After having the full battery of tests performed and getting her checked into a room, her temperature started to come down and the pain started to subside to the point that she started to critique the bedside manner of the nurses attending her.  THAT’s when the fun began!

Now, being a nurse and a patient at the same time is a double-edged sword.  On the plus side, you have ample medical knowledge and experience so you usually know what your body’s doing.  You also tend to have a pretty good network of medical professionals as well as access to all the medical “back channels.”  For example, Teri called and left a message for her doctor and the guy actually called her back!  

On the negative side, you can’t help but compare what everyone is doing, or not doing, with how you would have done it.  I got an earful of which nurse knew what they were doing and which one(s) didn’t have a clue.  After a while, I started to get an idea of how a hospital ward functions.

It turns out that there are nurses with two different nursing “styles.”  The first is hands on and proactive.  At the beginning of each shift, the nurse is supposed to make their rounds going to each patient, introducing themselves, and putting their hands physically on the patient as they check pulse, listen to their breathing, check their IV, and so on.  It doesn’t sound like much but an experienced nurse can tell a lot from this – like whether or not the patient is lucid and responsive, for example.  Being proactive and looking for potential problems before they occur is how Teri was taught so she expected the same kind of treatment.

The second nursing “style” is reactive.  This type of nurse clocks in and sits at the front desk and watches the board or does paperwork.  They assume that if a patient is having a problem, they’ll push the call button.  Then the nurse will get up and go see what the problem is and deal with it.  If no one calls with a problem, they won’t go looking for one.  This kind of nurse drives Teri bats, and after unsuccessfully waiting close to an hour after shift change for the nurse to show up, Teri finally went out to the Nurses Station looking for her.  She told me later that they had “had words.”

Why the difference I wondered?  One answer is the shortage of qualified nurses.  One blog post titled “The American Nurse, our New Endangered Species,” put it this way:

It’s the year 2020 and you’re in the hospital for a minor elective procedure that requires an overnight stay.  Lying in your bed, you try to call for a nurse.  You send your Tweet to the nurses desk.  No nurse.  You Tweet again, and again, and again.  Where is the nurse????  The nurse never comes, because there are no nurses.

A bit farfetched, but the American health system has a problem brewing that has nothing to do with the current healthcare reform legislation.  According to Marla Salmon, Dean of the University of Washington School Of Nursing, “We’re actually at a crisis point in terms of the shortage of nurses.” 

So add being short staffed and overworked to the already overloaded US medical system.   However, this post isn’t about what’s wrong with the healthcare system.  I wanted to pass along some advice on how best to deal with it.

So what can you do if you’re a patient?  Do the same thing Teri did – get out of bed (if you can, of course) and track down to the Nurses Station and ask who your nurse is.  Ask how long their shift is.  Ask what your treatment regimen is.  Ask what instructions (if any) the doctor left.  These are all things the nurse should have come and told you when they began their shift.  If they didn’t – if it’s starting to look like they’re not the proactive type – then YOU need to be the one that’s proactive.  

Some people just don’t want to be a bother.  However, you can NOT take that attitude when you’re in the hospital.  You’ve got to be like Teri – a “squeaky wheel” that keeps calling until they get what they’re supposed to be getting, when they’re supposed to be getting it.  If your doctor prescribes a type of medication every 4 hours (like an antibiotic), you need to have it every 4 hours – not whenever the nurse gets around to it.

When I went to check Teri out of the hospital, most of the other nurses were glad to see her go.  However, she left healthy – which was the whole point of the hospital stay in the first place!

Certified Fitness Nutrition Coach and
Personal Fitness Trainer (NESTA)

P.S. Be sure to get my latest Fitness Blueprint called “Little Things That Improve Your Health.” This ebook is packed with loads of helpful information on how to build a better body and you can get it FREE – for a limited time.  Just click on the title to be taken to the download page.  Enjoy!

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One of the medical teams that was mentioned in the news segment I was watching was a team from Israel.  What made them unique was their use of technology to totally document, diagnose, treat, and follow up with the people they were treating.

When a person first entered their medical “complex ” (actually, a series of tents), they were photographed with a digital camera.  All vital signs were entered into a computer.  All X-rays, lab tests, and the results of other diagnostic tests were digitized and included in the patients electronic file.

If the medical team needed to consult with outside specialists located back in Israel, they could easily transmit the electronic records and allow the specialists – thousands of miles away – to examine the same X-rays and test results, basically in real-time.  The reporter went on to say that this was “the new model” for emergency medical response.

My first thought was a sarcastic, “No s*** Sherlock, using digital technology to improve health care.  What a concept!”  After all, it’s 2010 for God’s sake.  It’s not like computers or the Internet are some “new-fangled thang” that might not catch on.  It’s way past time the American Health Care industry got on board.

The US Has Fallen Behind

I occasionally tune into “talk radio” and listen to Rush or Hannity, since they seem to be the only ones on most of the time.   One of the comments that I consistently hear from them is that “the US has the best health care system in the world.”  Sorry but that’s not true.

The study quoted most often was one performed by the World Health Organization (WHO) in 2000.  It looked at the state of health care in 191 countries in a variety of ways including “financial fairness.”  The US comes in 37th with France and Italy taking the number 1 and 2 spots respectively.

Now, I’d be the first to agree with the large numbers (including Rush and Hannity) that point out that the WHO study is very, very flawed.  But even if the US ranking was to improve by 50% to say, 18, it’s STILL not even in the Top 10.

So OK.  Let’s throw out the WHO study.  I live in Houston, TX, which has one of the best medical centers, especially for cancer treatment, in the US.  There are hospitals here that used to have entire floors of “luxury suites” designed for treating visiting Heads of State as well as the occasional Saudi Prince.  These are the types of people that can travel anywhere in the world for medical treatment.  Know what?  Many hospitals have closed these rooms down or have converted them to other uses.  The super rich are not coming to Houston, or the US for that matter, any more.  They’re seeking medical treatment elsewhere in the world.

No matter how you slice it, no matter what study you believe or what study you toss out, the end result is pretty much the same:  the US has fallen behind in the quality of our health care.

The World’s Largest and Most Inefficient

In a 2005 article in “Health Affairs” magazine, the authors of an article titled, “Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs” (Yeah, I know, medical articles never have short titles…) stated that:

The U.S. health care industry is arguably the world’s largest, most inefficient information enterprise. However, although health absorbs more than $1.7 trillion per year—twice the Organization for Economic Cooperation and Development (OECD) average—premature mortality in the United States is much higher than OECD averages.  Most medical records are still stored on paper, which means that they cannot be used to coordinate care, routinely measure quality, or reduce medical errors.  Also, consumers generally lack the information they need about costs or quality to make informed decisions about their care.

Did you catch the number?  $1.7 Trillion with a capital “T.”  That’s a number so huge, it doesn’t even register with most people.  One example from a CNN news story stated that, if you had started spending a million dollars every single day since Jesus was born, you still wouldn’t have spend a trillion dollars by the time 2010 had rolled around (see video below).

Behind the Technology Curve

The US is home to Silicon Valley and MIT and a host of other organizations and/or areas at the vanguard of technology research.  Computers and the Internet were “invented” here.  We should have the home field advantage in the use of technology to improve health care.  Yet only about 15-20% of doctors offices and only about 20-25% of hospitals have any type of electronic medical record systems in place.  Why is that?

If 90% of applicable facilities adopted electronic record keeping, it’s estimated that the potential efficiency savings for both inpatient and outpatient care could average more than $77 billion per year with most of the largest savings coming from reducing hospital lengths-of-stay, nurses’ administrative time, drug usage in hospitals, and drug and radiology usage in the outpatient setting.

This number does not even begin to estimate the savings in the number of lawsuits that would be prevented.

So Why Not?

So why hasn’t the medical industry implemented this the way other industries have?  I can log onto my banking account and see scanned in copies of every check I’ve ever written, including my water bill from 3 years ago.  Why can’t I do the same with my blood tests, prescriptions, and physical exams?

There are a lot of things wrong with the Health Care Bills that are currently making their ways through the House and Senate but electronic record keeping is one thing that should be taking place no matter how the other portions of the bill turn out.  To me, this is the only “no brainer” part that I can readily understand and easily see the impact of.

Hopefully, you do to.

Hiram

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1. The Cost of Not Reforming Healthcare

Now this is a fitness and health site, not a political one, so I really don’t want to get into the many, many arguments for and against the various proposals that have been promoted and discussed by both sides of the political aisle.  However, I do want to bring up one important point:  we really cannot afford to sit around and do nothing.

The reason why is summed up in a recent report titled, “Health Reform: The Cost of Failure” by The Urban Institute, a bipartisan think tank that studies social issues.  Here’s what it says…

The May 2009 study looked at what would happen to trends in health coverage and costs if healthcare reforms are not enacted, in other words, if we do nothing.  It’s not a pretty picture.

Using a computer simulation model, the Urban Institute looked at the current trends in insurance coverage and health costs and projected them out 10 years in the future for each of the 50 states.  Here’s a summary of what they found:

• There should be no surprise that of all income levels affected, the middle-class would be hardest hit with individual and family out-of-pocket costs increasing by more than 35%.
• In 29 states, the number of people without insurance would increase by more than 30%.  All told, the number of uninsured Americans would reach 65.7 million.
• Businesses would see their premiums continue to increase with it more than doubling in 27 states.
• Every state would see a smaller share of it’s population with employer-sponsored insurance.  (Why is that?  See the previous bullet point.)
• Every state would see its Medicare/CHIP spending rise by more than 75% by 2019 with half the states facing increases of more than 100%.
• The amount of uncompensated care – this is the cost of treating people with no health insurance and a cost that we ALL pay for in one way or another – would more than double in 45 states.

Like I said, it’s not a pretty picture, and in my opinion, a big reason for getting some sort of reform passed.  Again, I don’t want to debate the specific proposals that have been put on the table.  I just want to re-enforce the point that we can’t afford to do nothing.

As a small business owner, I’ve personally seen the cost of providing medical insurance for our employees go up significantly over the past 3 years.  At first, our premiums went up around 10% from the previous year (no real change in the number of employees or number of claims).  Now, our premiums have jumped 35% from the previous year – again with no real change in the number of employees or in the number of claims.

“No problem, you say.  All you have to do is to pass that additional cost to your customers, right?” Sorry, it doesn’t work that way – not in the middle of a recession.  There’s too much competition, many of which don’t provide any insurance at all for their employees, willing to do the same job for less.  It doesn’t take you long to realize that things have got to change.

No matter which way your political beliefs lean, no matter which news network you watch, no matter what the radio talk show hosts say, the way we insure and pay for healthcare has simply got to change.

Again, you can download the Urban Institute’s report here.

Hiram
The Balanced Health Guy

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