Saturday, January 24, 2009
I Stand In Awe
Get a cup of coffee, this could be a long one. I have been working extra and have so much pent up blogging I can't stand it any longer. The hospital is full and the nurses are short staffed. No shock. It is expected these days. The days we have enough staff are far outnumbered by the days we don't. I know it is not isolated to our hospital but it sucks none the less. Let me tell you some of the problems with health care as I see them. 1. It has somehow become a crime to die. We do not allow it. We put 93 year old people on the ventilator and expect them to get better and go on to do what? That's it- go back to the nursing home. We take every last shred of dignity someone has and trash it. And why? I don't know why. Many of my days at work are spent trying to save the lives of those who have already lived a full life and should be allowed to go to heaven or wherever it is they believe they will go but they are not allowed to. They are left to swell up like balloons, weep from their skin, develop bed sores no matter how often they are turned and their decision to not have wanted any of this has somehow been ignored. I only hope that when I am old my children have the decency to let me go. I know it will not be easy. Love is not always easy. 2. About 2 years ago we had a patient admitted who was from Mexico. She stayed in our hospital for no less then 6 months because she was not able to be weaned from the ventilator (thanks to her POS doctor). No other facility would take her because she had no funding, she was an illegal. She finally got a new doctor and was weaned from the vent but not before running up a bill with the hospital for over 1 million dollars. The hospital nor the doctors will ever see a penny of it. Then, this week my dear friend Jay's dad, who was dying from metastatic lung cancer, was in our hospital. He has insurance and it pays out nicely. However, the hospital was quite anxious to get him out of the hospital to a long term care (LTAC) facility because his insurance company was bugging the hospital. The man was dying and did not want to die at home. He was only conscious about 20 minutes each day and obviously had very few days left on this earth. What the hell? You can have no funding and stay forever but if you have worked hard all of your life you cannot stay and die in peace. Luckily for him, his time on earth ran out before his insurance company got the last word. Of note, Jay works at the hospital and has been a kick ass employee for years. 3. We have had this little shit head 21 year old taking up an ICU bed for the past 2 weeks. He overdosed by taking a whole bottle of Cymbalta. We all know I have psych problems and I am generally a bit sympathetic but not this time. This kid is a thug of the worst kind. He has tried on multiple occasions to beat up the nurses and has been a nightmare to deal with. Rather than hauling his ass off to jail where he belongs, we allow him to stay in out hospital and disrupt the care of people who are truly sick. He will eventually go to the state hospital but not before a few other people die waiting for the room he has occupied for too damn long. And why do we keep him in that room you ask? Good question- ask our administration. I have often considered writing a book about the things that go on at work but I feel confident it would be housed in the fiction section because no one would believe the shit we put up with really happens. It is amazing. I actually had to dodge (and luckily was successful) from projectile shit. It missed me and hit the wall. I had a patient who was dying from septic shock and had no family to be found. I was trying desperately to keep her alive at least long enough to locate some family. I finally located her mother who gave me a number for her sister also. I called the sister who came in to see the patient and quickly asked me if i could tell her what was going on. I started by explaining that the patient had called EMS the night before (more than 12 hours prior) complaining of difficulty breathing. The sister then says, "Oh, I know that, we live together." I pick my jaw up off of the floor and say, "So, you knew EMS brought her here?" She says, "Yes, I just didn't think it was that serious so I didn't come with her. I was going to check on her later." AYFKM? When were you going to check on her, when the funeral home called? I was so pissed. Here I was thinking this poor woman had no family and scrambling to find some when the family knew all along. Even if you couldn't get to he hospital wouldn't you at least call and check or send contact information with EMS. Don't feel too bad for the lady though, she was also an overdose (16 Oxycontin will cause aspiration pneumonia every time). People amaze me. I am quite sure there is something catching in the trailer park because all of its inhabitants ended up in the ICU at once. We had another couple who was out in the hall arguing (and she was scratching her boob up inside of her shirt) about whether to have McDonald's or Burger King for dinner. Meanwhile, her dad is in the room dying and about to take his last breath. And you are worried about dinner?