I guess it’s been awhile since I laid out my traumatic patient care experiences on my blog, experiences that at times were so emotionally painful and shocking that I saw a counselor through my employer. Experiences that cross two countries and healthcare systems.
After working about 50 hours this week preventing infections, talking to patients, nurse and doctors to determine how these infections can be prevented then developing the guidelines and education to make sure that happens. I still have homework I should be doing including a critical analysis of an ethnographic study of dementia patients in nursing homes and a paper/presentation outlining a recruitment/retention plan….
I was slightly dismayed to see a comment from this religious professional that began as his rant about how he couldn’t afford “Obamacare” on his salary. He (or one of his supporters) felt compelled to bring Cesear into the discussion…
This is the last word on this:
- It is not “Obama” care it is called the Affordable Care Act (ACA). It is a law. It has been upheld as constitutional by a panel of smarty pants judges you might be familiar with called The Supreme Court. It is not going away, it can and will be improved. Get used to it.
- No matter who you worship it is wrong…WRONG…to let anyone suffer because they do not have the ability to pay for healthcare.
- Let me repeat -it is NEVER okay, permissible or excusable to allow suffering based on ability to pay. ACA is a step towards more equitable access to healthcare in the US.
So then in my rare forays into twitter I ran across a gentleman who tweeted a broad sweeping generalization about how there is a long list of countries with better healthcare than the US. I am very familiar with this data, in fact the Quality person at my hospital uses it in her orientation presentation to say that we need to improve our outcomes. It measures core measures, outcomes to common conditions like heart failure, cancer etc and costs…..yes, costs. I responded to this tweet saying – then why do people come here for treatment? he said with an air of authority that they do not.
At first I thought maybe he was a doctor but no. He doesn’t seem to have any healthcare experience at all. He does have OBE after his name which gives a clue to a possible British connection. I’m sure he’s a
competely honest and reasonable guy (edited after reading his response) pompous ass-but honestly when if you have dedicated 20 years of your life working in healthcare, taking care of patients, watching them die, watching family members cry their hearts out and thankfully watching the vast majority of them regain their strength and go home…. I take it personally.
I am not defending the US healthcare system, it’s majorly fucked up. I moved to England to work for the NHS, looking for a system that ticked all the boxes including being free at the point of service. I was very disappointed. I found an extremely low paid, disgruntled workforce, limited access to relatively basic equipment and a very low threshold for witholding treatment.
If it’s my child, spouse, parent who needs a unique, specialized treatment that is not available in my hospital, city or country what difference does it make what some longitudinal, multi-center study shows??? I want my family member to have that treatment regardless of the cost!
I would illustrate the contrast between the two systems by describing 2 cases.
In England on a Saturday morning they brought in a patient who had been out drinking, he’s fallen, hit his head and bled into his brain. Unlikely to recover, they sent police to his apartment to try to contact next of kin, the police would not break in so no family were contacted. The doctor’s took the patient off the ventilator, re-positioned him on his side and told me to start a morphine infusion. The doctor came back a few hours later and saw the patient still alive and told me to turn up the morphine because they needed a bed.
In the US we recently had the case of the 13 year old girl who suffered an anoxic brain injury and despite brain death tests conclusively showing brain death her family insisted on keeping her artificially alive.
Both of these cases are revoltingly, sickeningly wrong. They are a gross manipulation of life.
Am I opinionated and judgmental?? Yes, absolutely. But I don’t have these conversations with my colleagues because there are millions of healthcare workers, heads down, in the trenches day in and day out taking care of patients in every country with whatever resources they have available to them.
I don’t try to tell a soldier what it’s like to be on a battlefield…I wish people who are not involved in healthcare would keep their opinions to themselves.
What’s that saying? Lead, Follow or get out of the way.