Articles Posted in Nursing Care

hospicenyer-300x123What happens when the highly vulnerable — older, sick, injured, and debilitated people — get left in the hands of profit-obsessed private enterprises operating under woefully lax regulatory oversight? Big messes abound, as news organizations have reported after taking deep dives into the workings of the “hustle” of for-profit hospice programs, or the chronic  staffing shortages that prevail at far too many private nursing homes.

Sure, this is a hectic time of the year, and it can be a challenge to carve out the time to pore over the painstaking reporting of fine journalists who race to make public their major investigations before the year’s end (including to qualify for major professional prizes).

Still, for anyone concerned about destructive failures in the U.S. health care system, how they blow up over time, and how they get ignored until they become crises, the reports by ProPublica, the New Yorker, and USA Today are important reading.

ACEP-300x98Almost three dozen leading groups representing a range of doctors, specialists, and other health workers have called on the Biden Administration to deal urgently with the long-running but increasing and dangerous practice of hospitals allowing their emergency care facilities to be overwhelmed because they also are parking patients waiting for rooms and treatment.

This “boarding” crisis, already at breaking points for many exhausted ER staffs, will worsen and imperil patients even more if the nation gets hit — as growing indicators suggest is occurring — with a “tripledemic,” a choking load of coronavirus, flu, and other respiratory infections serious enough to require hospitalization.

The American College of Emergency Physicians (38,000 members), has been joined by the American Medical Association, the American Nurses Association, American Academy of Emergency Medicine (8,000 members) and groups representing family doctors, allergists, anesthesiologists, radiologists, osteopaths, psychiatrists, and many others in a recent letter to the administration, reporting:

minnnursesstrike-150x150The coronavirus pandemic has not only caused sustained damage to the U.S. health workforce, it also apparently has accelerated a looming crisis in nursing care, as has been shown by a three-day strike by 15,000 private-sector nurses in Minnesota.

Theirs was the largest such walkout by nurses and it sought to underscore how pay inequities, staffing shortages, exhaustion, working conditions, and other management-employee issues strike at the heart of the quality, safety, and excellence of direct patient care, the Washington Post and other media outlets reported.

As Kelly Kelley Anaas, an intensive care unit nurse for 14 years at Abbott Northwestern Hospital in Minneapolis, told USA Today of the strains confronted by some of medicine’s most crucial frontline caregivers:

caring-150x150A glaring gap in the U.S. health care system — the giving of care at home — is burgeoning into a costly chasm.  Pretty much everybody involved needs to pay close attention and finally act to deal with the nation’s failure to support home caregiving for the sick, injured, debilitated, and aged.

The consequences of inaction already are becoming clear, as the dearth of home care is smacking the recovering economy, “contributing to labor shortages around the country and playing a role in overall inflation,” the Washington Post reported, finding:

“At least 6.6 million people who weren’t working in early March said it was because they were caring for someone else, according to the most recent Household Pulse Survey from the Census Bureau. Whether — and when — they return to work will play a role in the continued recovery and could reshape the post-Covid labor force. For all the attention on parents — and mothers in particular — who stopped working to care for children during the pandemic, four times as many people are out of the work force, caring for spouses, siblings, aging parents, and grandchildren, according to the Federal Reserve’s latest Monetary Policy Report.

academies-300x90The nation’s nursing homes and other long-term care facilities are in dire need of drastic overhaul to dramatically improve the quality and safety of their treatment of the aged, sick, and disabled. They too often now get what one expert has described as “ineffective, inefficient, inequitable, fragmented, and unsustainable” care.

To repair the glaring, longstanding wrongs in these facilities — problems that critics say contributed to 150,000 resident deaths during the coronavirus pandemic — requires sweeping practical, regulatory, and financial changes in an industry focused on profits and resistant to change, according to newly published expert research report by the National Academies of Sciences, Engineering, and Medicine.

The academies, with members who are leaders in their fields, are private, nonprofit institutions that work outside of government to provide objective advice on matters of science, technology, and health.

convictedtennnurse-150x150While nurses deserve patients’ gratitude and the highest praise for the valiant care they have provided during the coronavirus pandemic, a Nashville case has raised tough questions as to whether and when professional caregivers’ medical errors ought to be criminalized.

Prosecutors decided that some mistakes rise to the criminal level, after considering the evidence against RaDonda Vaught, a former nurse involved in a 2017 fatal drug error.

Vaught, who already has been stripped of her nursing license, has been convicted, NPR reported, of “gross neglect of an impaired adult and negligent homicide after a three-day trial … She faces three to six years in prison for neglect and one to two years for negligent homicide as a defendant with no prior convictions, according to sentencing guidelines provided by the Nashville district attorney’s office. Vaught is scheduled to be sentenced May 13, and her sentences are likely to run concurrently, said the district attorney’s spokesperson, Steve Hayslip.”

calmattersnhomestrandcover-300x256As experts drill down to discover why nursing homes and other long-term care facilities are not playing a vital role in the U.S. health system by admitting improving patients from costly care in overwhelmed hospitals, a disconcerting explanation is emerging on who is filling some of the invaluable institutional space.

They might be called system hostages of sorts, poorer residents of nursing homes and other facilities whose condition has gotten better but who are trapped in institutions for distinct reasons, including the grim reality that they owe money they cannot pay, according to Jesse Bedayn of the nonprofit news site CalMatters. As he reported of the situation in the Golden State and nationally:

“While elder care advocates sound the alarm about patient ‘dumping’ by some California nursing homes — kicking out their mentally ill or bereft patients who need stable housing and care — a parallel dilemma is also threatening vulnerable residents: how to get out of a nursing home. The vast majority of people admitted to California skilled nursing facilities stay for less than three months to rehabilitate a broken limb or recover from a stroke or other ailment, according to the California Association of Health Facilities, an industry trade group. After these short-term stays, residents typically return home. But for thousands of poor nursing home residents … a temporary stay can become indefinite. Saddled with hefty Medicare copayments that can reach $5,000 a month — and later stripped of Social Security income, diverted to pay ongoing nursing home costs — they are often unable to hang onto their former housing. They become effectively stranded, with Medi-Cal and Social Security paying for housing and daily living in the facility.”

baltsunjerryjackson-300x222In the spring of 2020, health workers were serenaded, cheered, and greeted as courageous heroes for their 24/7 commitment to battling the frightening, new coronavirus pandemic.

People — especially New Yorkers with their nightly eruptions — could not contain their admiration and gratitude for medicine’s marvels, with spontaneous and sustained demonstrations breaking out, as one news story reported, “from the Chinese epicenter of Wuhan to the medieval villages of Lombardy, from Milan to Madrid, onto Paris, and now London. There have been standing ovations, too, in Istanbul, Atlanta, Buenos Aires, and Tamil Nadu, India.”

Much has changed in the months since, of course, with the public’s health having become politicized and polarized, including with wild falsehoods and disinformation campaigns.

canursestaffingprotest-300x149The U.S. health care system and all who rely on it may be reaching painful reckonings on how the coronavirus pandemic keeps affecting caregiving personnel, whether with highly trained nurses who are forcing hospitals to pay them more or see them leave or with poorly paid and ill-trained aides who still aren’t getting Covid-19 shots to protect themselves and their vulnerable patients.

Great doctors, of course, may be vital to patients’ positive outcomes. But ask anyone knowledgeable how hospitals succeed — or don’t — and they will point to nurses. And that’s a professional treasure that has been battered by the pandemic,  Kaiser Health News service reported in partnership with NPR and WPLN radio in Nashville, Tenn.

Broadcast news reporter Blake Farmer found in Tennessee and nationally that hospitals are struggling to maintain their nursing ranks, particularly among their most seasoned and specially trained pros. They have spent grueling months giving patients the round-the-clock, intensive care demanded in serious cases, notably for coronavirus infections.

agedcare-300x200Nursing homes and other long-term care facilities keep bleeding staff, and their inability to hire and keep  workers poses significant risks to the well-being of aged, sick, and injured residents — a vulnerable group already savaged by the coronavirus pandemic.

The long-term care industry employed 3 million  personnel in July, which is 380,000 fewer staff than were on facilities payrolls in February 2020, the Wall Street Journal reported of federal labor statistics. Terry Robertson, chief executive of Josephine Caring Community, a long-term-care facility in Stanwood, Wash., told the newspaper this:

“I’ve been in the industry for 40 years and I’ve never seen it this bad.”

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