I've been a nurse a long time. I've been at the hospital where I work a long time. When I started here the hospital was by itself, now it is part of a large corporation like most hospitals.
As it became a larger corporation, it changed. There were moves toward "standardization" and "increased efficiency". I've seen medicine change and become big business. At this point it feels more like a business than a place where people get cared for. I guess thats reality.
As with any business, emphasis is placed where the money is made. Cardiac medicine has become a huge money maker. Cath labs make millions putting in stents. Hospitals are doing more and more sophisticated procedures like putting in LVADS (left ventricular heart device), heart transplants. They are doing CRT (continuous renal replacement therapy). Another technology is called ECMO which, if I understand it, is continuous cardiac bypass to rest the heart. This stuff is becoming like science fiction.
There are nurses who say that these procedures are being done on people who will die anyway, in other words they had no chance to begin with. They think some of it is inappropriate. The thing is it makes a lot of money for the hospital and the cardiologists. I wonder if down the road there will be an investigation of all of this. Profiteering at the expense of realistic patient care.
Hospitals are scrambling to stay afloat. I wonder how many are doing procedures that are questionable in an effort to do that. There are already rumblings about stents being no more effective than drug therapy in prolonging life.
The emphasis in hospital is on the areas that make money. They look like hotels. The rest of the hospital is like the ghetto things shabby and falling apart. How far will all of this technology, and along with it money making, go? It will be interesting to see.
Can we rationalize these procedures as teaching cardiologists and others about the heart and its intricacies? They have to learn on someone ?~!
ReplyDeleteYes, unfortunately most of these patients do die soon afterwards. The treatments/procedures sometimes buy days,weeks or months, often with very poor quality of life.
ReplyDeleteAnd yes, the cardiac areas of our hospital are gorgeous with all private rooms. The rest, not updated since 1965 or so.
Imagine if some of the money spent on futile procedures were redirected at underfunded programs such as patient education, health promotion, and harm reduction. *gasp* The ideal thinking ingrained in nursing school.
ReplyDeleteHealth education is overrated. Every 10 year old can tell you about the food pyramid. But when weighing the option of carrot vs twinkie, he's thinking screw the carrot while stuffing a twinkie in his pie whole.
ReplyDeleteI sent a 98 year old to cath lab today for a STEMI. Hmm...very sweet man though!
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