We Pay A Lot For Service Like This

I snapped this photo and found it intriguing on so many levels. First, it shows how nursing can be a very difficult job. The sign on the swing arm proclaims a weight limit of 440 pounds. It really was a symphony of coordinated moves to get my very sick patient out of bed and into a chair. Between the patient's physical pain, altered mental status, IV poll and foley catheter, it really was about a 15 minute process to move her three feet. These types of patients, the very sick, obese, old and terribly weak make up a large population of my patients. And they will only become more common as more grannies live longer. They are difficult to manage from a logistical stand point and very time consuming for nursing staff. And they certainly lead to work place injuries from lifting and moving.

In the ever worsening financial stresses being forced upon our system, one can see why nurses can feel overly burdened by very time consuming and needy patients while also trying to maintain a picture perfect paper trail of documentation that has overwhelmed their profession to much the same degree as physicians. They are burdened by constant staff shortages, high patient to staff ratios and conflicts with administration over forced over time and inadequate pay. When I wonder why the lab or chest x-ray I ordered four hours ago isn't done, it's because the nurse is busy taking care of things like this. Things that I as a doctor never have to worry about. I write the order to get out of bed and the nurses figure out a way to get it done. Nurses are angels. They are true heros in patient care. And they get shit on from all ends. It's really quite sad. When I find myself being short with a nurse, I have to constantly remind myself that we are on the same team and there is no excuse for it.

To add insult to injury, you wonder how CMS can institute a zero forgiveness payment policy on in- hospital falls and injuries. They are trying to tell me that this patient here should never fall. I can assure you, this patient, will fall. Whether it's during this orchestral maneuver by angel nurses, or sitting on the port-a-potty or trying to stand when nobody is around while delirious beyond all belief. These folks will fall.

My uncle just had knee surgery in Cairo, Egypt at a military hospital. I can assure you, this type of equipment would be a pipe dream for nursing staff there. It is but one of the many forms of technology that add to the cost of caring for really old sick people. Certainly makes for better care, but at a significant expense as well.

We will all bear the brunt of escalating health care costs as grandpa and grandma out live their natural mortality. These pictures are common place. This is American health care.

We pay a lot for service like this.