posted October 09, 2012 12:27 PM            

It has become so about the $$.

cha, ching...or nada~

The hospital I work at now, atleast provides us with the tools to do our jobs and care for out patients optimally, but, gotta cut costs somewhere, so the docs are urged to hurry up on things they probably should not and who pays in the end..you and I, with our health, our lives and our pocketbooks. And these docs are all young, employed by the hospital system...

The last hospital I worked at was a craphole, they cut expenses on enough staff, clean surroundings, supplies, but the patients were cared for appropriately. And the docs were experienced and been round the $$ block more than once...

I want to share a story, a VERY real story.

IF this wont scare anybody, then what will?

A 40 year old man comes to the hospital. A "frequent flyer" as we call them. A dialysis patient, end stage kidney failure, fluid overloaded so he cant breathe, so he is placed on a ventilator. (his bad, he did not keep up with his dialysis, drank too much, basically non-compliant)

A few days go by, he is dialyzed, the fluid is removed and the doc begins to wean him off the ventilator.

Weekend comes and a covering doc (who I DO NOT like) decides it is time for this man to come off the ventilator.

The nurse who had the man is a fairly new nurse and doesnt know the "ropes" we sometimes have to use to protect our patients, but she did know as we all did this man was not ready to come off the vent.

So, the silly-a$$ doc comes in, stops all sedation and pulls the tube. Puts the guy on a face mask for oxygen and leaves. The guy became very restless. The nurse paged the kidney doc and his reply was "he always gets like that, get his wife in there and she can calm him down.."

The man ended up crawling out of bed, falling in a puddle of his own poop on the floor. He is a BIG man (I kept calling him John Coffey cause he reminded me of him!!!) It took 5 nurses, I male and 4 females to get him back to bed.

Then after a while, he stops breathing. We got him back, but the docs could not get him reintubated (the breathing tube) so he ends up with some funky device to get him by till a surgeon could find time to come in and insert a tracheostomy (a hole in the throat, attached to a tube and a ventilator.)

Now, it took 1 hour and 10 minutes to finally get the guy stable..allthewhile he is not getting enough oxygen. He will likely never be the same due to lack of 02 in the brain.

THEN he, due to alot of things has a massive heart attack!

ALL because, I found out later, cause I know people in the know, the chief of staff wanted the man off the ventilator, probably cause he was not funded and it was costing the hospital too much.

SO, this is what I see, this is what I have to deal with, this is my consience.

I deal with it by taking optimal care of MY patients. I used to be able to find ways to slip in a statement or two, kind of off the record kind of thing to alert the family something the docs wern't able to do, or wouldn't do...but things have become so crazy I have to protect my license and my livlihood.

I really want to go work for some kindly old country doc, who carries around a leather bag and cares for snake bites, etc..but I will still know...

My words to the wise are this:

DO NOT LET anybody assume care of yourself or a loved one with out educating yourself. I preach this all the time to my patients and families.

GOOGLE is amazing!

Learn, ask questions, take a stand!

For anybody who reads this, thank you.

I am venting, but I have to let somebody know...

Else I cant get up and go to work another day!

blessins all~

posted October 09, 2012 05:43 PM            

quote:

---

Originally posted by RegardesPlatero:
I have a question: are doctors required to treat disobedient patients, when their disobedience costs time and money that could be spent saving the lives of people who are compliant/try to be compliant?

How do you guys in the healthcare world feel that way about patients who don't listen/who cause their own issues and do nothing to turn themselves around? Do you still want to help them, or do you feel angry, or both?

---

We love and take care of all....

MOST dont take care of themselves...I would venture to say 99%

Docs are required to be on call a certain amount of time per month..so that means ANYBODY that comes into the ER falls into their care.

YES docs are required to treat non compliant patients as they are compliant patients.

HOWEVER, it lies with the legality of the situation.

And yes, we still want and do care for them as well as others.

Really..MOST of the patients we see in San Antonio are non compliant, using yours and mine dollars.

It does not matter to nurses...we are paid by the places we work. Docs are paid per insurance (few and little) and are bound by medicare/medicade~

it all sux~

posted October 09, 2012 06:10 PM            

quote:

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Originally posted by hippichick:
We love and take care of all....

MOST dont take care of themselves...I would venture to say 99%

Docs are required to be on call a certain amount of time per month..so that means ANYBODY that comes into the ER falls into their care.

YES docs are required to treat non compliant patients as they are compliant patients.

HOWEVER, it lies with the legality of the situation.

And yes, we still want and do care for them as well as others.

Really..MOST of the patients we see in San Antonio are non compliant, using yours and mine dollars.

It does not matter to nurses...we are paid by the places we work. Docs are paid per insurance (few and little) and are bound by medicare/medicade~

it all sux~

But we as nurses and as docs treat them the same as somebody who did everything they could and still needed help.

---

if you don't mind me asking: why do you/how are you able to not have any anger or resentment towards them? especially when they eat up your time, emotions, and energy, and it could all be prevented? what is it that makes you feel compassion for them?

posted October 09, 2012 07:31 PM            

Cause it is my calling...it is my job, my career, my place in life...

We, nurses, joke, laugh, etc...and be judged for such.

I must take care of each and every one of them..no matter what brought them to me.

I can't live any other way~

Cause I see me in them~