Hospital Patients are More Complicated Than Ever: What It Means for Medicine
Ғылым және технология
The first time I saw a patient in the hospital was in 2004, twenty years ago, when I was a third-year med student. I mean, look at that guy. The things I could tell him.
Since that time, I have spent countless hours in the hospital as a resident, a renal fellow, and finally as an attending. And I’m sure many of you in the medical community feel the same thing I do - which is that patients are much more complicated now than they used to be. I’ll listen to an intern present a new case on rounds and she’ll have an assessment and plan that encompasses a dozen individual medical problems. Sometimes, I have to literally be like - wait, why is this patient here again?
But until now I had no data to convince myself that this feeling was real - that hospitalized patients are getting more and more complicated, or that they only seem more complicated because I’m getting older. Maybe I was better able to keep track of things when I was an intern rather than now as an attending, spending just a couple months of the year in the hospital. I mean, after all, if patients were getting more complicated, surely hospitals would know this and allocate more resources to patient care, right?
Right?
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Пікірлер: 1
Every patient in the hospitals now are very much in need of services. I became a nurse in 1978. We used to have patients come in the night before surgery and stay for at least one day. Now, it's all day surgery. Now, even when patients are at an almost intensive care level they are sent out to rehab unit and nursing homes. I worked in brain injury rehab and the admissions that we had would have never been released from the hospitals previously. Part of the issue in the USA is that hospitals are penalized by the government if any infections occur during hospitalization, so the idea is to get them out the door asap and let the problems happen at another facility, and thereby not count against the hospital. The point you make is dead on, especially with the patient to nurse ratio loads. When the ratios stay the same but the patient acuities go up, it puts a lot more work on staff.