so I will not be offended to your response to my post.
In response to the discussion about elderly women who are afraid of dying and beg their families to "do everything"...how sad...because the families, by pursuing every medical intervention (no matter how painful or invasive) insure that grandma's worst fears about dying come true. The family cannot save her life, they can only save her from the pain, suffering, and humiliation of the modern process of dying in a hospital. It is up to us, as health professionals to change this american experience with death.
| | No. 48 |
Oct 29, 2009, 08:06 PM
Re: ICU stay before death common in the U.S.
The biggest reform we need right now has to do with advance directives.
The family of a dying patient can simply IGNORE the wishes of their loved one. They can demand that everything be done, no matter what their wishes are, and the Doctors are too afraid of being sued to do anything but comply.
An advance directive needs to be IRONCLAD. If we protect the wishes of these dying patients, the cost of healthcare in this country will drop dramatically. How many of you have a patient that is 85 with an EF of 10% living on a dobut. drip and a vent in one of your ICU beds? (or similar)
Did this patient want to be kept alive like this? What are we really doing about it?
Off soapbox. Sorry, it just makes me ill to torture poor little old people to death.
God forbid we just let people go when it's time to go.
| | No. 49 |
Oct 29, 2009, 09:41 PM
Re: ICU stay before death common in the U.S. Originally Posted by SillyStudent The biggest reform we need right now has to do with advance directives.
The family of a dying patient can simply IGNORE the wishes of their loved one. They can demand that everything be done, no matter what their wishes are, and the Doctors are too afraid of being sued to do anything but comply.
Emphasis mine.
Tort reform.
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