I AM VINDICATED!! (But those who scoffed have moved.)

In the late 1970s, I started observing a trend in hospitals to cut back on nursing staff, including nurses aids and orderlies. I expressed my concern about it and was ignored, naturally. Shortly before the 80s, I observed that LPNs were being used to do nurses aides duties as well as their own – which was a slap in the face for the LPN.

I expressed concern over this also, citing the very real possibility of LPNs becoming a vanishing breed. Naturally, I was ignored.

By the 80s, RNs were doing both LPN and Nursing Aids work as the amount of LPNs graduating nursing school had dropped. After all, why go to school, learn nursing and then be regulated to bed pan and sheet changing? Plus, it had become the ‘in’ career to become lawyers – more money with less work and less danger. During this time, local schools started churning out Nurses Aides by the ton, which I felt would glut the market.

It did. Just about the time Nurses Aides were pouring out of everyone’s ears, the Hospitals went to being profit oriented and private. They cut the Nurses Aides and hired more RNs, who, depending on their education (2 or 4 year graduates), got to make up the difference.

I warned them again that Bad Things Were Going To Happen, and they scoffed at me. During this whole time, the cost of medical care in the hospitals started soaring to previously unknown heights. Hospital administration became a major business.

*Example: 1970, the local hospital administrator made approximately 60,000 a year, with medical, and retirement. A semiprivate room cost $50 a day.

1999, the administrator makes roughly $2 to $300,000 a year, has major stock options, a guaranteed 5% yearly bonus, his home paid for, his moving expenses paid for, his children’s privet school tuition paid for, a company car, 4 weeks vacation, business expense account – and it is a big one --, plus if terminated before the end of his contract, he gets a guaranteed $1,000,000!

A private room (there are no semiprivate anymore) is $300 a day and rising. NOTE: The hospital now takes more patients than before, yet in comparison to the ratio of patients to staff from 1970, has 50% less staff.*

According to the latest news report, due to inadequate staffing of aides and nurses, 98,000 people die in hospitals a year from errors! In some instances, housecleaning staff have been pressed into service to tend patients!! Nurses have found themselves over worked, forced into mandatory over time, and frequently required to do procedures they are not trained to do!

Vindication is not all that sweet when I can’t go back to the people I warned about all of this and scream I told you so !! in their faces.

When a hospital goes private and turns into a profit making machine, people suffer because in order to keep the profit high, costs get cut. I’ve been trying for ages to get a ceiling cap put on all medical lawsuits because it all works like a set of dominos.

You sue the Dr, who is human and makes a genuine error = the jury of your peers awards you a couple of million for a lost toe = the Dr.s malpractice goes up = he increases his rates = he charges your insurance more = you insurance rates go up.

It doesn’t stop there. You loose the toe in the hospital from some genuine error also of theirs = you sue the hospital = your jury of peers gives you a few million = the hospitals malpractice rate goes up = the hospital increases the cost of care = they bill your insurance more = your insurance bills you more. Now the hospital tags on administrative perks and costs plus strives for a profit picture to keep the stock holders happy = you loose!

The same thing happens with drug companies and medical equipment makers. You still loose.

Congress has made only the barest of considerations and suits still flood the courts.

A challenge: Find some doctor in your town who has been in practice at least 4 years who has not been sued!

There are something like 250 doctors in my town and all have had at least one malpractice suite! Does that mean all are bumbling clods? The hospital is almost always in court over some lawsuit.

Now, with the reduced staff, I expect it will be in court even more, along with many, many others.

Poor medical care equals lawsuits so how does cutting back on the nursing staff equal a higher profit for the hospital if patients are suing the hospital because of inadequate care? I figure something like this is what has caused the potential shutdown of those two long term and major hospitals in West Palm Beach. They have the population there to support both hospitals, but I figure they spent too much on profit pictures, lawsuits, insurance, administration and having to pay inflated equipment costs. (See malpractice suits above.)

I told them so! I raised the flag of dire warning! I screamed from the mainmast that there were dangerous shoals ahead! I pointed out the turbulence in their paths – and they ignored me.

I am vindicated, but it’s no fun.

I think I know how to fix it, but they still won’t listen to me.

It is a bad thing when medical services become private, profit oriented businesses. That indicates that life becomes a commodity to be bought and sold to the highest bidder.

I won’t deny the above happens, but how about:
You lose your toe because the hospital plainly commits an error which is totally their fault, they could have foreseen and prevented, but didn’t because it would have cost an additional 25 cents per patient = you sue the hospital = your jury of peers gives you a few million = the hospital sees the error of its ways and actually changes its procedures = better care for future patients and no additional lawsuits against the hospital for millions of bucks. Everyone wins!

Liability suits don’t just make insurance rates go up, they also change standards of care, thereby making the world a better and safer place. Granted they also make insurance rates go up, but that’s not the only thing they do, and the defendants in liability suits are rarely pure as the driven snow, as, for example, your hospitals which are having untrained people perform health care duties.

Oops, sorry about that run-on sentance there.

I must disagree!!

Hospital makes an error – presumably due to one person – who is over worked because of staffing cut backs = because the hospital is trying to pay increased malpractice rates/make a profit = no change in the error rate and everyone still looses. Side note here is the jury of your peers who is sympathetic with you against what they perceive to be a megabucks institution greedily overcharging hapless patients and in retribution award you 4 million for the loss of a small toe, which will have only impaired you cosmetically. A better award would have been the cancellation of all of your hospital bills, payment of any follow up care you might need and anywhere from 1 to $200,000 in cash.

In the 1970s hospitals were demanding nurses by the carload from LPNs, to RNs with 2, 4 and 6 year degrees. Now, with increased hazards to be faced by the nurses, aides and orderlies, from Hep B, AIDS and Herpes, they cut back on the staff, use less aides, fewer orderlies, and most nurses below the level of a 4 year degree can find themselves doing mainly aide work.

In 1973 I was privy to such plans in the making when the new hospital in my area was being designed and planned. Back then, they were planning to reduce the amount of aides and orderlies – who do the basic labor intensive work in order to free nurses to be nurses – and had already begun to do so, regulate LPNs to normal aide work because, in their opinion (these were Registered Nurses with Bachelors and masters degrees and supervisors of the place) LPNs were not really nurses after all. RNs of a 2 year associate degree would be the ‘work’ nurses who got to run behind the aides/LPNs giving medications, treatments, doing charts, changing bandages and so on while RNs with 4 years and up would be charge nurses and handle the ‘higher’ tasks.

I pointed out the obvious flaws, cited a dangerous decrease in the quality of care, which had already begun, and the eventual lack of LPNs - who wants to dump bedpans after you went and got your degree? I also pointed out the decrease in 2 year RNs, who would not be pleased doing LPN and RN work. Then there was the matter of the 4 year and up RNs, who were a whole lot more expensive, and in demand and if forced to do work below their station, would go elsewhere.

I was no longer privy to planning meetings after that. What I predicted came true. The thing of it was, I did not then realize that so many other hospitals were going to be doing the same thing.

To offset costs, some hospitals started hiring these foreign doctors fleeing the middle east and their standard of medicine is much different, as is their attitude towards patients. Over seas, in some areas, the Doctors were the elite. Not here, though. Their attitude is somewhat low on compassion, low on willingness to discuss anything with a patient, high on billing, and many still seem to look at the patient as a ‘lesser’ being.

(I know one who every time an elderly patient of his felt bad, he ran her through ER and had her admitted, then she spent 5 days in the hospital. We discovered that she was being billed by him for hospital visits at $100 a visit, if he so much as stood outside her room and said hello. We had her switch doctors and all of that stopped. At the most, she has had to spend a day in the hospital.)

Another Doctor, a lady from ‘over there,’ decided that an elderly woman I know needed certain medication. The lady protested that the pills made her ill, but the doctor insisted she take them. Shortly after, when the woman got worse, she decided an operation was needed and refused to even talk to the patient who wanted to ask questions. I persuaded the lady to see a doctor I knew, who almost fell over at the amount of pills she was taking, stopped them all, started her on just a few new ones and could not find any reason for an operation. The lady has improved.

So, the profit oriented hospitals in private hands are going nuts when it comes to cutbacks and cheap labor and everyone is paying for it. Only the stock holders and board are making money off of such places.

Yay. Woo-Hoo. Next!