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Thread: thanks to obamacare nurses got laid off

  1. #11
    Super Moderator cougarnurse's Avatar
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    On an aside, Hppy (and I am not negating what you all are saying, just playing Devil's Advocate):

    Before all the wonderful medical technology, pre/early 20th century, etc., we were born at home, died at home. If one was in the hospital, that meant you were dying. No thoughts of 'heroics', and all that stuff.

    Think of it: how many women died giving birth? And I am not talking infections, either; I mean after 6-10 kids or so. Sometimes the kid would die, also. Could have been a premature birth, or something else (I am thinking of one of the 'Anne of Green Gables' books here).

    With that said, I wonder what Darwin would think/say. Survival of the fittest? Or are we setting ourelves up for a weaker human race?

    Sorry, but this was something I have thought about.
    Last edited by cougarnurse; 08-04-2013 at 07:31 PM.

  2. #12
    Member Extraordinaire hppygr8ful's Avatar
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    No ,

    I totally get it. But in my area of nursing I really do get to know my consumers (patients) I have known most of them for years. I suppose it's easier when you are working in an acute setting and only see your patients for 1 to 3 days. When I get denials because medicare/Medicaid says a psych patient can't be on more than two psychotropics it kills me. My clients have multiple medical diagnoses but they still work and live in community settings. They literally have no voice in their care and need strong advocates. By way of example - Medi/Medi would not approve a medication change for one of my patient's until he had had a full neurological work-up, but they weren't going to pay for it. So it took me 18 months to get this profoundly delayed man an appointment for differential diagnosis at a medical school. All to get him a $20.00 a month medication. They would not approve it before because it would be an off-label use. He's been on it now for 3 months and experienced dramatic improvement. Still he had to wait almost two years to get it.


    Hppy

  3. #13
    Super Moderator cougarnurse's Avatar
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    Thanks for understanding my Devils Advocate stance. It is a fine line, if one thinks about it. How 'preemie' is too preemie? Insurace costs are way up there.

    I know that, when mom was dx'd with her heart failure, the cost of her stay was pretty expensive. That didn't even factor in the fact that she and dad pay private insurance premiums every 3 months. And LTC? Expensive as all get out; some homes are private pay only--after that, you're out the door.

    Orphan drug use? From what I have read, the cost of research/coming up with those drugs? Again, pretty wild. (Which reminds me---I should look for an article on Orphan Drugs and add it to the Medication Forum)

    I am going to strp off my soapbox for now. I hear coffee calling.




  4. #14
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    Agreed. Sometimes it feels like "1984" and sometimes it feels like "Brave New World." Either way, it's not a good feeling.

  5. #15
    Super Moderator cougarnurse's Avatar
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    Here's a link to a story I just posted in relevant Forums. Thought you all would be interested: http://www.ultimatenurse.com/forum/t...n-to-Governors

    And yes, I got some coffee in me.

  6. #16
    Member Extraordinaire hppygr8ful's Avatar
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    Hera's another good one for you = Since very few Physicians will see my clients and Medicare and Medicaid take anywhere from 3 to 6 months to pay - My clients are being denied at Urgent Care and being forced to use the much more expensive Emergency Room. We have also been told that very soon our clients who are seeing a psychiatrist will be forced to stop seeing the physician they've been seeing for years and go to the county Psych Clinic which for us is a 100 mile drive round trip.

    Hppy

  7. #17
    Member Extraordinaire hppygr8ful's Avatar
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  8. #18
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    My "Death Panel" reply was perhaps a bit harsh and definitely short on background but ironically, I think reflective of the rather long siege of complex EOL patient situations I am currently involved in and as a result, a little compassion fatigued. Issues surrounding end-of-life are complicated and deserve more attention than offered here but a few thoughts and opinions on the subject are included and commentary is invited. First, in this country, we hide from death or hide death from ourselves. Life is sacred and we have the technology to prolong it for a very long time in fact for many, beyond meaningful or purposeful existence. That said, there are individuals who live quite contently with advanced debility and/or disease but I believe that they are not common. Regardless, we avoid thinking about aging, infirmity and death whether it is our own or that of our loved ones. Eventually, death visits and a great many of us are not prepared to face it consequently, under pressure, opt for aggressive treatment and/or prolongation of life support, whether or not doing so is realistic. Often compounding this already complex issue is medical providers who themselves are poorly prepared to face end of life especially from the position of being able to offer that "one more chance." Indeed, sorting out feelings about death, disease and life support is challenging under the best circumstances but is a necessary process that is best handled before a crisis happens and decisions end up being made under duress. While the "death panel" as featured in the prime time expose might exist in some institutions, the ones that I have worked in over the past thirty years take the human element into account when guiding distraught loved ones through painful decision-making and financials don't factor into it.

  9. #19
    Member Extraordinaire hppygr8ful's Avatar
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    Very well said! I also believe that we as individuals need to have frank open discussions with our loved ones about death and dying. A colleague recently passed a way while eating a Hot Dog at Costco. He didn't choke just had a massive coronary. Funny thing was he lived well, exercised, ate right and had absolutely no symptoms of CAD. When my dad's cancer metastasized he told us point blank "Don't let me linger - My work here is done!" I will tell my family the same. My dad died in his bed at home, surrounded by his wife, children and grandchildren. That's the way it should be. One thing we all know about this life is nobody gets out alive. My girlfriends mother just passed away from pancreatic cancer and the girl just couldn't let her go in peace. She was receiving experimental treatment right up till the day she died.

    I just think that these decisions should be ours to make not some arbitrary government office telling us what we can and cannot have in our final days and moments.

    NUff Said I guess

    Peace and Namaste

    Hppy

  10. #20
    Super Moderator cougarnurse's Avatar
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    Hey, folks.....thanks for the discourse!

    Ricu, I understand the compassion fatigue.

    Don't forget the Hospice/Palliative Forum. Speaking of which, mind if I copy some of these posts to that forum for further discussion?

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