Pity the poor nursing home resident-- especially at Wingate/Springfield

I wrote about my friend's trials and tribulations at Baystate a few weeks ago, and how he wound up with a colostomy when he'd been admitted for a broken clavicle and ribs. (!)

He did, eventually, get transferred to a Wingate Healthcare facility on Bicentennial Highway in Springfield.  They kept him there nearly three weeks and then sent him home last Wednesday while he was in an extremely frail condition.  He lasted exactly two days, fell again, and is now back in Baystate.

I'm sure I don't know the half of what happened at Wingate, but I'll write what I do know.

There is no separate wing there for short stay patients; they're mixed in with people who will breathe their last breath in that facility.  My friend's roommate died while he was there.  Obviously it would be much more heartening to be housed with patients all of whom are working hard to go home.  Not all facilities are like this.

My friend is both diabetic and a vegetarian.  I presume they have a dietician on staff but the kitchen seemed not to know what to do with him.  Three meals in a row (minus breakfast) he received potatoes and a vegetable, five meals in a row he was served a grilled cheese sandwich.  After the third meal, I told him to insist that the kitchen at least add a vegetable.

Apparently they preferred to control his diabetes through insulin rather than diet and insulin.  I was visiting one afternoon when a nurse took a sugar reading and it was high-- 220.  He returned with an injection of insulin.

The physical therapy department seemed to be a well-functioning unit.  The therapists I met were kind but not wimpy.  They pushed my friend to help him regain his strength.

But they failed to properly train him in the full ramifications of having an ostomy, how to care for it, tips for changing the ostomy bag, or the fact that having an ostomy requires drinking extra liquid to avoid dehydration.  This lack of information beaame a crucial factor in why he wound up back at Baystate.

My friend had his blood drawn several times in three weeks, but apparently whatever lab the facility uses failed to recognize that my friend had an infection (later determined to be caused by a wound he was accidentally given in Baystate!) This became factor number two in his re-admittance.

Worse, when my friend went for a follow-up visit to his surgeon on Friday, just hours before he went back to Baystate, the surgeon was furious that Wingate had reduced my friend's pain medication to a level so low as to be ineffective.  He had also made it clear in written orders to Wingate that my friend was not to be discharged until he was truly able to care for himself, as he lives with his elderly mother.

I started out angry writing this but I'm ending up just sad. When people are sick they are the least able to be effective advocates for themselves, and not everyone has family and friends who also have the time and resources to fight for them.

I also have more to say about Baystate, but I think I'll save it until my friend is safely out of their care.

A win is a win is a loss

Well, I've been trying to write a decent post about the Scott Brown win yesterday and find I just can't do it. I think I'm already in the "Just deal with it" mode.

So let me just say two things I don't understand.

I don't understand how Pres. Obama and Congress have come up with a health care plan that's so incomprehensible that it can be misinterpreted at best and lied about at worst.  As Ernest Rutherford said, "If you can't explain your physics to a barmaid it is probably not very good physics."

I don't understand how the self-proclaimed "outraged, average Joe" voters of Massachusetts voters have come to think that the Republican party will even come close to representing their needs.  Does anyone remember the eight years of extravagant spending of George Bush on war?  Of course Obama inherited this, but he also continues it.  Would Scott Brown had won if he'd directed his outrage toward military spending?

Coakley/Brown: Holding my nose and voting

Scott Brown supporters have taken over the local news forums in the last week, outnumbering Coakley supporters, who I can only hope are saving their breath for getting their less politically active friends committed to voting.  I'll be walking around the corner later this morning and voting-- for Coakley.

I don't blame the majority of Brown voters for feeling unrepresented and as if their core concerns are being ignored by the majority political party.  That's the way Democrats felt for the eight years of George Bush!  Of course, Republicans would benefit from health care reform, stronger environmental laws and other Democratic agenda items, whereas, as a Democrat, I can't think of a single way I benefited from Bush's presidency.  He left us with wars, economic collapse and a near total neglect of the environment. It's always amazed me how short people's memory can be.

My disappointment with Obama and many of the Democrats is not what they have done, but what they haven't done.  On Sunday, NYTimes columnist Paul Krugman captured my feelings pretty well.

The Obama administration’s troubles are the result not of excessive ambition, but of policy and political misjudgments. The stimulus was too small; policy toward the banks wasn’t tough enough; and Mr. Obama didn’t do what Ronald Reagan, who also faced a poor economy early in his administration, did — namely, shelter himself from criticism with a narrative that placed the blame on previous administrations.

 For me, Obama hasn't been radical enough.  Krugman suspects that Obama really did have a belief that such as thing as bipartisanship could still exist in Washington, D.C., and that he wanted to make it possible for Republicans to support health care reform.  But let's face it-- no plan Obama comes up with is going to win Republican support, because they're more interested in seeing Obama fail than in assuring U.S. citizens have health care.  If you want some sense of how impossible bipartisan support has become, check out  Thomas Geoghegan's column on the filibuster.

Here in Massachusetts, where we already have health care, maybe it's easy for the state's Republicans to forget.  I have been and will continue to be a critic of our commonwealth's system.  Yet, in spite of the cost, I've had health care when I most needed it.

What I don't have, however, is a job.  I'm more than half-way through my unemployment benefits and getting a little scared.  And as an opponent of a biomass incinerator in Springfield, I'm unhappy that the Obama administration is so gung-ho for biomass.   But I do believe that the administration is open to the truth-- something I never felt under Bush.  And with the impossibility of bipartisanship, a vote for Scott Brown, who proudly proclaims himself as a spoiler, we can forget about health care.

I'm not a fan of Martha Coakley.  But I'm voting for her.  I have no alternative.

Senate unveils new health care plan

WASHINGTON (The Borowitz Report) - The United States Senate today unveiled details of its health care plan, tentatively called CompromiseCare^TM:

-- Under CompromiseCare^TM, people with no coverage will be allowed to keep their current plan.

-- Medicare will be extended to 55-year-olds as soon as they turn 65.

-- You will have access to cheap Canadian drugs if you live in Canada.

-- States whose names contain vowels will be allowed to opt out of the plan.

-- You get to choose which doctor you cannot afford to see.

-- You will not have to be pre-certified to qualify for cremation.

-- A patient will be considered "pre-existing" if he or she already exists.

-- You'll be free to choose between medications and heating fuel.

-- Patients can access quality health care if they can prove their name is "Lieberman."

-- You will have access to natural remedies, such as death.  More here.

From the Borowitz Report.  (Why have I never been to this site before?)

Photo from psyberartist's photostream at Flickr.

The REAL threat to Americans

From St.PeteforPeace.org.

How the health insurance industry shapes its message

Neal waffles on health care

A hundred people showed up yesterday for a rally at Congressman Richard E. Neal's Springfield office on State St. We were there to see if we could win Neal's support for HR 676, The United States National Health Insurance Act.

Many groups have met with Cong. Neal to ask him to support HR676. He just keeps putting off a real answer. Yesterday he released the following statement:

“Since President Obama’s election, I have pledged to work with him to reform America’s health care system. I share his goals that comprehensive health care reform must be affordable, provide coverage options for every American and guarantee quality care. As a member of the Ways and Means Committee, one of three committees in the U.S. House that has jurisdiction over health care, I am committed to passing real health care reform legislation this year. On numerous occasions, I have spoken with the White House and officials in the Obama administration about the importance of passing health care reform during the 111th session of Congress. I know they share my view that the American people cannot afford to wait any longer. As the debate in Congress resumes, I look forward to continuing my work with President Obama and the leadership in Congress to make health care affordable and accessible for every American.”

Well, blah, blah, blah.

Two days before the rally, a member of the Western Mass. Single Payer Network had a conversation with Neal's legislative aide Bill Powers about HR 676. The gist of it went like this:

• Rep. Neal has already met with 2-3 groups regarding his stance on healthcare, and can't keep spending time meeting with groups over this single issue.
• • Neal's position on health care is not clearly articulated in any public place and cannot be articulated without a "longer conversation" but unfortunatelty Neal is not available to meet on this topic for at least a month-and-a-half or two months in the future.
• • When asked whether Neal supports HR 676 or not, Powers stated that Neal takes issue with how HR 676 is written, but does not necessarily object to HR676. Again, his position on HR676 requires a "more lengthy discussion".

Could Neal's lack of support for HR 676 be linked to the fact that his top contributer category is insurance companies? That's not the case for any of the other 13 U.S. Senators and Representatives in Massachusetts.

Unfortunately it seems as if President Obama has yet to come around to supporting a true single payer plan. His current proposal gives too much power to insurance companies. A good fact check on his plan can be found at PolitiFact. A real problem is that his plan mimics the Massachusetts model. Yesterday's Boston Globe sees the state's health care costs spiraling out of control, waits for doctors increasing, and costs keeping patients from accessing prescription drugs and doctors.

It's not too late to win HR676, but we have our work cut out for us.

Photos: President of Arise Don James, Shirley McCready and John Bennett from Mass. Senior Action, Liz Bewsee from Arise and Ashley from OutNow, Arky Markham from Western Mass. Single Payer Network, Sadie Centeno and Vanessa Rivera from Arise, State rep. Ben Swan, City Council candidate Norm Oliver.

The Visa Commercial I'd like to see

By Jim Moss at the Seminal

Amount spent each year in Europe and the United States on pet food: $17 billion

Cost per year to achieve basic health and nutrition for the entire world: $13 billion

Amount spent on perfumes each year: $12 billion

Clean water for all the world: $9 billion

Amount spent on cosmetics in the US: $8 billion

Basic education for the world’s children: $6 billion

Total amount the US spends on Christmas each year: $450 billion (or 16 years worth of food, water, and education for the world)

Initial cost of the US Government bailout of failing financial institutions: $700 billion (or 25 years worth of food, water, and education for the world)

Coming to grips with the alarming disconnects of our consumerist society: Priceless

Mel Gibson at Mercy Hospital

I just came back from picking up a friend of mine and his girlfriend at the Mercy Hospital Emergency Room. He has a severe hernia and had been there since 11 a.m.; it was 6:30 p.m. when they climbed into my car.

"You'll never guess who was in the emergency room when I was," he said.

"Morgan?" I said, naming a friend who is missing in action.

"Way higher than that," he said.

"OK, who?" I said.

"Mel Gibson!"

"Really? What was he doing there?"

"Some minor accident on his movie set. Didn't really seem hurt. He had his own doctor with him. The nurses were all giggling."

"Yeah, one nurse said, "I'm all set, I touched his feet!' I don't like feet though, so that didn't do anything for me," my friend's girlfriend said.

"And how long was he actually in the emergency room?"

"He was in and out in about an hour and a half."

"Mel Gibson at Mercy," I pondered. "Oh, wait, I get it-- Mel Gibson's a Catholic."

"Yeah, and I'd gone outside to smoke a cigarette while I was waiting, and he came out, surrounded by five people, and got in the passenger seat of his stretch SUV. He looked right at me," my friend said.

"You know he's an anti-Semite"-- my friend looks at me blankly-- "someone prejudiced against Jews."

"Really?" my friend said, a bit crestfallen

"Yeah, when he was stopped for drunk driving a few years ago, he said the Jews were responsible for all the wars in the world. Called a female cop sugar-tits, too."

"Well, I certainly pick the exciting times to come to Mercy. The last time I was here, people were standing in the parking lot, looking at that window that was supposed to look like the Virgin Mary."

"Mel Gibson...the Virgin Mary....hmm."

"Man, I'm tired," my friend said. "Thanks for dropping me home."

"No problem," I said.

Help prevent 100,000 unnecessary deaths a year

Will you or a loved one spend time in a hospital any time soon?

Two million people will get a hospital-related infection this year, and 100,000 will die from it-- every single one a preventable death.

Protocols exist for IV lines and central line and urinary catheters, the most common (but hardly sole) sources of infection, but hospitals are inconsistent in applying them. 85 percent of the 95,000 people who will get MRSA, a drug-resistant and life-threatening inftction, get the infection in a hospital!

The Consumers Union is calling on the U.S. Congress to pass a national standards law to reduce the chances you'll get worse, not better, when you need to be hospitalized. You can sign a petition urging Congress to take action.

Photo from Bert Becker's photostream at Flickr Creative Commons

Baby talk no good for Alzheimer's patients

I don't usually print an article in its entirety but, given experiences during a recent hospitalization, this one really hit home:

Don't treat Alzheimer's patients like they are children, researchers say

August 7, 2008

Researchers from Kansas have offered a rare glimpse into the interior world of Alzheimer's patients with a new study presented at a major international conference in Chicago. The study, while small, is highly suggestive: Key findings indicate that patients - even those who may seem deeply disoriented or cognitively impaired - dislike being patronized or treated as if they are children.

This suggests that a sense of adult identity remains intact in people with dementia, even when individuals aren't able to remember how old they are, where they are, what day it is or which family members are alive and present. How people experience Alzheimer's disease, especially in its latter stages, is a mystery because those with the illness lose the ability to articulate their thoughts and feelings.

In the Kansas study, researchers tried to get around this hurdle by videotaping 20 elderly men and women living in three nursing homes during the course of a day as aides helped them bathe, brush their teeth, dress, eat and take their medicines, among other activities.

Researchers then analyzed the tapes, assessing how the manner in which staff interacted with patients influenced patients' behavior and the quality of care.

They discovered that when nursing aides communicated in a kind of baby talk for seniors - using a high-pitched sing-song tone, comments like "good girl," diminutives like "honey" and language that assumed a state of dependency ("Are we ready for our bath?") - Alzheimer's patients were twice as likely to resist their efforts to help.

Chicago Tribune
Copyright © 2008, The Baltimore Sun

A patient's search for dignity at Baystate Medical Center

I just spent the last three days as a patient at Baystate Medical Center. Suffice it to say I will live. I don't fault the medical care offered there-- much of it is excellent. (Only one mistake-- I hope-- and one near-mistake in my case.) But in the eleven and a half hours it took to me to get from the emergency room to a room of my own, I witnessed or experienced many different varieties of injury to the human spirit.
My first stop is a chair right next to the security guards' office directly opposite the ambulance entrance. The guard on duty is a hefty blonde named that someone calls Kel.. Ambulance services and fire and police departments from surrounding communities pass through those doors and there is much colleagial mingling.
A young woman comes through the ambulance entrance accompanied by a police officer. She's been crying very hard, her face is red and she has a tissue pressed to her eyes.
The guard says to two colleagues, "Bet she's headed for the crisis unit. 'I hate men, I hate men!'" she mimics.
I can't believe what I'm hearing.
Seeing as she's standing right next to me, I say, in a low voice, because it is not my intent to embarrass her, "You shouldn't talk like that in front of other patients." She looks at me and glowers, says nothing, and goes back in her room, where two of her colleagues are hanging. Voices grow hushed.
A minute later one of the men comes out, leans against the doorjam, and says, to no one in particular, "Well, I thought it was funny."

Three hours later I am finally sharing a chilly examining room with two other people, one of them a frail-looking elderly man who had already been hooked to an IV. He is sitting on the side of his cot, trying to put on his shirt but getting tangled in the process. (It's impossible; I know, I've tried it.)
A nurse comes in and in a teeny tiny high voice she says to him, vowels rounded, words cadenced, "Oh, Mr. Wilson, look what you've done, now just lay right back and let me untangle you." She's talking to him like a baby!
"Laying back has nothing to do with it!" he snaps.
"You're right!" I call over. Of course she just wants him to lie down. Later he and I talk and he tells me he's an engineer.
"Retired?" I say.
Yes."
"My dad was a civil engineer."
"Too much tromping around outside for me," he says.
We chat until someone comes to move him to a room. I find him to be a rational, intelligent adult who just happens to be 82 years old.

Finally, at 12:30 a.m., I am moved to a room in the Springfield building. The woman in the next bed has her TV on! And loud! I'm going to myself, Oh, for Christ's sake, I'm exhausted and this is ridiculous. I ask the woman, who is non-English-speaking, to please turn down her TV-- using gestures and pointing. She looks at me blankly.
I say to the TA, "Can you please ask her to turn down her TV? Isn't there any kind of a curfew about how late TVs can be on?"
She looks at me blankly.
"People have a right to have their TVs on," she says.
"And how does that compare to people's right to have peace and quiet in a hospital?" I ask.
"Why don't you just climb into bed, honey, and I'll get you a sleeping pill?"
That does it.
"Don't call me honey!" I snap, knowing I'm about to be labeled the bitch of the ward. But at that point I just don't give a damn.

The next day I write out a note and tape it to the end of my bed.
"Please don't call me 'Honey' 'Sweetie' or 'Cutie.' Please call me by my name or leave out the name altogether."
I know this form of address doesn't bother a lot of people-- maybe, in fact, in this cold, cold world, some people are even grateful-- but to me when medical personnel address a patient in this way it simply increases the power imbalance between them, and patients are disempowered enough as it is.

How anyone gets well in a hospital is a small miracle.

Our "wonderful" health care system

Michaelann: I got this email from my friend Holly yesterday and it was too good not to share...

hey...i was reading your blog and it got me thinking about this experience i had and how I, too, have been thinking much of this land of liberty and justice for all...

last week while eating nachos one of my back chewing teeth broke....I knew it was only a matter of time. after all, it was only a 'temporary' filling. I needed a crown 2 years ago. I couldn't afford the roughly $1200 for it then...and I surely couldn't afford it now. but, I knew if I didn't do something promptly the tooth was going to continue to crumble.

I haven't had dental insurance much of the past 20 years. I now have health insurance, thanks to Massachusetts's 'universal health care' law. I have to pay $240/month to not have prescriptions covered. this year, though, the state also mandates this coverage, and my policy has gone up. all it means is that I have co-pays for everything that still leaves most care cost prohibitive when you live paycheck to paycheck and have no money in the bank...or anywhere else for that matter.

anyway, I digress. so I go to the dentist to be met first by the dental hygienist. she told me she had twins and one was in need of braces. she said she was glad to work for a dentist because she got some discount. she ended saying the braces were going to cost her a couple thousand dollars or so. she said she didn't really have the money, "but,. what are you going do?" she seemed very positive about it all. I was sitting in the chair, with her in and out of my mouth, and I was so angered. I was angry that I knew my own tooth (and many others in my mouth actually) was not affordable; and, I was angry that she was so jolly in her resignation that this is just the way it is here...that we have to pay thousands of dollars for our care and that everything is an 'extra' and that barely anything is just covered with 'insurance.'

the dentist comes in and looks at my x-ray. she says she is not sure what she can do for me, "you really need a crown." she has an edge to her. I say I cannot afford a crown and I'm hoping she can give me another temporary filling. she tells me, again with and edge, "I'm not sure what I'll be able to do until I get in there and look at how bad it is." I inquire about the price of a crown currently, and she says it ranges from $1200 to $1500, and adds, "that's not that bad."

she then looks at her watch and says to me and the hygienist, "Oh, I don't have time for this. I can't do this now." she states she has someone else coming for an appointment in the next room. I'm thinking to myself, well crap...if I don't get this done now, I'm not coming back. but then what. my damn tooth isn't gonna fix itself. I already can't chew on my right side because I have a big back tooth missing and I need a bridge. interesting...bridges and crowns...these symbols of access and privilege that I am locked out of.

anyway, she decides to stay with me. she says the other person can wait. I feel bad for that other person.

she swiftly carries on with Novocain, and follows with chit chat with the hygienist. apparently she has just arrived here from the mid west. she is just out of dental school and is on day 2 of driving her brand new SUV. she remarks, "Yea, I don't need a Lexus." every now and again she asks if I'm numb yet (and she means my tooth area, not to this system that I am seething about and am anything but numb to). as she gets ready to proceed with me, she again tells me she does not know what she is going to find, and that I really must get a crown. I tell her, again, I wish I could. she begins drilling and commenting, "Oh, well, this could be bad...I can't tell if this is decay or staining...If it's decay, I don't know what you're gonna do." I'm thinking...YOU don't know what I'm gonna do?! didn't you just graduate from dental school? should I look myself and make a decision? anyway, while all this is running through my head, she says, "Oh, good...it's just staining." she continues to give me the temporary filling, wraps up the work and walks me to the reception desk so I can pay up. she shakes my hand and, again, tells me in a plastic sort of way, "you know, you really are going need a crown. that temporarily filling isn't gonna last you," and she walks away.

I pay the bill with a credit card, and leave hoping for the best: hoping this filling goes a couple of years and hoping I'll be able to pay off my mounting debt that is accruing for necessities.

Patient Safety Act passes the Massachusetts House

Last February I wrote about why we need the Patient Safety Act, which would require a certain ratio of nurses to patients. Hey, we go into the hospital hopefully to get better, not to catch a hospital-related infection or get an overdose of a drug-- or the wrong drug entirely!

Naturally, hospitals oppose such legislation-- just like the drug companies are opposing legislation prohibiting them from giving gifts to doctors and nursing homes are opposing legislation requiring a 50/50 split of state money with home care providers.

Looks like institutional power may be giving way to common sense, at least as far as the Patient Safety Act goes. The legislation has been passed by the House and is now going to the Senate.

You can find out your senator and his/her phone number here. There's a new bill number-- HB 4714. Let them know you want to be safe in the hospital. You can get more infromation at the Mass. Nurses Association website.

Live in Massachusetts? Thinking about changing doctors? Think twice

I wrote a bit last week about why Massachusetts' universal health care program was a budget-buster for this state, currently facing with a $1.3 billion budget deficit. Don't get me wrong-- I'm all in favor of universal health care, but not on a state by state level and not the one we have in Massachusetts.

Now the New York Times reports that the Massachusetts system is struggling with the increased patient load It's not so much that there are fewer doctors (although that's true with primary care) but that more people are now seeking long-delayed care and treatment-- an additional 340,000 just in the last year. The average wait for a new patient to see an internist has gone from 33 days in 2006 to 52 days in 2007. Specialties fare no better. For the first time in my life, I have private health care; my primary care doctor scheduled a visit with an endocrinologist for me-- and it's six months away!

Other problems with Massachusetts' system are emerging, some outlined in the NYTimes article. Woe to the Massachusetts non-profits, especially Health Care for All, that abandoned a truly universal coverage plan to support then-Governor Romney's mandatory, private-pay system. What good is health care if you can't get in to see a doctor in a timely manner?

Photo by The Opportunity Agenda

My new campaign

My sister was admitted to Baystate Medical last night through the emergency room (always a zoo).
I left her at 2 am. when I knew she would be admitted and started calling at 7 am. this morning to try to find out how she is. The hospital nearly gave me a heart attack twice when they transfered me to Cardiac ICU and they couldn't find her; we went around several times before I finally got to the right place. She's OK for now; tests to come.

Meanwhile, while I am on hold for many minutes, I am subjected to a string quartet of extremely staccato nature played very quickly. I should recognize the piece but can't. It might be good housework music, but certainly nothing that should be played to anxious relatives.

Once I had to have an MRI and the technician asked what kind of music I wanted in my headphones. I told her classical-- and suddenly Bach's Concerto in D Minor (I think) thundered through my ears. It's the kind of piece you use as music in productions like Phantom of the Opera. DUM da da da DUM DUM. "Stop!" I shouted.

So somebody who knows that they're doing at Bay State needs to change their music.

I think what I am experiencing is displacement of anxiety.

Why Massachusetts' health care plan is doomed to fail

Romney thought he'd use the creation of a mandated health insurance plan for all uninsured residents to launch his bid for president. His campaign failed and the failure of the state plan may be only a couple of years behind. Even the lowest co-pays are out of reach of many, but if you don't choose a plan, you lose your state income tax refund. The Nation has a good breakdown of why this failure is inevitable.

Why we need more nurses

The first time I heard a nurse speak about the need for the Patient Safety Act, she said that when she went home at night, she worried about mistakes she might have made, what she might have forgotten to write down in a chart, what she might have left undone, because there were too many patients and not enough nurses.

I was shocked by her honesty but not surprised. The previous year my sister had had an emergency splenectomy and then gone two days without seeing a doctor because someone had neglected to put her on the medical rotation list. Later she was accidentally over-medicated.and her breathing was suppressd. She survived both events, minor in the grand scheme of things, but others have not been so fortunate.

Don't get me wrong-- I'm not saying that hospital-acquired illnesses, complications and mortality are all attributable to a shortage of nurses. But consider the following

• One out of ten patients admitted to six Massachusetts hospitals :suffer serious and avoidable medication mistakes, according to a Boston Globe article last week.
• The higher the patient to nurse ratio, the more likely there will be patient deaths or complications after surgery. Each additional patient per nurse over four is associated with a 7% increase in mortality.
• Inadequate staffing precipitates one-fourth of all unexpected occurences that lead to patient death, injuries or permanent loss of function.
• The more nurses, the lower the infection rate in patients. Sources for this information can be found at the Mass Nurses Association.

Nurses become nurses because they want to help people, but they can wind up working in conditions we wouldn't tolerate on the assembly line. Overworked nurses quickly burn out and many leave the profession or cease to work at the bedside.

You'd think that hospital administrators would want to do everything possible to maintain a good workforce and ensure safety for its patients, but no-- they've been vehement in opposing legislation requiring safe staffing ratios, saying hospitals can't afford it. This year, however, H. 2059, the Patient Safety Act, has a good change of passing.

You can send a message to your legislators asking them to support H. 2059 at the Mass Nurses Association website.

how much is a life worth?

The New York Times reported today (in the Business section) that Medicare is going to reduce its reimbursement rate for two successful cancer drugs to such a degree that hospitals will stop offering the drugs for treatment-- AND, due to federal rules, hospitals aren't allowed to administer a drug to ANY patient if they can't give it to Medicare patients.

These drugs have been incredibly successful in creating long-term remission for non-Hodgkins lymphoma patients when other treatments have failed. Medicare says hospitals are charging too much to buy and administer the drugs.

I wonder just how Medicare figured out the cost of a human life?

Wasn't this a Law & Order episode? & other homeless news

LAW & ORDER: Insurance agent Richard James and a co-defendant are on trial for felony murder in NYC for taking out life insurance policies on at least three homeless people and then killing them.

CAN'T SEE THIS HAPPENING HERE: Mayors in Nevada rallied for $20 million in funding for transitional housing for the homeless. Apparently they were inspired to action after lawmakers and homeless advocates spent a snowy night in tents back in February on the lawn of the Nevada Legislature.

ON THE OTHER HAND, THIS SEEMS LIKELY: The Democratic National Convention is coming to Denver next summer, so the city plans to keep its winter-only shelters open through the summer and for 24 hours instead of just overnight. Black Star News

NO DUMPING HERE..JUST BACK AND FORTH FROM HOSPITAL TO SHELTER: LOS ANGELES -

LOS ANGELES - A paraplegic man with a broken colostomy bag was found crawling in the gutter. An elderly woman, wearing only a hospital gown and slippers, was dumped on the street by a taxi called by the hospital.
For years, few people took seriously reports that Los Angeles hospitals were taking sick, confused and homeless patients by ambulance to the city's notorious "Skid Row" and leaving them there.
Today, Los Angeles city officials and a major hospital group announced a deal they hoped marks the beginning of the end to the dumping of vulnerable people in an area thought to have the highest concentration of homeless in the country.
Kaiser Foundation Hospitals, the nation's largest non-profit health-care provider, agreed to find shelter places for all homeless patients it discharges in Los Angeles.

It will also contribute US$500,000 to homeless services on Skid Row including a free legal clinic, a shelter bed database and extra beds for recovering patients. More at New Zealand Herald.