Our Flawed Healthcare System: A Nurse’s Perspective

Before I decided to become a nurse, I wanted to be an attorney. I loved the idea of being better equipped to fight against some of the injustice in the world. When I became a nurse, I loved the fact that part of the job description for nurses included the title of Patient Advocate. So, for today, pretend that I am your nurse—I am your advocate. As your advocate, I want to encourage and empower you to ask questions of all your healthcare providers; conduct your own research about prospective treatment protocols; and always challenge the current healthcare system to improve. Here are five reasons why.

Systems break down and people are far from perfect.

I used to be a temporary employee (assignments ranged from one day to one year) at quite a few companies; despite my relatively young age, I have had a lot of jobs. I have worked at corporations with seemingly caring, amazing leaders and appropriate protocols. But if I was with any company for longer than a week, I would eventually discover that the company had a high turn-over rate, poor training, a lack of communication, a less-than-stellar staff or all of the above. Medical offices and hospitals suffer from the same dysfunction. Therefore, when using the healthcare system, be vigilant; don’t let yourself or your loved ones fall through the cracks of a dysfunctional healthcare system. Do your research and ask questions.

Healthcare workers are exhausted and cannot always provide adequate care to patients.

This is how I felt when I was a bedside nurse.

6:00 PM

It’s so cold and dark outside. I feel like I haven’t seen the sun in awhile. I miss the sun. Maybe if I get hit by a car I won’t have to go to work. Heh. I’m not going to tell anyone that. If I do, they will think that I’m suicidal. I really need more sleep ’cause three hours is not cutting it. Do they have to schedule a two-hour mandatory training session after the night nurses have already been on their feet for 14 hours? I don’t know how Med-Surg nurses do this for so many years. I feel like I’m dying.

7:45 PM

I just have to get through a couple more of these shifts and then I can sleep. I’ll just try to plaster a smile on my face until then. Looks like I have three heavy patients tonight. I have the very loud paranoid schizophrenic in 1218 that threw his bedpan at me yesterday. I also have the 400-pound Mrs. P with a ventilator, urinary catheter, ostomy bag, and stage 3 pressure ulcers. The charge nurse gave me the patient in room 1216 with sickle cell disease. He’s going to need pain medication every two hours and he will need a new IV line. I also have the man chained to his bed—I wonder what kind of crime he committed. Oh well. Maybe the other three patients will sleep—at least a little bit—tonight. I hope that I don’t get another admission tonight. The paperwork will take me forever to finish.

11:30 PM

Finally done passing out medications. I really need to get some charting done or I will be backed up in the morning. Shoot—1216 wants pain medications and Mrs. P. needs to be changed. Her pressure ulcers can’t get worse. I am really not in the mood to be cursed out by her son tonight. I can’t believe 1224 has cancer. She’s so young. I wish I had some time to talk to her to see how she is doing. But there’s never any time for that.

2:00 AM (the next day)

1218 is screaming again. I don’t think that his medication is working. If he starts getting violent, Security better get here quick. I can finally get a little bit of charting done. Oh, wait, can’t do that yet. Julie went on break and her patient with Chron’s Disease needs her pain medication. Better give her that medication first and then I have to help Mrs. P ’cause her ostomy bag is leaking. Gross. I haven’t taken a break yet. I really need to pee.

3:30 AM

1216 is having trouble breathing?! Why am I being paged about 1222? I don’t care that he needs a toothbrush right now!

6:00 AM

The Day Shift is going to be here soon. After all the running around that I did tonight, I hope they understand that not everything will be done. I always stay two hours after my shift to tie up loose ends and help them, but a few of them don’t seem to care. Even the nurse that has been with this hospital a little while longer than me is rude and unforgiving. I have barely done any charting tonight. That’s going to take me awhile.

7:00 AM

Mrs. P’s BP is sky high?? Oh, Mrs. P, please don’t code on me. Please—hang in there.

1:30 PM

Finally in my bed. If someone tries to call me, I will throw my cell phone at the wall.

Science is inadequate and flawed.

Our scientific discoveries are only as good as our experimental designs and the data that is obtained from them. Even if we have flawless scientific designs and data, the information that is communicated to the medical community and general public is often biased and misinterpreted. Why? The data is interpreted by people with bias, conflicts of interest, and flaws.

For some people, money is more appealing than integrity.

If a treatment is being presented to you that does not make sense to you, ask yourself, will this really benefit my health or is some person/organization hoping that my ignorance will help to pad their own pockets? Please note—I don’t want you to be overly paranoid. I also don’t want you to be overly naive.

Our livelihood depends on it.

Despite all the above, I hope that it encourages you to know that most of the people that I have worked with in hospital and pharmaceutical settings seem to be people with above average ethical standards. Unfortunately, it only takes a few bad apples or one bad policy to affect the health of our families and communities. Because of this, we cannot become complacent about flaws in our healthcare system—we must ask questions, do our own research, and work to improve our healthcare system for the sake of our loved ones.