My monthly semi-coherent rant on the state of healthcare

[rngreenhorn]

Healthcare is screwed. The new CMS regulations that are cutting funding to hospitals, added to the general bad state of the economy, are causing staffing cuts. The new rules that base reimbursement on patient satisfaction mean more staffing cuts, worse CMS scores, more decreased payments, and even more staffing cuts. Add to that, cuts to Medicaid, and the fact that no one knows what is going to happen with private insurance once the PPACA is fully implemented, and the future is pretty bleak. Pretty soon, in hospitals across the nation, there is going to be one nurse taking care of 10 agitated and /or mad patients on each unit.

Before you all respond with the question, "Well what are you doing about it?" I'll tell you: 1) I'm getting angry, 2) I have completed my employee satisfaction survey with a 3 page essay of "the problem, and ways to fix it" (and everyone knows surveys fix everything), 3) I've caused my unit manager to quit (with all my complaints and the fact that her hands are tied by the unreasonable demand of administration), it's no damn wonder she quit, 4) I've talked to: my boss, her boss, the staffing office, the house sup, the COO of the unit, the "head in her a** of nurse theory" CNO of the hospital, doctors, and I have even discussed it with by dog, and 5) I've done some soul searching to see if it possible just my problem, including having my hormone level checked by my PCP. But after another horrendous day, being stuck in one of my patient's rooms, and being punched by said head injured patient (because there is no budget to staff a 1:1), that lead to really pi** poor nursing for the rest of my patients, I'm beyond frustrated. The impossible rules and regulations of those in power are completely detached from reality.

And let me "pre-respond" to the new nurses, nurse manager, nurse administrators, nurse educators and such, before you say "well if you hate it so much, then you should quit, you clearly don't have the temperament and warm fussy approach to be a compassionate nurse. Didn't you study theory?" I'll say, you are right, I don't. This profession sucks. I will be looking for another career. The sad thing is, I believe in the nursing philosophy, I think people are basically good. It's just that the leaders and regulators in healthcare are suffering from some serious group think.

You may say, "Well healthcare in the U.S. is too expensive." I agree, yes it is. But is it going to be one heck of a road to equilibrium. I once loved my job, but I am beaten down, dishearten, and afraid for what's to come... Also, I am not a martyr, I will help people (it is in all our natures), but I will not condone stupidity.

PS. Yes, the grammar in this rant sucks. Sue me.

[barbyann]

ditto

[GHGoonette, BSN, RN]

I've been warned by my colleagues not to get so angry about working conditions and management attitudes; they're worried about my blood pressure

What can I say? Sadly, you've hit the nail on the head. People and their needs come last in competition with money. The only way you can change it is by offering, en masse, to take a pay cut A better solution would be to insist that MANAGEMENT take a pay cut, and that CEOs, if they want to work, should do so as volunteers They, at least, can afford to live off their investments!

Best advice? Chill out, dude before your BP goes through the ceiling!

[VivaLasViejas, ASN, RN]

Someone else will have to pay the lawyers. I can't disagree with a word you've said here.

It's going to take the total collapse of the crazy-quilt we call a healthcare "system" to change things for the better. I really wish I could be more optimistic, but as a member of the huge, aging Baby Boomer generation, I am quite frankly terrified of growing old in this country. I fear any long-term benefits gained from this impending disaster will be far too late to do us any good, that my generation will find it necessary to commit suicide in large numbers so that we can pass into history with some dignity, rather than live out our sunset years in cardboard boxes because we can't afford both shelter and medicine and there isn't enough of either for 76 million old people.

Socialized medicine isn't the answer. Mandating the purchase of health "insurance" isn't the answer. I'm not really sure there even IS a single answer, at least not one that's palatable to the majority and affordable. Personally, I think one of the biggest issues no one is addressing is the necessity of reining in massive malpractice-suit awards and preventing frivolous court proceedings, but I'm obviously in the minority. At any rate, I'm not looking forward to my so-called golden years..........I got started way too late in life to have built up any kind of savings, and I know I'll never be able to afford health care on my own if Medicare becomes insolvent by the time I'm eligible in a dozen years.

It's not anyone else's fault; it's my responsibility to take care of myself, and if I can't it is just going to suck. And I have the feeling I won't be alone in the suckage; just about everyone who's not independently wealthy will probably be right down there with me, where the best we can hope for is to be able to work until we literally can't put one foot in front of the other anymore. At that point, I imagine I will want to be swiftly and mercifully taken out via a quick MI or a brief bout with pneumonia so I don't have to be a burden on society or my family.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Went from being a care giver to disabled. Insurance company screwed me every way they could, had to use all my retirement savings and credit cards and went bankrupt to get a correct diagnosis. I agree with everything you say but would add that "for profit" is what's killing our system.

I can't put into words how demeaning it became trying to get care once my money and insurance were gone. In essence, when the money runs out so does the doctor. Had hoped to get fixed and back to work ASAP. Never thought I'd be permanently S.O.L.

[DixieRedHead, ASN, RN]

What kills me and I mean it absolutely KILLS me is that we no longer take care of people. We take care of charts.

[student forever]

We have become so sophisticated in our care that the beloved "freind of the aged" -the MI and pneumonia- are bred out of possibility!

[AJPV]

Reforming frivolous malpractice suits - I couldn't agree more! One of the surgeons I work with was subjected to a completely meritless investigation/suit. It was a looooong process and it was ugly. We came close to losing an outstanding surgeon with decades of experience. I would choose him as my surgeon any day. Everyone knew the suit was crap, but it also came very close to destroying his career - and it wasted TONS of money (which of course is passed on in the form of increased patient costs).

[sweetnurse63, BSN, RN]

All of us nurses need a town hall meeting with the Pres of USA. No administrators or CEOs, just bedside nurses.

[neatnurse30]

Very well written. Yes, we don't care any more about the patients- because we have so many things to work on beside the patient: hourly rounds, belonging sheets fill up, tickets to ride ( each time pt leaves the unit), safety sheet to be signed by the patient, and zillion other things to document. Forget the patient, he/she can lie in poop, wait for pain medication etc.- I'm busy charting everything.

Well, nursing is pathetic especially in the hospital. Coworkers are leaving in droves our hospital.

[nicenurselpn, LPN]

Fortunately I work for a "non-profit" facility. Supplies are always available and staffing is decent. However no raise in just over 2 years now. But our CEO is now driving a nice new mercedes benz.........

I used to work in a ltc, where one weekend we were completely out of blood glucose test strips, we have run out of adult briefs and were told to ration them out for the weekend, we ran out of plastic spoons and plastic cups to give our meds, and all the nurses pooled their money so someone could make a run to Sam's club to get those basics. Meanwhile while the corporate level got richer with huge bonuses, patient care suffered..............

[MN-Nurse, ASN, RN]

I used to work in a ltc, where one weekend we were completely out of blood glucose test strips, we have run out of adult briefs and were told to ration them out for the weekend, we ran out of plastic spoons and plastic cups to give our meds, and all the nurses pooled their money so someone could make a run to Sam's club to get those basics. Meanwhile while the corporate level got richer with huge bonuses, patient care suffered.............. [/b]

I as CNA at an LTC that had similar problems with supplies. I got so mad one day I made a trip to Walgreen's for plastic bags and gloves.

A coworker said, "You shouldn't do that, soon you will be doing it all the time."

I responded, "I don't plan on working here much longer."

Left that position soon after.