Friday, November 21, 2014

patients are products on a corporate medicine assembly line

OK its official. I am overwhelmed. I have been an ER nurse for 25 years. If your arm was dangling by a thread from your shoulder, I would calmly take you back to the stab room. If you unexpectantly go into v fib, I would have the patches on so fast, your head would spin even though you are dead. In other words, I have seen a lot of stuff and can remain calm under lots of stress.

However, I am getting to the point of no return with the amount of information and job requirements there are these days.

I work in a large inner city ER in a hospital which does all kinds of fancy-dancy shit: LVADS, ECMO, CRT, interventional radiology, robotic surgery. You name the complicated medical condition and we probably do it. My point? Our ER is filled with complicated chronically ill patients on a daily basis. These patients are not your ankle sprains, lacerations, appys. They are people who are quadriplegics on dialysis with complicated heart histories. Those patients make up a good proportion of our patients.

The other population we serve is the neighborhood hood rat element. They use us as a clinic. They bring their dysfunctional lives into the ER with them. We serve a large immigrant population. We see many, many mental health patients.

In other words, our ER population is heavy duty. So we are already running around like banshees trying to keep it under control.

Now add to that the 20 emails I get daily about different changes to policies, procedures. Add to that the 10-15 education classes I am supposed to complete every quarter, preferably during my shift. Add on being preparing for various organizations that come every couple of months to certify the hospital in one thing or another: LVAD, magnet, bariatric care, stroke management, chest pain, etc. Add on to that a new drug dispensing system that has been put in place in the last month. Add on to that BLS, ACLS, PALS, TNCC. Add on to that the ebola scare and preparing for that. Add on to that JCAHO, CMS, Department of Health visits.  Add on to that monthly staff meeting, quarterly charge nurse meetings.

How much more can nurses take, seriously? In all of this ridiculous frenzy of information and certification, interaction with the patient seems to be the last thing on anybodys mind. The patients have become products on an assembly line of corporate medicine. The human element of todays corporate medicine, the nurse, has no time to talk, empathize with, care for, the patient. They are too busy trying to keep up with all the certification/regulatory bullshit.


Jacqueline Bennetts said...

I have been following Suzanne Gordan's blog for a while since she spoke at our New Zealand nurses conference a few years ago and I am heartedn that at least there are those outside of nursing that can see the stupidity and the disjointed nature of the problem solving. If you haven't heard of her go take a look (if you have well isn't she good, don't you think).

Liz said...

My hospital's new favorite thing is adding all these "due NOW" mandatory online education sessions that consist of us having to sit and listen to a 10+ minute lectures that basically just list more work we have to do and document. Who has time for that? Not to mention that half the computers don't have working audio.

Sherry said...

I am beginning to wonder about the value of mandatory education. We are ticking off check boxes for the hospital so they can prove they provided the necessary training. However, in my experience, the training has lost its value as we move through in assembly line fashion. Educators seem overwhelmed and sometimes not as engaged with the students as they used to be; the sage on the stage spits out something that we are expected to regurgitate in return, and off we go. I am not trying to place blame anywhere, but something is broken.

It seems like some of the passion is gone ... from teaching AND learning. What happened?

The last time I took a mandatory education computer course, the three instructors sat at a table and chatted, drank coffee, had snacks, and came over to the students if asked. Their conversation was distracting, and when they did "assist," it was at such a rapid pace ("click this, then this, now this") that one would think they were delivering a baby in the other room.

I miss the old days when we had the time and interest for 3-4 nurses to sit together and go through written materials as a learning experience. As we took the test, if someone got stuck, we gave them the page number for the answer, not just "d ... c... a... c... d..." Is there a better system?

Appreciate this blog and the opportunity to discuss our world with other ER nurses. :)