The corrupt system of "Health care" insurance certainly adds to the pressure on everyone. In my opinion, they are to blame for nearly every problem we see. Our health care providers shouldn't be suffering so much when all they ever wanted was to heal and help. The bureaucrats get to sit safely in their offices (probably working remotely with all their privilege) while the front liners and the patients continue to suffer. When is this going to end? Something has to change.
Many healthcare workers would agree, there's been so much written recently about the moral injury that many folks feel as though they are "party to a crime" or like the constraints of the system are preventing provision of care at the level that many folks expected while in school and training. I don't have a great solution, but there is a reckoning coming when we need to look long and hard at healthcare, reprioritize the patient and their care and how best to support a workforce that is struggling.
I believe it's coming....we can't waste this moment. I don't even like to use the word healthcare because that implies that the caregivers are the problem. It's the insurers who need to be named. I've seen much of that writing about moral injury--the fact that those who make a life choice because they have compassion and this is how they end up feeling? This country is sick, sick sick. The savage indifference to humanity that has become the dominant narrative needs to stop. But we are NOT all like this and we will eventually be heard.
In my years of physician-hood, these incidents have origin in fa,ily members unhinged from catastrophic health situations...perhaps we need to start with more screening and interventions there
The specific target of interventions is exactly the issue, many of the initiatives with trainings for employees for recognition and deescalation ultimately are difficult to fit into a busy clinical day and with sometimes limited interactions with family members, situations erupt faster than the medical team can anticipate. With the situation at UPMC, I thought a lot about the supposed safe guards in place with social work and spiritual care and all the adjuncts to provide support along the way for grief processing but these are a limited resource and it's hard to prioritize them when so much is reimbursement driven.
I work in a Tribal clinic. I've had de-escalation training, code-black training...and we keep asking for security to no avail. Our behavioral health *maybe* will get some. The tribal police don't come on duty until 1400, and serve 4 different communities across a state line (We're covered by the county police when they are not available.
Personally, I've been screamed at ("this clinic belongs to me!") threatened, bullied and told that I killed someone (because, after ignoring her liver cancer care for years, I forgot to set up transportation for one IR ablation tx). We've come within minutes of someone being physically assaulted. We have the usual issues - ETOH and meth use. We have a pharmacy, and while we don't have any controlled meds higher than Percocet (which apparently is the most salable prescription drug right now), but that's enough of a temptation. Our behavioral health, besides caring for people with serious MH issues, has a SUD and MAT clinic, and half of the SUD clients are court-ordered.
Not quite sure where I'm going with this other than to say that yeah, health care setting violence is pervasive, and not just in hospitals, and here's my most recent examples.
The corrupt system of "Health care" insurance certainly adds to the pressure on everyone. In my opinion, they are to blame for nearly every problem we see. Our health care providers shouldn't be suffering so much when all they ever wanted was to heal and help. The bureaucrats get to sit safely in their offices (probably working remotely with all their privilege) while the front liners and the patients continue to suffer. When is this going to end? Something has to change.
Many healthcare workers would agree, there's been so much written recently about the moral injury that many folks feel as though they are "party to a crime" or like the constraints of the system are preventing provision of care at the level that many folks expected while in school and training. I don't have a great solution, but there is a reckoning coming when we need to look long and hard at healthcare, reprioritize the patient and their care and how best to support a workforce that is struggling.
I believe it's coming....we can't waste this moment. I don't even like to use the word healthcare because that implies that the caregivers are the problem. It's the insurers who need to be named. I've seen much of that writing about moral injury--the fact that those who make a life choice because they have compassion and this is how they end up feeling? This country is sick, sick sick. The savage indifference to humanity that has become the dominant narrative needs to stop. But we are NOT all like this and we will eventually be heard.
In my years of physician-hood, these incidents have origin in fa,ily members unhinged from catastrophic health situations...perhaps we need to start with more screening and interventions there
The specific target of interventions is exactly the issue, many of the initiatives with trainings for employees for recognition and deescalation ultimately are difficult to fit into a busy clinical day and with sometimes limited interactions with family members, situations erupt faster than the medical team can anticipate. With the situation at UPMC, I thought a lot about the supposed safe guards in place with social work and spiritual care and all the adjuncts to provide support along the way for grief processing but these are a limited resource and it's hard to prioritize them when so much is reimbursement driven.
What was noted over a century ago still seems true today:
“PHYSICIAN, n. One upon whom we set our hopes when ill and our dogs when well.”
From “The Devil's Dictionary” by Ambrose Bierce (1911).
I work in a Tribal clinic. I've had de-escalation training, code-black training...and we keep asking for security to no avail. Our behavioral health *maybe* will get some. The tribal police don't come on duty until 1400, and serve 4 different communities across a state line (We're covered by the county police when they are not available.
Personally, I've been screamed at ("this clinic belongs to me!") threatened, bullied and told that I killed someone (because, after ignoring her liver cancer care for years, I forgot to set up transportation for one IR ablation tx). We've come within minutes of someone being physically assaulted. We have the usual issues - ETOH and meth use. We have a pharmacy, and while we don't have any controlled meds higher than Percocet (which apparently is the most salable prescription drug right now), but that's enough of a temptation. Our behavioral health, besides caring for people with serious MH issues, has a SUD and MAT clinic, and half of the SUD clients are court-ordered.
Not quite sure where I'm going with this other than to say that yeah, health care setting violence is pervasive, and not just in hospitals, and here's my most recent examples.