quality of care

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About two years ago when I got confined in the hospital for giving birth via C-section, it was then that I truly experienced what it was like to be a part of the medically underserved population. I very well understand that staffing issues have always been a problem in public hospitals, the question is “is having too much to do an excuse to neglect patients in need?”. Isn’t attending to patients the main responsibility of the nurse? For most of the patients in the ward, they dare not ask for assistance from nurses in fear of getting yelled at or to avoid being a pain to the ever so busy nurses running up and down the floor. Being a nurse myself, this experience wouldn’t change anything about my perception of nurses or in health care services in general. But for first-time patients, situations like this will definitely have an impact on how the look at nurses and the kind of services that they provide.

Situation 1

1 day post-surgery, I noticed my hand, where they put in an IV line, bulging and cold to touch. My hand was swelling so much that I couldn’t curl my fingers to bring it to a closed fist. I knew that the line went out of the vein and that the IVF was infusing to the surrounding tissues. When I called the attention of one of the nurses who passed by, she looked at my hand and told me to wait. I waited for a while but the nurse never came back. Again I called the attention of another nurse who was attending to the patient beside me. She came to my side but instead of looking at my hand, she manipulated the IV regulator. Finding that the fluid was infusing just fine, she said that there’s nothing wrong with it and that she didn’t know what my problem was. Deep inside I was starting to get furious but decided to keep it to myself. Calmly, I showed her my bulging hand with IV fluid already leaking at the tapes and asked her if that was normal. She then called the resident on duty who ordered the removal of the IV line.

Situation 2

The physician doing the daily morning rounds, upon finding me sitting on a chair, ordered that I get discharged that day. It was only two days since I went out of surgery and I felt that it was too early for me to leave the hospital since I haven’t even started ambulating yet. However, the whole experience and environment is making me more fatigued and perhaps at home is the best place for me to recover.

Prior to going home, they have to clean the wound and change the dressings. My mother was already done settling the bills but still no one came to do the dressing change. After requesting for about 3 times and waiting for more than an hour, we decided that we would just ask my aunt, who is also a nurse, to do it at home. It was only then that a medical intern came to attend to my needs.

These examples are only two of the many unpleasant experiences that I went through during those two days of hospitalization. I left without having any discharge teachings, without a wheelchair, and even with no one to assist me with walking. If I slipped and fell during that time, sure enough they would put the blame on me.

I didn’t hold any grudges to the doctors or nurses who failed to make my stay in the hospital a more pleasant experience. I just feel sad that this had to be the situation for most people who cannot afford to go to a private hospital where health providers made sure that patients are kept comfortable and all their needs are met immediately. This was a truly humbling experience for me and I believe that being in a situation where nurses didn’t have much care made me more empathetic and sensitive to my patients’ feelings.

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A study comparing nursing care between for-profit and non-profit nursing homes reveals that the latter provides better quality nursing care.

The statistical data gathered during the research showed that nursing care for non-profit nursing homes were better in two of the most commonly used criteria for quality measures which are staffing and occurrence of pressure ulcers or bedsores. There were also fewer uses of restraints and fewer violations in non-profit nursing homes.

According to the study’s author, the reason why for-profit institutions deliver less quality patient care is that administrators spend on revenues for shareholders and paying taxes. To ensure that shareholders get a return on their investment, they cut corners and because of this, quality of care is sacrificed.

The vision of the institution may also play a major part in the difference of the quality of care between non-profit and for-profit nursing homes. Non-profit organizations’ mainly focus on providing care with the goal of being able to be of service to people. Though for-profit care facilities offer the same services, their main focus is not for economic gain. Also, individuals working in facilities that aim to help people have a stronger drive to provide care which makes them more effective. Having a stronger drive means people in non-profit organizations work more for the gratification of being able to help than for money.

See original article

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See this episode of the Nursing Show for a brief review on pressure ulcers

Staging Pressure Ulcers and Episode 84

Like this?  find more articles and study aids at Nursing Top Student.com

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Kim from the Emergiblog always has great comments on the state of nursing both in her perspective as an RN in the ER and on nursing in general.  One of her recent posts paid tribute to a job I used to have back in the day – ER tech.

ER Techs Unite!

She called the ER techs the unsung heroes of the ER and I have to agree with her (even though I might be a little bit biased).  If made me wonder who else we overlook in our jobs.  There are a lot of people who make our lives easier, safer, and a little bit more bearable on those difficult days.

From the aforementioned ER Techs to our unit clerks, housekeeping staff, transportation volunteers, and security and safety staff who make our walk back to the car at night a little less stressful, these co-workers in the hospitals and facilities in which we work are also a key part of the team that provides care to our patients.

Don’t forget these unsung heroes. Remember them during your work week and when you’re making something to bring in on a food day.  As quality improvement becomes the watchword of the health care industry, a team approach to patient care is going to be vital to making sure of the best care for everyone.  There are more members of that team than many give credit to.  Don’t forget!

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