Monday, February 25, 2008

Compassion, Real or Fake?

I've came across a observation that I have finally seemed to put my finger on and it deals with compassion towards our patients and with all health care workers that I have dealt with.

First off how about a definition which I took off of Wikipedia:

Compassion is an understanding of the emotional state of another or oneself. Not to be confused with empathy, compassion is often combined with a desire to alleviate or reduce the suffering of another or to show special kindness to those who suffer. However, compassion may lead an individual to feel empathy with another person.

Now that that is out of the way I will continue.

As health care workers we need to be able to show compassion and empathy towards people who are not feeling well or even dying. This is something we are told in school that we need to use is compassion towards our patients.

Understand that not everyone in health care is able to show compassion and those are the one try entirely to hard to fake showing compassion. This is what my observation is about. I have noticed that it is really easy to spot a person who really doesn't have a whole lot of compassion and is just doing this as a good paying job, but they are not necessarily suited for this type of job.

Some jobs take more than just understanding and knowing the position and knowing how to do that particular job. Need more than just schooling and getting a good GPA in their degree.

Let me try some examples:
A photographer can know all the settings, but they also have to know how to see the world, how to work with their subjects.

A bartender can know how to make every drink in the book but still needs to be able to listen and talk with people, who wants to sit a bar and have a unsociable bartender.

A teacher could of graduated with perfect grades from college, but still has to be able to communicate to the class, and be able to be a mentor.

A Psychologist can know everything there is to know about Freud but they also need to know how to listen and get a person to trust them.

A waitress/waiter needs to know what is on the menu but also needs to be able to be personable with the customers, who wants a unfriendly waitress...sorry no tip.

OK by now I'm sure you get the idea. We, RT's, nurses, doctors, xray techs, lab techs, hell anyone who works with sick or injured people has to be able to show compassion to these people, let them know we do care that they are ill and wish for them to get better and that we will do what we can to help them.

I've come to notice that there are some people out there who do not possess this skill, but do know their job. These people try to disguise this by being overly compassionate, looking to eager to do their job, almost forcefully doing their job. Just plain faking it. It's it totally obvious if you look, you can see it in their faces, hear it in the tone of voice and especially notice it as they walk out of the room.

The people who are compassionate do not try to force their way through the job, they just do their job. Just watch the nurses you can tell, the ones who are good are the ones who don't get overly rattled, the ones who look more relaxed and not rushed. When they talk to the patient their words and expressions don't look like they are acting, they look comfortable and not trying to hard to be overly nice.

Oh yes just look around and watch, you can definitely tell.

I feel like I'm compassionate with my patients and I don't force it, I just be myself and I usually get along with my patients. I don't fake anything, I just am who I am.

Don't fake it, people can always tell ... Yes ladies even your boyfriends and husbands can to.

Sunday, February 10, 2008

Do you have any Coupons?

First off I want to say thank you for the kinds words about our accident, everyone is recovered now and things are finally back to normal, again thank you.

Have you ever wondered what the patient is going to be charged for those great therapy's we provide for them?

Well I have wondered that, and were I currently work the night shift RT does all respiratory charges for the day on the patients. I did a little digging and found a area in our computer system that allows me to see exactly what it costs the patient for their different therapys they have received, pretty interesting and a little fun to see how much people are up to on their bills for the stay they are currently in.

So anyways here is what I have found for prices with respiratory therapy services here at my little hospital. Also keep in mind that some of these items I am told are package deals where more than one piece of equipment is included in the cost, what a bargain right...but I will try and distinguish which ones they are. Each of the prices I am showing are only a single charge unless I state otherwise. So like a room will be per night.

First I will start with the room charges, yea I know this isn't really a RT charge but hell compare this to a hotel room and WOW, more bang for the buck in a hotel room in my opinion. No package deal here, just the room cost.

Standard Floor Room: $826.00
Intensive Care Room: $1960.00

Next I will do some standard medication prices, not to back actually but can add up.

Albuterol for Neb: $7.40
Atrovent for Neb: $7.80
Xopenex for Neb: $10.25
Mucomyst for Neb: $7.75
Advair 500/50: $348.40 This would be a full Diskus
Flovent MDI: $256.30 Full MDI

Now I will do the Respiratory Therapy service prices, somehow I think we should get a bigger cut from this, but don't we always want more pay.

Initial nebulizer treatment, includes equipment and our service: $77.25
Subsequent nebulizer treatment: $57.25
Initial nebulizer with Ezpap treatment: $295.50
Subsequent nebulizer with Ezpap treatment x 10 mins: $85.75

At my hospital we change nebs out everyday, so a QID neb orders each day would be charged for the Initial and 3 Subsequent prices. I think we change out to often but that infection control's thing.

Initial MDI treatment: $49.50
Subsequent MDI treatments: $34.25

I think that is just for services, seems pretty steep for me.

Here are our Oxygen prices, now I couldn't find prices for different O2 Equipment like cannula's and masks so I don't know about them, I'm guessing they are included in something.

Oxygen per hour: $17.25
24hr of Oxygen: $414.00
Bubble Humidifier: $11.75
Pulse oximeter check: $35.50 This is just us going in an recording a Sat!

Now lets get to some ventilator and bipap charges, this can definitly add up.

Initial Ventilator day: $1576.50
Subsequent Ventilator day: Exact Same as above

Suposedly this included all equipment, checks, oxygen, nice package deal.

Bipap per day: $167.50
Mask: $131.75
Tubing: $37.75
Headgear: $75.50
24 Hours of Bipap: $945.50

Some reason we charge for that headgear, but it comes in the same package with the mask. Someone is getting over I think.

Now just some other miscelleanous stuff:

ABG: $190.75
EKG: $195.00
Ambu Bag: $140.50
CO2 Detector: $116.25

Now just for fun lets see what a QID Albuterol and Atrovent neb would be:

Inital Neb Tx: $77.25
3 Subsequent Tx's: $57.25 x 4 = $229.00
4 Albuterols: $7.40 x 4 = $29.60
4 Atrovents: $7.80 x 4 = $31.20

Grand total of: $367.05

Yep thats our daily price for QID Albuterol and Atrovent nebs. Not even sure if we charge a sales tax or anything, I don't think so but you never know.

Well there you have it, our pricing scheme, I'm sure it' probably pretty close to most hospitals, I though it was just interesting to see.

Any of you know some of your prices it would but fun to compare prices with types and sizes of hospitals, could be interesting. I'm damn glad I have decent insurance because hospital costs can really add up. There is probably a good possibility that prices become inflated from patients with no insurance and us taxpayers cover the cost.

Just my opinion but I think if you don't have insurance and you come to the ER with something that could be taken care of at a clinic, you should have to pay something, even just $10, might make people think twice. There are too many people who take advantage of the ER and if you charge them these people might have to make a decision beween their cigarettes and beer or how bad there stuffy nose really is. You know these types and I know I'm not the only one who thinks like this.

Anyway take care everyone and thanks for reading.

Drive on RT's.

Sunday, February 3, 2008

Gotta Love the Grand Caravan's

Just a quick posting here tonight.

I haven't been able to get around to posting lately due to an automobile accident my family and I had last Saturday.

We were on the way home from my girls swim meet and traveling on a country road when our vehicle became caught in some slush and ice on the side of the road and started pulling our van off the road, my wife tried to keep up on the road but over corrected a bit and we flew across the road head first into a telephone pole breaking it in half. The back end of our vehicle flipped over and we were on the roof and then started rolling finally ending up on the passenger side of the vehicle.

When we finally stopped I figured out that I really wasn't hurt but then became the scariest part of it, getting ready to look around and see if my wife and 4 kids were ok or horribly hurt, possibly even worse. First I looked up to see my wife hanging from her seat and she had blood running down her face and was very swollen but she was alert and talking to me. I then tried to get her to stop moving but as a mother she yelled at me to get her unhooked from the seatbelts so she could go see how the kids are, so I did and pushed her up and out of her window which had broken out. She went around back to get the girls out and they were fine, just a little big banged up and scared because of the crash and how their mother looked. I unbuckled and crawled through the van to get my boys out of the middle from their car seats, these two were perfectly fine but crying, hell who can blame them. So I was able to get them out of the back of the van also. When I finally was able to get out there was a couple from the house we landed in front of there with blankets and were taking the kids and my wife into their house and started dressing wounds along with calling 911 for us which I also had done on my cellphone while crawling out of the vehicle.

EMS and police responded fast and before we knew it we were off in the ambulances. Overall we only spent 3 hours in the ER with my oldest and wife getting CT Scans and xrays and the rest of us were fine, my left hand was pretty cut up plus I had glass all over my face but none of it cut me. My oldest (11) has a headache and a swollen knee, my 10 year old was just a bit shook up, my 3 year old was fine as was my 11 month old, the car seats worked well.

Now my wife had multiple cuts on her head and the right side was very swollen. Her left hand needed stiches and she had a concussion. The next day she ended having 2 black eyes and a bruised face. We also noticed that a area in the front of her head her hair was sliced off to about 1/2 inches instead of her normal 6 inch long bangs. Something sharp flew over her head.

In the end we did $15,000 in damage to our van, some of us here banged up, we were all sore the next day and a little leary to drive anywhere so we ordered in pizza. My wife of course made a hair appointment for the next day to fix the area where she lost some hair, funny I did find the hair when I went to get what I could out of the vehicle.

Amazingly we were very lucky and I put a lot of that luck on how our vehicle was made and how safe it was, also the importance of seatbelts and carseats was totally proven to me and my family, yep we all had them on. My kids are now especially good now about putting on their seatbelts and making sure everyone else has them on.

Probably wondering what this vehicle was, well it was a 2001 Dodge Grand Caravan and it held up wonderfully, so much so that we went out and bought another, only this time it's the new 2008 model.

I will be back with more posting this week, thanks for reading.