Maddy wrote: ↑Sat Dec 19, 2020 6:49 am
glennds wrote: ↑Fri Dec 18, 2020 10:57 pm
If you worked at a hospital that was going on ED divert several times a week all year round, then you're working in a seriously underbedded market.
What exactly do you do? May I take a guess?
Respiratory therapist? Lab or pharmacy tech? Phlebotomy? PT, OT or Speech?
Sophie is an M.D.--a neurologist.
Here we seemingly have two completely different interpretations of what an 8% remaining capacity means. Is it, or is it not, status quo for this time of year? Patient census statistics ought to resolve the question definitively one way or another.
Sophie's explanation that hospitals contract and expand their capacities to maximize profits rings absolutely true to me. Sophie has proven herself over and over to be a real stickler when it comes to the interpretation of data, so I have confidence that she's not speaking out of her ass. And I'm all too aware that we were intentionally duped on this very point earlier this year when--right here in my locale--we were led to believe that the hospitals were "overwhelmed" when in fact their censuses were so low that a few months later they were on the verge of closing.
Glennds maintains that the present situation is highly abnormal, but I see no attempt to back that position up. Glennds, what, in particular makes you conclude that the 8% statistic represents something out of the ordinary?
Maddy,
My earlier question of hospital position was directed at Tomfoolery not Sophie. I did indirectly ask Sophie whether she is a physician who provides direct patient care, and she has clarified that as a faculty physician/scientist, she does not. I would argue that without one being "better" than the other, a scientist/academic physician will have a different perspective than a direct patient care attending or consulting physician.
This distinction provides a backdrop for my comment on the 8% remaining capacity comment. It's not about the 8% or any percent for that matter. My comment about the present circumstances on the hospital floors (in my market) being abnormal has to do with the conditions present. It's not the amount of capacity, it's the
kind of census.
In hospitals, we utilize a ladder of precautions in the course of infection control. Right now, those precautions are elevated to the highest level and not for certain patients, but all patients. To have a situation where essentially every patient is either under source or protective isolation at 92% of capacity is RADICALLY different than 92% capacity under normal circumstances where this is not the case. The demand on staff is enormous because of donning/doffing PPE procedures, segregated assignments, increase in Point of Care (POC) dedicated equipment, meaning the POC equipment cannot be moved from room to room for now. Think about the demands this places on the biohazard staff, central supply personnel, environmental services, and even medication distribution.
It would be as though yes you have the same 92% that you had last year, but 5x the churn of PPE, DME and biohazard procedures.
And consider that direct care staff are forced to work at (maybe) 50% of productivity because of all the momentum obstacles. This is prompting considerably higher staffing ratios and more overtime than would be typical. Also, we are seeing maybe 30%-40% more traveler/contract/out-of-state caregivers than normal to supplement the load (if you can find them). Right now the rent-a-nurse agencies are fleecing the providers because well, that's the free market).
We're talking mostly nurses and respiratory therapists. Don't even get me started on the family restrictions and management demands and what it is doing to the case managers.
I am in no way suggesting that Sophie is speaking out of her ass or that she's anything less than competent. Nor am I challenging her credentials or professional medical opinion. Its just that if she is an academic physician and not working in direct patient care or hospital administration, understandably she may not have this field operational perspective and neither would you, being a legal professional.
Is the description above something that you can envision, and if so will you accept it as a good faith attempt to back up my position that COVID has introduced abnormal circumstances to the inpatient hospital side of the health care industry?
A few disclaimers:
I do not know what is going on in other markets. There could very well be hospitals in some places that are not confronting the load I am describing.
I am not getting my information from the media. I am a hospital industry insider, and have co-workers, friends, attending and consulting physicians who are in the trenches every day from whom I am getting this information. I have visited two hospitals where I used to work and they have no resemblance to what I would call normal. War zone is what came to my mind.
This is why I responded, not to argue, but to provide a reality check.
I am not debating anyone's political opinions in this post, I am merely providing feedback on the current conditions in inpatient hospitals and vigorously objecting to the suggestion that they are totally normal.
