I have been busy seeing patients at the new office and am finding rural health very challenging. Some of my patients are reporting chest pain and are in the population with the highest risk of heart attack. We offer sliding scale fee for those who don’t have insurance. This helps get people into the office but what happens after they report the chest pain? I tell them that they need to be evaluated with a stress test.
Here’s how it usually goes….
I’ll have to wait and see what happens or go to the Emergency Room if I have chest pain that won’t go away.
“You need to understand the risk of sudden death if you don’t evaluate the reason for the chest pain, right?”
Sure… but you know how it is. I have to put food on the table and pay the bills. I can’t afford to have a stress test.
“What will happen to your family if you pass away or become permanently disabled with a stroke? What about burial expenses?”
“Can you afford to die?”
“Can your throw your life away over being stubborn?”
While I was a NP student, I read an article by Gail Guterl. She is a consulting editor for Advance for Nurses magazine. She questioned the need for public disclosure of hospital acquired infections. There are 6 six states, Pennsylvania, Florida, Illinois, Missouri, Nevada and Virginia who require this information be public. The author wondered if this was viewed as a public shaming in order to force hospitals to lower the rates of infection.
This could also bring a higher incidence of lawsuits as well. Her question to the readers of the article was “Do we have a solution?”
After a bit of thought, I still thought that public disclosure was a good idea and I still do. If you try to hide information that could be potentially important to patients, it could be perceived as suspicious. I would like to have as much information about a facility before I am admitted in order to make a more informed choice. If I know that there is a higher rate of post-surgical infection, you can better believe I won’t be having surgery there. This information should not be used to punish facilities, but to help them to investigate why the increased infection rates are occurring.
Another thought on the subject of “hospital acquired infections”?? How many times have you instructed family members when a patient is on contact isolation with MRSA, VRE and C-diff about the importance of using the proper precautions? Multiple times I have explained this and find families respond with “I live with so and so. If I was going to be infected, I would already have it.” These people pick up the infection and pass them to others. If a person wants to infect themselves and take a serious health risk, whatever.. But don’t expose your children who are too young to understand the risks.
The solution? Put the visitation restrictions back in place regarding 12 and younger children. No babies allowed in the hospitals. Period. You don’t follow precautions before entering a patient’s room, you don’t get to enter. Period. Watch the number of infections drop. Enough said…
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