By Lydia A. Meyers RN, MSN, CWCN
Today's health care changes are a necessity. Unfortunately, both the country's economy and overspending with abuse of the system contributed to this need for change. What are the predictions for the future? How can educated health care professionals prepare for the future and protect themselves? How will these changes affect wound care and wound care nurses? Within this blog, I will try to answer these questions with information gained from life, education, lifelong research, critical thinking, and looking outside of the box.
CASE IN POINT: When Medicare was started, the health care system viewed the program as a free ride and with that, the system was abused. No one questioned the doctors, no one questioned the hospitals and no one questioned the patients for decisions that were made. Many long-term nurses told me of days when many patients were admitted just because of too much stress. Testing and special procedures were done without question. Sometimes procedures were even billed when they were not actually done. Even today things are happening in the health care system that are mind-blowing! Will there not be Social Security left for the many people getting ready to retire? Consider how many unnecessary dollars have been spent because of this abuse of the Medicare system, and how much is actually left available for those retiring.
This poses an even grimmer financial outlook for the generation behind the "baby boomers," because the previous generation has always been the one paying the way for the next. That is how the system was designed. Another issue with the system is that people are now living longer, and that was not figured into the idea of Medicare and Social Security. Health care has become more expensive because of increased wages, increased cost of specialists, increased cost of equipment and increases in how health care is delivered (as well as lawsuits). The days of our parents are gone, but the same kind of care is still expected. The freedom to make our own choices on our own terms is the dream of today.
What is my personal opinion of Obamacare? Reform is definitely needed in health care. Is socialized medicine the answer? Has the government done well at running our health care? Is Medicare really working? I think we need time to think about this. I feel that educating patients, and giving them choices about what is right for themselves, is important to help decrease the cost of health care. For instance, a patient that is contracted, not aware of what is going on, has little to no family to come visit – what is their quality of life? You look into the patient's eyes and see pain. You move the patient and can feel the shaking.
Is it the choice of the patient or the choice of the family? A good change would be to assist families in making better decisions instead of a person "being allowed to live" in a socialistic manner. This is a change that is needed in the new health care system: help families to make the best decisions based on the patient's true needs. There are good and bad things within the new system, but it is here now, and we need to be sure we use the system wisely.
Health Care Reform and What Health Care Providers Need to Know
- The educated patient who wants to make money by suing the facility or health professionals. There are far too many malpractice lawsuits. Why was malpractice started? It was started to make changes and assure the best medical care was being given.
- Patients should be made aware of choices and plan for their care. Patients and families should no longer be kept in the dark and not allowed to know what is going to happen. Patient rights are the most important rights we can put into place. Doctors need to talk to both the patients and their families. Health care workers need to introduce themselves and explain what is going to happen with the patient's care. Nothing should be done unless the patient (or the patient's family) is aware of contraindications and what can happen. Is this bad? No, patient education is the most important thing that we can offer as health care providers.
- The best way to decrease lawsuits is to treat the patient like he/she deserves to be treated -- with compassion and caring. Treat that patient like a part of your family.
- People need to know medicine is a practice and not a science. Each person is different and I am glad that is true. This creates an opportunity to offer truly individualize health care.
Practical Tips for Wound Care Providers
How will this affect wound care and wound care nurses? Since I am being engaged in both worlds, I will answer based on what I see happening in the industry. The wound care industry needs to follow the rest of the health care industry in looking at costs, using resources to the fullest capacity, and considering a better or more cost-effective way to do business. Healing wounds needs to be done in a manner that decreases costs. Using expensive dressings just because they are available is not using resources effectively or intelligently. An example: silver dressings should only be used for short periods of time and only when truly needed.
A smart wound care doctor taught me two mnemonics to remember when looking at wounds to determine if infection is present: 1) NERDS, and 2), STONES.
E: Increase in amount and look of the exudate
R: Extremely reddened tissue in the wound bed that bleeds easily
D: Increase amount of debris in the wound bed
S: An unpleasant smell after the wound is cleansed.
S: Size is bigger
T: Temperature increases (patient temperature)
O: Osteo, exposed bone
N: New areas of breakdown or satellite areas of breakdown
E: Erythema, exudate, edema
S: An unpleasant smell after the wound is cleansed.
The first rule is: when the wound is not healing there is a problem. With a proper assessment, an appropriate dressing can be used and the wound could go to healing, decreasing overall cost to treat the patient.
In summary, health care needs to change. The right and wrong answer is still out there and I'm not sure what the answer should be. What I do know is the patient remains the most important thing nurses need to take care of and be there for. Patient and patient care is why I became a nurse. I hope only to do what is best for the patient and take care of the patient.
About the Author
Lydia Meyers RN, MSN, CWCN has been a certified wound care nurse for over 15 years with experience working in home healthcare, extended care facilities, hospice care, acute care, LTAC, and wound clinics. Her nursing philosophy to "heal wounds as quickly as possible" is the guiding force behind her educational pursuits, both as a teacher and a student.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.