I have unfortunately spent quite a bit of time in the hospital over the last 4 years.
In all the hospitals I found the same short comings. They are sterile and cold, the food is not only sub par but not ideal for promoting healing. Ill stop there for now but I have found from personal experience that the above concerns can have a great impact on health.
My question is, is this all about the money? I just feel like patient care could be taken to new heights by incorporating some pretty basic things.
I know, I know, I am idealistic and ignorant to the reality of health care as a business but I would love to understand the in's and out's of the business side (I have a finance degree and see myself heading that way eventually)
What would you recommend as a resource to help understand for profit health care in the United States? I would like to learn about old issues that have plagued the system for a long time and new ones as well. I would really love to get an understanding of how the national health care act has effected hospitals as well; good or bad.
I would love to know who would be ideal to talk to in a hospital that could guide me.
Specializes in BNAT instructor, ICU, Hospice,triage.
I am an old ICU nurse working in the ICU for 20 years. Doctors and all health care professionals need to paint an accurate picture with the truth and STOP the futile medical treatments. There is nothing on the earth that makes me more upset than all the futile treatments I saw ever single stinkin day. I was getting so sick of it. I have worked in hospice now for 5 years and there is a very good, peaceful, compassionate, non-cold sterile institutionalized way to be treated. To me, from what I have seen this is one of the number one reasons for wasted money and dignity thrown in the toilet. I treasure every life and people should never be treated the way they are treated. A team of palliative care professionals need to be on every case and talk about these things. People need to choose and know that there are better ways to honor a person's life than laying there in a sterile cold facility with tubes coming out of every singe body orifice and sometimes several tubes coming out every body orifice.
And chemo, people need to know what they are doing. They need to know what their life can look like if they choose chemo. These treatments don't HAVE to be done. There are choices and we need to tell people about the money and the side effects and the turmoil families may have to go through. Doctors think they are "giving up", that's not giving up, that is giving them hope. Hope to be able to enjoy their days. Hope to find real meaning to their lives, instead of focusing on side effects and getting whiplash from scrambling to the doctor racing to the x-ray department racing to this that and the other, cause all 15 doctors on the case, have to cover their gluteals ya know. Make sure the cardiologist and the internist and the surgeon and the oncologist and on and on are all seen every 2 seconds!!
Its not about the style of food its about quality - you are what you eat, and this is becoming more and more clear each day. Hospital food is trash, chalked full of sodium, chemicals and preservatives, absolute junk that is in direct contradiction to healing, the whole purpose of what a hospital is for.
The time of excuses is over.
Food is a very powerful at restoring health, in the next 10 yrs it will be a main stream healer instead of reaching of the scripts.
In every hospital I've worked at, by far the most common complaint is that the food is too healthy, and lack of salt is probably a close second.
Hospitalizing patients is extremely expensive, spending is tightly controlled and for good reason, this includes food. And while the "captive audience" aspects of feeding hospitalized patients provides a good opportunity to expose patients to eating the foods they want to eat but prepared in a healthier manner, which is something most hospitals do, being too aggressive and just having a large portion of patients with insufficient nutritional intake while in the hospital is much more of a threat to their health.
Overall, I don't think the problem is as much with how much the various services in the hospitals cost, it's that we provide them unnecessarily. A large portion of the treatments we provide in hospitals are of no benefit and probably do more harm, particularly with terminal conditions. We need to change our culture of denying the unchangeable process of death as well as how hospitals enable that culture.
A large portion of the treatments we provide in hospitals are of no benefit and probably do more harm, particularly with terminal conditions. We need to change our culture of denying the unchangeable process of death as well as how hospitals enable that culture.
Working in hospice, I can tell you this is so true. We get people after they've been through the meat grinder. I see all the time the consequences of treatments that should never have been done. Everyone knew they weren't saving that life, and now their last few weeks are destroyed by the painful consequences of those treatments instead of being time they could have spent with their families.
Americans need to stop being afraid of death, and we need to get over the mythology that somehow we can beat it. It's very weird that a whole culture would believe that but at times I really think we somehow do....
Overall, I don't think the problem is as much with how much the various services in the hospitals cost, it's that we provide them unnecessarily. A large portion of the treatments we provide in hospitals are of no benefit and probably do more harm, particularly with terminal conditions. We need to change our culture of denying the unchangeable process of death as well as how hospitals enable that culture.
I am so glad you said this and couldn't agree more. My mother and I were in and out of the hospital for 4 years. The final day was horrible and I became very anger at the Dr's b/c they were trying to perform some last minute surgery that was absolutely crap and would have done nothing to help her in any way. She was ventilated, against her wishes mind you, horrible #'s and they were talking about doing some bullcrap surgery....all 20 minutes before she passed. It was not out of compassion but b/c it was a teaching hospital.
How do you figure? Until produce distributors have lobbyists as strong as pharmaceutical companies (read: never) your Ten Year Plan is a pipe dream! No, scripts will always overpower food products, so long as the money is there.
So 'yes', it's all about the money.
Hello. I should have clarified this statement; otherwise you are absolutely correct.
What I meant was for people to pick food over scripts, not hospitals.
For instance, I was diagnosed with ocular rosacea, rosacea on my face, seborrheic dermatitis and high blood pressure and high cholesterol. It wasn't long before I realized what the Dr.'s had me on was crap and was making my quality of life worse. I turned inside and changed things up complete, I no longer have any of the above problems but the BP, its a bit elevated a 135/70 but I am off the beta's and now on a 5mg CCB.
There is a real awakening among people with common disorders like diabetes, high blood pressure, high cholesterol etc to turn away from tradition meds and seek out other methods. Look at Lipitor, massive lawsuit against Pfizer, the drug not only gives people diabetes (which apparently they knew) but the artificially lowering of cholesterol is shown not to even help people. Recent research shows that the cholesterol is a good thing b/c it is patching week spots in there arterial wall due to inflammation....inflammation most likely cause by diet. In my case it was, my cholesterol after 5 months plummeted, not by the use of drugs but by diet.
Pipe dream, maybe, but with results like mine its a dream worth having and pushing forward.
@mursecumberbatch. I love your username! CUMBERB*TCHES UNITE
He's the best, my new favorite actor. Loved him in the Holmes series. I had just watched him on youtube doing impressions just prior to signing up on the board so he was on my mind.
Specializes in BNAT instructor, ICU, Hospice,triage.
The real expense comes from all of the x-rays, scans, treatments, specialists, etc.... Do you know how much every bag of TPN costs? At my hospital 10 years ago they were $1400 per each bag. Some of my ICU patients had like 40 some bags of TPN during their stay while we put them through the meat grinder to keep them alive at all costs. Food is not as expensive as the futile surgeries and aggressive treatments that we do to people. Aggressive palliative care teams need to educate and form goals with the patient.
My father-in-law had cancer. He had a huge surgery, the cancer was extremely advanced in his colon. My mother-in-law has no medical background, she told them to do everything. What she needed was a person that takes the time to paint a picture and tell her what it would look like. Instead, father-in-law lays in the ICU for a month then the med-surg floor begging to go home, begging to be with his little dog that he loved so much. Begging to end the needles and invasive treatments. Finally, mother-in-law agreed to let my husband talk to the doctor and ask "what do we have to do to get him home" ANd they had him home that same day. You see, mother-in-law did not know what questions to ask, she did not know there were choices, no one asked FIL or MIL what their goals were or what their financial situation allowed.
This thread took a good turn here. I think people hear phrases like "cancer warrior" and "lost her courageous battle with cancer" and really, there were other alternatives all along. No, not everyone is cut out to go into a losing battle with guns ablaze. Really, just spending your remaining time on Earth enjoying loved ones is O.K.
I just had this talk with several family members and we all said the same thing. "Keep me comfortable and at home with my dog," just like a previous poster said.
Specializes in BNAT instructor, ICU, Hospice,triage.
And people need to be educated about the expensive and very painful treatments like CPR. Its not like on TV where you pump them a few times on the chest and they magically live happily every after. No, we see these people in and out of ICU constantly. So people need to know that these expensive treatments are not the best care. Saving your life is not always the best idea. But compassion and comfort and treating the whole person instead of suctioning them till they gag themselves into the most misery they could ever imagine and then their nose and throat get so irritated and bleed all the time constantly like we used to in ICU. Never getting any peace or rest. This is really where all the money is wasted and dignity is lost.
Specializes in BNAT instructor, ICU, Hospice,triage.
Truly if hospitals want to do better they need to have lots of conversations with patients and families, they need to put palliative care into high gear.
And people need to be educated about the expensive and very painful treatments like CPR. Its not like on TV where you pump them a few times on the chest and they magically live happily every after. No, we see these people in and out of ICU constantly. So people need to know that these expensive treatments are not the best care. Saving your life is not always the best idea. But compassion and comfort and treating the whole person instead of suctioning them till they gag themselves into the most misery they could ever imagine and then their nose and throat get so irritated and bleed all the time constantly like we used to in ICU. Never getting any peace or rest. This is really where all the money is wasted and dignity is lost.
While various practitioners may believe that providing these expensive treatments are not the best care, that opinion is only valid for themselves. The patient has his/her own values, may wish to prolong his/her life, and is the only person who can determine what constitutes quality of life for them. Provide sufficient information about all options for care, what the treatments/procedures involve, risks/benefits, other alternatives, and then the choice/decision is the patient's (often with the help of their family member/s) to make. The only person who can determine whether the effort and personal suffering involved in any procedure/treatment makes the procedure/treatment worth undergoing, is the person living the life, or (if the person is unable to make decisions for themself) a carefully chosen health care decision maker or close family member who knows the patient's wishes and whom the patient would wish to be involved in their care. Be very careful of assuming that patients will want what you think is best for them. Not every patient wishes to receive, or even consider, palliative care or hospice care at the time a nurse/physician thinks they should.
As far as having conversations with patients and family to push palliative care, unless the patient or their family initiates this discussion, or obviously wishes to participate in the discussion, I strongly suggest waiting until the patient or their family indicates that they would welcome this discussion. Of course, that time may never come. But be prepared for a great deal of resistance, and even hostility, if you prematurely and insensitively bring up the subject of closing the door to curative care before the patient and their family are really ready to do this.
Specializes in BNAT instructor, ICU, Hospice,triage.
While various practitioners may believe that providing these expensive treatments are not the best care, that opinion is only valid for themselves. The patient has his/her own values, may wish to prolong his/her life, and is the only person who can determine what constitutes quality of life for them. Provide sufficient information about all options for care, what the treatments/procedures involve, risks/benefits, other alternatives, and then the choice/decision is the patient's (often with the help of their family member/s) to make. The only person who can determine whether the effort and personal suffering involved in any procedure/treatment makes the procedure/treatment worth undergoing, is the person living the life, or (if the person is unable to make decisions for themself) a carefully chosen health care decision maker or close family member who knows the patient's wishes and whom the patient would wish to be involved in their care. Be very careful of assuming that patients will want what you think is best for them. Not every patient wishes to receive, or even consider, palliative care or hospice care at the time a nurse/physician thinks they should.
As far as having conversations with patients and family to push palliative care, unless the patient or their family initiates this discussion, or obviously wishes to participate in the discussion, I strongly suggest waiting until the patient or their family indicates that they would welcome this discussion. Of course, that time may never come. But be prepared for a great deal of resistance, and even hostility, if you prematurely and insensitively bring up the subject of closing the door to curative care before the patient and their family are really ready to do this.
That's my whole point is that there are choices. Patients are not getting the choices. They are just following what is assumed they want and they aren't told how expensive it is and how the outcome is going to be if they chose to blindly do whatever the health care providers suggest. I have seen it and I have seen it 7 million times. Palliative care = choices
I totally agree one of the previous posters that said we need to eat the right food and treat that like medicine and I think something else that is ignored is the brain health. When you have high amounts of stress there are many hormones and neurotransmitters that are produced, one of which is cortisol. We know that cortisol actually destroys brain cells in the memory centers and it can devastate. So having a mechanism to counteract and deal with the stress is crucial. Even preventing alzheimers which costs our health care system tons of money. Drugs alcohol and overeating actually harms the brain.
I think we can make healthcare better if we allow more choices and really educate about what that means if they choose chemo, scans, needles, painful invasive procedures, surgeries, medicines that the side effects are worse than the reason you are giving it, expensive specialists, CPR, suctioning, let them see what that looks like give choices MORE choices MORE talking, MORE time sitting down with people. And for people like me that do not have chronic or acute illness at this exact time right now, educate how to eat, deal with stress, and educate about choices to make health care better.
As an aside, I had an info visit for hospice several years ago. The man had zero cognitive function left, he could do no ADLs, could not talk, was visibly suffering greatly (all 6 of his kids and his wife agreed that he was suffering greatly from dragging him to dialysis, and other treatments). The dialysis cost us $50,000 per month plus the nursing home costs $6,000 per month plus his other specialists and treatments. This had been going on for over 10 years. He was greatly declining. But because he never told his family specifically what he wanted the family could not agree to allow hospice services. The family was split and the wife would not allow comfort measures because of the fact that he never talked to her.
So if we really educate big time, show people what it looks like to have invasive procedures and what it looks like financially let them make the decision based not on what the doctor's beliefs and what he 'thinks' they would want or that the doctor doesn't want to 'let them down' or 'give up' (which it is NOT giving up it is giving hope). Prepare them. Instead of blindly following various practitioners that just assume or just do what they believe is right that curative care by ordering all those expensive tests and procedures, I think health care could really improve by doing these things. There are choices. They should be allowed choices and daily educated unlike my father-in-law was and unlike the patients I took care of in ICU for all those years.
Vtachy1
448 Posts
I am an old ICU nurse working in the ICU for 20 years. Doctors and all health care professionals need to paint an accurate picture with the truth and STOP the futile medical treatments. There is nothing on the earth that makes me more upset than all the futile treatments I saw ever single stinkin day. I was getting so sick of it. I have worked in hospice now for 5 years and there is a very good, peaceful, compassionate, non-cold sterile institutionalized way to be treated. To me, from what I have seen this is one of the number one reasons for wasted money and dignity thrown in the toilet. I treasure every life and people should never be treated the way they are treated. A team of palliative care professionals need to be on every case and talk about these things. People need to choose and know that there are better ways to honor a person's life than laying there in a sterile cold facility with tubes coming out of every singe body orifice and sometimes several tubes coming out every body orifice.
And chemo, people need to know what they are doing. They need to know what their life can look like if they choose chemo. These treatments don't HAVE to be done. There are choices and we need to tell people about the money and the side effects and the turmoil families may have to go through. Doctors think they are "giving up", that's not giving up, that is giving them hope. Hope to be able to enjoy their days. Hope to find real meaning to their lives, instead of focusing on side effects and getting whiplash from scrambling to the doctor racing to the x-ray department racing to this that and the other, cause all 15 doctors on the case, have to cover their gluteals ya know. Make sure the cardiologist and the internist and the surgeon and the oncologist and on and on are all seen every 2 seconds!!