Sad Observations on Health Care: How to kill patients and get away with it

How To Kill Patients and Get Away With It.

This hits at so many levels and is truer than anyone is willing to accept.  If the public only knew and understood the depths of convoluted  thought, good ideas gone horribly awry and true inanity that is the backbone of our modern health care system they would be clamoring for reform.  But no, we’re locked into an ideological debate over something where ideology has no place.

The sad truth is that I can point to a half dozen (or more) items that contributed to the death of my daughter.  Sad.

Is Protecting Yourself a Joint Commission Violation? | WhiteCoat’s Call Room

When are you guys going to learn? When a patient is choking the life out of you, you HAVE to offer them milk and cookies then tell them to go to a secluded room before you try to defend yourself. Those are the rules. If they have their hands around your windpipe and you can’t breathe, then just point emphatically to the secluded area.

via Is Protecting Yourself a Joint Commission Violation? | WhiteCoat’s Call Room.

Yes.  Yes it is.

This is the inherent problem of large regulatory bodies like the Joint Commission:  they do not operate in reality.  They exist in a perfect fantasy land where falls never happen, infections are impossible and ED (and all patients) are well behaved.  They do NOT understand the complex and dangerous reality that is modern health care.  Like managers, they should be required to spend an amount, say a week a year, of time where they are the primary surveyors.  Your primary survey (management) area is ED?  You get to spend a week in the trenches.   The people who are writing the rules NEED to be intimately familiar with the true consequences of their actions.  Handing down edicts from on high isn’t as easy when you know what it means to the actual providers.

Of course that is just a fantasy because like most bureaucrats, they got into this line of work to avoid (or couldn’t hack it) just this sort of thing.  Actual patient contact?  Ewww.

This and That

I’m starting to get my mojo back.  It’s slow, but the ability to write more than 140 characters (damn you Twitter!) is slowly coming back.  Lots of stuff churning, fermenting and running around in my brain.  Just not completely ready yet.


This whole Facebook placenta explusion drama deserves a comment.

Was it a HIPAA violation?  No.  Did it in any way endanger a patient?  No.  Was it in poor taste?  Yeah, it probably was.  I believe that the school in question over-reacted and by doing so created the social media furor that has ensued.  Give a small issue large exposure and the chances of it going away quietly is pretty slim (see Sarah  Palin…).

How this reflects poorly on the nursing profession is beyond me.  All I saw in the picture – the grainy B&W picture, was a young female in scrubs showcasing an unidentifiable thing.  If no one had mentioned it was a placenta, I never would have guessed.  Did you see the excitement in her eyes?  Could you feel the zest for learning that exuded from the picture?  It was almost palpable.  Sad that the school saw this a gross violation of, well, everything and decided the 4 students involved had to pay.  As the old saying goes, “Heads will roll!”

All we have ended up teaching these students is that nursing is reactive, vindictive, punitive and slow to change.  It’s not like they were using the placenta as a marionette, or some twisted nursing school version of “Weekend at Bernie’s”.  It was a mistake on the part of the students, but not one as grievous as the administrators would lead you to believe.

Here’s what they should have done…  Quietly ask the student to remove the post, explaining that it reflects poorly on the school – with a reason why it does so.  Give a small reprimand, make the students take a media ethics course or what-not and take the time as administrators to formulate a comprehensive social media policy that is easy to understand and adhere to.  Done, no muss, no fuss.  A simple explanation of why and a punishment that fits the “crime” would have caused far less of a brouhaha than the route they took.

But that’s just my take on it.