What factors do you think have changed that has an impact on healthcare

allnurses Guide · Sep 5, 2008

Eeek, too vague. =) Like, in the past how many years are you talking about? 20 years? 50?

nursingsteph · Sep 5, 2008

The American healthcare system is complex. It is composed of a mix of what has been over the last century and the challenge of what is needed presently in a consumer driven, cost managed system. Healthcare professionals are concerned with the state of what could be, based on new science and technology, hampered with conflicting values, access demands, and excessive costs.

Rapid and ongoing change, as well as limited access and resources have become facts of life for healthcare professionals and organizations. What are some of the factors that have changed or impacted healthcare today? Im trying to write up a paper and looking for the perspective of other nurses.

BinkieRN, BSN, RN · Sep 5, 2008

The pulse oximeter I think has made a huge difference in the way nurses care for patients :nurse:

allnurses Guide · Sep 5, 2008

You could somehow refer to the "epidemics" that are effecting health care today, such as the rise in obesity (especially in children), the MRSA epidemic, the seeming rise in food allergies among children.

bossynurse101 · Sep 5, 2008

Whoooa. Where to start. I know for me, the advent of the legal system trying to lure every family member out of the woodwork to sue every chance they get probably has much to do with the ENORMOUS mounds of paperwork that we have to do to cover our you-know-whats. Today's nurse might actually have a minute or two to spend with their patient if they wern't busy doing skin assessments, pain assessments, mini mental assessments, IV assessments, smoking safety assessments, Medicare charting, fall risk assessments, elopement risk assessments, wound measurements, narcotic logs, pharmacy logs, HIPPA paperwork, medical releases, etc etc. No I am not talking about good old nursing process data to utilize a diagnosis so that one can give competant and appropriate care, but the kind of useless crap that we are required to do so that when we end up in a deposition we can stay out of jail.

:banghead:

loricatus · Sep 5, 2008

I believe that the greatest influence on health care delivery has been the insurance companies. After the development of the HMO, it has gone downhill from there. I remember when I was young insurance companies did not question the provider. Once the cost cutting HMO's started to surface, insurance companies started making medical judgements to avoid paying out claims & rewarded substandard treatment.

plumrn, BSN, RN · Sep 5, 2008

bossynurse101 has my vote. That is the major difference I have seen in my years of nursing. When I was a new nurse, all I worried about was taking good care of my patients, and in turn, they were so appreciative and there was such a gratifying nurse/patient relationship. Not nearly the stress that I feel today and the feeling of distrust you can sometimes sense.

nursej22, MSN, RN · Sep 5, 2008

The advances in technology have been both a benefit and a draw back, i.e. powerful antibiotics that save lives, but are partly responsible for resistant superbugs.

Likewise, people who would have died of heart disease 20 years ago are in and out of the hospital getting a new stent every month, and upgrade to their pacer or tuning up their CHF.

This has boosted costs making every source of reimbursement wanting lots and lots of documentation. Medicare ain't gonna pay for Grandma's 2 days of furosemide unless we document that we offered her smoking cessation, we taught her to weigh herself for the umpteenth time, and declared her a fall risk again.

And pts just seem sicker and sicker with multiple illnesses--diabetes, hepatitis, asthma, GERD, etc. Is this a result of us baby boomers having to pay for not taking better care of ourselves?

tntrn, ASN, RN · Sep 5, 2008

Have to agree with bossynurse. The focus is less and less on actual patient care and safety and more and more on making sure the paper work looks pretty. I can get all stressed out just thinking about the stupid computer charting. Then there's JCAHO. Don't get me started on them.

Jolie, BSN · Sep 5, 2008

I think one of the most pervasive factors affecting healthcare today is the sense of entitlement so many people have as it relates to healthcare.

The "I want it all, it want it now, and I don't expect to pay out of my pocket" attitude that has been fostered by elected officials pandering for votes, employers trying to attract workers, insurance compaines pushing "all inclusive" plans, and lawyers looking for a fast buck.

Until we expect individuals to be primarily responsible for controlling their own healthcare costs, (making responsible choices regarding nutrition, exercise, substance use and preventive care, using primary care instead of the ER, using OTC and older Rx. drugs when appropriate instead of the demanding the newest, most expensive prescription, relying on physician exam when appropriate instead of demanding expensive tests such as MRI for every little ache and pain, trying less invasive methods of treatment first, without demanding surgery as a quick fix for everything that ails us) it simply won't happen, and our system will draw ever closer to collapse.

MAISY, RN-ER, BSN, RN · Sep 5, 2008

I think one of the most pervasive factors affecting healthcare today is the sense of entitlement so many people have as it relates to healthcare.
The "I want it all, it want it now, and I don't expect to pay out of my pocket" attitude that has been fostered by elected officials pandering for votes, employers trying to attract workers, insurance compaines pushing "all inclusive" plans, and lawyers looking for a fast buck.
Until we expect individuals to be primarily responsible for controlling their own healthcare costs, (making responsible choices regarding nutrition, exercise, substance use and preventive care, using primary care instead of the ER, using OTC and older Rx. drugs when appropriate instead of the demanding the newest, most expensive prescription, relying on physician exam when appropriate instead of demanding expensive tests such as MRI for every little ache and pain, trying less invasive methods of treatment first, without demanding surgery as a quick fix for everything that ails us) it simply won't happen, and our system will draw ever closer to collapse.

You are right, let's forget the advancements we've had in medicine....if you can't pay....OH WELL!

Seriously, you are throwing alot of incredients into this stew without quantifying what the true problems is....American healthcare is not available to all, people are struggling and failing in this country, bad food is cheap-wholesome food is expensive!....people have to choose between medication and food...and doctors don't actually talk to or educate their patients, it's easier to rule out problems than diagnose them!

Take it from me, I work ER....the answer for every problem: send to ER r/o whatever please eval and get back to me. Why does anyone need a PMD? No wonder urgent cares are everywhere,BUT RARELY COVERED.

I believe the future of healthcare will be socialized, set up in a central location and be patient friendly. Malls were set up so that consumers could buy from a variety of merchants. I think a mall like complex of healthcare would be great for us the consumers. The ability to go to a complex and not take months of time for results is the way to go! An ER workup is completed in a few hours-soup to nuts! That same workup as an outpatient takes weeks-NO WONDER PMDs SEND THEM TO US!

Finally, if a medication works....then use it! There are many medications like Zofran that were expensive and finally came off of patent. It was the best med for the job....held back due to cost....so are you saying people should suffer if the right med is available? If so, that is not advocating. Whether you are the patient or the healthcare professional....it's what is best for the patient, not just a matter of cost!

JMHO

Maisy