Dear Mr. Romney:

TO: Mitt Romney

FROM: Madness the nurse

RE:  care of  uninsured in the emergency room

Dear Mr. Romney:

Regarding your comments on a recent 60 minutes program in which you stated that the 50 million uninsured can get care in the emergency room. You referenced somebody having a heart attack and their ability to call 911 and then be taken to the ER for care.

Mr. Romney, I wonder if you realize that the reason why that uninsured person ends up in the emergency room is because they have untreated heart disease, high blood pressure, diabetes, etc.
All of these things are UNTREATED because this person does not have a regular doctor that  can monitor those problems.  Mr. Romney, why do you think these people don't have a regular doctor? BECAUSE THEY DON'T HAVE HEALTH INSURANCE.

This kind of uncompensated care runs up millions and millions of dollars every year in hospitals throughout the country.  Hospital eat the cost.  Meanwhile, reimbursement for medicare/private insurance/medicaid keeps decreasing.  The health care system is headed for collapse.

Surely, someone like you, knows these facts, right?  RIGHT?! Maybe not. No doubt you have what is commonly referred to as "concierge medicine".  This is care for wealthy people like yourself in which you pay lets say 20,000 a year to have a doctor at your beck and call.

I can only conclude you are a CLUELESS BASTARD. 

Affectionately yours,

Madness the nurse

its too much to take in

Bad week in ER #3

You are finally getting used to this parenting thing. The shock has worn off. The baby is smiling and cooing and life is great.

You start having some trouble though. No big deal, off to the doctor you go. The doctor sends you to the hospital for an expensive test just to make sure there is nothing going on. Turns out there is something going on.  And the results aren't good. In an instant your prospects for a future are dimmer.

Your life has now completely changed. It will never be the same. Your childs life will never be the same. How will you get through this? What if you don't get through this? Who will take care of the baby?

Its too much to take in. You are in a daze. Your spouse is in a daze. As you go up to your hospital room, all we can do is say a little prayer for you.

tell Dad to wake up

Bad week in the ER #2

You and your family are living your life. Going along, as families do, working, going to school, having dinner together, la de dah. You all love each other, mom, dad, 2.2 kids, living an ordinary all American life.

Family member develops a symptom, goes to local ER. Family member doesn't do well at local ER, almost dies. Local ER decides to transfer family member to big time fancy smancy ER.

Family member arrives to big time fancy smancy ER, not in good shape. Family member is unstable. They are never stable again. They die. A couple of times, and are brought back, then die again permanently.

Family member is parent. Parent has children, old enough to know whats what. Children arrive and are in a state of shock. This isn't supposed to happen to parent. Son says: "Tell Dad to wake up". We hear you crying. It brings tears to our eyes.

Everyone's life is changed forever. Yesterday everything was OK.

things aren't always what they seem

Sometimes trauma sneaks up on you. Somebody arrives by ambulance. It seems fairly straightforward. Blah blah blah. No big deal. Then it becomes more complicated. What seemed simple is now much more involved than originally thought. Tests are ordered. More fractures are found that didn't seem obvious at first. Suddenly its a whole new ball game. This person is severely injured. Most people would be yelling in this situation, but not this one. They refuse pain meds, stating that if they don't move they are fine. I don't usually encourage pain meds, but I tell them its OK to take them. They still refuse. Wow. I know that this person, with the extent of their injuries will have months of recovery. They may never be the same. Their life has changed. What started out as a beautiful sunny day for them, enjoying themselves, has morphed into tragedy.

triage before and after

This is me in triage:

before triage:

during triage:

After triage: