This is not a simple complaint about the way hospitals are run these days. The CEO sets policy at the bedside, it's ridiculous. When a nurse wants to move a patient to isolation the order has to come from a physician and then only with specific qualities. Isolation would demand higher costs of use by one patient and the hospital 'system' scrutinizes the actions of the 'hired help.'
...Conflicting reports (click here) abound in the press and social media about Texas Health Presbyterian Hospital Dallas’ ER staff failure to correctly diagnose the late Thomas Eric Duncan on his first visit there Sept. 25. The differing accounts have focused mostly on individual, institutional or technological culpability.
...Conflicting reports (click here) abound in the press and social media about Texas Health Presbyterian Hospital Dallas’ ER staff failure to correctly diagnose the late Thomas Eric Duncan on his first visit there Sept. 25. The differing accounts have focused mostly on individual, institutional or technological culpability.
First we were told that the nurse in the emergency room hadn’t properly communicated information about the patient’s travel history to physicians. Then we were told that physicians had not read the nurses’ notes that were, in fact, entered into the hospital’s electronic health record. Then we were told that the hospital’s electronic health record would not permit the doctor to read the nurses’ notes.
As the Internet chatter escalates, people continue the blame game. For example, why didn’t the nurse arm-wrestle physicians into paying attention?...
The CEO of the hospital system has priorities set and then the medical and nursing administration is suppose to apply those priorities to patient care. The nurse has a great deal of responsibility in modern day patient care, but, has no authority to carry it out when it deviates from a 'cost effective paradigm.' A nurse's license don't mean that much anymore. As a matter of fact the medical profession would rather replace nurses with medical technicians because of cost. The benefit of a nurses rather vast education is under utilized.
A medical technician can't assess. Nurses spend a great deal of time in education learning to assess the patient. Medical technicians are primarily glorified nursing assistants. The nurse is always the first to see the patient in any setting. Their are triage rooms in ERs now and the person in charge of that room is a nurse. There really isn't any reason for slip ups, especially considering the Dallas Hospital just was 'in serviced'/taught about the protocol the staff was suppose to consider for Ebola.
This is not the problem ONLY of the hospital in Dallas. In Boston, the possibility of finding an infected patient is proving to be effective, but, the hospitals in Boston work differently. The nursing personnel can remove a patient from the population when the patient fits the criteria. The patient is then RULED OUT of testing positive for Ebola rather than being RULED IN. There is a huge difference in that paradigm. Boston is having more frequent false positives and that is okay. That is the way it is suppose to work.
When a hospital system limits the 'care activity' a patient based upon a doctor's order rather than a nursing judgement they are literally removing the authority of many care givers possible of the assessment to one. The nurse patient ratio is dissolved in a top to bottom heirarchy whereby all care is based only on doctor's orders. Frequently, a top to bottom heirarchy is based solely in PAYMENT from insurance companies. In other words, every nickel spent on patient care bleeds rather than having the billing to insurances reflect optimal patient care.
DRGs still live and in far to many hospitals they are god.
Boston hospitals spend money on patient care and ask questions later. I guarantee you their billing offices are lined with very tough folks, both in payment by insurance company and payment by deductibles.
I am not surprised nurses in Dallas turned to unionized nurses in California. Hospitals with unionized nurses don't put up with much.
There is a difference between a 'doctor's hospital' and a 'nurse's hospital.' In a nurse's hospital the CEO decorates the halls while the care is administered on the basis of nursing assessment which occurs on an ongoing basis.
It is interesting that today a unionized nurses organization now has the responsibility of being a support to peers without empowerment. Very interesting.
