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Sunday, March 15, 2009

Is profit now more important than saving lives??

Most respiratory therapists are pretty good at what they do. We aren't just chums and peons who slap a neb in someone's mouth and leave the room, we assess and we do creative thinking to the benefit of the patient.

But many doctors and nurses and Rt bosses and administrators don't understand that. They see us as ancillary staff, no better than the technician that draws your blood or performs an ordinary x-ray.

Very few times in the 13 years I've been in this profession have I heard of one of my coworkers making a mistake that endangered the life of one of the patients. In fact, I can think of no examples of which this happened. In fact, perhaps it never has.

Yet we have all spent time in the RT Bosses office from time to time defending ourselves because of some write up for some stupid reason, or, most common, because we forgot to chart a treatment.

It's almost to the point now that I spend so much time worrying that I'm charting correctly, and charting all my therapies, that charting has become the priority, with patients taking a distant second place. The number one goal of hospitals is not to save lives and make sick people better, it's to make money.

My coworker told me that she told the boss several years ago if it ever got to the point she was paranoid that she was going to make a mistake for creative thinking that she would quit. Now that's exactly what it's come to here at Shoreline Medical Center. We have all become paranoid.

We're not paranoid because we think we are going to compromise our patients, because they always come first to us. We are paranoid because we are afraid we aren't going to chart perfectly. We are told if we don't chart all our stuff we (meaning the department) won't get paid for a procedure.

Now I certainly want the department to make money, as I want to make a paycheck, but I think it's bull crap now that it's to the point we are all paranoid.

It makes one think this way:

"Which is more important: Doing something to harm a patient or forgetting to chart a treatment?"

I like to think, as do most ethical human beings, that the first goal is to do no harm. Yet now I'm beginning to wonder if the greater priority is making sure we chart so we can make the hospital profitable.

It's a shame I have to write about this, but it's true.


Matt said...

This is a great observation. As a respiratory therapist at a pediatric facility, there are times when charting must be triaged as multiple patients at one time can be having acute issues. Sometimes it helps to remember that from the administration side, lawsuits are real and they happen more frequently than we hear about. So, I wouldn't say the facility is neccessarily worried about getting money (although they all do, for sure) but it's keeping everything in-line for when that lawsuit comes knocking. Fortunately, I work at a place where our charges are seperate from our charting. We enter our procedures on a computer but chart on paper (for now). I can say using barcode scanning for things such as treatments has been a great help - it gives the clinician a backup, if you will, just in case that one treatment was not charted.

Freadom said...

Well, the goal of any business is to make a profit, but it's not supposed to be this obvious.