If you had lots and lots and lots of money

in reality, all of this has been a total load of old bollocks
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take5_d_shorterer
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Re: If you had lots and lots and lots of money

Postby take5_d_shorterer » 12 May 2018, 19:35

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.

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Minnie the Minx
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Re: If you had lots and lots and lots of money

Postby Minnie the Minx » 12 May 2018, 19:44

The point you are making doesn’t relate to the story you shared. A crap nurse is a crap nurse in any institution, and failing to follow up on someone following a fall and falsifying documentation - something that happens alarmingly frequently - could happen anywhere, in the best staffed institution.
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Re: If you had lots and lots and lots of money

Postby take5_d_shorterer » 12 May 2018, 20:06

No, it does.

In an extreme case, an advocate would simply be there full time, and that would help address circumstances such as the one that McMaster, Sr. endured.

The timeline, by the way, regarding this tragedy is very unfortunate. McMaster, Sr. had a stroke in early April. McMaster, Jr. was fired by Trump from his position about the same time, and officially resigned on April 9th. Then McMaster, Sr. fell and died on April 12th.

Given the demands of dealing with the current president, I doubt McMaster, Jr. had any time at all to advocate for his father's health concerns. His wikipedia entry notes that he intends to retire from the military this year. Had his father had the stroke after his retirement, he would have been far more able to attend to his father's health.

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Re: If you had lots and lots and lots of money

Postby Minnie the Minx » 12 May 2018, 20:25

Ok. Your last post has a sentence that leads me to better understand your point, that of someone being there ALL THE TIME. Which wasn’t clear in your other posts.

Of course, having someone constantly by your side is a possibility. If that’s what the patient wants. It would drive me fucking nuts, but each to their own.
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Re: If you had lots and lots and lots of money

Postby sloopjohnc » 13 May 2018, 05:23

take5_d_shorterer wrote:
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.


I was listening to a fairly progressive religious leader on NPR today and he said something funny, and I paraphrase: I don't remember Jesus charging a co-pay when he cured lepers. Our medical system is messed up.

Having gone through the whole senior care and resident home hoo-hah with my dad, and talking to other folks, it takes a crap load of money to be old in the US and get adequate care. And my dad had good coverage. I had actually convinced him to take out an specific elder care insurance policy years ago, which paid 80% of his care. If he had lasted longer than a year, we would have had to use all his annuities and then some. I had a friend whose mom lasted 10 years in a resident home with Alzheimer's.

But I know people who've had to sell or get a second mortgage on their folks' homes to pay for it and use up the entire parents' savings.
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