Reality Rounds

Get a Second Opinion

Archive for March, 2009

Electronic Medical Records, HIPAA, and Octo Mom

Posted by realityrounds on March 31, 2009

pmc0107

I am not surprised this happened:  15 medical workers at California’s Kaiser Permanente Medical Center were fired, and 8 were disciplined, for violating HIPAA regulations for peaking at Octo Mom’s medical records.  It appears no information was leaked to the media.  It is currently unknown what type of employees were fired and what ones were only disciplined.  I am curious as to why some were fired and others “disciplined”My guess is that the eight employees who were “disciplined” were doctors, and the 15 who were fired were nurses and/or ancillary staff.   Just an educated guess based on hospital administration status quo.

Anyone who has worked in a hospital or health care for the last five years has had HIPAA regulations jammed down their throats.  It cracks me up seeing stories of hospital workers reading the electronic medical records   of celebrities (George Clooney, Farah Fawcett, Britney Spears etc).  You are being stupid, and you will be caught.  I wonder if it was worth it for those 15, now unemployed workers at Kaiser.  Could it have been that interesting reading about Octo Mom’s C/S operative note, or fundus checks, or care plan?  Most medical charts are relatively boring and dry.  Unless there is a note by Social Work, those tend to be fascinating.

It makes me wonder why it was so easy for those workers to breech the EMR of such a high profile patient. There should be a way to only allow access to Octo Mom’s primary care providers and no one else. I am not forgiving those employees for purposely violating HIPAA, but come on, some of this is just human nature.  Their curiosity got the best of them, and now they are receiving unemployment checks, just like Octo Mom herself.

This to me is an example of the hugely flawed EMR system.  There has been a huge push and vast amounts of money allocated by the current presidential administration to promote EMRs.   I am all for advances in technology, but not at throwing money at a currently flawed system.  Electronic Medical Records needs to be starting from scratch.  I heard of some systems which are very efficient and easy to use, I personally have not been introduced to these yet.

If there are any tech-geeks reading this post (highly doubtful I know.  I can’t compete with engadget) let me know what EMR technologies are being developed.  Is there something out there now that is easy to use?

RR

Posted in health, healthcare reform, nursing, politics | Tagged: , , , , , , , | 7 Comments »

Realities of Being a Nurse

Posted by realityrounds on March 29, 2009

Let’s face it.  Nurses deal with the public day in and day out.  We see all the good and bad of what humanity has to offer.  If you have been a nurse long enough, you have probably encountered threatening and violent interactions with patients.  I personally have had 6 foot tall gang bangers yelling in my face, an irate dad bringing a gun to the NICU to prove a point, and a patient kicking me in the stomach and throwing a drawer at my head.  I have been purposely pissed on, spit on, and almost shit on.

My question is this:  Are nurses obligated to put up with this kind of abuse?  I often wonder because the profession is dominated by women, that we are expected to just “deal with it”.  I am going to take the leap of faith and say that if nursing was a male dominated profession, this kind of abuse would not be happening.

One enounter of mine with a father of one of my patients is still embedded in my head.  This particular father was pissed off about how his wife and infant were being cared for.  I played the perfect customer service queen and attempted to provide “service recovery” with this family.  “What can I do to make this better?”  “Is there anything I can provide to make you more comfortable?”  “How can I personally assist you in making sure you have everything you need for your wife and child?”

The father’s answer to my questions:  “You are a nurse.  If I ask you to wipe my ass, you better wipe my ass.  That is your job!”

God, if I only could have said what I wanted to say to this jag-off, without losing my job.  No one should be talked to like this.  Why do we allow it?

*This post is written in honor of the nurse who lost her life while on the line of duty.  May her and her family find peace in this tragedy.  cnn
RR

Posted in health, nursing | Tagged: , , , , , | 16 Comments »

Researching the Obvious

Posted by realityrounds on March 28, 2009

p4255668

A study in England found that :

Traditional parenting methods that focus on breastfeeding, disclipline and high expectations are most likely to produce well-adjusted and able children, a study has shown. Telegraph UK

So I guess the modern parenting methods of formula feeding, leniency and low expectations will lead to mal-adjusted and disabled children.

I know common sense cannot be legislated or taught, but do we really need a research study to highlight the obvious?

BTW, England has one of the lowest rates of breastfeeding in Europe.  What gives limeys?

RR

Posted in health, infant health, moms, research, useless research | Tagged: , , , , | 3 Comments »

Pets: Public Health Hazards

Posted by realityrounds on March 27, 2009

I will hurt you!

I will hurt you!

The CDC is reporting that over 86,000 people report to the emergency room because of falling over Fido.  Scientific American It appears pets are public safety hazards.  Thousands of unsuspecting pet owners trip over their furry friends and break all sorts of bones and body parts.

What a bunch of klutzes.  I mean really.  Who could be so spatially challenged that they can not recognize when their pet is at their feet?

Yes, the answer would be me.  I admit I am a CDC statistic.  I once fell down the stairs, tripping over the evil cat pictured above, and falling flat on my ass.  I could barely walk after.  While at work, I was instructed to visit the ER, where they did the one thing they should not have done,  X-Ray my butt.  Turns out I had a broken coccyx, which should be diagnosed by history and symptoms, not by a butt X-Ray.

I may be posting that cat for sale on EBay, if anyone is interested.

RR

Posted in health | Tagged: , , , , , | 7 Comments »

President Obama Gives a Shout-Out to Nurses.

Posted by realityrounds on March 27, 2009

As noted in a previous post (The Incredible, Invisible Nurse), I discussed how nursing is often absent in any and all media coverage of health care.  We are the pointless individuals in medical TV shows, who hand doctors stuff, are mostly mute, and roll our eyes at the nurses’ station.  Rarely are our opinions asked regarding anything to do with health care.  (Thank God for blogs).

So, when the leader of the free world gave a shout- out to nurses in his first on- line town hall meeting, I almost pissed in my scrubs.  Oh come on, like you have never almost peed yourself on one of those 12 hour shifts with no break. President Barack Obama took a question from a nurse regarding nursing representation in health care reform.  Nurse Linda was unfortunately a little bit too fawning and star struck in her presentation, but at least she brought nursing to the forefront of the national media.  Here is their exchange:

Q My name is Linda Bock and I’m a registered nurse just in Prince George’s County, Maryland — been there 34 years at a free senior health center. And I’m here with my fellow nurses from SEIU. First of all, thank you for listening to us, because as nurses we do listen to our patients all the time. We’re their advocate. And so we appreciate this opportunity for you to hear from us.

One of the things we want to make sure is that nurses are represented in the health care forum committees — reform committees because we want to be there on behalf of our fellow nurses and on behalf of the patients that we sometimes have to speak up for. So I really hope that we can be there so we can push the things like prevention and education that are so very important so that we don’t use our emergency rooms for their doctor visits and that we have more community-based health centers for those that are in need. And I just — I really appreciate this opportunity to be heard.

THE PRESIDENT: Well, I appreciate that. I guarantee you nurses were part of the health care summit, and they will be at the table in all these discussions. I’m biased toward nurses, I just like nurses — (laughter). When Michelle and I went in and Malia was being born, the OB/GYNE was a close friend of ours and so was much more attentive than the usual OB/GYNE might be. But the fact is, we only saw her for like 15 minutes. The rest of the time, it was nurses who were doing everything. When Sasha, our little precious pea — (laughter) — she got meningitis when she was three months old — very dangerous. The doctors did a terrific job, but, frankly, it was the nurses that were there with us when she had to get a spinal tap, and all sorts of things that were just bringing me to tears.

And we’ve got a problem in this country, which is we have a shortage of nurses — makes no sense, given this unemployment rate. But the reason is, is because the pay of nurses, the hours of nurses, the quality of life of nurses, the fact that nurse professors are even worse paid than the nurses themselves, so that you get these huge bottlenecks in terms of training as many nurses as we want.

All these issues are part of the inefficiency of the health care system that has to be fixed. And the more we’re emphasizing primary care, preventive care, wellness — all of which will save us money in the long term — the more that we can deploy nurses as the troops on the front lines in ultimately driving down some of these health care costs.

So I think it’s very important that nurses are a part of this process.

(For full transcript, click here:  NY Times)

Again, the interaction to me seemed a little bit staged, with the mention of the union to the presidential butt-kissing approach to the question.  (What the hell was her question anyway?).  But, this is all besides the point.  It was so refreshing to see the importance of nursing mentioned on the national stage.  Regardless of your politics, I am hoping nurses were thinking, finally!

I am glad that President Obama is “biased” towards nursing, because I sure am.  It is about time someone in power is.  Maybe it takes a person who has actually had to deal with multiple hospitalizations to realize what the heck it is that nurses really do.  Nurses are anything but invisible in the hospital setting.  As the president pointed out, it was nursing who helped his wife bring a child into the world, and it was nursing that was present at the bedside, supporting his family during a medical emergency.

Put your call lights on and answer me this:  If you had the opportunity, what would you have asked the president regarding nursing/health care at the town hall meeting?

RR

Posted in health, healthcare reform, politics | Tagged: , , , , , , | 14 Comments »

A Fish Tale

Posted by realityrounds on March 25, 2009

Warning:  Do not eat the fish swimming in water treatment plants.  I know it is tempting to caste your line in the waters that filter out all the shit, pee, vomit, puke, or anything else that you flush down the toilet. But, it turns out the little fishes swimming in these plants are drug addicts.  I kid you not.  These fish are chock full of anti-depressants, anti-seizure drugs, anti-hypertensives,  and pleasantly, pretty, pretty fragrances found in perfumes.  Chicago Tribune

I say “Hooray for Fish!”  The only type of fish I want ta eat are happy, non-spastic, low-blood pressured, nice smelling shit eaters.  Hooray for Fish!

Seriously, what is the problem with all the environmentalists out there?  It is only a good thing to have fish hopped up on the drugs we dump in the toilets and “dump” in the toilets.  Americans are grossly under medicated.  We need more and more and more and more drugs to survive.  Fish deserve the same treatment, dammit.

I would have liked to have made this story up, but alas, it is not a Fish Tale.

RR

Posted in health | Tagged: , , , | Comments Off

Natasha Richardson’s Gift of Life

Posted by realityrounds on March 25, 2009

I have always been a proponent of organ donation.  The back of my driver’s license is signed as a donor.  Is yours?

In a previous post I talked about how Natasha Richardson’s death had really affected me.  I find solace in the fact that she and her family have decided to donate her organs after her untimely death.  I hope this act will encourage others to do the same thing.  For me, I feel like it would give me and my family peace to know that in my death I allowed others to live.  In death, there is life.

RR

Posted in health | Tagged: , , , | Comments Off

Manic Depressive Infants

Posted by realityrounds on March 24, 2009

Fascinating medical research from my favorite source of news, The Onion.  As the not-Pulitzer prize winning paper reports, 98% of babies are manic depressive.

I knew it!  How else do you explain those little psychos?  Crying incessantly one minute.  Smiling non-stop at the cat the next minute.

I see a Nobel prize in the future for these scientists.

RR

Posted in Onions are Good for Your Health | Tagged: , , , | 4 Comments »

Octo Mom: “I don’t need no stinkin’ nurses!”

Posted by realityrounds on March 24, 2009

Oh Nayda, how you disappoint me.  Lately I have been writing with a more sympathetic tone about your vida loca.  Then ya had to go and do this:    Fire Nurses!  Oh no you didn’t!

Nayda fired the nurses who were working with the Angels in Waiting organization, because she felt they were spying on her (paranoid anyone).  She believed the nurses were reporting her to child welfare workers about the situation in the home.  KTLA

Octo Mom of course has a right to fire anyone working for her.  It is her home, and she can do what she wants, to a point.  The hospital would only release the infants if she had enough caregivers and a safe home environment.  Thankfully, she has hired other nurses on her own dime, provided by the hospital the octuplets were born at.

I hope Nayda realizes that all nurses are state mandated reporters, meaning they are obligated by law to report any evidence of child abuse or neglect.  These new nurses will be under the same obligation as the Angels in Waiting nurses were, to report unsafe conditions.  She will not get a free pass.

On a side note, the above link includes a video from Radar Online, with the Octo Mom discussing Octo-Daddy-Sperm-Donor-Dude.  It is beyond disturbing to me.  The interview is lit up like something out of the Blair Witch Project, in a weird black and white, eye glowing sort of way.  Nayda is lying seductively on her bed, propped up on one arm.  She keeps tossing her hair, playing with her shirt, and giggling.  She is very coy and flirtatious with the interviewer and appears to love the attention.  I don’t know why, but she reminds me of the Joker in Bat Man (Why so serious?).

Watching this video confims my belief that I could never be a home health nurse.  God Bless you home health nurses out there.  How do you do it?  I would only be able to put up with this broad for about 5 seconds.  I have heard horror stories of home health nurses having to deal with drunk amorous fathers, cock roach infested homes, garbage strewn living rooms, and pulling up to gang ridden projects.  One nurse told me she had an armed police escort to one apartment she had to visit.  I suppose dealing with Octo-Mom and Radar Online crews would be mild in comparison.

RR

Posted in health, multiple births, nursing | Tagged: , , , , , , , | 3 Comments »

Center of Nursing Advocacy to Close

Posted by realityrounds on March 23, 2009

Sad news for nurses.  The Center of Nursing Advocacy is closing.  This was a site dedicated to improving nursing image in the media.  They often reviewed media stories across the globe, and analyzed how nurse-friendly they were.  Their goal was to try and increase the global image of nursing.

The Center offered this explanation as to why they are closing:

It is important for you to know that this decision was a difficult one and was the result of thoughtful deliberation on the part of every Board member. The Center’s records were in disarray, the Center’s taxes had not been paid for years, serious matters had been hidden from the Board of Directors, and the Center was in legal crisis. Indeed, after considering all the options, we felt that we were legally required to dissolve the Center as a corporation.

EEK.  That doesn’t sound good.  Unfortunately that statement from a nursing organization makes us sound like a bunch of whiny, unorganized, harpies.  Oh well.

I wish all involved in the Center of Nursing Advocacy good luck.  You did a great job to promote nurse’s image.  I will try and pick up some of the slack on this site.

RR

Posted in health, nursing | Tagged: , , , | 1 Comment »