Thursday, October 2, 2014

This is Health Care?

So, a nurse in the ER at Presbyterian Hospital in Dallas noted on the
chart that the patient stated he had just arrived from Liberia, one of
the West African countries at the center of the Ebola epidemic. And
somehow this information was not "transmitted" to the rest of the
medical team treating the man, who was subsequently sent home,
only to return via ambulance two days later, seriously ill. And only
then, ONLY THEN, was the diagnosis made. In the meantime this
man had become contagious, exposing everyone in the household
where he was staying to this potentially deadly virus.

Yes, I'm on a rant about health care in this country. You see, I was
an R.N. back in the seventies- that's the nineteen-seventies- in
a small, not-for-profit community hospital known for its nursing
care. And I can tell you, that lack of transmission of information
would not have happened. No way, no how. We took good
histories and we passed on significant information, perhaps
because we weren't relying on electronic devices to communicate
our findings. We used pen and paper, as well as the telephone
and face-to-face conversations to convey significant
someone just arriving from a country battling a serious, often-
deadly illness.

And all is this has absolutely nothing to do with the Affordable
Care Act, about whether you're for or against it. It has to do with
the quality of care we are receiving, even at some of the
supposedly best hospitals in this country. Somehow the bottom
line has crept into the delivery of medical care, with for-profit
corporations owning the vast majority of hospitals. And corpor-
ations have stock holders...and CEOs making big salaries...and
contracts with drug and medical supply manufacturers...yet while
costs sky rocket, the actual care provided is of far lower quality
than that provided back in the sixties and seventies and eighties.

My own major quarrel with the supposed health care reform is
that it did not look at why costs have risen so dramatically, with
health care outpacing virtually every other segment of our
society, costwise. Mr. President, members of Congress, you
spoke to, consulted, the wrong people when you were writing the
health care legislation. The people you should have consulted
are the nurses and doctors who were delivering care before the
tadvent of disposable everything...who knew and practiced good
sterile technique...who considered nosocomial infections an
affront to the quality of care they delivered and not just part of
the cost of "doing business". Perhaps these dedicated man and
women could have pointed you in the direction of excellence of
care which depended far more on the skill of the practotioner
than on the latest machinery or electronic gadget.

Don't get me wrong. Medicine has made strides in some areas,
without a doubt. But it has also moved in the direction of doing
expensive tests and procedures which often add nothing to
quality of life and put health care costs through the roof. It's
bottom line stuff again...limiting how long a doctor can spend
with a patient, for example...covering costly tests through
Medicare but failing to cover things which could keep one
healthy like seeing a nutritionist or getting therapeutic
massage or acupuncture.

It's high time we stopped being so defensive and took a look
at how health care is managed in other industrialized
countries- most of whose life expectancies are  higher than
ours, by the way, and most of which place far greater
emphasis on wellness and staying well, maintaining good

Well, time to get down from my soap box and get to bed.
After all, I need those eight hours to stay healthy and well-
and out of a hospital.

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