A Collection of Problems with the US Health Care System

Registered Nurse. Tennessee. Statement 10117.

Categories: Health Care Professional Statements
Tagged as:

State:: Tennessee

Occupation:: Registered Nurse

I grew up in a 2 bedroom home, we always had elderly and/or ill individuals to care for and did a good job of caring for them. I have been a nurse for over 30 year and have seen multiple changes. When I first entered nursing we took care of people, now we take care of paper work. I am assuming overall (I work in a nursing home) there is close to 10 times as much time spent with documentation as there is patient care.

Another issue that really annoys me is to hear commercials encouraging families to file suit of negligence or abuse. I invite any individual to work one day in a nursing home. It takes a very dedicated person to do this type of work. Yes, negligence occurs, yes abuse occurs. For example, you have two workers (CNA’s) and a nurse per hall of 30 plus patients. Baths must be done, (hopefully you have a bath team working today) most patients must be spoon fed, most of them are incontinent, most are confused and angry about being at the nursing home. The worker is daily abused as they struggle to keep from being hit, bit, spit on, pinched, kicked, cursed at and told how much “I hate you, you old……” Yes there is negligence, the two workers on the hall have 4 – 5 call lights blinking, state regulations say these must each be responded to within 5 minutes, or you are negligent, there are approx. 15 – 20 of these patients who have had incontinent episodes and the longer each one has to wait the greater the chance of that patient having skin breakdown. At least 2 – 3 of these patients become impatient because you did not get to them quickly enough and attempt to go to the bathroom alone, and will likely fall and sustain a fracture. (Don’t forget to report all injuries.) State regulations discourage any type of device to keep confused residents from getting up on their own. Oh yeah, and the resident that fell (injury or not) an incident report which takes about an hour to complete must be done and that patient must have complete vital sign and neurological assessment every 15 minutes for a period of time. Families and doctors must be notified (hopefully the family or responsible party still has a valid phone #). In the mean time a new patient is being admitted which requires total assessment and hours of documentation. A few rooms up there is a patient dying and you really need to be at their bedside. One of the other rooms has a patient which has just passed away, a minimum of 2 hours time. Another patient on the hall is turning blue and must be suctioned immediately. Oh, we haven’t had a fire drill on this shift, state requires a certain # of drills. Two confused patients are in an altercation which must be interrupted promptly, oops two more incident reports to do. Mr.____bumped his arm on the door knob and his arm is bleeding and must be attended to, another treatment and incident report to complete. One of the CNA’s has already been working 12 hours because someone called in sick. And mercy forbid you go overtime to get your job done, and you can’t work off the clock, this is a liability issue. You should have left work 4 hours ago but a disgruntled family member doesn’t like the nurse on duty now and they are demanding that YOU hear them out and get the concern resolved. Be sure you chart everything you did, if it’s not charted it’s the same as not done.

Does it matter to surveyors, lawyers, administration if the job gets done as long as it is documented? Oops false documentation. Be real, do these people really think everything that was supposed to be done in 8 hours and everything documented as done, actually was?

Everytime I hear “we are changing__________it will cut down on paper work,” I think “who are you kidding?” Why can’t we take care of people instead of paperwork?

CNA’s can work at fast food restaurants and make as much money as they can working in the nursing home. In addition they wouldn’t have to be worried that before they get off work someone is going to ask them to work another shift. Neither would they have to worry about being called to come in to work on their day off just as they have fallen asleep after working a double shift. Nurse’s, CNA’s, firefighters, policemen, emergency medical personnel have very stressed lives, put their lives and their families lives on hold to sacrifice for others, and for what salary? Our entertainers, ballplayers, moviestars, singers, and many other titles far exceed the salaries of those who sacrifice for others. And although we don’t expect thanks, we do it because we want to help others. The thanks we get is to live every moment of our lives worried about liability. O h h h-the price of liability insurance.

Granted, you do not have a patient die every day you work, a fall, patients in an altercation etc. However, there are more things than you could possible imagine I haven’t mentioned which must be done. Make rounds with the doctor, get to the end of the hall and get paged for a phone call, and multiple, multiple little things. And don’t forget to smile.