Obama Speaks to Nurses on Health Care

As a PGY3 IM Im very worried that President Obama wants to overhaul healthcare because after watching this video I now understand that President Obama doesnt have a clue as to the day to day work of a doctor working in a hospital setting. Did he asked the OB/GYN doctors how many more deliveries she/he had? how many were high risk?

President Obama, nurses are assign 4-6 pt (and Im using my hospital in MA as an example) on the floors and 2 on the intercare and units. HOspitalist physicians are assign 15-20 patients per day, some as high as 25, not including new admissions. Specialist have 20-30 patients to see per day and I have seen it >30 in the ID and renal service.

And lets not forget 1- that they have to see all this patients, they have to writte beautiful notes explaining everything in detail because if not they might be sue or receive a call from someone in administration that might be supervising charts. 2- The have to call other specialists/case managers/social services/primary care doctors after seen each patient to get more information to provide quality care 3- They have to perform procedures (GI= endo/colonoscopies, ercp), Renal: line placement for HD, Neuro: LP's etc etc 4- Talk to the families which then you have to accomodate for a specific hour to meet them and sometimes you have to meet them more than one time per day 5- Admit patient if you are a hospitalist while seeing 15-20 patients per day.

And lets not forget this patients might be in 3 different buildings/wings of a hospital. Were I practice is 700 beds with 4 buildings and you walk alot during a normal day.

I know President Obama loves nurses, me too and I respect them alot. Their job is hard/stressful/diffcult but I really feel the President really doesnt understand the role of a physician and, again, Im very worried that he wants to change completely the healthcare system w/o really understanding this.

What has insurance for people to do with a doctors job, in the meaning patient/doctor ratio?
Nurses fought and are still fighting hard to maintain or gain quality, there are still places where one nurse is assigned to 60 patients.
I think it's up to the doctors to fight for more quality, and reduce the ratio, but for some the money they are gaining seems to be more important than everything else, if you see more patients you get more money, right?

5cats

Correct me if I am wrong- Obama IS a Lawyer, he went to Law school. These administrarive Nurses he consults, coffee clatches with are just that- they are ADMINISTRATIVE nurses, who have NOT been at the bedside of a patient with a REAL patient assignment in HOW LONG? When was the last time OBAMA gave a injection or HIS patient crashed and CODED or Threw-up on HIS nursemates!!. When was the last time one of these nurse's he "talks/Consults with changed/emptied a bedpan or colostomy bag and had a screaming family member in their Spa make-uped face. When was the Last time Obama and his NURSE freinds walked in our shoes for period of time(not just a 1 day "look-see" tour of hospital disney land or freakshow) and were assigned/obligated to care for an treat and be 'RESPONSIBLE' for a Live patient assignment. NEVER- so, how can he and his group of NURSES expound, preach, spout-off and decide on what WE (NURSES and DOCTORS) need and should have to perform our duties/jobs/responsiblities-safely,competently,ethically and high quality? I am sick and tired of Lawyers telling Doctors and Nurses what we need,should do and how to do it. We need to go into their LAW Offices and BARGING into their courtrooms and start telling them how to do their jobs and run their Legal practices. I'm sure this would go ever like a LEAD BALLOON. How is a Lawyer qualified to critique the world's of nursing and medicine when they have to us a spell check to type of the medical terminology. And these Nursing Advisors/administrators/management need to have their Prada's vomited or pooped on to remind them what nursing REALLY is about!!

Obama talks about cutting healthcare costs. Has anyone noticed nursing salaries since this big hiring freeze/layoff of nurses around the ENTIRE country. Go to start a new nursing position somewhere- see what you get offered. there ARE positions opening up again. In NJ/Phila- we use to have rates as high as $44.00/ (hospital staff rates-not agency) They are now down to $31, $32, $35/hour. The AGENCIES are also offering these same rates. some it's in the $20's- I worked for this rate in 2000. This has set nurses wages back 9 YEARS. This hiring freeze has allowed hospitals to reset nursing salaries at 2000 and 2001 levels hoping we forgot what we were making before we lost our positions. Maybe we should turn into NURSE Jackies- get close enough to the CEO to pick his/her pocket and divide up their cash, credit cards, car keys and house keys- They can keep the spouse and kids.

The main topic is healthinsurance!
He doesn't have to know how nurses or doctors are working to implement a health insurance.

That's not the topic here.
Nurses salaries are not a topic here either, when they are dropping now, that has different reasons but certainly not the discussion about health insurance.

5cats

I'm curious too about what salaries or the nurse/physician daily work has got to do with health insurance for everyone.

sigh.

Hearing all this is so depressing. No one ever gets to the root of the problem.

why is it that everyone thinks more government involvement in healthcare is the solution, when the government is the one responsible for making it the turdball it is in the first place?

I think that insurance agencies dictating what they will and will not pay is a huge crock. Actually health insurance in its current form is a huge crock.

Everyone knows what contributes to astronomical health care prices, so if you want to "trim the fat" why not start at the root of the issue, trim that down, decrease health care costs, in turn, decrease insurance costs, increase number of covered individuals, and streamline and maximize reimbursement? Why? because no one wants to. Because that means some people who cant pay for help wouldnt recieve it. Oh god, we cant have that....groan.
I'd like to go back in time, find the guy who started the phrase "everyone is entitled to healthcare." and slap him in the face. That philosphy is what has caused healthcare to turn into the money pit that it is.

lots of things we consider rights really arent. The philosphy of "everyone has the right to healthcare." is rediculous. By that logic, everyone has the right to food. Would you walk into a grocery store, grab a bag of bread without any form of payment and expect to walk out the door with it? No, thats called shoplifting, and its a crime. The only time healthcare will be fixed for the better is when all of these bleeding hearts come to the realization that healthcare is and needs to be run as a buisness. Until that time, we are all screwed.

furthermore, on the same topic....

all of these government programs need to go away. until they do we will continue to hemmorhage money.

The government was created to protect the public, not support them.


most of the problem can be summed up in four words.

False. Sense. Of. Entitlement.

(not sure about physician workload)

but when it comes to nursing salaries affecting health insurance....correct me if im wrong...

hospitals have unit budgets > Employee salaries come out of unit budget > Unit budget dictated by reimbursement > Reimbursement dictated by insurance companies > Employee salaries dictated by insurance company.

yes/no?