Archive for the ‘nurses’ Category

Government Health Care Often Means Waiting Lines, Rationed “Care”

March 11, 2009

In Canada, Britain and Europe, government health care often means long waiting lines and rationed treatment and care.

Here’s today’s example:

by Rebecca Smith, Medical Editor
Telegraph (UK)

Patients face a significant increase in waiting times for operations as ‘insane’ European rules mean doctors’ hours are cut so much medics will not be able to cope, surgeons have warned.
The key pledge of Labour’s NHS reform has been to reduce waiting lists and now the majority of patients are treated within the target of 18 weeks from seeing their GP.

However this will be reversed as junior doctors will be limited to working a 48-hour week, from their current 56 hours, it is claimed.
The extension of the European Working Time Directive will effectively result in the loss of thousands of doctor shifts, John Black, President of the Royal College of Surgeons said.

And the Government fears there will be a lack of locum doctors available to step in and help fill the gaps, following changes in doctors’ recruitment.

It means patients will have to wait months for routine operations as surgeons prioritise emergencies rather than scheduled cases.

The Royal College of Surgeons wants trainee surgeons on a 65-hour working week in order to produce safe, properly trained doctors and cover the workload required by hospitals.

Mr Black said: “If the 48 hour limit is enforced, surgeons will have to make a hard choice between caring for emergency cases and dealing with elective cases as there will not be the time available to do both. Surgeons will put patient safety first and focus on looking after emergency patients.

“All the progress on reducing waiting lists will go out of the window. Forty eight hours for surgeons is currently insane if we want maintain surgery in the NHS.”

Doctors have calculated an average hospital trust outside London will lose the equivalent of three trainee surgeons and other specialities such as paediatrics, trauma, and intensive care are likely to be similarly affected.

Smaller surgical units may have to shut or be merged in order to comply with the Directive, Shadow Health Secretary Andrew Lansley warned.

It is understood the Department of Health is considering increasing the length of time it takes to qualify as a consultant surgeon from seven years to eight or nine so doctors can gain enough experience and also comply with the limited working week.

Vanessa Bourne of the Patients Association said: “How can this be happening in a supposedly patient-centred service? Access to high quality safe care is the paramount requisite for patient and clinician alike and this muddle needs sorting out before patients are put at risk.”

The new regulations come into force on August 1 at the same time hospital trusts are trying to cope with organising the new intake of junior doctors.

The shake-up of doctors’ training, which caused a fiasco in 2007, means more trainees are in longer-term posts so there are now fewer candidates looking for locum posts and temporary jobs.

Read the rest:
http://www.telegraph.co.uk/news/newstopics/pol
itics/4975055/Hospital-waiting-lists-will-soar-du
e-to-European-laws-surgeons-warn.html

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In the U.S., Some 50,000 applicants to nursing schools were turned away last year because there weren’t enough spots, even as a nursing shortage leaves hundreds of thousands of jobs vacant and threatens the quality of care in hospitals and nursing homes, Reuters reports. The federal stimulus package contains some $500 million to address health staffing shortages, of which about $100 million will go to address the nursing shortfall.

Health Care: Computerized Records Just Won’t Lead to Better “Care” or Cost Savings

March 5, 2009

If the cheerleaders – including the one in the Oval Office – are right, computerized medical records will save us all: save jobs, save money, reduce errors, and transform health care as we know it. In a January speech, President Obama evoked the promise of new technology: This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests,” he said, and he has proposed investing $50 billion over the next five years to help make it happen.

By Scot Haig
Time Magazine

 

Any doctor will tell you the advantages of having lots of patient data on computers: it helps us avoid redundant tests, gather huge amounts of data for research, screen automatically for drug interactions, all with no problems with our famously illegible handwriting. I would be happy if every patient could hand me a digital file of everything about him; it could really save time on first visits. But against our government’s push to get all patients’ records computerized we must keep in mind there will be a cost to this – far beyond the billions to be spent setting it up. Many of us in medicine are concerned that the greatest cost will be in the quality of medicine that we practice. (Read “The Year in Medicine 2008: From A to Z”)

 

American doctors have not been enemies of the digital revolution. Looking up lab results and x-rays on our computer screens beat out carbon copies and sheet film in an instant. We like e-mail; we shop, take tests and read our journals on line. But the romance, for most of us, began to sour with Computerized Physician Order Entry [CPOE]: entering patients’ hospital orders on the computer. This is when we first confronted the downside to uploading our every medical judgment.

 

The majority of us are forced to use computerized orders or risk losing our hospital privileges. But most of us have found that CPOE is a lot harder than writing out orders on paper, takes far more time and in too many ways is just not as good. We’re never quite sure that what we’ve typed is going to be seen by a real, live, analog nurse, that it isn’t just going to disappear. (It does.) We can’t order certain things with those buttons and pull-down menus that we could in writing – things like “patient may wear her own flannel nightgown and underwear” or “please, please get the x-ray I ordered for yesterday”, or “prop up patient’s legs with pillows like this” followed by a little stick-figure drawing. (See pictures from an X-Ray studio.)

Read the rest:
http://news.yahoo.com/s/time/200903
05/hl_time/08599188300200

Health clinics overwhelmed by cholera cases in Zimbabwe

December 10, 2008

In Zimbabwe, a cholera epidemic is claiming hundreds of lives.  The medical system has totally broken down.  Western aid agencies have arrived in force after the Mugabe regime reluctantly appealed for international help last week. They are flying in medics, medicines and equipment.

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The room suddenly fell silent. The local health official momentarily stopped his briefing of aid workers visiting the cholera treatment centre in Chitungwiza, a township 20 miles from Harare.

Right outside the open window four labourers in latex gloves were loading a rigid corpse, trussed up in black plastic sheeting, on to a pick-up truck that had come to take it away for burial.

It was a sight that reinforced the message of the official dramatically. Here in Chitungwiza, as in many other communities across Zimbabwe, the cholera epidemic is overwhelming the skeletal remains of social services.

The corpses of two other victims lay wrapped in blankets in the makeshift mortuary of the centre, which is in the former maternity unit of the clinic. Their deaths raised the total in this wretched, densely populated township to more than 80.

By Martin Fletcher
The Times (UK)

A baby drinks water from her mother's hand in Harare, Zimbabwe ... 
A baby drinks water from her mother’s hand in Harare, Zimbabwe Monday, Dec. 8, 2008. European Union nations moved to tighten sanctions against Zimbabwe’s government on Monday and stood united in calling for the country’s authoritarian leader Robert Mugabe to ‘step down.’ The move was to protest the deteriorating humanitarian situation in Zimbabwe, where a cholera outbreak is claiming thousands of live due to poor state of health care there. .(AP Photo/Tsvangirayi Mukwazhi)

Read the rest:
http://www.timesonline.co.uk/tol/news/w
orld/africa/article5315386.ece