Obamacare: A Nurses Perspective

I tried to warn everyone about Obamacare.

As an RN for over thirty years I can factually tell you more government regulations and laws do not give you better care at a hospital, or in any healthcare setting. If anything the more rules they make for caregivers and facilities the less the focus is on you, the patient.

I personally refuse to work for any hospital anymore.  Why?  Because I did not enter the profession to work hours on providing regulated documentation for the government. I do not want to document things in triplicate with the nanny state dictating how I should care for you if you are my patient.

I do not want to sit through constant “orientations” on how to do everything except wipe a patient’s rear end.

Of course, now that I have said that, I’m sure some government bureaucrat will now focus on that study for a cost of over $150K a year and will write a volume on “How Hospitals Should Wipe Rear Ends.”  They will then hire ten additional government union employees for this study, at salaries and benefits of 1.5 million, not including computers, office space, electricity, etc.  For 5 years they will discuss Rear End Wiping, write a manual, and implement the Wiping department nationally and $10 MILLION later we still have not solved any healthcare ills…

The days of having time to care for your patients are over. The old days when I had four times the amount of patients, they got better care and saw more of their nurse.

Nowadays you will be lucky if the RN has time to spend half an hour with you during her entire 8.5-hour shift (and good luck getting good healthcare with that ratio…).

During admission the RN will ask you approximately 15 pages worth of questions. She will then get your vital signs, weight and then she has to put together the “CHART”.

The Chart is considered a legal document, so next she has to call an MD to get the MD orders. Sounds simple, huh? Well, the MD has to see the patient first before giving orders; he can’t simply give you a telephone order or verbal order. So in the meantime you have other patients and pharmacists, visitors, and other distractions. You practically have to document a novel just on admission.

The questions on admission are about almost anything you can imagine, including sex behavior, drug history, your family history and on and on…and on.

This is only the admission part.

The RN also has to do a “plan of care” for the patient and because this is considered a legal document, every “t” needs to be crossed and every “i” must be dotted and you must be very careful because basically you are a legal HOT POTATO while you’re lying in that bed, sick as a dog.  If I were to mess up your paperwork, the hospital can be sued, fined or lose Joint Commission of Hospital standing.

Nurses have to think legalities at every turn and twist. Documenting is one thing, but writing a novel on each patient according to government paperwork is quite another thing.

To add insult to injury, they will probably discharge you the next day, despite the fact that you’re still sick as a dog and you will have to start all over with a new ER visit—so you may as well get in line right away…

Everywhere you turn in any U.S. hospital an RN will see signs that the average person doesn’t even notice. “Hazardous waste” is one. The government, in its infinite wisdom, thinks you need to be oriented on how to put a needle in a “sharp container”. The unfortunate thing is professionals are treated like idiots by the regulators who oversee how hospitals are doing things.

All of these layers and “checking” create maximum bureaucracies for our already monolithic government agencies. Ironically, the only type of work they ever actually do is constantly justify their own existence and reinforce the need for more government and more regulation.

However, they can afford to be as inefficient and useless because our tax dollars seem to be infinite with them.  These multi-tiered agencies and their meddling “wisdom” is a bottomless pit that only our government can seem to afford.

In the old days we seemed to do more without being told how to do it via regulations. Now we even have duplicitous regulations on both the Federal and State sides. Somehow in the private sector– before all the regulations took over– we avoided lawsuits by doing things the right way without being told how to via regulations. Amazing, huh?!

Trust me—nothing is run more efficiently with more government involvement.  Nothing!  If you gave them all the money and power (aka Obamacare…) to decide what is needed in order for you to do your job, you would never get anything done.

Amazingly, the government does not seem to be regulating itself.  It can remain as inefficient and as behemoth and costly as it wants to be because of all the lawyers involved.  Yes, we can thank the lawyers for making government big, and making themselves rich in the process. Lawyers sue hospitals for anything and everything from the inside via government attorneys and the outside via private attorneys. It is a big giant prosperous game.

This is why your penny aspirin costs you $20.00. You have to factor the regulatory fees as well as the lawyer’s fees.

My last job was in Home Healthcare as a visiting RN.  They have regulations there, too.

How is it they have managed to make all the paperwork and questions for every visit by an RN easier for the Input Clerk and the government?

Yes, you read that right:  The paperwork is geared for them, not the patient– and most certainly not the healthcare professional.  Almost one hour of documentation is geared toward the government.  Forget the patient and what is pertinent; you have to get through 15-20 pages of non-pertinent information and checklists.

Four years ago I was able to see 8-10 patients in their homes and complete their documentation. Now the new “government approved” documentation is so tedious and burdensome I was lucky to see FOUR patients per day in order to complete my burdensome paperwork! Good job Feds and Obama-NO-care, you just cut my efficiency by half– and because I was paid per visit, my salary, too! Factor in the high gasoline prices and I can’t make any money as a home healthcare RN!

Patients who need more than three RN visits—like if they have a wound, an IV, or some appliance, for which they need teaching, still only get those three visits.   Even if you just had your chest cracked open for a quadruple bypass it doesn’t matter—the government and insurance companies have decided you get THREE visits, period.  And sadly, I am sure they will eventually cut that down too in the future to hasten our demises.

It doesn’t matter what is “good for the consumer/patient”—nahhh, things are just hunky dory.

And if you’re an RN, if you try to get more visits for your patient you’ll have to jump through flaming hoops, deal with endless phone calls and even then you might get ONE extra visit authorized.  You have to maneuver through endless agency mazes simply to get your patient the basic care they need.  And if they make the paperwork even more burdensome with Obamacare, you may DIE waiting for authorization.

It is truly disgusting how those of us who pay for private insurance get the even shorter end of the stick, but that is a whole different spiel for another day.

We do pay for this with our lives—literally– and our pocketbooks.  Meanwhile I am sure the manual on “How to Wipe a Rear End” is busily being typed and discussed as we speak by the nanny healthcare government agency called Obamacare.  It will probably cost us taxpayers and extra $50 million just to implement the new rear-end-wiping regulations nationwide. I can’t wait ~ NOT!