health care


As this morning progresses, I have to admit being in the midst of a quiet torture.  Let me back up a minute.  I moved into a job at work requiring me to call individuals who leave the hospital without a primary care physician and offer them care from our clinic.  If they have a primary care physician out of our area or with a different group, ensure that they are being seen for a follow up to the hospital visit.  Next detail is that our insurance requires a PCP.  I have come to realize that were the occurrence such that I had a hospital visit, my name would be on my list.  I suppose it would be easy to call myself, but decided to be proper and establish care with a PCP.  The physician was chosen and date set.  This doctor also decided to do labs ahead of time.  I don’t know how much of what is being taken, but do know they are supposed to be fasting, so have started this day being “good” in anticipation of having a needle remove some of , well, you know the rest.  So here I sit doing my morning routine without the coffee – as I had wonders about my willpower were a pot made.  The cafeteria may have breakfast available – with coffee – and I’m going to find out this morning after being drained.

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I had a new employee at work assigned to me for the task of introducing our system of visits and charting. This employee and I had time in the truck to talk and during the conversation the subject of hours came up:
NE: Yes, I have odd hours at my other job. They total 35 hours and that is called “full time”
ME: The reason they call it full time is because that was mandated in Obammacare.
NE: Really?
ME: Yes, and further, when employers who have low wage workers are required to provide the benefits of full time, they will cut the hours to 28 or fewer. This will force the workers to get two part time jobs to make a living, and at the end of the year, the government will fine them $2000 for not having insurance.
NE: I see why you call him zero.

County songs have a classic reputation given by the old question: what happens when you play country music backwards? You get your wife back, you get your kids back, you get your dog back, you get your job back, etc. I told that to a fellow worker and was informed, “leave my country music alone.”
A couple of those style songs express the idea of longing for the end of work. One I especially found disturbing was 5-o-clock somewhere. The time I listened to the lyrics, describes someone who has to be drunk at noon to finish the day.
How sad.
How about working for the weekend? Again, work is something required to be done and once that bitter pill is swallowed, the enjoyment of the weekend can be had.
What would it be like to go to work and actually enjoy the day? How would your outlook be if doing something all day that satisfied one’s desire to produce?
One concept from the “Underground History of American Education” was the need for corporations to produce laborers for their factories who could do meaningless labor all day. School was designed with that desire in mind, down to the requirement to change one’s focus whenever the bell rings.
The point of this effort was to remove dependence upon craftsmen and focus desire on mass production. This put more emphasis on the item produced, or later wanted, and reduced the desirability for individually produced products. For the corporation, this was the ultimate manufacture of a market, and for the craftsman, this was the deathnell of their trade.
The personal cost of this trade was noted in the Underground History and that is the loss of the person’s ability to spend their day producing something of real value.
I used to work in a car plant. On the assembly line, I placed certain parts on the car, and repeated that same procedure every minute all day. The work was so boring, I tried to come up with ways to mentally make it through the day. ex: figuring a way to raise the Titanic with compressed air. This required a series of compression stations at progressively lower depths until the pressure could be released into the hull and cause the ship to raise.
Practical? Not at all. But it was an exercise I remember doing to get through the day.
I made spouseinbox a foot box for Christmas. This involved obtaining the wood, cutting, sanding, using a Dremel to decorate, and then staining and varnishing the completed box. Comparing all my time on assembly to the box I would note that the pay on assembly was much greater, but the satisfaction of presenting the box was so much better because the work was personal, complete, and I had actually produced something entirely by myself. The box was useful, fairly good looking, and more importantly – I made it.
Back to the idea at the top, imagine being able to do that sort of labor through the day all week. For myself, I have stayed in my level of nursing precisely because the next step up on training gets a phenomenal amount of paperwork and less patient contact. Enjoyment of patient contact is why I do what I do. So I am a lucky individual to enjoy my work through the week and not have to look forward to the weekend except in the need for extra time to catch up on household items.
I can only wish similar for others.
For reference:
http://www.madehow.com/Volume-1/Automobile.html (background section)

Start with the idea that deficit spending will lower the deficit.
*cough* *ahem*
Don’t forget that adding 15 million additional individuals to the care rolls also won’t add a problem.
*cough* *ahem*
Oh, and remove 1/2 of the funding for medicare to provide for all the additional services and it will be deficit neutral.
*cough* *gag* *ahem*
Now to real life:
http://www.villainouscompany.com/vcblog/archives/2010/08/myths_of_obamac.html

I have used the old nursing joke with a patient. Nurses normally don’t have a decent regular schedule, and as such can get lost in the day of the week. With that background, “You know you’re a nurse when…you are doing a set of neuro checks (date, time, etc) and don’t know the answers yourself.”
I have a new one to add to the lexicon. You know you’re a home health nurse in West Texas when….you leave a patient’s house and hit a buzzard. After the bird has been dispatched, you turn the corner and run over a rattle snake.
(the snake was already dead)
OK
(four feet)
I just helped in the decomposition cycle.

Shamelessly stolen from http://www.mostlycajun.com
This expresses the situation well.
You Passed Something

I am a nurse and as such have a different kind of work than the average bear. The following tale is changed appropriately, with HIPPA in mind, but the point is maintained.
I was working on a surgical floor some time back and was required to change a wet to dry dressing. For the uninitiated, this is a dressing that is put on wet, allowed to dry, and then pulled off to remove the dead tissue underneath. It’s not the most pleasant procedure, and that is compounded by the fact that there is a problem that required it in the first place. Anyhow, I went in to said patient with an RN as assistant and removed said dressing. Now getting into the nurse’s point of view, I like to see a wound that has good color, absence of active bleeding and other undesirables – eschar (dead tissue), drainage of whatever the color and no odor is definitely a plus (in more than one way.) This wound had good color, great granulation (beginning of scar tissue) clean of the undesirables, as well as no drainage. I thought it looked wonderful, as wounds go, and proceeded to tell my opinions to the RN who voiced the same. In midcomplement, I looked at the patient to realize, to my surprise, the look of horror and hear the words, “I can’t believe that’s my arm.” (We were looking down into the muscle) Nix the conversation, let’s get this one covered. I’ve carried that experience with me through the years and have endeavored to only give the patient the amount of information needed/wanted.
Note, I said endeavored. I’m still the one who asked for an epidural for a surgery so I could be awake and have the doctor describe what he was doing through the repair. He must have had words with the anesthesiologist, I was asleep through the surgery. Bummer.

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