most troubling trend in healthcare

blondy2061h, MSN, RN · May 9, 2012

In one of my nursing school classes, the professor INSISTED that we refer to pts as clients. I flat out refused. I turned in a case study for this class and used the word PATIENT, so she gave me an F. I took it to the dean and explained that as a nurse, I CARE for my patients. It is PATIENT care to me, not CLIENT care...that sounded absurd to me. The dean brought in my professor for a meeting so we could fight about it in her office, and the professor emphatically stated that we are providing a SERVICE to our CLIENTS. When I responded that I would announce to my family, my friends and my co-workers and all of the doctors that I knew that my school taught me how to SERVICE CLIENTS very well, they both realized that it sounded like they were running a brothel and gave the students a choice in how to refer to patients/clients. I got my A for that case study!

This reminds me of when I worked at target and they insisted that they weren't customers, they were Guests. I actually watched a manager correct a customer looking for "customer service" into calling it "Guest Service," proof that you can get the language right and screw up the concept.

blondy2061h, MSN, RN · May 9, 2012

Just saw this FDA may let patients buy drugs without prescriptions - Washington Times must say this is a scary trend. I've already seen it. Meds for allergies, GERD, and constipation that never used to be OTC now are. A GI doctor told me she is catching esophageal cancer at later and later stages now because people Prilosec and Prevacid themselves like crazy before going to the doctor. I get that access to a doctor can be a problem, but we should try and fix that rather than just saying, "Patient: treat thyself."I'm already scared for the situations we'll see. I'm picturing a patient killing their liver with Lipitor, frying their kidneys with Lasix, and thinking a steroid inhaler will help their SOB when actually their hgb is 6.

OCNRN63, RN · May 9, 2012

the nm hangs up the comments from the surveys each week and one comment was a complaint that this woman was never offered to have her pillows fluffed or to get a back rub. seriously?
honestly, i will get a little annoyed if you ask me to do this for you (i'm a pca), because it isn't a hospital or a spa, but i will do it for you....if you ask.

have you ever been hospitalized for a long time and unable to move? i was; it doesn't feel good. several times, the aides would offer to rub my back, but i always said no, because i knew they were busy.

one evening, an older woman who was an aide came in my room and told me she was there to give me a back rub. i said, "that's ok, i'm fine." she told me no ifs, ands or buts about it that she was going to rub my back. it was heaven. i had no idea until then just how good a back rub felt, or how much it relaxed you.

back rubs help release endorphins, the body's natural pain killers. they help with circulation and relaxation. if a pt. asks me for a back rub, i'll make sure either i or the aide do it. it's not about being in a "spa." it makes patients feel better, and no one is above doing it. when i went to nursing school, not only were we expected to give back rubs, we were also expected to know the different techniques in giving one. it's not about slopping lotion on someone's back and giving them a perfunctory back rub.

stuff like this a hot-button issue with me. we've lost a lot of the "care" in "caregiving," and we have people out there (not necessarily this poster) who don't know all that goes into tasks that seem menial. while the pillow-fluffing was a little over the top, a pt. shouldn't have to ask for a back rub, and an aide/pca shouldn't take the attitude that they're only going to do certain things if asked. it would be like me saying i'm only going to give a patient his meds if he asks for them.

OCNRN63, RN · May 9, 2012

it seems that i must have misunderstood the intent of this thread. i thought it was about issues in health care that raise concerns, not just a b*tchfest about management.

my concern is what to do with all the people out there who are uninsured/underinsured. the train is coming straight at us on that one. the other issue is as another poster mentioned: shortages of crucial drugs. the way things are, you'd think we were in a third world country. drug companies that deliberately drag their feet at manufacturing drugs that are out of patent should be held accountable--big time. if someone's death could be directly traced to not having the needed drug due to the pharm. company, then the pharm. company should be held liable. i'd really like to see the government step in on this one and penalize drug manufacturers that create shortages/outages. we're being held hostage by their greediness; it's time to slap them back in line.

CompleteUnknown · May 9, 2012

have you ever been hospitalized for a long time and unable to move? i was; it doesn't feel good. several times, the aides would offer to rub my back, but i always said no, because i knew they were busy.

one evening, an older woman who was an aide came in my room and told me she was there to give me a back rub. i said, "that's ok, i'm fine." she told me no ifs, ands or buts about it that she was going to rub my back. it was heaven. i had no idea until then just how good a back rub felt, or how much it relaxed you.

back rubs help release endorphins, the body's natural pain killers. they help with circulation and relaxation. if a pt. asks me for a back rub, i'll make sure either i or the aide do it. it's not about being in a "spa." it makes patients feel better, and no one is above doing it. when i went to nursing school, not only were we expected to give back rubs, we were also expected to know the different techniques in giving one. it's not about slopping lotion on someone's back and giving them a perfunctory back rub.

stuff like this a hot-button issue with me. we've lost a lot of the "care" in "caregiving," and we have people out there (not necessarily this poster) who don't know all that goes into tasks that seem menial. while the pillow-fluffing was a little over the top, a pt. shouldn't have to ask for a back rub, and an aide/pca shouldn't take the attitude that they're only going to do certain things if asked. it would be like me saying i'm only going to give a patient his meds if he asks for them.

totally agree with you ocrn. i've never understood the opposition to 'pillow fluffing'. i pick up my pillows and give them a bit of shake or plump up and smooth out the creases in the pillow slip every day. doesn't everyone?

i had surgery a couple of years ago and on the first post-op night, i was awake and very uncomfortable. the sheet were all bunched up underneath me, the top blanket felt like it was falling off one side, my leg was getting a cramp and my pillow was all squashed. i was very groggy, i couldn't move much and i certainly couldn't have gotten myself out of bed to smooth out the bedding and rearrange my pillows. when the nurse came in and asked me how i was, i said i was quite uncomfortable. she said she'd get me 'something for that' and then returned and gave me something iv.

it worked, the pain lessened and i went to sleep. but actually what i wanted more than anything was some assistance with repositioning and to have my sheets tidied up a bit and my pillow moved. maybe i wouldn't have even needed the iv med if that had been done. yes, i could have asked, i'm not sure why i didn't - perhaps a combination of being groggy, not wanting to be a pain in the neck, and just assuming that this was something that would be done without me specifically asking.

oh well. i woke up the next morning in the same position and even more uncomfortable. by that time i was able to stretch out a bit and shuffle myself around to where i felt reasonably okay. those damn sheets were still bunched up under me though and they stayed that way until i got out of bed and fixed them myself later in the day.

i know, i know, being uncomfortable didn't kill me, but i would have killed for someone to give me a back rub that night!

OCNRN63, RN · May 9, 2012

i know what you mean. maybe we wouldn't need to medicate people so much if the little things were taken care of. funny how years ago, it was standard that the sheets were completely changed every day years ago. now, you almost have to ask to have your sheets changed if they're not visibly soiled.

Horseshoe, BSN, RN · May 9, 2012

I think a very disturbing trend is the ever increasing nurse to patient ratio. The impact from this one problem is like the waves a pebble leaves in a pond when you toss it across the water.

BlueDevil,DNP, DNP, RN · May 9, 2012

double post

BlueDevil,DNP, DNP, RN · May 9, 2012

never mind, just realized the post I was responding to was more than 6 months old. Who keeps bumping all this old stuff?

OCNRN63, RN · May 9, 2012

never mind, just realized the post i was responding to was more than 6 months old. who keeps bumping all this old stuff?

you think this is bad? the other day i started reading a thread that was 12 years old. i don't know how you even drag up a thread that old...maybe with the "search" function.

OCNRN63, RN · May 9, 2012

you think that's bad? i started reading a thread the other day that was 12 years old.

OCNRN63, RN · May 9, 2012

i don't know what's going on here; i tried to delete the double post (which i don't know why it happened) and it didn't work. sorry.