I Just Can't Agree

Alright so back in Mid-Winter I had to spend 3 days in the hospital for a general GI workup. Long story, doesn't have to be retold.


Well, ever since then I've felt a lot better. However ever since then I've been getting claims from my insurance company. None of them have been bills, but they've simply been telling me "We spent this much money on you-I hope you're happy!"

Well, I just got the total one for claims, that basically clumped everything together that I had previously known about. All together, my 3 day hospital stay- which included the following:

-ER services (medications, lab workup)
- CT Scan (1 view)
- daily lab workups
- blood cultures
- EGD (includes anesthesia)
- GI consult



Keep in mind this is a Community, non-profit hospital. Its the hospital I work in.


Whats the total bill?  $21,117.



WHAT.


Alright so thankfully I work there and so far all I've been asked to pay is $20 for the initial ER visit. So far benefits are awesome.


But still. What if I didn't have insurance? How in flipping monkey bean kingdom do people, so many of MY daily patients, pay for the extraordinary amount of care we provide? If my stay was 3 days, what does a 2 week stay look like? What does an ICU stay look like? How do the people pay that get 6 MD consults? Multiple unnecessary tests run?


So I thought about it. $21,000. That's like a year, A YEAR, at college. At my college I went to, that would cover my room and board and tuition combined for one year. Then I thought, whats the most expensive college I can think of, offhand? Harvard?  Its probably not the most expensive in the country but Its the one I chose to look up.

Tuition for Harvard for one year, for a student of my/my parents income, would be $20,600. So my THREE DAY hospital stay for a GENERAL work up on a MED/SURG unit at a NONPROFIT community hospital, cost $500 MORE than a YEAR at an IVY LEAGUE school.


How do we live in this kind of country? What is wrong with this picture? What is wrong with this health care system when a year's worth of education at one of our countries best schools is less expensive than a 3 day hospital stay when you're really sick?

Granted, I could go buy a corvette right now and spend more than a year's worth of tuition in just one signature, in one hour. Yes. But that would be my choice. I would save up for that, plan for that, work that into my budget. But people don't plan to get sick. They get slammed in the face with it.

I understand that I was seen in my ER after a two hour wait and I got a CT scan within 3 hours of being seen. In a country where healthcare is free, I might have had to wait weeks for that CT scan. I get that. But right now- If I hadn't had insurance, I damn well would have waited weeks for that CT scan if it meant I didn't have to pay. Then again they were ruling out appendicitis, so...


It just bothers me. I don't have enough research or political drive to slam against the entire system. I'm just pointing out a small flaw.



~WNB


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Observation Skills WIN

So last night at work we emptied out for the holiday weekend, but-as always- emptying out can only mean one thing....Admissions. And lots of them.

Well, every nurse has their "thing" that they really prefer not to do if they can avoid it. My "thing" is admitting people. It makes me anxious, the unpredictability. From the first moment we get their information called up to the floor, nurses try to predict what their patient will be like. Based off their diagnosis, what problems will we encounter with them when they get to the floor? What will we be doing for them? Based off their age, what do we need in the room to accommodate their needs? Based off the Doctor, is it an attending and we won't have any orders all night? Or is it a hospitalist and getting orders won't be a problem?


However, admitting/ER sometimes ***forgets*** to tell us certain things about the patients because they don't want us as floor nurses to freak out and try and "divert" the admissions. So, usually the common result is we get patients admitted for one thing and turn out to be a complete psycho. Or they come up screaming, when the diagnosis is something not scream-worthy like cellulitis. Or, sometimes, they totally come up handcuffed to the bed with a police officer with them, because they live in....the jail. And they are violent and loud and not cooperative in any way. And the admitting department just *forgot* to give you a heads up.


Well, last night I get an admission called up. Pneumonia, older gentleman. I figured it would be pretty routine. Patient feels like total crap after multiple days of failed attempts working cold medicines at homes. We get them situated, start some antibiotics, nebulizers, get them to sleep, etc.

Well my "pneumonia" guy comes up on the stretcher, with nothing less but a city cop- hand gun, their little walkie talkie scanner thing, badge, uniform, the whole get up. Legit.

So I'm like, oh- fabulous. I mean a nurse cares for her patients regardless of their status. Regardless of race, age, gender or poor life choices. But still, I wasn't thrilled about the idea of listening to a prisoners bowel sounds that might spit in my face.

Before entering the room, I so badly wanted to pull the cop over in the hallway (ha-ha, no pun intended) and ask what the patient *did*. But I didn't. I decided it didn't matter and I didn't want to know anyway. I was going to care for him the same no matter what.

So I start my admission assessment, composed of a whole bunch of questions about the patients history. The patient is elderly, a little scruffy, tall, lanky. Not your typical prisoner type, but then again who am I to know what a typical prisoner looks like besides whats on TV?  So as we discussed his medical background, the cop kept chiming in, "Oh, you had that ulcer right? And that lung cancer, you had the chemotherapy for 30 weeks, right?"

So I'm like, Wow- This cop really knows a lot about his inmates. He must have been in this jail for...a long time. Wouldn't that be the state jail? I don't know much about our criminal justice system. Clearly.

So I go about my clinical hands on assessment, trying to keep my guard up for any *sudden* movements from my patient, noting that for some reason he wasn't handcuffed to the bed as all prisoners usually are. And why is he in penguin sweatpants?

So then comes a question that we have to ask. Who do you live with? Do you have a support system? If so, who? I always think it's an awkward question, prying into personal lives as such.

So this is how this short lived conversation went down that made me look like a total idiot, which- I am.

Me: "So...........You live with.....I mean, In.............the....jail?"  I make awkward eye shifting contact between my patient and this cop. The patients facial expression was pure confusion and therefore I felt the need to verify my statement with looking at the cop. Awkwardly. Long pause.

Cop: "Oh! OH! NO! noooooo. Oh! I'm his son! I'm on shift, they just called and said he was over here."

Me: "Oh....I was wondering why he wasn't handcuffed to the bed."

Patient: "Do I really look that bad?!"

Me: "No! No of course not!"


Thank goodness we all had a good laugh over it but I was seriously kicking myself. I should have known when I saw the penguin sweatpants.


I went and told my coworker the story, thinking it would be totally suspenseful and she wouldn't guess that the cop that came up with my patient was actually the son in the end. Instead she's all like, "Didn't you see the cops badge? It was totally the same as the patients last name."


I win the super award for naivety because she was with this patient for like 2 minutes and I was with him for 45 minutes and I didn't notice the nametag. Super observations skills WIN.



-A Writer in an (unobservant) Nurse's Body


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Epiphany of the Month

Hey all,

So lately my brain has been in a major blank status. Each day I rise and I think, what can I blog about today? And I come up with nothing. Reasons being lately all I have been able to do is:

1) Work

2) Sleep (you don't really want to hear about my dreams, do you?)

3) Eat ( I actually almost did blog about my dinner the other night, I was desperate)

4) Photography job (this is not interesting to blog about, I tried)

5) See friends (I don't usually blog about people I know)

6) Play Racquetball (I'm failing miserably- not blog worthy)



And thats it. Yup.


This entire month of May has not only been very hectic but as my friend put it, "I am a very lucky girl and have many blessings, but sometimes life just keeps slapping you in the face." Thats how I feel. Like I'm swimming in the ocean, enjoying myself one minute- then I get hit by an enormous wave, it knocks me down. I think- OK- I am strong, I can get back up. Big setback but I can handle it. Then I stand back up and there's another wave waiting for me, knocks me down harder. I sit on the ground a little longer this time, wallowing- but get back up more slowly this time. And you guessed- another wave. At this point you're at the bottom of the ocean, sand between your fingers and you're just thinking REALLY?! You remain at the bottom (figuratively speaking- otherwise you'd drown) and try and think of a gameplan. The waves can't keep knocking you down if you just stay down, right?

So within the past couple days, I've been sitting down on the bottom of the ocean, so to speak. I've just recently "learned" that I can swim to shore and just get out of the water. I know success comes to those who go back out and surf (stay with my metaphor here), but sometimes you just need a moment to reflect and sit on the damn sand, dry.

I'm starting to learn that the waves will always be there. But if I want to get out to the peaceful ocean beyond those incoming shore waves, I have to get knocked down first. A lot. And as much as that sucks, I'm okay with that. My defense mechanisms start to turn on and say, "Hey, this is starting to just be comical. Keep it coming! It can't get any worse and eventually it has to get better."

I had a really good April. And so far my June is looking pretty darn awesome....So I just have to sit on the sand for a little and play in the shallow end for a little and remember how lucky I am to have all four limbs, to be alive, to be able to walk, to see, to hear, to have family and friends that love me, a full time job with opportunities ahead, a home to live in, etc......the shallow end isn't so bad.

 Just gotta lay low and roll with the punches.
And laugh about it every once in awhile.
Tell the devil, I really don't give a flying shitwad. Then wiggle.  :-)



~ WNB



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Total Movie Moment

The male cashier at my local Barnes & Noble cafe just knew my complete order-down to my size, type of tea and even my weird preference for only one tea bag in a large cup.

I have never seen him before.


I feel like he's waited for a long time for his moment to do that.

I feel like an unobservant jerk!


But it was one of those total movie moments, very sweet. Blown away!

Then again.....I DO Go there like 3 X a week..... Not sure whose case that helps.


Good story.