HEALTH CARE: Mrs. Rustbelt is Grouchy
by Tom aka Rusty Rustbelt
HEALTH CARE: Mrs. Rustbelt is Grouchy
Mrs. Rustbelt (aka the world’s great nurse) is a paragon of competence, compassion, service and self-sacrifice. When grandma is ill you want Mrs. R to be granny’s nurse. She routinely gets letters and call from families praising her work, and this is the only thing that makes her lose her composure.
But Mrs. Rustbelt is getting grouchy. Mrs. R is really tired of:
super morbidly obese patients
diabetic and overweight patients who ignore their diets
diabetic and overweight patients who refuse their meds
families who bring junk food to patients with dietary restrictions
She gets upset about nurse aides, who despite training and equipment, get inevitable back injuries. And don’t get her starting on smoking.
Apparently inserting a catheter into a female patient who is 5′ 2″ and 265 pounds is not a whole lot of fun.
If Americans want good health Americans have to start taking some responsibility.
The triple stacker bacon burger is not good for you, get it?
(My lipid panel numbers are good, one advantage of being married to a nurse.)
Responsibility?????
You’ve got to be kidding. The entire left and a large segment of the right no longer beleives in responsibility, especially on an individual bases. Doesn’t matter if its crime, illegal drugs, immagration, education, jobs, housing, heck you name it.
Why is Mrs Rustbelt not bitching about the druggies? (she might not see them, depends where she works).
No one wants to actually be held responsible for their actions, at any level.
********************************************
Rdam – if your out there, can you start an open thread? I have an iteresting story about the Oil Spill to tell and it doesn’t fit anywhere…
Thanks
I suspect the subset of people into whom it is fun to insert a catheter is very small… at least for most people.
Rusty–Thank you and Mrs. Rusty for this excellent post. Good advice. N Ortiz
buffy is, of course, not lying, because expressing a biased point of view is not a lie. If a biased point of view were a lie, buffy would be lying like stink in a ditch, but it isn’t, so he isn’t.
“The entire left and a large segment of the right no longer beleives (sic) in responsibility, especially on an individual bases (sic).”
I’m sic of watching buffy lie.
Buff
i agree with you. don’t know if that makes me a “what’s left of the right” or “what doesn’t exist on the left.”
but you see, Social Security is a way of taking responsibility for yourself… by using the power of government to guarantee a minimum of savings sufficient to support you in your old age.
It’s hard to see that as taking responsibility with the right wanting to put you on the Big Casino retirement plan, and the left wanting “the rich” to pay for your retirement.
“5′-2″ and 265 pounds.”
She wouldn’t happend to have a phone number to that beauty queen, would she? There are some countries where 5′-2″ and 265 pounds is considered a blessing not a problem.
kharris
i don’t think buffy is lying. possibly exaggerating a bit, but he is describing the people i know. the only ones who believe in “responsibility” are those who have been lucky and think they did it all by themselves.
Dear Mrs Rustbelt
first, your husband loves you, and that is the important thing.
but I need to say that I have gotten “back injuries” despite being compulsively careful about my back. where i let myself down, perhaps, is in not following religiously an exercise regime that would probably reduce or eliminate the (fairlly rare) episodes of serious back pain, if not actual injury.
my guess is that even with training and equipment some nurses are going to hurt their back. the mechanics of the situation suggest it’s going to happen sooner or later. and i’d bet, maybe not in your hospital, but in many, that the working conditions do not allow the nurses to be “always careful” or even to have a fighting chance to avoid the stresses that ultimately result in an episode of severe back pain.
as for diet, i agree with you. but having watched doctor induced fad diets for fifty years i can understand why lots of people don’t really believe the doctor. and of course there is nothing in the american way of eating that encourages, or even allows time for, not to say money for, eating a good (in all senses of the word) diet.
and just in case… you and i don’t know what’s going on inside that morbidly obese person. i never had to worry about my weight for the first 67 years so i can’t claim any virtue in not being obese. i did lose a bit of weight lately on purpose and was congratulaing myself… when i stopped losing. wanted to lose a few more pounds but couldn’t. same me. same “virtue.” just didn’t work any more. so i have no reason to look at another person having trouble losing,or not gaining, weight and feel superior.
moral of the story: be kind. even in your thoughts. and be grateful.
Kharris,
How about I change that sentance to,” Almost the entire left and almost the entire right…”
Would that make you feel better? Now the two sides may disagree on what you have to be personnally responsible for, but I see little signs that either side in general beleive in personel responsilbility.
Islam will change
ilsm is retired reserve officer very good pension and Tricare (free of premium). Also, retired federal GS high grade extremely good pension and FEHB.
ilsm has enough years in non fed work to have good OASDI.
ilsm has good health due genetics, to keeping fit and world wide deployable, and having enough pension coverage that life is good.
If all I had to depend on for old age were OASDI I would not have lost 15 pounds in the past year nor would I have stopped the humongous jalapeno laden bacon smoking BBQ burgers and cheesy fiies with my other retired ilsm’s.
I would further be imbibing on copious amounts of Milwaukee’s Best and pork rinds rather than cancer preventing imported dark beer in due moderation with sour dough pretzels.
If one is not anticipatng the good life why care for a long sad life???
My first wife was same profession as Mrs Rustbelt. Happily that burden wandered off years ago to a more unhealthy partner.
Jimi,
Those ocuntries have kids starving in the streets, thats why being obese is a sign of being wealthy….
Islam will change
STR-After ten years og a being a stay at home mom my wife started a carreer as a labor and delivery nurse this January. She was an excellent student and landed a nursing internship (paid thank goodness!)at a hospital that delivers over 5000 babies per year. Obesity? Ask Mrs. R about inserting a foley catheter into a 350 lbs. pregnant woman. Care for me to describe the smell? How about the pregnant sixteen year old…who already has two children at home. The drug addict who smokes crack in the delivery suite while waiting to give birth and has had her other six children taken by child protective services? Pregnant meth addicts? Check. Uncontrolled diabetic stillbirths? Check. And we put creedence into the WHO health care rankings? We listened to some who used infant mortality as proof of our terrible healthcare system? And as an aside while my wife is apolitical she does report that 90% of her patients are paid for by Medicaid. And I thought access was a pressing problem.
little john,
Death panels.
There are folks who use end of life expenses to ‘justify’ wrecking SS and medicare.
Do you abort the children from obese or drug abusing mothers or bring them to term.
And brought to term do you, society, pay for the raising, rearing and correcting?
I know no figures but assume the % of births in the related sad categories are small in the general population.
A lot of interesting responses here. I’ll add mine to ilsm’s and coberly’s, and go on to say that unfortunately, one of many contributing factors to obesity is a tendency to self-medicate for emotional stress by eating. Once begun, this is a pretty self-defeating behavior that becomes ever more difficult to overcome by “will-” or “won’t-” power.
“Stop eating” sounds so simple. So does “give up crack” or even “get a job.” Sometimes things are doable, but they aren’t simple. Does Medicaid pay for obesity treatment/counseling? I somehow doubt it. We may have a War on Drugs, but we don’t have a War on Drug Addiction or a War on Misery.
Sounds like your wife works at a County or non-profit hospital. What you’ve described is a litany of misery. I doubt anyone can read it without shaking their head.
In a good healthcare system, the problems that you list would be addressed via access to help, treatment, and a system that followed up. The problem isn’t access to emergency care. It’s access to every other kind of care.
In a system where the types of problems you list were recognized and a coordinated system to help people with them existed, there would likely be fewer of these cases coming in to be cared for by your wife. When we pay for ER care and for surgery but not for nutritional education, or drug abuse (except in some cases after arrest and sentencing), we are bound to get what we pay for.
“Apparently inserting a catheter into a female patient who is 5′ 2″ and 265 pounds is not a whole lot of fun.”
Inserting anything into that part of a woman that weighs, at that height, 19 stone, is neither enjoyable nor easy.
But slightly more to the point: so, what do we do? What is likely to reduce the number of women of that weight who need cathetirisation? (err, catheterising?)
Is it that, when needing medical treatment, such women have it all paid for by the federal taxpayers?
Or is it that when needing treatment such women have the costs of their own behaviour brought home to them, directly, through their pocket books?
Answers on a postcard to those calling for single payer health care……
And why is it not considered wealthy in America?
You know this country is in big trouble when we would actually save more money by paying people not to eat, instead of having to pay for rolling (literally) them into a hospital.
We need a national Anorexia Campaign ASAP!
I’d bet that if your tax return was based on your percetage of body fat, the problem might go away pretty quick……..
Buff:
Mrs. R deals with the elderly, and they get lots and lots of drugs without even asking.
Thank Mrs. R, she is the angel.
Notice the word inevitable attahce dto back injuries. It is tough to see good people suffer because they were trying to do good.
Mrs. R applies the same level of compassion and care despite weight and even self-destructive behavior.
Mrs. R did med-surg, OB, psych and a few herion junkies when she was young.
She prefers the relative calm of the elderly, even the difficult ones.
Mrs. R agrees with you on the “food as opium” problem, but also recognizes such factors as heredity, diabetes, metabolism problems, and orthopedic problems compounding weigh problems.
Just about everyone over the age of 65 has Medicare or a comparable local government retiree plan.
To be fair, elderly bodies eventually just wear out, but the weight makes it worse.
Mrs. R update:
Mrs. R went to work today intending to do her monthkly 8 hours of infection control logging and tracking.
Instead she spent six hours helping other nurses with clinical crisis, new doctors orders and pharm orders, then she came home, had a snack, chengd uniforms and is now doing a nine hour shift to fill in for a sick charge nurse. Another day at work.
One of the more interesting clinical crisis was doing the transfer paperwork on an elderly male who, although technically in his right mind, thinks it is ok to smack nurse aides.
Someday she wants to write a book – lots of interesting stories.
good old tim
let’s kill off the unfortunate because it’s all their fault. and of course the best and only way to control behavior is by charging for it, except that since you didn’t pay for it in the first place, they don’t have the money to pay for what you are trying to sell them.
i haven’t worked myself up to the insanity yet of thinking those people are hurting me. and i like to think that “we” can solve those problems if we keep trying to.
but in worstall world the sick and the poor just die in the streets. that’ll teach em.
rusty
not to sound too much like Worstall, but smaking a nurse’s aid would happen just once if there weren’t rules against decking him. i imagine most nurses are up to it.
now, no doubt there are good and humane reasons not to do this, but still…
Have you noticed “responsibility” is always something OTHER people should be assuming?
Rusty–I’m sure Mrs. R has observed what I have–after a certain point, obese people have little left to enjoy but food and the condition is irreversible anyway. Even extreme diets have little effect on the weight of extremely obese people. If you weigh 375 and lose 100 lbs, you still weigh 275, are still 5’2″ and still essentially immobile if you have any health crisis. My husband’s family had a genetic predisposition to diabetes. He eventually died from its complications: obesity led to congestive heart failure and a fatal stroke. This is a fearful thing to observe. It is worse to experience. Trust me, it’s a good idea to pass up the bean dip, the coconut cream pie, the double bacon cheeseburgers–all great stuff. But, it’ll kill you if you over do it.
Let me posit another thought on the food as opium, is it possible that at least some are in the process of a slow speed suicide? Depression according to Thoreau is the common state of humans, and if you listen to the news enough it makes one want to follow the comment in the bible about eating drinking and being merry (I would add do drugs today), because we are all going to die soon of 555 different things the media and some grant seeking scientist dreamt up. Medicine runs in fads, and of course the basic problem is that we have created an environment we did not evolve into. We evolved in an environment of food scaricity where the abilty to store food internally for the coming famine was a good thing. Now we have put our bodies into a state where the animal and the brain are in conflict. (Recall that cats dogs and horses have the same problem humans do).
Actually, no. I’ve found that most people understand they are responsible for their own behavior and how they deal with the behaviors of others. But we don’t live in B&W World, where that’s all there is to it.
Most of the patients my son (BSN plus) has dealt with in med surg had drug induced aggression…drugs that were part of normal hospital treatment, not meth.
He is 6’3′ and many of the aides and nurses are much shorter, so for him there is always the awkwardness of leverage even using proper lifting procedures for heavy patients.
then again there were also some real assholes.
How about the intensive childhood training that comes with McD advertising? Does the person designing and implementing said training have personal responsibility? Do the subsidies gravy train with corn syrup which makes some foods cheaper come with personal responsibility?
Dan
thanks for pointing out the reason i couldn’t think of. still, a lot of the axles get away with stuff they shouldn’t because other people really can’t help themselves.
and having thought further, i have to admit that as often as not i agree with jimmi about paying taxes to treat patients we ought to just pay to stop killing themselves. of course it wouldn’t work, but it is one reason i am resistant to insurance.
Linda
actually yes and no. sometimes people seem to be aware of their need to be responsible for their own behavior. most of the time they havn’t got a clue. and all of the time they rationalize or project like mad to blame the other guy.
Linda:
Tax Salt, Sugar, and Fat. Lijmit fat food restaurants
rdan:
an answer:
Communities Have the Right to Plan and Zone
Why does it have to be more fast food restaurants when there are already 400 saturating a 32 square mile area? Granted an ordinance is a rather crude way of accomplishing zoning to cut down on the proliferation of fast food restaurants.
“Jan Perry, a Los Angeles city-council member, is spearheading legislation that would ban new fast-food restaurants like McDonald’s and KFC from opening in a 32-square-mile chunk of the city, including her district. The targeted area is already home to some 400 fast-food restaurants, she says, possibly contributing to high obesity rates there — 30% of adults, compared with about 21% in the rest of the city. Nationally, 25.6% of adults are obese, according to the Centers for Disease Control and Prevention.”
http://online.wsj.com/public/article/SB121668254978871827.html “Exiling ‘The Happy Meal’”
400 “fat and fast” drive-thrus, walk-ups, and carts or ~ 12 per square mile, or 1 per an ~ 2.4 million square feet, or 1 per 1250 people. Anyone still think we are stomping on the rights of people to get their “hot and greasy” when so many exist already? Think any of those fast food places are providing healthcare insurance to their workers as they delve out and into those chunks of fat.
The preferred way of minimizing an overwhelming abundance of one type of business is to develop a master plan for that area and zone it accordingly with the appropriate restrictions. No community wants all super stores, all fast food, all cleaners, etc. because the fallout is closed store fronts which create other issues. Master Planning and Zoning is the preferred method of planning for a community and if done appropriately it is not a “takings” as long as it is the same as or above the last zoning. One methodology to use for this area is Transit Oriented Developments (TODS) or Mixed Village Use. In each situation, a plan is developed that gives a vision to the developer of what the City Planning Commission would like to see there . . . such as parks, single family homes, apartments, senior housing, neighborhood grocery, offices, drug stores, senior center, community center, etc. It requires a little more forethought than just throwing an ordinance at it.
As a member of a […]
In a 2004 U.S Department of Health study, “The High Concentration of U.S. Healthcare Expenditures;” the study goes on to list 15 different disorders that account for 44% of all healthcare expenditures in 1996, 5 of which (heart disease, cancer, trauma, mental disorders, and pulmonary conditions ) were the most expensive to treat in 2002. Looking at the 5 disorders, can anyone deny there can be a link between diet and heart disease or cancer? Or that 25% of the population suffers from multiples of the study goes on to cite:
“For 16 of the 20 most expensive conditions, the rise in the number of people being treated accounted for more than half the growth in private insurance health care spending. Researchers attribute the additional numbers of people being treated to three factors:
· – The continued rise in the share of privately insured adults classified as obese.
· – Changes in clinical treatment guidelines and standards for treating patients without symptoms or with mild symptoms only.
· – The availability of new medical technologies to diagnose and treat patients.
Especially important is the increase in the number of people treated for conditions clinically linked to obesity. From 1987 to 2002, the proportion of the population treated increased 64 percent for diabetes (accounting for 80 percent of the increase in costs) and increased 500 percent for hyperlipidemia (accounting for almost 90 percent of the increase in costs). A number of factors might explain the substantial increase in treatment rates for conditions linked to obesity. These factors include a rise in the number of people with obesity-related conditions, a rise in the number of more seriously ill patients, a greater emphasis on preventive care, and the introduction of broader treatment options.”
As recent as the passage of the caloric intake posting in NY, the restaurant association executive vice president made this statement: […]
No scientific claims about the links between eating too much, obesity, and disorders? We have not even touched upon children and their sedentary life styles coupled to fast food eating or the plight of the poor and those in poverty who are uninsured. Still think fast food does not impact this? Healthcare and healthcare insurance costs are the biggest issues facing the US economy today and it surpasses the “alleged” bankruptcy of Social Security. 40 million people will walk around without healthcare insurance or a loss of healthcare insurance during some portion of the year. We are clamoring for government intervention granting healthcare for all people without the very same people lifting one finger to change their lifestyles all based upon the individual’s right to freedom of choice. Does it seem reasonable for the government to intervene and pay for healthcare insurance and/or healthcare costs without requiring something in return to lower healthcare cost and the risk of poor health?
Perhaps, the way to get people to modify poor eating and lifestyle habits is to educate people and hit them in their pocketbooks? The same as higher gasoline prices forcing fewer car trips and slower driving to conserve on gasoline, it may be that same impetus needed to force the issue of improving lifestyle for those that can do such. There is a direct link between food and obesity caused disorders, the same as cigarettes and cancer. Perhaps, a tax can be placed on fatty foods of higher calorie count. A tax that could go into a fund to treat those people who wish a non-healthy lifestyle and at least then a greater portion of the cost could be picked up by those who wish to indulge. Fast fatty foods should not be cheap.
The one issue I have not touched upon is that of those living in poverty or are poor as defined by this administration as being 250% of the poverty limit. In many of the neighborhoods, the availability of fresh foods with low fat and sodium content is somewhat limited as suggested by 400 fast food restaurants whose prime mission to sell the whopper, the classic, or the big mac. Many heads households are single women who find little time to be cooking fresh meals as much of their time is spent working to make a living. It is often times cheaper and easier to turn to fast foods to feed a family. So why not more nutritious and lower fat menus at fast food restaurants? http://fray.slate.com/discuss/forums/post/1578245.aspx
Coberly,
Actually, I was careful to say “most people” because we all do know someone for whom it tends to be the other guy’s fault. In some of those cases I suspect it’s more opportunism than genuine. Another complication.
This society won’t abort because of parental defects and will pay to raise, rear and correct. I think you are right, these are a small fraction of births, just common at my wife’s work.
You’re right, the sad stories are heartbreaking. I always thank my wife for telling me these stories and bursting my carefully constructed bubble! Believe it or not my wife’s hospital is a for profit hospital which is part of a national hospital corporation. Our county hospital delivers about 10,000 babies per year. The crazy part is that there is the availability of no-cost prenatal care but the vast majority of these sad cases never utilize these resources.
She sounds like a great and experienced nurse. Thanks for the post!
Really. I never thought of that but I can believe it.
little john
and you sound like a better person than i thought you were from other exchanges. hang in there. we may understand each other yet.
run
that might help. but let me be the first to say that “nanny government” is not the best solution to every problem.
linda
i shouldn’t keep beating this horse, but you must know a better class of people than i know. but for sure some people are worse about this than others, or at least louder about it.
Lyle
i am not sure that quiet desperation is the same as depression. But i think you are right about the eating as suicide. Like most of life, there seem to be at least two more or less opposite causes for the same behavior. Some are depressed and eat to ease the pain. And some are depressed and eat “bad” stuff because they don’t care if they live or not.
But I’d bet there are people who eat too much because their bodies won’t give them the energy they need without taking in more calories than they spend… storing the excess. We don’t know as much about “fat” as we like to think. it’s not a simple matter of calories and exercise.
But your last point seems to me most likely. We humans, some more than others, evolved with a metabolism that is “set” at a higher energy expenditure level than we either need or can achieve under modern conditions. It is a “chore” to manage calorie intake, or force exercise. And what is a chore is usually not easily undertaken if the cost of not taking it only appears after ten years or so.
run
sorry to say yours is an example of “not taking responsibility for ourselves” and gives me, at least, a reason to oppose national health care. if i have to pay to take care of people who should have taken better care of themselves, i get grouchy. and i am not very likely to accept as an answer your proposal to tax or otherwise restrict people’s access to fast foods or bad foods.
before living in a country like that, i’d take my chances with the insane right.
now, please understand, that i am in general a believer in national health care, and not a friend of the fast food business… or the corn syrup business. but there’s gotta be a better way to approach the problem than food police.
and i did want to say there is nothing wrong with that triple cheese bacon burger once a year or so. it’s when it is once a week or every day in one form or another… when you don’t even really like it anymore… that it is a problem.
amen – and since it is a holiday………….
In this case – asshole.
Nurse slang:
PITA – pain in the ass