Tuesday, February 5, 2008

I look good in orange...

Busy..can you say it like a four letter word? My life has been a ball of chaos, but the storm is in full force now and the momentum of change is taking over...so..life is grand..right where I enjoy it the most....on that note..I am a tad fired up about a bit of information that was given to me last week, and the more I have had time to digest,dwell and ponder, the more irritated and angry I have become. So, in typical fashion I am going to vent. Enjoy..Jana

I wonder how many of my esteemed collegues, like I; wake up mid night drenched in a panic/nightmare sweat of being arrested for something that happened while their building was under their watch? Yes America, we have criminalized care and you all have not only allowed it but condone and encourage it. I have decided that if something bad is going to happen, a mistake getting made, a rule broken, and I am ultimately responsible for anothers actions, my only saving grace is that orange is a good color for me. No longer is it just my personal actions that come under scrutiny, it is any action, mistake,regulation not followed that could lead me to hand cuffs and the orange jumpsuit..and quite frankly I have asked myself after every nightmare why do you do this to yourself? What is worth this personal torture? I have decided that either I am a glutton for punishment, or I am a fighter and am willing to put myself out there for what is right and worthy; damned be the consequences....

Up until last week, fighting against a known entitiy, unneccesary regulations that are subjectively imposed; and attorney generals who enjoy using nursing homes as a back bone for campaign strategy...Those were my two known potential handcuff wielders..Now? Our own physicians have entered into the "punishment" arena as a means of obtaining notice for their agendas. Apparently, we, nursing home administrators make nice targets for public scrutiny and out cry. Yes we are a criminal bunch; the whole lot of us.

Currently in Michigan there is legislation proposed that will offer up some form of "punishment" for nursing home administrators of homes that have too many patient/elder discharges back to hospitals. Confused? So am I. As an administrator, I do not wield the pen/phone/fax that sends people to the hospital; the Dr. does. So how does criminalizing me, (by the way, I have been told that the original legislative proposal has been watered down to eliminate criminal action against my type, it is now simply fines and money penalties to be levied against us/our buildings.) make this stop residents from going to the hospital uneccessarily? As an elder advocate, this legislation frightens me on several accounts..

First, as an elder I should have the right to demand hospitalization when I feel it is needed...It is my right as a patient/resident. Second; the Dr. should retain his medical judgment to determine the need/necessity of hospitalization. Third, few administrators are clinical based individuals, why would you want them to determine who goes and who doesn't?

I understand somewhat the need to stop unneccessary hospital admissions and discharges from nursing homes. It is costly; it can be cumbersome. But companies who benefit from keeping residents in care facilities, (check with your managed care/HMO provider..they tout this as a selling point) are pushing this agenda, as it benefits them in the long run..My uneducated but rational mind tends to wonder if this legislation isn't a tad self serving to these companies that make money by keeping people in the nursing home; and avoiding hospital stays? It is their reward/payment system set up by our government.

So in my mind, by using us, Administrators; they are hoping to put fear in our hearts to keep residents in our building, and money in their pockets. Nice..and it should scare you that the HMO/Managed care organizations behind this proposed legislation has partnerships with physicians who provide services in many Michigan nursing homes. Do the pieces of this puzzle fit for you now? They certainly do for me..and the entire story is leaving me more then a tad ill. To think that the very Dr.'s who provide services in many of our homes; would bite this hand that feeds them; to gain a tad more in the other hand.

Huh, and we wonder why american's are apathetic about their government really representing the best interests of all.....