I feel like we are rapidly reaching jump ship level. My own sister (in her 40s with 4 kids and natural born Texas/US citizen) is actively migrating her family to Canada next year. Her daughter with a clef pallet cost her family 90K last year WITH insurance. Her husband makes $150K a year, so they managed...but Christ! My sister is so serious that she already submitted all her immigration papers and is waiting to hear back.
I work in a clinic. The ER at the hospital I work for has sent critical patients to our clinic because they 1) apparently have no staff that know how to evaluate for a emergency (I say this having 8 years ER experience under my belt). I had a patient go to the ER twice in 24 hours for urinary pain, bleeding 1 week post op. They sent him to the clinic pale AF, orthostatic blood pressure 80/40, bladder scan showed 330 after voiding (ended up being a giant number of clots that I got to try to hand irrigate in the OFFICE!). The ER did a UA at both visits and NOTHING ELSE.
You might want to say this is my institution in particular...however I haven't held a job at 1 institution for more than 3 years. I've traveled. So, yes, there are better and worse.....but they are ALL getting worse. Process improvement usually involve trying to make up care gaps with unlicensed, under educated, unqualified people OR have one qualified person do the work of 3-4 people (both of which create gross care gaps).
I wish I could go with my sister. This has only gotten worse in the 15 years I've been a nurse. I'm not proud of my field.
Specializes in NICU, PICU, Transport, L&D, Hospice.
Hoosier_RN said:
And sadly, it's not just limited to cleft palate. So many anomalies, it's mind boggling!
Millions of an Americans are stuck in the past when thinking about our health system. Once upon a time it was the best in the world but now it's simply the most expensive treatment system that doesn't provide the best health outcomes.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
toomuchbaloney said:
Sorry. I post exclusively from my phone in the interior of Alaska and Samsung too often second guesses me when I'm not taking my time.
I spent a bunch of years running a good sized PICU after spending the beginnings of my long and fulfilling nursing journey in a large NICU. That means that rather than speak to the information that I shared, you opted to use a misspelled word to jump to a very negative and wrong assumption about me. That says something about you, although neither one of us is the topic.
Why not dispute my claim rather than trying to make personal insults because I offered a different POV? Do you think there's a possibility that the cost of ongoing and related care for these congenital anomalies can accumulate into the hundreds of thousands of dollars in the USA?
It's not a personal insult. I'm pointing out that you and the OP both have not spelled cleft palate correctly. My autocorrect accepts both words, so I'm not buying that excuse. I don't know why posting from a Samsung in the interior of Alaska would cause you to misspell cleft palate. If you were experienced in dealing with cleft palate, I think you would be able to spell it. So I'm suspicious. It's not a personal attack and it's based on the fact that the word was misspelled.
My mother was a spelling Nazi. It wasn't a relationship builder when she mailed back a letter with the misspelled words crossed out, and corrected. When I stopped sending letters, she then complained that I wasn't mailing letters anymore. This was back in the 1970s and '80s. Yes, she was an English and History teacher. I think she regretted adopting kids. She would have liked to have had a daughter who took after her.
Specializes in NICU, PICU, Transport, L&D, Hospice.
FolksBtrippin said:
It's not a personal insult. I'm pointing out that you and the OP both have not spelled cleft palate correctly. My autocorrect accepts both words, so I'm not buying that excuse. I don't know why posting from a Samsung in the interior of Alaska would cause you to misspell cleft palate. If you were experienced in dealing with cleft palate, I think you would be able to spell it. So I'm suspicious. It's not a personal attack and it's based on the fact that the word was misspelled.
Oh... it's too bad that you aren't even aware that you engage in personal insults. Claiming that you don't know anything about the autocorrect function on smartphones simply makes you appear dishonest as well. Well done.
I notice that you carefully avoided answering the question about cumulative costs associated with birth anomalies in our broken and expensive "health"system". Maybe making and publishing assumptions about others rather than discussing the topic is easier for you. So far you've just been wrong as well as rude, I'm waiting for something more substative.
Specializes in NICU, PICU, Transport, L&D, Hospice.
Fortunately, FolksBtrippin isn't my mother and her inability to discuss the topic rather than her feelings and assumptions about my post only reflects upon her.
It's not a personal insult. I'm pointing out that you and the OP both have not spelled cleft palate correctly. My autocorrect accepts both words, so I'm not buying that excuse. I don't know why posting from a Samsung in the interior of Alaska would cause you to misspell cleft palate. If you were experienced in dealing with cleft palate, I think you would be able to spell it. So I'm suspicious. It's not a personal attack and it's based on the fact that the word was misspelled.
I can attest as someone who uses my Samsung smartphone as well it is easy to miss typos because the screen is quite small. Typos happen for all kinds of reasons unrelated to knowledge of the topic at hand.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
toomuchbaloney said:
Oh... it's too bad that you aren't even aware that you engage in personal insults. Claiming that you don't know anything about the autocorrect function on smartphones simply makes you appear dishonest as well. Well done.
I notice that you carefully avoided answering the question about cumulative costs associated with birth anomalies in our broken and expensive "health"system". Maybe making and publishing assumptions about others rather than discussing the topic is easier for you. So far you've just been wrong as well as rude, I'm waiting for something more substative.
Well, if you're insulted then I guess you see it as an insult. I see it as a correction and a suspicion.
But to your implication that my post derails a conversation about the brokenness of the US healthcare system— I can see that point and I take it. That is my fault. So I'm not going to correct the other misspelled words in your post, even though it is tempting.
I agree that the US healthcare system is broken. I am not sure if it is collapsing and it is hard for me to imagine what that would look like. But is it broken? Yes it's very broken. We work in a broken system and I will not gaslight anyone who points that out.
Specializes in NICU, PICU, Transport, L&D, Hospice.
FolksBtrippin said:
Well, if you're insulted then I guess you see it as an insult. I see it as a correction and a suspicion.
But to your implication that my post derails a conversation about the brokenness of the US healthcare system— I can see that point and I take it. That is my fault. So I'm not going to correct the other misspelled words in your post, even though it is tempting.
I agree that the US healthcare system is broken. I am not sure if it is collapsing and it is hard for me to imagine what that would look like. But is it broken? Yes it's very broken. We work in a broken system and I will not gaslight anyone who points that out.
Pointing out your weak attempt to insult a participant rather than defend your own claim isn't evidence that they are actually offended, it's evidence that I (and other members) recognize that tactic.
Once again, you carefully avoided addressing the question that you were asked while pretending that you weren't just being rude. Do you think that the ongoing care for cleft palate can cost more than $100,000 for a patient and family? Your previous post seemed to suggest that belief.
When you jumped to an attempt to insult another member over a spelling error, you didn't "correct" anything related to the actual discussion, you tried to insult the member rather than defend your own claim. Now you should expand upon your claims about cost of repair and care for patients with cleft palate, so it doesn't appear that you are just gas lighting us.
Speaking at the STAT Summit in Boston last week, Finkelstein explained that the reality of the current U.S. health care system is that taxpayers already wind up footing the bill when people are unable to pay for the costs of their medical treatment.
"We're already paying as taxpayers for universal basic automatic coverage, we're just not getting it,” Finkelstein told STAT reporter Bob Herman at the summit. "We might as well formalize and fund that commitment upfront.”
We are already paying for universal care, the middle man is robbing us.
My understanding is the following: Prior legal cases have brought up the definition of stabilizing care, and this includes the definition of emergency care. My understanding is that the general view, based on prior legal cases, is that if a patient's medical problems are such that deterioration would be expected/likely if they were discharged home from the emergency room, then the patient should be admitted for inpatient care, and a duty of care exists in this regard. In the above situation, the stabilization of the patient concludes when the patient is admitted as an inpatient. The exception is that if the emergency room is unable to provide the type of stabilizing care necessary, they must then transfer the patient to a facility where they can receive the necessary stabilizing care.
This is incorrect. I have seen hospitals discharge from ER with a script or some follow up pcp advice and pt turns right back around in 72 h or less with a much worsening problem. They may get admitted, may not, sometimes depends on doc covering ER that night.. Slippery slope choosing who's getting admitted and who's not for sure.
.thumb.jpg.e7b5bd336d518053002d5b4dbeef882b.jpg){kind=small}
toomuchbaloney
16,036 Posts
Millions of an Americans are stuck in the past when thinking about our health system. Once upon a time it was the best in the world but now it's simply the most expensive treatment system that doesn't provide the best health outcomes.