It’s an odd thing, to take care of someone who is chained to a bed, guarded 24/7 by bored corrections officers idling away time with TV and card games, who cannot receive visitors or even phone calls. But it happens when prison inmates are sick enough that they need care that only a hospital can provide.
Sometimes it’s the doctors, not the families, who can’t let a patient go.
“What if we gave her some aloe vera gel?”
The question was from a thin woman, and though her query came out of desperation, her face was pinched with fury. She was a relative of the patient in the room, a young woman who was dying of an infection.
A classic “Far Side” cartoon shows a man talking forcefully to his dog. The man says: “Okay, Ginger! I’ve had it! You stay out of the garbage!” But the dog hears only: “Blah blah Ginger blah blah blah blah blah blah blah blah Ginger …”
As a nurse, I often worry that patients’ comprehension of doctors and nurses is equally limited — except what the patient hears from us is: “Blah blah blah Heart Attack blah blah blah Cancer.”
My patient was shaking uncontrollably. People say such shaking feels unbelievably bad, but rigoring, as the medical profession calls it, is treatable with the narcotic Demerol. I hurried to the computer to order some from the pharmacy, thinking “rigors = Demerol.”
For several hundred patients at the University of Pittsburgh Medical Center, it started with a certified letter informing them that they were no longer allowed to see their physicians. The reason? They were unlucky enough to have insurance called Community Blue, which is offered by a rival hospital system. Astoundingly, they were barred even if they could pay for the care themselves.
We nurses all have stories — if we’re lucky, it’s just one — about the time we failed a patient. It’s usually a problem of being too busy: too many cases, too many procedures to keep track of until one critical step, just one, slips through our frenetic fingers and someone gets hurt.
In late October 2010, Amy Berman, a registered nurse and a senior program officer at the John A. Hartford Foundation in New York City, received a diagnosis of Stage 4 inflammatory breast cancer. This Stage 4 cancer is always metastatic, meaning it has spread to other parts of the body. There is zero probability of a cure, though five-year survival rates vary for individuals.
The visceral phrase “skin in the game” keeps popping up in discussions of American health care policy. It’s the idea that if patients spend their own money on care, they will spend it more carefully, and health care costs will go down. Conservatives worry that as the government becomes more involved with health care, patients will become less responsible about costs because the money being spent — their “skin” — is not their own.
Wisconsin, Aurora, Virginia Tech, Columbine. We all know these place names and what happened there. By the time this column appears, there may well be a new locale to add to the list. Such is the state of enabled and murderous mayhem in the United States.