Minnie the Minx wrote:I’m a bit confused as to the point you are making here.
I read the story you linked to, but have not looked into the follow up story or the specifics of the incident of what the nurse allegedly did or didn’t do. However, not performing follow up checks on a patient who has fallen could happen absolutely anywhere at any time in any setting, from residential through to nursing care and even hospitals. Often hospitals, actually. If the allegations are correct, that’s a lousy nurse. On another day the outcome might have been different.
You seem to be conflating a poor clinical decision from an individual with a systemic issue of financially motivated decisions about care. A person can fall in the best hospital in the land and if you have a lousy nurse, you are toast.
My points are these:
1) Nursing homes often have a pricing policy in which the amount they charge per patient per day is the same, about $10,000/month. Compare this to other businesses. Plumbers don't charge the same amount for every repair they make because the jobs are different. As a result, the way to allocate resources is to have approximately the same amount for every patient. Those that require more care to stay healthy or to recuperate suffer.
2) The one way I can think of for such a patient with greater needs to receive adequate care is for that patient to have an external advocate who monitors the situation and discusses this with the institution.
3) Without such an advocate, the patient, even a very well politically connected one, is at greater risk of receiving substandard care. Of course, it's possible that anyone, even with an advocate, could happen to receive bad care, but medical care is often a matter of allocating enough resources to the task at hand.
Health care is messed up in significant ways in the US. There are hospitals with very good nurse to patient ratios (e.g., 3 to 1), and there are hospitals that are waiting for disasters to happen.
This is a conscious choice made by the hospital management, by the way, and it's motivated by money.
While we're on the subject, if anyone has links to rankings of hospitals by nurse to patient ratios, I'd be interested. I've looked for this, and I can't find it. It's one of the most fundamental attributes of a hospital. It should be as well-known for a medical institution as, let's say, the price of gas is for a gas station.