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 Geriatrics.

Currently, on my unit, I have 3 pt's who have zero quality of life. Two are now 300 + lbs due to constant GT feeding, edema, and a complete inability to move any part of thier bodies. Family doesn't come in to see them because it is "too painful to see Mom like that". The third is a young person (40-50yrs), body contracted, unable to comunicate, or respond and lately having increased difficulty to swallow. A brain disease has removed her from her life. Due to her inreased inability to swallow the family is comtemplating having a GT placed. My heart cries for her, this procedure will not improve her quality of life. It will however, cause her to become like the first two pts. Do I feel it is a "waste" to do this procedure? Yes! It will not make her better, and I forsee only more pain for her. Will I follow her families requests?? With all that I have, all that I am, as much grace and respect as the good Lord can give me, and in anyway possible. Why?? Because they love her, and they need whatever time it takes to accept the true condition she is in. I became a Nurse to help others. Sometimes that means doing things I would want done to my self or my loved ones. Sometimes it means caring for not only my pt, but, thier families needs too. Just my thoughts and opinions, don't mean a thing to others but, only to me.

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Specializes in Geriatrics.
Sometimes that means doing things I would want done to my self or my loved ones.

Sorry, I meant things I would not want done to myself or my loved ones.

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sorry, but it's not about you or any other family member.

it is only about the pt.

and it goes far beyond sustaining them.

these folks suffer.

and when i hear about families who insist on doing everything possible (even in spite of pt wishes), i want to whack them on the upside.

haleysmum, as a daughter, you want to keep your mom as long as possible, no matter how she suffers?

that's the real question here.

leslie

My point was is that as any family member would feel, I would, as a daughter, for my own selfish reasons, want to have her for as long as I could, I admit that. I also know as a nurse that she is suffering and that part of me would want her to be at peace. I get it. And I have had pts whose family member is dying and should be allowed to pass. Yet they want everything done to keep them alive. And at times I have felt like sitting them down and telling them as much. However, they don't see the pain the pt may be in they see the person they love and dont want to be without.

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Specializes in Trauma ICU, Surgical ICU, Medical ICU.

Update!

So right on schedule, we had ethics rounds at work today. An MD on our ethics board trained in ethics met today to discuss the law and how ethical dilemmas like this are solved.

Per NC law: In Lay terms; If a person is homeless or illegal and no family can be found for them by trying to find them (IE you call the cops and try to find the next of kin) the doc has the right to decide if it is futile and can pull the plug,

HOWEVER,

if a next of kin is found; like say, we have a homeless man who has a son and the son has never met his dad and wants nothing to do with making decisions, we are stuck. We cannot make any decisions since we know there is a next of kin. The next of kin can say he does not want to make these decisions though and he can relinquish his status and it again falls to the docs.

In one case in our hosp, he told us that there was a woman who was dying. She had a sister who refused to relinquish her status as next of kin and would ONLY agree to make decisions IF the hospital paid for the funeral. They did and she allowed the patient to die. I was shocked that this was allowed, but heck, one day was more expensive than paying for the funeral. Could you imagine what families would demand if they knew this law and knew hospitals would give in to requests like these, they'd never make decisions! I know I was shocked and it didn't seem very fair at all! The ethics board is currently lobbying for more fair treatment of all involved. Just a little tidbit of info I thought I'd share.

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