Hospital floors

Every day, I see either someone letting their baby crawl around on the hospital floor or letting their kid run barefoot in the halls.  You can't say anything to these parents without eliciting an angry, defensive response.

This really grosses me out.  Hospital floors are covered in millions upon millions of disease-causing germs, tracked all over from various rooms.  These germs, while together on the floors, share mechanisms for resisting antibiotics and evading the immune system like suburban housewives trading recipes. ("You simply must tell me how you manage not to be killed by antibiotics!"  "Of course!  But only if you tell me how you manage to fool those immune cells so neatly!")  Hospital staff don't observe the 5-second rule.  If a piece of food falls below knee height, it's done.

If that weren't enough, hospital personnel clean those floors with very harsh chemicals in an attempt to keep the population down (yeah, right.  Hospital germs would survive a disaster that killed all the cockroaches.). No eco-friendly, non-toxic stuff here.  And it isn't rinsed off the floors, either.  The longer it stays there, the longer it takes the population of germs to rebound.

So, a baby who crawls on that floor (then puts her hand in her mouth!! Ewwwww!!) is likely to either catch a horrible disease or be poisoned by chemical residue.  Or both.  Keep your kids off the bare floor!

Bad days

Most doctors and nurses love what they do, and love the human interaction involved.  However, some days we are just not feeling warm and fuzzy.  Maybe there are problems at home.  Maybe the ER woke us up at 2 am to ask if we thought it was safe to discharge the asthmatic who cleared after one treatment (yes, it happened to me).  Maybe the weather is crappy.  Whatever the reason, some days we just aren't chipper.  We still do our best for the patients, we just are far more...businesslike about it. Oh well.

If you don't trust doctors...

I get that some parents don't trust the medical profession.  I get that they think medications are poison.  I get that they think doctors care about money more than patients.  I get that they think nature is better.  What I don't get is why they bring their kids to the hospital, then refuse to let us do anything!  Why?!?

The Not-So-Affordable Care Act

We were assured, when the ACA was passed, that all Americans would have affordable insurance that would cover their medical costs.  That, apparently, is not true:

http://www.nbcnews.com/health/some-say-obamacares-affordable-coverage-isnt-affordable-them-4B11241833

Not only will some people have to pay out of pocket and wait for the subsidies, there's another sneaky little problem.  When the government is calculating whether the insurance your employer offers is "affordable,"  they look at what it costs just to cover you-even if you have a family to cover.  They don't look at what it costs to cover your family.  You may be able to afford coverage for yourself-but not for your family.  Don't count on getting affordable coverage if you are in the middle class.

Some of you may be thinking, Doc Rugrat's in the medical field; I bet Doc has good insurance.  And you're right.  But not all of my family and friends are that lucky.  And if I have family and friends who are in trouble, they can't be alone.  Unfortunately, even if the ACA were reversed right now, it's too late.  Companies that raised their premiums aren't going to lower them again.  We must find a way out of this mess.

Not clear on the team concept

Vanderbilt University hospital is apparently cutting its housekeeping staff and will have the nurses do much of the cleaning.  Great.  When I need a nurse to push drugs in a code, I don't want to have to look for one who isn't suited out, mopping the bathroom after the last diarrhea patient.

http://emergency-room-nurse.blogspot.com/2013/09/vanderbilt-university-medical-center.html

Sometimes the PARENT is the problem.

The kid is just fine with getting the shot, IV, whatever-until the parent goes apeshit with "oh, baby, it won't hurt, you'll be just fine, I'm right here, it'll be okay, it'll be over soon" and so on and so forth.  Then the kid bursts into tears, terrified.
THANKS, MOM!

Back to school time

It's that time of year when I am soooooo glad I don't have an outpatient practice.  All the parents who haven't bothered scheduling their kids' back to school physicals are frantically calling, and they don't understand why they can't get in immediately.

But all is not wonderful on the inpatient side, either.  The little dears who can't bear to go back to school are showing up in the ER complaining of abdominal pain.  They put on award-winning performances that get them admitted to the hospital after the million-dollar workup.

Once school starts, the kids who have kept their germs to themselves all summer start sharing generously with their classmates, and we start seeing the fall viral surge.

Oh well.  The pediatrician summer vacation is over.