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Why our hospitals are close to total failure/modern day patients/ obamacare

 
The Registered Nurse
User ID: 7191620
United States
05/02/2014 10:25 PM
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Why our hospitals are close to total failure/modern day patients/ obamacare
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.
OP (OP)
User ID: 7191620
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05/03/2014 11:05 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
True story.
Anonymous Coward
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05/03/2014 11:11 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Why don't doctors speak up about these issue? You never hear anything in the press.
Anonymous Coward
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05/03/2014 11:17 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Pelosi said, "We have to pass it to find out what's in it."

Well, now we know. obumercare is a weapon of mass financial destruction. it is designed to crash the economy, which is only being offset by the FED's QE program.

One day soon, the whole house of cards is going to come crashing down. That will be D-Day.

The 'D' stands for Death.

Have a nice day.
Anonymous Coward
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05/03/2014 11:18 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
That's why insurances had to dump their obligations to their long term customers.

Back when many started, the life expectancy and treatments were more limited.
The insurances couldnt make a guaranteed profit and stick to their obligations, to they found and promoted someone that would fix their problem yet make it appear that they had nothing to do with it.

Now they have implemented prepayment, interim payments and post payments, again even moreso guaranteeing a very comfortable guaranteed profit for the insurer class which enjoys running the liberal party wherever its found.
OP (OP)
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05/03/2014 11:32 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Why don't doctors speak up about these issue? You never hear anything in the press.
 Quoting: Anonymous Coward 56844832


Because it is considered "unprofessional". There is also HIPPA privacy laws that prevent them from talking.
Anonymous Coward
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05/03/2014 11:33 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
EMTALA should be cancelled because we now have Obamacare. Hospitals should no longer be forced to treat those without insurance. Illegals should be denied service. Years ago, there were "charity hospitals" to treat those who could not pay. This would bring healthcare costs way down.
OP (OP)
User ID: 7191620
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05/03/2014 11:39 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
These patients are so expensively medically complicated and yet non compliant with lifestyle changes. Their expectations are ridiculous. It's hellish. The nurses and doctors are on their knees. And management and society really has a "customer is always right" attitude regarding patients.

Unsustainable clusterfuck.
scottfree

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05/03/2014 11:51 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Why don't doctors speak up about these issue? You never hear anything in the press.
 Quoting: Anonymous Coward 56844832


Because it is considered "unprofessional". There is also HIPPA privacy laws that prevent them from talking.
 Quoting: OP 7191620


Doctors are also banned from joining together in a group to strike or protest in any way for changes to improve their, and our, lot. The AMA is nothing but a bunch of lawyers doing what lawyers do. hf Just wanted to add that. Good post OP and 5 *'s for you!
scottfree = the truth shall make you free

"I may not know much, but I suspect alot!" Junior Sample on Hee Haw

"And if ye be Christ's, then are ye Abraham's seed, and heirs according to the promise." Galatians chap 3, verse 29

"The first time I saw Billy, he came walking out of a cloud." McMurtry
Anonymous Coward
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05/03/2014 11:59 AM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
People that become a drain to society should be left by the wayside.
JamesB

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05/03/2014 12:00 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Wrong the "western medical system" is a total failure because of it's fundamental principal is symptomatology the treatment of symptoms rather than the curing of disease.

Christian bleeding heart stupidity just makes a bad situation worse.

The fact that there is no money to be made off of health people is also a factor.

The parasitic nature of the political/party system.

Standardized compulsory schooling turning out badly programed robots.

Wow western "civilization" is a total failure and Obamacare is simple one more symptom of abject stupidity in action.
JamesB
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05/03/2014 12:02 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
I tried to make a career change and become an LPN. I found out, that as you say, we are giving out 20+ medications per patient, 4 times a day, in addition to the regular status checks etc. Some of these meds are IV, some are tube feed - they take time to administer. Trying to get to all these meds in a crowded little corridor that passes as a "meds room" is a nightmare.

I thought that as a nurse, I would actually be helping people. Instead I was just a stressed out drug pusher for the pharmaceutical companies.

Thank you for sticking in there, OP. I couldn't do it. I am back at my old trade working steady night shifts. Even pulling in lots of overtime, my schedule leaves me more free quality time than a 35 hour/week nursing job.
talkstory

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05/03/2014 12:04 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Hmmm OP, interesting post. I'm 63, take no meds, and have been to hospital 1 in the last 30 years. I had no Idea, thanks for sharing your experiences.

I can only think that there is no place to go but down. Sad story.
talkstory
Anonymous Coward
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05/03/2014 12:21 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
The entire idea of health insurance is faulty.

I mean, the whole medical system is crap, nut insurance most of all. You know you're going to need health care at some point, it's not insurance. Especially not when health disasters leave you just as screwed financially as without(even if the numbers on the former are just a little less.)

The most rational solution is socialized medicine, like damn near every other country on the planet. We can admit the US is screwed up everywhere else, but God forbid we try to do something like that, lest it be un-American.
Anonymous Coward
User ID: 57655025
United States
05/03/2014 12:26 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Yes. Does this not prove that Obama, and ALL of the USA govt leadership, are the enemies of the American People? It should.

Name anything that has improved since 9-11.

It can't be done.

America is under attack by the very people who claim to be the govt. Why do people continue to obey these people?

I am not calling for violence or protests in the streets. I'm asking why people obey? Peaceful non-compliance to "laws and rules" that harm us, is a good thing.

Why do people obey?
talkstory

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Thailand
05/03/2014 12:29 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Health care insurance helps to support a mentality that lacks one tacking responsibility for one's own health and learning to make healthier choices.
talkstory
Anonymous Coward
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05/03/2014 12:29 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
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.
 Quoting: The Registered Nurse 7191620




this is the truest most disturbing summary I have seen on this subject to date. You should be the spokesperson for fixing the broken system. Healthcare needs reforming. The ACA has serious flaws. We need people like you on versions 2, 3, 4, 5 of the ACA until it gets perfected. Or whatever other laws replace that act. Kudos to you for sharing whats really going on. I know many of those patients you speak of. We all see them out in society, using the skooters in walmart to shop for those doritos and twinkies, while wheeling their fat wielding bodies over the top of you....I can not imagine how messed up it is trying to provide compassionate care to these losers that have no respect for themselves and abuse their bodies so. My father is one of those. I constantly apologize to nursing staff if/when he requires care. He abuses his body, never leaves the couch, emphysema so bad, sucking oxygen while smoking his cigarettes, guzzling his alcohol, all the while slamming his meds to help his liver failure, and all his countless issues. This is where I think deathpanels should be applied. Those people deserve to receive zero treatment. My father is a leech to society, and those patients you discuss are the same.
Anonymous Coward
User ID: 56574829
United States
05/03/2014 12:30 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Well, now we know. obumercare is a weapon of mass financial destruction. it is designed to crash the economy,
 Quoting: Anonymous Coward 56309597


Was it? Or are they just that passionately incompetent? I'm leaning toward the latter...
Anonymous Coward
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05/03/2014 12:31 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
The doctors and nurses are as dumb as a box of rocks as well.
Sorry.
Nothing beats watched an un gloved nurse handle someone's chemo port and them wonder why they have a stroke in the next few days.
Anonymous Coward
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05/03/2014 12:32 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Health care insurance helps to support a mentality that lacks one tacking responsibility for one's own health and learning to make healthier choices.
 Quoting: talkstory


^^ QUOTED FOR TRUTH
Anonymous Coward
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05/03/2014 12:35 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Health care insurance helps to support a mentality that lacks one tacking responsibility for one's own health and learning to make healthier choices.
 Quoting: talkstory


agreed. there are people who believe they can do and eat and drink whatever they please and the medical system will be there to fix it when it breaks. i know people exactly like this, drinking themselves to death ala frank gallager.....
CHL2T
Handle it Man!

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05/03/2014 12:37 PM

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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
You are spot on OP. I have been saying for years that with the current medical tech. there are literally millions of people who should not have lived past their first year. This in turn, introduces weak DNA into the human bloodlines thereby weakening the entire human population. This produces less and less viable offspring that in turn require constant medical attention to maintain a "normal" resemblance of health.....
Behind every great fortune, there is a crime ~ Balzac

He was and was not, He was encompassed in the name yet not encompassed in the name, having as yet no name other than the desire to be called by a name.... ~Umberto Eco

Daydreaming without action is just hallucinating......
Anonymous Coward
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05/03/2014 12:38 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Omg this is so true.the worst is in the emergency room and every idiot thinks they are going to be seen right away because they are in the "er"
Anonymous Coward
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05/03/2014 12:39 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
I work in a hospital too.

Absolutely 110% correct. And the worst part is EVERYONE on the floor for more than about a day can tell you exactly who is non compliant and a losing proposition. But the staff is absolutely powerless to do anything about stopping it, because we will be fired (and sued, and not to mention the bad press and gub'm'nt fines and fees and such that will come down on your head) for just flat out telling the patient 'You are non-compliant, this is your fault, and we will not re-admit you'.

You can only help the patients who are willing to help themselves. They don't want to be told that. They just want to keep eating their junk food and smoking and drinking and pounding pills.

I've had a patient flat out tell me he never drinks water. (his urine was FOUL!)

Another who drank about three liters of mountain dew a day (that we knew about) in addition to the only-can-guess amount of calories in pure carb snack foods he ate and wanted to know why we couldn't keep his blood sugar under control, "just give me more insulin!"

"I've been smoking since I was ten, that isn't what caused this" says the cancer patient going down to have a lobe removed.

Look, I'm all for freedom of choice in regards to how you treat your body. Believe me, nobody who actually works on the floor of these facilities gives a single half a shit what you do to yourself. But we are ALL sick and tired of being FORCED to treat you, when the only treatment you need a radical attitude adjustment. You're wasting time, money, and not to mention a whole boat load of our patience and good will.

The system as it is now WILL fail, because only one half of the caregiver/patient relationship is actually interested in getting better and truly being healthy. The other half just wants to watch Judge Judy and eat junk food and expect you to make them better.

The second the money quits being good (government finally has to take over or let everything go to shit and these bums riot) I am out. A great many others are too.
Anonymous Coward
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05/03/2014 12:39 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Hmmm OP, interesting post. I'm 63, take no meds, and have been to hospital 1 in the last 30 years. I had no Idea, thanks for sharing your experiences.

I can only think that there is no place to go but down. Sad story.
 Quoting: talkstory


But in this country
DO This Do That Every This way
Execept the right

May GOD Bless You
Doctors AND Nurses of the
World
Anonymous Coward
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05/03/2014 12:40 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
People that become a drain to society should be left by the wayside.
 Quoting: Anonymous Coward 1447110


I think that is the purpose of it all. If someone will not take care of his *basic* health then he will die. I know people(like most others)who will complain about their health but eat like crap, smoke and drink and get no exercise but want others to take care of them. It really has to stop and it will. If people won't take care of themselves then no one else should do it for them. Maybe then they will finally the light will go off and they will do something about their life. Then maybe not. Their choice.
Anonymous Coward
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05/03/2014 12:44 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Health care insurance helps to support a mentality that lacks one tacking responsibility for one's own health and learning to make healthier choices.
 Quoting: talkstory


agreed. there are people who believe they can do and eat and drink whatever they please and the medical system will be there to fix it when it breaks. i know people exactly like this, drinking themselves to death ala frank gallager.....
 Quoting: Anonymous Coward 39252090


Those people would do that insurance or no insurance.
American Zombie
Socialization Psyop

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05/03/2014 12:45 PM

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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
EMTALA should be cancelled because we now have Obamacare. Hospitals should no longer be forced to treat those without insurance. Illegals should be denied service. Years ago, there were "charity hospitals" to treat those who could not pay. This would bring healthcare costs way down.
 Quoting: Anonymous Coward 23436250


Yeah, that's right, leave our newest citizens to born on the
sidewalk and grandma rotting to the bone in her own juices.

Perfect solution

Oh and by the way those "Charity Hospitals" were ANY
hospital receiving federal funds.

As of a couple of months ago NO MORE CHARITY CARE.
Public hospitals are now Medicaid/Obamacare kiosks.

Last Edited by American Zombie on 05/03/2014 12:46 PM
Ahhh, I wear your red like a badge of honor!
Anonymous Coward
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05/03/2014 12:50 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
You must not be working in the elite hospitals.
Anonymous Coward
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05/03/2014 12:53 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
I skipped ahead after reading the opening post and a few that follow, but I crave and absorb these "true" reality, I do it everyday type posts.

They relay and personalize some of the news topics that are posted and discussed here at GLP.

I'm not opining one way or the other on the topic, just thanking you for the time you took for relaying your personal experiences with the situation.
Anonymous Coward
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05/03/2014 12:56 PM
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Re: Why our hospitals are close to total failure/modern day patients/ obamacare
Walk into a hospital and leave dead

News