Do illnesses take weekends off? Of course not…so why do hospitals?
Have you ever been in a hospital on a Friday Night or Saturday morning? If you have, no doubt you have seen the skeletal crew making up the ghost town hospitals fade into on the weekend. The dilapidated state hospitals fall into during this time is dangerous to patients!
We have experienced many doctors' preference to "wait and see" during this precious weekend time period. They have decided more than a couple times to "wait and see" if our son's problems did constitute an emergency. On one specific occasion, they decided to "wait and see" if our son's inability to control his bowels and stools (i.e. the poor little guy had it coming out both ends) was an emergency rather than call the specialist needed to ascertain what might be causing this difficult situation (we will call this specialist Dr. Tom). God forbid we bother Dr. Tom! Who cares if this kid might have severe Grapht Versus Host Disease of the gut and the only way to determine this is for Dr. Tom to be called in. Dr. Tom must have time for his boat and his Porsche. Apparently, weekends are sacred in the medical world and we would rather make patients suffer than bother Dr. Tom! Don't get me wrong, I am all for boats and Porsche's, but don’t patients matter more? And I realize it may not be Dr. Tom's fault the hospital is improperly staffed over the weekend, but whoever does determine the staffing over the weekend should really be made to stay in the hospital over the weekend when they cannot control their bowels or keep any food down, throw up their NG tube (NasoGastric feeding tube) and have over 40 diapers in a 24 hour period (so much so that they are bleeding continuously from their rectum). After a hospital stay of this kind, I would bet their decision to inadequately staff the hospital over the weekend may change.
Have no fear, I’m sure the doctors and hospital administrators have told AIDS, cancer, Grapht Versus Host Disease (GVHD) as well as all chronic health issues to take Saturday and Sunday off and to come back Monday morning. So, we are okay with not actively treating issues we are uncertain about 2 out of every 7 days? This means we are not actively treating chronic or longer term diseases/illnesses 29% of the time!
Furthermore, if you take into account nighttime, hospitals only actively fight 36% of the time!!! (There are 168 hours in a week. * Hospitals actively fight chronic diseases when Attending doctors are at the hospital working), conservatively, 60 hours a week. 60/168 = 36%.) Is 36% good enough? Can we expect to beat these extremely deadly chronic illnesses by only fighting them 36% of the time?
Because both have to do with life or death, I equate illnesses to war. Having graduated from the Air Force Academy, served over 11 years on active duty and been involved in our latest conflicts, I can say the military does not take nights or weekends off during war! Okay, okay, maybe the Navy does, but the rest of us do not (I never miss a chance to poke fun of the Navy!). Perhaps most of our productive work takes place during nighttime and weekends.
It is no wonder there is a “weekend effect” (for more info on the weekend effect click here ) http://www.kevinmd.com/blog/2013/11/solving-weekend-effect-patients-hospital.html which basically means if you have a weekend hospital stay you are at further risk of dying or at the very least lengthening your hospital stay. This is due to the fact many testing facilities within the hospital close unless an “emergency” arises. The problem is, when dealing with chronic illnesses like GVHD, doctors don’t know WHEN it is an emergency or not unless they have access to the testing that is shut down for the weekend. And since they don’t want to call their fellow doctors and hospital coworkers in on a Saturday and cause undue strife, they take a delayed approach and HOPE it’s not an emergency. In our 9 year in-depth hospital experience, we have learned chronic illnesses need more than 35% of our time to fight them and our patients are suffering for this inadequacy.
The solution is not popular with hospital staff, but GVHD doesn’t care, AIDS doesn’t care, cancer doesn’t care. We have to develop a system where doctors have access to the testing they need to determine issues 24 hours a day, 7 days a week. If Las Vegas has been able to conquer the effects of the night, surely the brainiacs who work in hospitals can at least copy the sharks of Vegas. I’m talking lighting, attitude, but more importantly testing. Obviously, hospitals need to work on this and insurance companies as well as patients need to pressure them. Insurance companies should apply pressure knowing that, in many cases, 2 out of 7 days a patient is not being actively treated yet the insurance company is still getting billed for the stay. Patients obviously know more time spent in the hospital is counterproductive to their health and means more time away from family, work, the pool and Starbucks. It also means more bedsores and the subjection to more hospital viruses among other things.
I believe we need hospital boards to shift their mindsets to that of military war staffs and start fighting illnesses 24 hours a day, 7 days a week. I realize Dr. Tom needs time for his boat and Porsche, but that doesn’t mean the hospital stops. Guess what? If Maverick the fighter pilot isn’t providing support to the ground soldier, there is another guy in his place providing support. So Dr. Tom go boating, but let’s get Dr. Steve in so while you’re out catching trout, we can fight the battles needing fought and stop “waiting and seeing!” Chronic illnesses don’t take weekends off and neither should we!
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Roar,
Mighty Lionhearts
*This calculation is derived from a 12 hour, 5 day work week.
