Long and boring

God, I wish I had Jake's energy! I also wish I still had his innocent curiosity. I'm just old, tired and crusty or something like that. At least that is how I feel at this moment. Yesterday I was charge nurse, which I find to be very stressful, and I was also on call. It could have been worse but I did have to work in the night and now I am very tired because my sweet little boy insisted that Mommy not sleep the day away. Actually, he did let me sleep until almost 8 so I can't complain too much. It is nice to wake up to him in his crib and to the sound of his sweet jabbering.

Thankfully, I am off today so I can recover. I was hoping to make a trip out of town to do some shopping but I don't think I am up to it today. However, my being off is a mixed blessing. I am off due to down staffing. That isn't really a good thing is it? We are really having some issue with the hospital and my memory isn't firing right now as to if I have shared those issues and concerns here. The economy does not help the current health care state. People can't afford to have necessary but not urgent surgeries. Like maybe a hernia that needs to be fixed but they have lived with it for x amount of time already so they can live with it longer or a back that is bothering them but it will just have to wait or a bladder that is drooping but well, they have been able to tolerate it this long so it can wait awhile longer. Do I blame people? No. It is expensive to have anything done regardless of how wonderful your insurance may be. There are also people who no longer have insurance so they can't get that gallbladder out until they are deathly ill.

So the highest of the high at the hospital had this wonderful plan that they had been working on for several years I'm sure. We need to be like some of the great big wonderful hospitals. The hospital and the doctors' offices need to all join together and become a super power. The hospital will acquire the offices, and all their staff, and patients will be able to get better care. If you go to doctor A for a headache and Dr A does some tests and then you go to Dr B for your sore knee, Dr B can just look in the new magic computer and instantly all the information that Dr A has is there! So Dr B doesn't have to do some of the same labs or something or if Dr B does, he can compare and see the difference. Then if you go to the hospital because you broke your hip (god forbid!) all the information from Drs A and B is instantly available. Do I think this is wonderful for you that they can see that you take 50mg of medication X not 100mg when they are asking you and you can't remember because of the pain? Yes, this is a good thing for the patient IN THEORY.

Why am I not over joyed with our ability to provide better, safer patient care? Sure it is great, BUT there are some huge downfalls that impact me. So for the hospital the the doctors' office to merge the hospital had to BUY the practices from the doctors. The hospital now has a tremendous number of additional employees that all want to be paid and want to have benefits and stuff. Now the doctors earn salaries based on their work. Okay, but every time you go to the doctor you have to hand over a wad of cash, right? So now the hospital takes that money in and it pays the overhead and salaries and crap right? Sort of. This whole process seemed to be planned by idiots. We now have all these boards that over see all sorts of crap. That is expensive. Part of the problem is that they didn't figure out some of the critical things before the actual merger occurred. Oh, say, like billing. They sort of did. I mean someday you will only get one bill no matter where you go. All the visits will show up together in one HUGE bill. You only have to pay one time right? Well, they didn't get all of the billing figured out before hand. Everything in the world has a code for billing, but they only got it started. So if what you had done was way down the number line, they didn't have the ability to charge you or your insurance for it for a couple of MONTHS at least. So that means the employees are still getting paid. The doctors are still getting paid. The lights and water are still on in the office, but money isn't coming in. Hello? And we are talking about dozens of doctors. We are talking about big and little bills. We are talking about MILLIONS of dollars not coming in. So eventually it will all get caught up, right? Yes, eventually it will, but it isn't still. Besides, how much money did it take to BUY all of the practices? Where did all that money come from? Hmmm

Now not all the doctors liked this idea. Suddenly they have a giant boss that can tell them what to do. Okay, so they don't have to join. But what does that mean? Dr A and Dr B both practice the same kind of medicine. Dr A is part of the megapower. Dr B isn't. When you see a Dr that is part of the megapower and they need to refer you, who are they going to refer you to? Another doctor in the megapower. So this means that Dr B's practice is going in the crapper so Dr B decides to move away. Now we don't have Dr B coming to surgery anymore. Okay so the patients have to see Dr A and he/she will do the surgery instead. Well, it is going to take you twice as long to get into see that doctor it also means that doctor has more cases to do when they do operate so now they are operating longer and later in the day. Where has this affected us the most? Orthopedics. We used to have two practice with 6 surgeons and they were trying to recruit more. In a very short time we will have 1, yes, I said 1 orthopedic surgeon. We used to run 2.5 rooms a day in just orthopedics. Today there were just two cases from traveling surgeon squeezed in. So not even a whole room.

Okay, so this megapower is supposed to be a recruiting benefit for new doctors. They can come here and they don't have to worry about buying into a practice. They don't have to worry about setting up an office. They just come and it is there. They come to work and get a paycheck. But it takes a lot of time to get new doctors. We don't exactly have a big draw here. At the moment, who are the doctors that we can get to come and look? Mostly brand new doctors and foreign doctors. Okay, a new doctor, that isn't so bad right? They have a lot of years still to practice right. Well, we are just a stepping stone to gain experience. And they don't have the experience that we need. Foreign doctors might have more experience but they don't go over all that well in this older farming community. You are going to have people that travel to other communities rather than to have that foreign doctor touch them.

So where does that leave me? We have less work. That means we make less money. We have staff standing around. We have to cut huge amounts of money because they SPENT SO MUCH money and it isn't coming in. We aren't getting raises and all of our expenses went up. We are getting sent home and told you still have a job but... And we are running rooms late in the night because fewer doctors are now doing the work. There is less work but there is still work. This bites. I got paid yesterday and Mike saw the amount in the checking account and called me and wanted to know what happened. Where the rest of my paycheck went. No honey that is it. I did increase the amount held out for my flex account but that is a $50 pretax amount so it shouldn't make a huge difference, but the cut hours were there. But, the silver lining to this very black cloud is that I have had more time with my son. That doesn't keep food on the table or pay for his doctor bills but at least we were together. It has also helped with my stress levels and guilt levels.

So, I should wake up. Get myself cleaned up. Make my shopping list and go buy some food with my meager check because the pantry, the cupboard and the fridge are bare.