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Subject Why our hospitals are close to total failure/modern day patients/ obamacare
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Original Message 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 "fuck off doc, fuck 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 fucking 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.
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