I think there's some meat on these bones worth picking...medical "care"

Found this on another forum and I think it's well worth thinking about...

Why our hospitals are close to total failure/modern day patients/ obamacare
50 years ago most of our current patients would be dead as a result of their conditions. Now they survive with chronic illness that need management with expensive meds and treatments. Those that devised social security could never have anticipated this.

As a nurse I admit patients in the hospital with past medical histories a mile long. You just wouldnt't believe it :something like 30 medical and 10 psyche conditions listed per patient. They take 20 different meds three times a day. They are miserable, non compliant with treatment plans(fluid restrictions and low salt diets, diabetic diets) but they are obsessed with all their medications and want drug after drug, most are addicted to narcotics too.

That heart attack that would have killed a diabetic, kidney failure patient in 1940 is now survivable. He survives it but he is left with congestive cardiac failure. He is not compliant with controlling his fluid intake and gets readmitted to hospital ever other week. Patients with congestive failure cannot drink to much fluid or they get overloaded and have to come into hospital. He also has emphysema that flairs up and causes him to be readmitted because he still smokes. His diabetes is a problem and he is non compliant with his diet. His family sneak Pepsi, doritos and mcdonalds into his room. His kidneys are shot and that alone should kill him but he gets dialysis. He is supposed to eat a kidney safe diet and gets a lot of education as to why this is important. His response to this education is "(word automatically deleted by Forum) off doc, (word automatically deleted by Forum) off nurse, I can do what I want." But then he wants the taxpayer to fund millions worth of medications, treatments, and hospitalizations.

When he isn't getting admitted constantly for his congestive cardiac failure flare ups he is getting admitted at least monthly for cellulitis (skin infections) under his skin folds because he is so obese. This requires expensive IV antibiotics on top of his 50 million other medications plus more narcotics for pain control. Then every 5 minutes he is on the call bell, he wants Benadryl, something for anxiety, a pill for nausea, something for indigestion and then more pain meds. He will do this 5 times an hour for 12 hours.
In past decades the heart attack or the diabetes or the kidney failure alone would have killed the guy. Now this train wreck just keeps surviving as a miserable, nasty, hot mess. They are beyond salvation.

What I am describing is all we see in the hospital these days. And when a patient like this finally crashes his family wants ICU, ventilators, tube feedings, ($$$$$$$) and they want to sue everyone. These are the same people who were smuggling cigs, drugs, pepsi, and burger king to the guy.

These patients are also nasty, demanding, and stupid. They cost the system more money than they ever paid in BY MILLIONS. The hospitals are cutting staffing levels to try and deal with the cost. I work at a top American hospital and there was one medical doctor to over 200 medical patients last night. One nurse to every 10 on my ward. And man oh man do these patients get nasty when they don't get what they want when they want it.

Two things to keep in mind about Obamacare:

It hits hospitals with financial penalties when patients like I am describing above are readmitted more than twice a year. According to the government the fault lies with the doctors and nurses for not educating these people about a healthy lifestyle. It is clearly set up to fail.

It hits hospitals with financial penalties when patients complain on press gainey surveys. The complaint can be total bullshit, it doesn't matter. Hospital gets fined if an 800 pound patient complains that two nurses wouldn't lift him up by themselves.

The patient I am describing is readmitted constantly to the hospital due to his life style and conditions. He complains on every survey about the fact that he "couldn't get the food he wanted" (his hospital doctor put him on a diabetic kidney safe diet with restricted fluids because of his heart). He complains that his call bell didn't get answered fast enough when he wanted more narcotics (his nurse had 9 other patients sicker than him). etc etc.

Epic f*cking fail.

The staffing level cuts that are being made in our hospitals are nuts. The hospital financial managers know that the budget is really going to get a kicking because of lack of reimbursement from obamacare. We have to admit and take care of people but not only will the government not reimburse for provided care, they are going to constantly fine the hospitals for issues that cannot be helped. The patients think they are in a goddamn hospital and often complaint about "service" not actually grasping that their doc and nurse are overwhelmed with an unreasonable patient load.

It isn't just older people. We get people in their 20s that are obese, addicted to narcotics, already suffering from diabetes and kidney failure, and completely non compliant. They get re-admitted all the time because of wounds under their fat skin folds that require surgery and antibiotics to fix. They are on disability but have ipads, Iphones, marlboros, etc. These high cost non compliant patients (whether young or old) cost so much more than what they ever paid or will pay in taxes

I reckon the hospitals are just going to crash out in the next 10 years. Management is telling us that not even the privately insured patients money can make a dent, so high is the cost of the rest. This is completely unsustainable.

This is what I am seeing. Discuss.

"This is completely unsustainable"

That statement is true of so much in our society. Matter of time.

I agree 100% about the patients not following dr orders and the families bringing in food and drinks they shouldn't have..

Any health care system based on "patient satisfaction scores" is destined to fail!

Any hospital ran by administrators is based on making or saving MONEY, not patient health..  I know 2 different people released from hospitals due to insurance issues and they both died within 6 hours of arriving home..  Oh yeah, they were BOTH taxpaying citizens, prior military but not covered due to not being retired or active duty..

First of all, I'm glad I've never had the person who wrote that article as a nurse. Describing a patient as a train wreck is not the sign of a good health provider. Teo, here is the problem with everything you wrote, and it truly has nothing to do with Obamacare. According to the PNJ today, hospitals are receiving a pretty good increase in revenue over the last 3 months because of new patients who did not previously have enough healthcare, or who had too high of deductables, to actually go in and receive treatment. The extra revenue will not hurt  the hospital system. Also, new Obamacare patients aren' t the ones who have been overloading the system for years. They didn't have the coverage to do that.

The problem is the American citizen and the simple fact that we are outliving our bodies. I say this because I have an elderly parent who is completely blind, who is wheelchair bound (from a broken hip and a broken shoulder which were patched up and taken care of) and who is well over 90 and completely miserable about everything in her life.  I can guarantee you that 25 years ago, she would have been dead by now. But with the statins for the heart and the cholesterol meds, the neurotin for the nerve pain and the drugs to help with digestive problems and acid reflux, and the ever present oxygen bottles, life is miserable but sustainable for who knows how long. She's even losing her sense of touch (a great thing when you're already blind) and has to have someone to dial the phone for her, she's completely reliant on depends due to incontinence, and quite frankly, she's stated on at least 100 occasions that she would love for God to take her home.
However, since she's using $460 per month in prescription drugs alone (she has great insurance but that's the cost above the insurance) and since she goes to the doctor at least twice a week, she's also being very certain that she does not allow God to take her home. She goes from doctor to doctor hoping to find one who will put her back on a solid diet because she can't stand her liquid diet, but solid foods make her choke. And yes, there are some family members who cannot be convinced to stop bringing her solid foods behind the backs of the dietician at the center she lives at. I truly hope I never live to be the age she is and in the condition she is. But I believe that deep down, she still wants to live.
That's completely understandable. I can imagine being her age and I can understand the human will to live, no matter what the misery of the life is. No matter what your belief in an afterlife is, there will always be an uncertainty, so long as you are a human being.  The real  problem is that medication has come so far now that people are not allowed to die when their bodies can no longer sustain them. And doctors gladly take the money that a good insurance policy plus medicare will give them to take care of the smallest skin rash or ache or pain someone like this has because hey, it's money. It's my experience that no doctor yet will simply explain to my mother that she is 92 and should expect some physical problems. They all make nearly monthly appointments for her, trying this and that drug for whatever ails her because they know medicare will pay for it, and all it does is convince her that she should be able to cure whatever ails her because the doctor gave her some medicine for it. When that does not work, she thinks  it's because she needs different meds. It is not, definitely, because she is over 90 years old and just is not going to get any better. And I'm certain she has used up at least a couple of hundred thousand dollars in Medicare over the last year, yet since she never worked, she never paid a dime in. Do I begrudge her that, no, because she's my mom. That patient talked about in the article you posted has family that love him too, I'm sure. I think the person who  wrote that article looks on the man as  a patient and not a person. That's the author's problem, not the man's.

I blame medical science and money hungry doctors for the situation, and also the fact that Americans EXPECT a good quality of life, no matter how non-realistic it might be. After all, we're Americans so we deserve it.
The only solution to people who drain the system when there is no hope is to deny help, and doctors won't do that either because of their oaths or because of money.
So there is no solution. It's not Obama's fault. We keep ourselves alive far too long these days and that's because of the advances in medical science. It's just the times we live in. Nobody wants to go back and get rid of those advances, but everybody knows somebody that is outliving their bodies and it's just sad.

That's what it is, it's sad. It's not a political argument.

"everybody knows somebody that is outliving their bodies"

Interesting concept...there's an answer in that statement somewhere....

Otter, I was touched by your post above. This must be so difficult for you. I know how difficult it was for my sisters and me when our mother was ill. We finally took her home with assistance from a local hospice. Our mother died quietly at home surrounded by all three of her daughters.

I, too noticed the negative tone of the nurse's post above. Sad though it is to say, some nurses reach the point at which patients become and are labeled by their illness: the "heart surgery" in room 1, the "trauma patient" in room 2, and so on.

One of my pet peeves when I was working as a nurse was staff members who referred to patients as "room 1A" or "that schizophrenic" rather than using the patient's name. Using anything other than the patient's name degrades and dehumanizes the patient, in my opinion.

It sounds to me that the nurse who wrote that post is beyond burnout. She or he probably needs a break from nursing. Burnout can happen to the best of us.

There is also a phenomenon known as "caretaker fatigue" or "compassion fatigue." I have seen this manifest in the best of health care providers. It also happens to people who are caring for another person, such as an aging relative. There are lots of resources online pertaining to this.

Here is one excellent resource: http://www.compassionfatigue.org

Christine and I were blessed to take care of my mom in her last 6 years. Thankfully, she was well right up until the end... when she refused to eat and then kept ripping her feeding tube out. Dementia, I can handle, at least, the forgetful kind she had.

My heart goes out to those caregivers that take care of frustrated and anguished parents that you have to watch like a hawk (for wandering). I never had to clean up my mom's bowel movements once and I wasn't looking forward to that, I tell you.

When she was 88, we had her cataracts removed, and I remember them asking us what kind of meds she was taking. They were aghast that she wasn't taking anything at the time.