How much waste do you see?

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So after the MM 'sicko' thread, me and some of my co-workers got to talking last night about the whole univ health care issue and what's best. We all agreed that, on our unit esp, we see a lot of dollars that could go elsewhere and we see a lot of wasteful spending in our system. We basically take patients that are dead or near death. We save patients that are homeless and leave them on vents for months at a time where we know we will never get that money back when they die. We also see the same with illegals. About 1/2 of our patients do not have any form of insurance (so they wont be paying) and they still get to sit on the vent and rot until they die for thousands of dollars a day. This is a huge waste to me. In other units perspectively, how much wasting of healthcare dollars do you see?

Specializes in PICU/NICU.

yeah- thats what I say..... the stuff is in packaging!!!

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Specializes in ICU/Critical Care.
OK, you have me intrigued because we really dont do this nearly enough. So, in this case, was the pt at this level for a while or less than 24hrs? And, hypothetically speaking, IF this patient was able to get to the OR and wound fixed and no more bleeding, sats ok and bp ok, but the pt had severe neurological problems from poor perfusion to the brain and the pt was in a vegitative state and would not recover, what would your unit do? Family consult and try to explain the situation? How long, if the family said they would not want to remove support, would they allow the pt to remain on life support if the pt could not go to an outside facility for whatever reason? Indefinately?

On our unit, its more of a "well lets wait and see" approach and nothing ever gets done for months at a time, and its irritating.

That patient didn't last for more than 2 hours. They weren't able to take the patient to OR because he was too unstable. And even if they did get him to OR and back I'm sure he would have had some type of neurological damage if he ever had any chance for recovery. But if that was the case then the docs would have a family meeting, explain the situation, what we have done for the patient and explain to the family that the patient will more than likely remain in a vegatative state. If the family wished for the patient to remain vented, a neuro consult would be done so we could see if the patient was perfusing blood at all to the brain. A doctor from the ethics committee would also be consulted to meet with the family.

I'm going to PM another example just because there are some people I work with the visit this site. It really just depends on the situation. Some families say they want to continue and the docs go along with it, doing what they can to save the patient even though its futile, giving the family time to see that the patient is not recovering, but continue to paint the picture of the outcomes of the patient. I understand what you mean about the "never gets done" approach but that's not how it is where I work compared to where I used to work.

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Specializes in Medsurg/ICU, Mental Health, Home Health.

i know many times it seems as if what we're doing is ridiculous, futile and a lot of effort for nothing. a lot of times this may be true. however, we can only do what our scope of practice allows. sometimes advocating, education, putting bugs in doctors' ears, etc., is not enough. and if the majority of your patients seem to be wasting resources, do you think maybe you should find a different place to work? i am not saying this to be rude, or to even say that you are wrong. i do know, though, that if i felt that way, i would not be capable of providing the best care possible to my patients. i hate to be a pessimist, but i am not completely sure how to change these things. if you do, more power to you, and i think you will have to change your position to do accomplish this. if you do not, perhaps a change of scenery may help. i did my senior preceptorship in the nicu. i have not set foot in one as an rn, because i felt that i was going to be too frustrated with absent or addicted parents or families who appeared to be torturing their children by keeping them alive by artificial means. i am still upset by those scenarios, but it doesn't affect my nursing at the moment, so my patients are not affected.

jess

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Specializes in Cardiothoracic Transplant Telemetry.
As much as I love the clinical stuff I see, medicine is running a business & there are a lot of people that can't manage or run a business unit efficiently. I'm a former banker & I see waste on a daily basis on soooooo many levels. VERY SAD & this is a result of VERY DUMB people who have passed the NCLEX & can't deliver safe care, let alone balance their own checkbooks. Anyway, this is of course one of the reasons healthcare is so expensive. Then people wonder why it costs so much. I was thinking about taking some time off, but once I get my NCLEX out of the way, I'm going to start positioning myself for an MBA b/c it's going to get worse before it gets better. BTW what did you guys do to study for the NCLEX? Haven't passed twice & I'm working through Suzanne's 1st step, but I'm just curious.

Wow

In one short post you talk about all of the "VERY DUMB" people that passed the NCLEX and how you are going to leave and go get an MBA, then in the very next sentence you state that you have failed twice and ask all of us very dumb people for help in passing

Go figure

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Specializes in CVICU, Burns, Trauma, BMT, Infection control.
On our unit, everything that is left in a patient's room after they leave is thrown out.... rolls of tape, unused tegaderm, packaged 2X2s, packaged suction caths, packaged yankauers, and always a few of those prepackaged 10cc saline flushes are very common leftovers.... these all go in the garbage due to "infection control issues". We try not to bring too many supplies into the room, but you know how it is- you grab some stuff and go.

It just makes me sick to throw this stuff away! Does anyone else have this policy???

Yes we had that policy in the Burn Center and to a lesser extent in Bone Marrow T. In the Burn Center we had specially made carts that could be cleaned,the room was terminally cleaned and everything was either autoclaved or discarded in between pts because they were there so long that it was assumed that whatever in the room was contaminated by either contact or droplet/airborne bugs. This population didn't have a lot of chances to recover from a nosocomial infections and the resistant organism rate was pretty low there.

Where I worked in BMTU they weren't so careful about terminal cleaning and discarding supplies in the rooms. Those folks were actually more susceptible than the burn pts and they caught everything. There were lots of problems there I suspect were related to ineffective terminal cleaning as well as contaminated supplies.

I think if the pt who was there had resistant organisms or a really long stay the supplies should be thrown out because you can't clean the outside of the paper packages so you can't open it without contaminating what you touch next.

I wish they would do more studies regarding this so that we had more decisive criteria so we're just not throwing usable supplies away in fear of infection without the actual studies then write effective P&P. I always err on the side of caution myself. It's a quandary.

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Specializes in Geriatrics.
A life is a life and you chose nursing to save/preserve life, right?

Waste is drawing too much meds and throwing out half of it.

Waste is staff thinking that the utility closet is their shopping store.

Waste is not recycling all of the non hazardous stuff hospitals throw away.

etc.....

Waste is not giving dying patients the right to die with a little dignity, no matter who they are or where they came from.

Just my opinion.

:yeah::yeah::yeah::yeah: WELL SAID! :yeah::yeah::yeah::yeah:

Waste is the meds I destroy each month because the pt's have either gone home, were taken off the med, or passed to that better place! I truely wish I could donate those drugs to clinics for people who can't afford to pay for them.

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Specializes in NICU.

"Waste" to me is the bazillion man hours for little "in-services."

It's wasting 95% of a med container because that's cheaper than paying a pharmacy tech to draw up the correct dose.

It's people who pocket medical supplies from their floor to stock their private first aid kits.

It's people who think their credentials mean they're above wiping off a counter or emptying a trash can, and page housekeeping "stat" instead, while they go back to texting their boyfriend.

It's staff members who routinely don't manage their time well, spend their time surfing the Net, talking on the phone, gossiping about everyone else....because they know someone else will do what they fail to do.

It's the facility giving away all kinds of free junk.

Really...I could go on. Not once did I think of allowing someone's body a chance to heal and perhaps recover as a "waste."

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Specializes in Staff nurse.

I see alot of waste in TIME, when having to deal with non-emergent demanding patients who are high maintenance because they are bored or power-happy. I am not referring to the pt. who is scared and needs some reassurance, or the pt. who needs close monitoring, but the "entitled".

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I find your post disgusting and an embarrassment to the nursing profession.

Saving a life- any life- is NEVER a waste.

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Specializes in Cardiac.
I find your post disgusting and an embarrassment to the nursing profession.

Saving a life- any life- is NEVER a waste.

If you read, the OP never said anything about not 'saving a life'. She was talking about the futile. The people who are terminal who remain on vents and are full codes. That the majority of money is spent in the last few months of life. That people remain on vents for way too long in agony and without dignity.

I already posted my opinion-that I felt we could save money on recycling, turning off lights, etc.

But I hate when people don't read and understand posts. And the OP is being hung out to dry because of it.

Another poster menitoned that others' probably agreed with the OP but wouldn't post due to posts like this-

I think being called disgusting was uncalled for.

Just my opinion, which I have never had a problem expressing...

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If you read, the OP never said anything about not 'saving a life'. She was talking about the futile. The people who are terminal who remain on vents and are full codes. That the majority of money is spent in the last few months of life. That people remain on vents for way too long in agony and without dignity.

Actually if YOU read the original post you will see that the poster stated how the hospital will "never get the money back" when homeless and "illegals" die. The poster goes on to complain that 1/2 of the patients don't have insurance and closes with the question of how much "healthcare dollars go to waste." It NEVER states anything about dying with dignity- only money.

I don't see how calling this post disgusting could be uncalled for- because the original post was focused on wasting money on patients that are unable to pay.

I did notice subsequent posts by the OP in which they tried to back peddle and change in order to sound as though they were complaining about venting the terminal, but this is not what the original post focused on.

I too hate when people don't read the post.

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Specializes in Trauma ICU, Surgical ICU, Medical ICU.
I find your post disgusting and an embarrassment to the nursing profession.

Saving a life- any life- is NEVER a waste.

I see you are a nursing student, let me know how that philosophy works out for ya in the REAL world when you see bloated rotting corpses on vents who cannot eat for months at a time (not even TF, think stomach CA), their skin is falling off, they have no bottom left due to sores, their teeth are falling out, they have hardly any brain function left, and they are left to sit there and poop themselves all day. Is that saving anyone??? When you see it, you let me know how you feel. I find the fact that you'd want to "save" people like this disgusting!!! There is no saving someone who cannot be saved! You DONT COME BACK FROM THAT!!! So you code someone for 30 minutes and break their ribs and leave them bound and broken while the family (who wanted this in the first place) has their last memory of their loved one with you jumping up and down on their chest, hearing the ribs crack under your fingers, seeing blood and sputum fly from all orifices. After that happens for ya, I would love to really know how you feel.

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