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?

We are spoiled and careless.

in a nutshell, oncnurse.

of course i could think of a few more juicy adjectives to describe american values (or lack thereof) but this is the crux of the matter.

there are many dynamics that come into play, that results in this wastefulness.

we need more agencies that focus on recycling the waste, and would bring fruition to other nations in need.

and when we talk of 'wasting lives', are we talking about the cost of futile care or are we talking about the waste of precious time these pts are robbed of?

leslie

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I've read the entire thread, and I have something that hasn't even been brought up. How about the waste of money on promoting a Press-Ganey Hilton atmosphere, and catering to the "customers"? When people make ridiculous complaints and get those service recovery gifts, it won't take long for word to get around on how to get the freebies. How much money did they spend bringing in Press-Ganey that they could have spent on hiring staff? How much is wasted on hiring bonuses because the workng conditions are creating a high turnover? And how much was spent on redecorating the lobby like a fancy hotel, rather on needed supplies?

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Specializes in Cardiac.
I've read the entire thread, and I have something that hasn't even been brought up. How about the waste of money on promoting a Press-Ganey Hilton atmosphere, and catering to the "customers"? When people make ridiculous complaints and get those service recovery gifts, it won't take long for word to get around on how to get the freebies. How much money did they spend bringing in Press-Ganey that they could have spent on hiring staff? How much is wasted on hiring bonuses because the workng conditions are creating a high turnover? And how much was spent on redecorating the lobby like a fancy hotel, rather on needed supplies?

What?? People get presents for complaining? Please tell me you're kidding!

I'm lucky that where I live, there are no "PG" people. I don't know how you guys deal with all that...

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It's an ethical debate... would it be ok with you for someone to "waste away" if they were a millionere and could pay for the healthcare? How does that change things in your eyes?

Just a question...

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What?? People get presents for complaining? Please tell me you're kidding!

I'm lucky that where I live, there are no "PG" people. I don't know how you guys deal with all that...

I have heard of it before on these forums. "Entitled" people with ridiculous complaints, and managers who are big on "customer service". Luckily, where I live Press-Ganey hasn't infested the hospital and I don't think it ever will. I went to clinicals in a big city hospital and they were in the process of bringing in that nonsense. I also overheard an employee talking about the money they twice spent on outside consultants that basically said to hire more staff. Somehow I don't think that was going to happen. They did find the money for Press-Ganey.

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Specializes in Trauma ICU, Surgical ICU, Medical ICU.

Thanks for redirecting the thread those of you who did.

I have never heard of anyone getting anything special for complaining besides more attention or if things get really bad, risk management steps in.

Another thing that I have found to be very wasteful is new, state-of-the-art charting systems every 6 years that cost over a few 100K to run (big teaching hospital) when ours are not broken, yet we only have 6 glucometers on the floor to share.

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Thanks for redirecting the thread those of you who did.

I have never heard of anyone getting anything special for complaining besides more attention or if things get really bad, risk management steps in.

Another thing that I have found to be very wasteful is new, state-of-the-art charting systems every 6 years that cost over a few 100K to run (big teaching hospital) when ours are not broken, yet we only have 6 glucometers on the floor to share.

Another thing is, if half of a vial of a med is used, and the pt. will need another dose why waste that half vial?

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Specializes in CVICU, Burns, Trauma, BMT, Infection control.
I have heard of it before on these forums. "Entitled" people with ridiculous complaints, and managers who are big on "customer service". Luckily, where I live Press-Ganey hasn't infested the hospital and I don't think it ever will. I went to clinicals in a big city hospital and they were in the process of bringing in that nonsense. I also overheard an employee talking about the money they twice spent on outside consultants that basically said to hire more staff. Somehow I don't think that was going to happen. They did find the money for Press-Ganey.

That's what it's all about. :(

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Specializes in Trauma ICU, Surgical ICU, Medical ICU.
Another thing is, if half of a vial of a med is used, and the pt. will need another dose why waste that half vial?

I usually keep the vial for later, especially with PRN things like lasix and the bottle is bigger, usually 100mg. I just put it in their drawer and use it again. I mean we do the same with insulin so why not? We also keep lidocaine vials. As long as you throw em away when the patient leaves I see nothing wrong with it but I guess it has something to do with infection control issues or med safety.

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Specializes in Staff nurse.
I usually keep the vial for later, especially with PRN things like lasix and the bottle is bigger, usually 100mg. I just put it in their drawer and use it again. I mean we do the same with insulin so why not? We also keep lidocaine vials. As long as you throw em away when the patient leaves I see nothing wrong with it but I guess it has something to do with infection control issues or med safety.

...yes, infection control, a biggie to be sure. It may also cut down on narcotics being "diverted" to staff.

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Specializes in Trauma ICU, Surgical ICU, Medical ICU.
It's an ethical debate... would it be ok with you for someone to "waste away" if they were a millionere and could pay for the healthcare? How does that change things in your eyes?

Just a question...

No, I would try to do everything I can to get them to see that this care is futile, no matter how much they were able to pay. I think everyone has the right to die comfortably and with dignity. Dealing with these patients for me is never ok and it tests my ethics each day because I find the 'ethical' thing to do is this:

1) Family meeting, discuss the prognosis and talk about goals you want for the patient (die without pain, wait for Uncle X to come in from out of town to see the pt before he goes, all measures no matter what, etc) Discuss plans for CPR.

2) Document and follow family's wishes. If family chooses to keep pt as a full code, explain to family over and over again what this entails, discuss who will be present during the code and lay down any rules for the code (IE: no children, if you cannot yourself in the right manner you will be foreced to leave, etc). Document this as well.

3) If pt continues to live and pt is in pain, more education about how we can tell the pt is in pain (VS up, facial expressions, etc), another family meeting, possible ethics consult if patent is suffering needlessly. Document.

4) Family member codes, follow rules previously described. Even through code, let family members know that its ok to tell the code team to stop.

This should be done no matter who is paying, the hospital or the family. This doesn't really even come to play during the process. Do I still feel bad for putting a patient through needless torture, yes. To me that is not-ethical, so it is a grey area. However if a patient has a chance and a life can be saved, this is never a waste.

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Specializes in Trauma ICU, Surgical ICU, Medical ICU.
...yes, infection control, a biggie to be sure. It may also cut down on narcotics being "diverted" to staff.

Yeah I would never do this with narcs unless were pumping them in like crazy (end of life care) but we usually just start a gtt so this isnt an issue.

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