WhiteCoat

Healthcare Update — 02-28-2011

Also see the satellite edition of this week’s update over at ER Stories.

Its about time. California hospitals fined by California OSHA for failing to protect workers from violence in the emergency department. The hospitals claim that the California Nursing Association is “sensationalizing” the fines in order to “apply pressure at the bargaining table.” Have to admit that some “safety issues” claimed by the nurses are a little lame. Being cited because nurses “feel unsafe” when caring for a gunshot victim?

Step in the right direction. Virginia passes law making it a misdemeanor and requiring jail time for anyone convicted of assaulting emergency medical providers. A minimum of two whole days in jail, though? Whoa. That ought to send a chill through the spines of all those patients gone wild.

Speaking about patients gone wild …. Patient in upstate New York hospital arrested and charged with a misdemeanor after punching emergency department staffer in the face and breaking the staffer’s nose.

74 year old Chicago-area perv charged with aggravated criminal sexual abuse after putting sleeping pills into fruit drinks of his home healthcare providers … then sexually assaulting them after they fell asleep.

$1.7 million verdict against physician who fails to diagnose episode of chest pain as being due to a “leaky valve”. The patient died a year later – allegedly from failure to have a replacement valve inserted.

FDA “crackdown” on drug safety – for many drugs that have been on the market for years – now causing drug shortages as manufacturers get tied up in governmental administrative hassles and discontinue drug production. Other pharmaceutical companies stop producing generic drugs because of the low profit margin. Right now, there are 150 drugs in short supply – including 60 medications that are “medically necessary” for treatment of cancer and other serious diseases. I wonder whether we’re beginning to see an unintended consequence of WalMart’s $4 list.

11 year old Arizona girl ends up in emergency department with severe head injuries after the “bounce house” in which she was jumping gets blown over by a strong gust of wind. Well, not just blown over, but actually swept away … they had to rescue the poor kid from a neighbor’s roof.

Arizona Senate panel votes to kill patients … er, um … kill Medicaid … and forgo $7.5 billion in federal funding for the state Medicaid program. Currently, Arizona Medicaid covers about 1.3 million people – roughly 1 in 5 residents in the state. The proposed program would cover only about 100,000 patients and leave the remainder to fend for themselves. One state senator predicted that “by Christmas time, there will not be a rural hospital open in the state of Arizona.” Another state senator stated that “we’re going to see a real influx of demand for uncompensated care in hospitals and our emergency rooms.”
Once again, the difference between “insurance” and “access” will soon become readily apparent to many Arizona residents.
If Arizona goes through with its plans, a lot of cash-strapped states will be closely watching to see how Arizona’s state finances are affected.

Use alcohol sanitizers on your hands, get the trots. One study presented at the Annual Meeting of the American College of Preventive Medicine shows that you’re more than three times as likely to get a norovirus infection when you use alcohol-based hand sanitizers. Use soap and water instead.

Government plans to spend $4.3 billion to move patients out of long term care facilities and into their communities in the “Money Follows the Person” program. Wonder if JCAHO will then start crawling up the caregivers’ collective rectums to “ensure patient safety.”

 

13 Responses to “Healthcare Update — 02-28-2011”

  1. tracy says:

    i knew there was a reason i always avoid those hand sanitizers at the store, etc…besides the fact that i don’t care about germs. Ewww, i sound nasty, don’t i? i’m really not so bad, i do wash, believe me! ;) Soap and water!

  2. D says:

    I wouldn’t dismiss the complaint of nurses caring for the gunshot victim. The article says they felt “unsafe while tending to the victim outside.” In Oakland. I don’t think I’d feel safe either.

  3. Anonymous says:

    “The proposed program would cover only about 100,000 patients and leave the remainder to fend for themselves”

    Finally. Couple this with a law bringing EDs back to being for E’s and not the kind of cases that could in a blue moon unicorn fairy be an E if you do a billion dollars worth of diagnostics just to make sure.

    “shows that you’re more than three times as likely to get a norovirus infection when you use alcohol-based hand sanitizers. ”

    As a college student, I use hand sanitizer probably around 10 times a day. I haven’t had any illnesses in the last 2 years.

    RE: The leaky heart valve, what you fail to mention is that it was known he had a heart valve problem before he had chest pains. Thus I agree with the jury, doc f-ed up.

    • DensityDuck says:

      “As a college student, I use hand sanitizer probably around 10 times a day. I haven’t had any illnesses in the last 2 years.”

      I carry a magic rock that repels tigers. I haven’t been eaten by tigers at any point in my life.

  4. girlvet says:

    Don’t be so quick to dismiss the nurse not feeling safe. I’m not sure where you work but shootings are often gang related and the staff has every right to feel unsafe. You don’t know if the homies are gonna come en masse to the ER.
    Lots of hospitals don’t have very good security.

  5. WhiteCoat says:

    To D and Girlvet –

    I would presume that if there was more to the “unsafe” conditions than the nurses’ subjective feelings, OSHA would have mentioned it in the citation.
    There is a big difference between a subjectively feeling unsafe and objectively being unsafe.

    Imagine that you run a hospital. What affirmative steps should a hospital be required to take to ensure that every employee “feels” safe at all times when they are on the job?
    In this article, the nurses felt unsafe tending to a patient in at the front of the hospital which is the same entrance that hundreds of patients go through every day. Does the hospital now need to establish a military presence at all points of entrance so that everyone “feels” safe?

    Kind of like giving patients disability because they “feel” like they have had strokes. No focal deficits. Workups are negative. But in the patient’s minds they feel as if they have had strokes and they deserve disability.

  6. Matt says:

    “Step in the right direction. Virginia passes law making it a misdemeanor and requiring jail time for anyone convicted of assaulting emergency medical providers”

    Not really a step in the right direction. There are enough laws on the books, and assault has always been a crime. The only thing that changed is that the jail time is mandatory (although it doesn’t say if it can be suspended). Either way, if you’re going to knock around an emergency physician, you’re probably not all that concerned about a misdemeanor or a weekend in county.

    There was no need for this law, other than some special interest lobbyist wanted to say they were doing something.

    • Nurse K says:

      Hey there Matt, in your job, are you mandated by Federal law to lay hands on violent, labile drunks and crack addicts and “help” them whether or not there is adequate security around to help you? (At my hospital, I think it’s pretty adequate, but sometimes people just flip out unexpectedly or whatever).

      Trust me, I’m not really excited about leaning over a crackhead with Hepatitis C and starting an IV with a sharp needle when they’re cursing at me. Outside of the ER, these people would just be arrested and removed. It would be as if everyone who is screaming, cursing, and throwing things in a grocery store was mandated to have a personal shopper walk with them around the store and then not make it a crime when that person gets smacked.

      If the government is forcing me to be in harm’s way or else, they should lock up anyone who smacks me around. I think it should be a felony as it is in some states, especially if bones are broken, but whatever.

      • Matt says:

        Not in my job, no. There are legal jobs where you must sit in a room with the worst of the worst, but I didn’t choose that one.

        You’re a nurse, and it sounds like you chose an area of nursing you don’t like. But there is great news for you – there are a ton of nursing jobs where you’re not subjected to whatever federal law you’re referring to.

        And it would likely be felony battery in almost all states if a bone was broken. You don’t need this extra law specifically naming you for that. The only thing this did was put a mandatory weekend in jail on a misdemeanor. It seems to be just more useless legislation, unless there are a bunch of people getting fines and no jail times after attacking ED personnel. I’m not aware of many judges who think so lightly about that, but perhaps in that state there are.

        I don’t know about you, but I think we’ve got enough laws.

      • VA Hopeful says:

        It seems like that was just something put into place to make sure people who abuse ED staff actually get some kind of punishment. Often times nothing is done in cases like this, even if the police get called.

      • Hueydoc says:

        So what’s the charge for assaulting a judge ?
        Bet it’s a lot stiffer than 2 days.

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