Nursing’s Great Peril Which the U.S. will now face with Disastrous Effects for All!

The United States is now reaching a breaking point in regards to the practice of Nursing in medicine.

At a time when the baby boom generation -an estimated 78 million- is entering retirement who will care for them in their so-called golden years.

Hospitals driven by profit margins and not quality care have cut nursing staff and reduced Nurse to Patient ratios to Dangerously low levels. By 2005, roughly half a million U.S. registered nurses (about one fifth of the national total) had chosen not to work in nursing. It is projected that if current trends continue by 2010 that the U.S. will need to train 1.1 million new nurses by the year 2012, which is estimated to be half of our current nursing level.

So who will care for the onslaught of this countries aging population of 78 million coupled with the fact that the U.S. population overall has risen above the 300 million mark.

Hospitals have addressed the pressing needs of their Shareholders by pushing the equation down the line to the nursing staff. Or even further by passing down tasks formerly performed by professionally educated and clinically trained nurses to less educated staff members.

They are now Giving nurses Dangerously high patient counts to care for it is not their concern that the patient receives quality care.

Nurses without the needed resources, horrid working conditions coupled with the nurses well founded fear they cannot adequately care for their patients are all leading to a profoundly troubling conclusion. This should be disturbing for us all as countless nurses have come to realize they can no longer adequately perform their duties and leave the profession altogether.

When patient ratios rise nurses cannot properly monitor their patients they just don’t have the time. Drugs along with their importance of timely delivery which are extremely important if not imperative to treatment are quite often given at a later time all to the patients detriment and this is just one aspect.

There was a time when nurses could properly monitor their patients not only checking their vitals but also observing the overall organism which is the patient. The fingernails, skin color the presentation of the eyes changes in respiration and more. Patients on ventilators require even more time to be clinically observed for signs of distress or deterioration.

Case in point fifty year old patient whom staff denotes is agitated and has to be restrained. Shift after shift given their precious few moments to see the patient all verbally note this as does a respiratory specialist and a speech pathologist. This occurs over a 3 day period when finally a more well rounded RN checks on the patient at the beginning of her shift. Within 5-10 minutes a syringe with a semi-neon substance is brought in the unit and is injected into the patient. The agitation ceases the restraints are no longer needed the patient is still semi-lucid as they were before only now more relaxed.

This nurse for whatever reason read the patients chart and took the time to observe and even though she fell a little behind in her duties, she treated the patient. Here this poor man unable to communicate as he had a trach tube, was in rather excruciating pain. Luckily for him a skilled, caring and comprehensive nurse who had not yet suffered burn-out was handed his chart for the day along with many others. If it were not for this lucky occurrence of events who knows how long this man would have suffered needlessly.

Doctors see patients however Nurses carry out and truly care for the patient in a day to day setting.

As long as hospitals only address the issues of their Shareholders (stock holders) and keep inventing methods to improve Profits without a care in the world to Patient care we will all suffer. Until nursing staffing levels and working conditions are addressed this extremely troubling trend will continue in medicine as hospitals further deteriorate.

For the 78 million baby boomer’s who will require extensive, complicated and more demanding procedures and care the outlook is Bleak.

Needed now more than ever and in Greater Numbers with better working conditions. If this issue is not addressed many will Suffer and Die Needlessly.

FAIR USE NOTICE: This blog may contain copyrighted material. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. This constitutes a ‘fair use’ of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit.

Liposuction Dangers is it worth the risk

In two bordering counties in a southern US state five women died from Liposuction procedures in 2011 over a six month period. All of these women were in their thirties and early forties were there warning signs ahead of time?

In 2006 over four hundred thousand of these procedures were performed and complications have been reduced since the advent of this technique.

One women in particular went for this simple procedure however there were warning signs. The physician was not Board-Certified had switched specialties twice in their career and had only performed a general surgery residency over 25 years ago. This doctor also had no Privileges at Any of the local hospitals or any for that matter.

The staff also included a Nurse Practitioner and a receptionist however there was No Crash Cart on-site or the needed monitoring equipment.

What was to be a simple Liposuction procedure went dreadfully wrong as the patient went into an Acute Myocardial Infarction or heart attack. As the physician had No Lifesaving equipment or medications on hand 911 was called upon her arrival at a properly equipped ER twenty minutes later she was pronounced DOA.

All medical procedures carry associated risks however they can be mitigated with the proper staffing, equipment and training.

Early in my career I had the distinct opportunity of working with a very talented and experienced RN who was very aware of current trends in the field. She told of the untold physicians coming to my state and opening Internal medicine and Oncology practices. The reasons were simple their was Money to be made in these specialties the doctors realized this changed their specialty and they came to my state with a vengeance.

No matter that they had not practiced this specialty before, their medical license allowed them to be legally specialized whether they had the training or not it was that way over 25 years ago and it still is today. After completing their medical education a doctor can be a brain surgeon on Monday and a Cardiac (heart) surgeon on Tuesday that’s just the way it works, don’t believe me just check.

Many of these newly practicing specialists really were unsure of what they were doing there was and is money to be made if there is a large swath of patients to choose from in their new field. Calling upon a skilled surgeon in the specialty the night before the novice was to perform a procedure was a somewhat common practice. The nurses in the Operating room knowing that such and such surgeon was to operate that day which caused alarming concern. Oh know Dr. 123 is operating today we need to call for extra blood and plasma as this physician was well know as somewhat of a butcher a somewhat common occurrence thank God some nurses have a keen eye for these things. Yes these things occurred 25 years ago and they still happen today.

So before you undertake any cosmetic surgery including liposuction do your research and get at least two opinions. Are the doctors Board-Certified do they have the need monitoring equipment on hand? Is there a Crash Cart on the premise and are they close to a major metropolitan hospital or any hospital.

What type of liposuction are you going to have done there are different types with differing rates of complications, risks and outcomes.

How much and where on Your body is the procedure to be performed? Has the physician given you too high of an expectation on removal of fat tissue or adipose tissue. The America Society of Plastic Surgeons defines large as 5 liters or 8 1/2 pints. This is consider complex and possibly Life Threatening for large amounts of tissue do you really want to push it? While there are some reports of the removal of much larger masses of material I would hope you would not want to be that much of a risk taker, that is with your Life!

During your research you might wish to find out if an IV (Intravenous Line) is going to be inserted during your procedure. This is a Very Important component as this is a life line for life saving infusion of Live Saving drugs and fluids in case of an Emergency. Monitoring Equipment Cannot be Overemphasized during these types or other types of procedures. If you want to look or feel better about yourself it’s your right and no one says there is anything wrong with trying to improve yourself.

It’s just so important to do your homework are you a good candidate? Who is this doctor and what are his academic credentials are there any malpractice claims is he Board-Certified in the specialty in which you are going to have your procedure done? Is his or her Board-Certification Current every state in the USA has government websites where you can check on their status.

All physicians will recommend or encourage a patient getting a second opinion so why should you not go ahead and get two before hand more knowledge is Power.

Cosmetic surgery is growing by leaps and bounds in this country be forewarned read up on liposuction or whatever procedure you are having. Either at home on the net or at your local library it might be even better at the library or with a close confidant at your or their home.

I would STRESS Monitoring Equipment on Site, a Crash Cart, Proper Supplies of needed Emergency management materials drugs & fluids. Whenever having procedure be sure you are going to have a Line or IV line in you during the procedure this and a Crash Cart could be the difference between Life and Death.

Enjoy your life do what ever it is that makes you happy and if Liposuction is going to give that to you Great. Just do your research get Educated and Most Importantly Check out your Doctor.

THE IMPORTANCE OF BOARD CERTIFICATION! A Beginning Series of Posts in regards to Medicine today!

Is your doctor Board-Certified?

Are you aware you can check this as every state in the USA has a government website available for you to check.

From this you can research the doctor’s educational background along with their academic achievements, hospital privileges, Board-Certifications as well as any disciplinary actions within the last ten years.

All state governments have a website to check on your prospective doctor. In Florida just type; fla state medical license check. From there enter the doctors name it’s always a good idea to do a five minute check ahead of time to get good quality care.

If a medical doctor graduates from medical school with No Fellowships (specialties) there medical education stopped the day they left medical school and after their residencies.

To make sure you are getting good quality care five minutes of your time will be more than worth it.

I would strongly advise that you Never see a specialist who is not Board-Certified in their chosen specialty. This certification shows that the physician has had continuing education and is up on the latest treatment protocols. What works and what isn’t so rather then spending months and getting no good results or becoming sicker and possible progressing to a terminal state or worse. It’s always better to check out & verify you have chosen the best you can find in your area who will also accept your insurance.

You can also find out if your prospective physicians is what is called in the trade a “Procedural Doctor” not a good sign. If you are admitted hospitals will and do refer their inpatients to Non-Board Certified doctors. Some Gastroenterologists are known for this, your doctors history might show that they have hospital privileges at 3 or more hospitals. Many are not Board-Certified, their income is made by performing procedures not seeing patients at their practice. Many who have outdated medial education more bad signs.

Procedural Doctors take a little more research however this can be easily done. You can check on their practice and how many patients they see annually, low numbers are a cause for concern.

If you find a Procedural Doctor, promptly turn around and head the other way.

This is also why I strongly Advise that if possible have a Patient Advocate if you spend anytime even just hours at a facility. If educated just minimally they can remember to ask questions and watch out for you during your stay. Everyone is thrown a little off guard by hospital and medical settings so an Advocate is worth their weight in gold.

How many malpractice claims has the physician had more than 2 or 3 in ten years is a cause for concern. Where did they go to medical school, where did they do their Fellowship (specialty training) or residency. How many Academic appointments have they received? Are they affiliated with a teaching hospital or university (A Very Big Plus!).

During most occurrences you will be able to ask the hospital what specialist they are referring you to and whether they are Board-Certified? If they are not you have the right to ask the question, refuse that doctor and ask for only a Board-Certified doctor. This will not create a delay in your care however it will provide for a more thorough productive procedure with better treatment protocols and in the end a healthier patient. You are paying for this adventure Please be prepared have a friend act as your advocate if needed.

Your advocate should have the time available to spend 8-10hrs a day with you. Having an advocate involved will Greatly Benefit and Enhance your stay which should produce a more promising outcome to a stressful experience. If your dressings are not being changed, your medications are not being distributed in a timely manner, etc. All of these situations can be tactfully handled by your Patient Advocate. Believe it or not I was hospitalized with a condition that affects over 5 million American citizens per year. Yet I had to call and instruct their dietetic staff on what foods I should not be given among other aspects. Even after speaking with their dietetic staff they still immediately sent me food that would only have made my condition deteriorate and potentially worsen via additional infections (Bezoars). Again this occurred after they were instructed on the proper diet for the condition. This was a large urban hospital in one of the largest metropolitan areas of the USA. It took them a full 3 days to finally get my diet correctly addressed and this was No Exotic condition 5 million US citizens suffer from this annually yet it took a Major metropolitan hospital 3 days to feed a patient the proper food, Unbelievable but True.

Trust me from real life experiences a Board-Certified physician and a Patient Advocate can prove to be a real life saver if you are hospitalized.

Learn to research via easily accessible Internet resources take notes before your doctor’s visit. In today’s world of medicine 5-10 minute doctor visits Do Not Provide comprehensive medical treatment. Just because someone has graduated medical school does not make them GOD, so don’t expect them to be, ask questions, get a second opinion.

Educate yourself and those that you might call upon during a medical emergency.

While medicine has found outstanding cures and treatments for various diseases in recent history. Medicine along with the patient care on the whole in the last 15-20 years has fallen dangerously low on the tree for which patients suffer the consequences. There are now many doctor’s practicing who are in fact Dangerous. However as many of you possibly have experienced physicians will not speak the truth about their colleagues (they never do). It is Your job to educate yourself and those that you love, if you fail to do so it will be at your own peril or possibly a loved one or child.

Be assertive ask questions and be ready to say NO or to point out poor medical care. While even at the hospital you have the right to call for the Attending Physician (doctor on duty) to voice your concerns. You the patient have Rights, exercise them believe it or not many hospitals will respond appropriately to an assertive patient or Patient Advocate. More often than not you will receive better care then the patient who allows themselves to be treated like livestock at a farm.

Also be aware that numerous tests are performed only to protect the doctor and have nothing to do with your medical condition, treatment or outcome. If you are being scheduled for a test ask what it has to do with you care. On the other hand are you aware of the thousands of Perfectly Good Gall Bladders that are removed daily because physician fail to perform a simple HIDA exam to confirm their diagnosis. Often many doctors do not perform this non-invasive procedure. Patients then endure an invasive surgical procedure as well as having the possibility of a Post-Op infection kill them or contribute to the deterioration of their condition, all because a licensed medical professional failed to do their job. Ask questions, during a recent stay myself over two days I requested over ten times to be weighed. This was because of the fact that I was to be anesthetized and the anesthesiologist needs this important information as it is Crucial. Even though I continually tried to get my weight charted this never occurred, why, well I truly have no answer. Someone however entered false data on a medical chart and even after notifying the hospital of this no action whatsoever was taken. Because of this failure to get my proper weight charted I was Over-Anesthetized with propofol an Excellent medication, the patient goes under quite easily and comes out very cleanly. After this procedure this was not the case it took the staff over 20-25 minutes to bring me back around. This after only 2 months earlier the same procedures were done with the same medication from which I awoke Extremely lucid with little or no adverse reactions. It’s also of note that the Non-Board-Certified physician had performed 2 procedures of which only 1 was actually needed. However the doctor was a Procedural Doctor, more procedures equal more money in his pocket. This was verified by a practicing specialist of over 25 years with impeccable credentials who was utterly amazed at what had occurred.

Also remember the saying, ” If there isn’t a picture it didn’t happen”. In medicine, ” If it isn’t Charted it didn’t happen” if there is a problem with your care make sure it is CHARTED. Otherwise it did not happen.

I will be writing more postings on the state of medicine in the coming days that hopefully someone will find useful.

Do your research, Ask questions prepare for the worst that hopefully will never occur. I am not advocating for anyone to become paranoid or obsessive only to use a few minutes on the Internet to become a better educated patient who will receive excellent care during a trying, stressful experience. In the end you or a loved one will be better served for just a few minutes of research.

I only hope for the best outcome for you or a loved during your medical care and experiences.

FAIR USE NOTICE: This blog may contain copyrighted material. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. This constitutes a ‘fair use’ of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit.

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