It's my blog and I'll rant if I want to

A couple months ago, I picked up a part time gig as a visiting nurse.  While an extra paycheck is nice, I had ulterior motives:

One: I'm super curious about how and where people live. I love old mansions and falling down farm houses. I want to know what goes on in trailers and run of the mill suburban homes. How people live interests me. Why the hell else does someone get a sociology degree before deciding to go to nursing school?

Two: I love Southerners. I love their sayings, their style and their swagger. Working in a big city university hospital certainly gets me some patients flown in from Alabama and Kentucky, but that's not the same as rolling up to some country folks house and seeing how they get down day to day.

Three: Working in a cardiovascular ICU requires a very specific skill and knowledge set. I have days where I miss the diversity of the clinic or my old medical surgical psych floor. I want to keep all my nursing skills nice and fresh.

Four: I lament the health care field of yesteryear and disdain the current health care system. I think it's fabulous and brilliant that people used to have real family doctors. These doctors followed their patients from birth to death, cared for generations within families and provided medical care both in the community and in the hospital. If you yearn for efficient, safe, patient centered health care, legit family doctors are the solution. All y'all politicians and other fools can take your Electronic Medical Records (EMR's) and send them to Mars with all the other useless projects our government spends money on. If you have not yet had the dehumanizing experience of going to a doctor's office while the doctor or nurse spends the visit with their eyes glued to a laptop instead of you, brace yourself, it's coming.

Further more, just because a patient's chart is in electronic format does not mean that all of your digitalized progress notes from doctor's visits are going to form a neat conglomerate chart in the magical land known as the internet. Give me a break. We're going to have to pay billions of dollars on top of the money already spent going digital to make that happen. Thanks to stringent health care laws protecting your privacy (such as HIPPA), even it were technologically possible to neatly package all of your medical records into one happy electronic chart, our laws would probably prevent it. And how comfortable are you with having your most private information floating around the web?

Why bother having a conversation with a patient when you could just click pretty boxes??



What's the real path to receiving top notch and affordable health care? Hard core family doctors, just like in the old movies. But guess what? Primary care doctors get paid dick. So, most medical students go into high paying glamourous specialities that offer cushy hours. You can't really blame medical students. They go to school for billions of years and most leave with ginormous student loan debt and red eyes from lack of sleep. Sure primary care can be rewarding, but with a shortage of MD's willing to go into this speciality and an ever growing society needing this type of MD, the workload can be grueling and the hours endless. The quality of care practitioners go into primary care to give is often made impossible by the extreme workload. It's a lose/lose situation.

The next time someone tells you a story about how the healthcare system sucks or is too expensive, tell them that congress ought to increase the reimbursement pay for primary care doctor visits, give student loan forgiveness to MD's and Nurse Practitioners who choose primary care and stop wasting money on EMR's. Tell them we need to get 1920's on our healthcare system!! Tell them primary care is the most badass speciality there is! Then, send them my way and we'll work out the specifics.

So, I went into visiting nursing to live out my 20th century health care professional dream, and my dreams are coming true. This was my second solo week in the field and I visited a patient I had met for the first time last week. We had hit it off pretty well and I was sitting on her couch, petting her dog talking to her about her depression, her blood pressure and the crap all over her house that she was bound to trip on.

"I don't know if this is legal," she began, "but can I give you some grapes?" Before I could answer she presents me with a soda box full of concord grapes from her garden. I tell her I'll just take one bunch. She refuses and dumps the whole lot of them into a bag for me. Then she sneaks a couple tomatoes in. I then ask for a tour of her garden, which she gladly gives. Without the slightest bit of suggestion that I take on the task she tells me that she can't weed and has no one to do it for her. I pick a few weeds on the tour and desperately want to attack the whole project but I hold back. After I leave, I feel like crap for not just weeding her whole garden. I'll attack it a little at a time I console myself. The good news is that I didn't just take her blood pressure, pretend to listen to her as I typed data into a computer and run back to my car after five minutes. We had a real patient and nurse interaction. I believe we both greatly benefited.