I just finished these this morning!  They are my first attempt at colorwork in a sock; I am never very good at following a pattern word for word and wanted to try a few things.  It didn’t all work out, but the socks are for me so it doesn’t matter.  I finally figured out that the only way I’ll ever end up with anything I make for me is if I use me as the practice person!

Why do we have such long wait times in ER’s?

Hospital bills woman who never saw doctor

I actually linked to this article originally from someone else’s blog.  I have a few things to say about this based on my own professional experiences in a big city, non profit ER where we don’t even ask about insurance information until the pt is already in a room.  The comments that were posted regarding this story on that other blog showed a complete ignorance of what happens when you go to the emergency room.

First of all, if you’re not dying, you’re going to sit for a long time in most ER’s.  The average wait time nationwide to get to a room is 6 hours — and I’m not going to tell you how much longer after that it usually is to see the doctor.

Why, you ask?  Well, a couple of reasons.  The first is since we don’t have any sort of functioning safety net insurance wise — universal health care, requirements for employers to cover ALL employees, caps on what insurance companies can charge and what they can refuse to pay for — that means that people who might otherwise have seen their doctor, or gone to an urgent care, for their minor illnesses and chronic conditions don’t.  They come to the emergency room.  Now, sometimes this is for really stupid stuff:  I triaged in a guy that came to our ER complaining that his hemorrhoids hurt.  Sometimes this is for stuff that really doesn’t belong in an ER:  grandma brought her grandson in because she says he has a fever and has been vomiting:  kid doesn’t have a fever, isn’t vomiting, but he does have a runny nose-and he just got sick today.  Why is this not a primary care physician issue?  Even more importantly, why is this not a take the kid home, give him some chicken soup and let him sleep and get better thing?  Sometimes this is for stuff that, if the person had HAD insurance would never have gotten this serious:  the grandma who probably had a stroke, who was ‘fine’ yesterday, who has high blood pressure and uncontrolled diabetes and can’t afford to see a doctor for the medication refills.  Well, now she’s going to be living in a nursing home, and getting her meds won’t be a problem…too little too late. And a lot more than sometimes, it is because the ‘pt’ is purely a drug seeker and is going to get a $10k workup for a problem they don’t actually have, simply because the doctor is afraid of a lawsuit if he calls a spade a spade and god forbid there’s actually something *finally* really wrong with the pt.  My ER has many patients like that…we see them two or three times a week sometimes, and they get the same tests run on them every time they come in, even when we know they’re full of crap.  And sometimes they also get the drugs they’re hoping for.  Which rewards them and keeps them coming back.

The problem with an ER, is that it is not legally able to turn anyone away.  It has nothing to do with patients with insurance getting treated better — at least not at the facility I work at.  Everyone gets the same treatment.  We have people with great insurance, people with crappy insurance, people with state insurance, people with no insurance, and illegals who not only don’t have insurance but don’t care if they have it.

So.  When you have 50 people or more in a waiting room, 70% of whom should have gone to their doctors (and many of whom think waiting a week to see the doctor is too long) 30% of whom probably actually need to be there, you can see why the wait times are so long.

My second bone of contention with the article is that the person is unhappy about her bill ‘even though she never saw a doctor’ well, girly, I hate to tell you this, but we operate under standing orders — protocols — for certain things.  This means that the medical director, a DOCTOR, has signed his name to a piece of paper that says that if the triage nurse sees ‘this’ then she is authorized by him to take ‘that’ action.  The nurse is the doctor’s eyes and ears.  Secondly, even if this girl never saw a doctor, she was still activating the system — she saw a nurse, a tech, a registration clerk, the radiology techs, and a radiologist read her xrays.  Those people all need to get paid.  I would say that $168 is pretty reasonable.  Secondly, if she already knew the bone was broken, why didn’t she just set up an appointment with an orthopedist?  That’s all we would have done for her in our ED anyway — her bone wasn’t displaced, she got a walking boot, and went to an orthopedic specialist anyway.  For this she needed to sit 19 hours?  Oh, and by the way.  Just because she’s now in the waiting room doesn’t mean she’s no longer the triage nurse’s problem.  EVERYONE in the waiting room is the nurse’s patient…which means that vitals need to be repeated periodically, wounds need to be reassessed, etc.

Third, even if you ARE sick, DO need to be seen emergently, and HAVE been triaged to that level — if the rooms are already full, there is no place to put you.  And if someone else comes in who is even sicker than you are, guess what?  They get to cut in line.  It sucks, but there it is.  The guy who died from a heart attack in the article:  it is standard practice to do a 12 lead EKG on patients who are suspicious for heart attack.  I can’t say for sure that was done on him, I don’t know what his presentation was, but I can tell you if he didn’t have significant EKG changes, he wasn’t going to go back right away.  That also sucks, but there it is.

Our nation’s ER’s are at a breaking point.  Many have, or are, closing down.  Many more will close in the coming years.  The ER is the arterial hemorrhage of a hospital — it’s a public service, it never makes money even at the ritziest facility in the richest part of town.  Please keep that in mind the next time you gripe about the wait times at your local ER, and honestly ask yourself if this is a real EMERGENCY?  Can you truly be seen at an urgent care?  Can you truly wait and see your doctor?  Keep our emergency rooms for emergencies, and wait times will be less — staff won’t be so overworked and under compassionate — and care will be much better.

Thanks for reading the rant.

It’s official. Recession is here.

It’s mainstream news now.  I hope it doesn’t get worse.

Gardening is looking like it may become a necessity — I am not sure what I’ll do for my cat if worse comes to worst, I went shopping yesterday for more cat food and I was SHOCKED at how much it costs now!

Definitely getting meat chicks in the spring, we should have the freezer cleaned out by then.

Sometimes mistakes are good.

Mr. TFH and I were told by an estimator for our gutter installation that we would need to paint the eaves before the gutters were installed; we already knew this but having it said out loud put urgency into the need; I painted the back and front last week (still have the sides to go but there aren’t gutters going up there).  Well, we repainted it the ORIGINAL color of forest green, NOT the slate blue crap color it is now.  Somehow, although the estimator had written down the correct color when he came out to finalize the estimate and get our down payment, the crap slate blue remained the color listed for the gutters.

The installers came out this morning, right as scheduled, with the crap slate blue loaded.  Now, those of you who know me might be thinking that this could get ugly…well actually I was relieved.  I haven’t finished even getting all the rain barrels yet, let alone installing the hardware needed to make them usable.  So.  They’ll be back out next Tuesday, and I now have a fire lit under my behind to get busy and finish the barrels!

Critical thinking…lost art. Common sense…not so common.

Now, let me preface this by saying I am voting for my friend Justin for president; I just can’t hold my nose and vote for either candidate.  They are two sides of the same coin in my opinion, they both voted for FISA, they both voted for Iraq, they both voted for the bailout.

That being said, I’ll get to the reason for my post.

I received an chain email from a Pagan friend the other day,  blaming everything that has happened in this country in the last 8 years — more specifically the last 4 — on the Democrats.  The last line in the email urged me to vote McCain/Palin.  I was astounded that this woman, who is anything BUT a conservative as they are described these days, would send me such an email!  Why would someone belonging to a nonmainstream religion, who has personally experienced persecution as a direct result of her religion, urge me to vote for a ticket with members with religious ties that directly advocate violence against people who don’t belong to their religion?  I am speaking of Palin, who belongs to the Assemblies of God church — she had an African minister who is proud of the fact that having personally decided a woman in his village was a witch, proceeded to persecute her, convince the other villagers this woman was the cause of all their misfortune due to her witch status, and get the townspeople to threaten physical violence against this woman in order to make her leave town…Palin specifically asked him to pray over her that no acts of witchcraft could harm her.  THIS is the vice president my Pagan friend wants me to vote for???  Is she f*cking kidding me??  This church has made it its open mission to involve itself in politics in order to force their view of how the world should be run, and what religion everyone can practice down the public throat at large.

Case in point number two:  I work at a medical facility.  At lunch our designated city police officer was watching the debate and mentioned to someone else there he won’t vote for Obama because he “is afraid we’ll end up with socialized medicine.”  I stopped what I was doing midstream and asked him, “Why?  You’re socialized — we pay for security and public safety with our taxes.  What’s wrong with that?”  He didn’t answer me but he had the most surprised look on his face. I don’t think anyone had EVER pointed out that little detail to him before.  Later, right before he left, I asked again “If John McCain says socialized medicine is so bad for us, why has he benefited from it his whole life?  Why is it OK for him and not for us?”  Again no answer. This same police officer has also mentioned that he doesn’t want his taxes to go up…well, if you want a raise or to continue to have retirement maybe you’d better rethink that position sir.  And by the way, are you planning to have medicare and/or social security when you retire, Mr. Police Man?  Guess what — both are socialized programs.  So is public safety retirement — the money you pay into it instead of paying into social security comes from the taxes we pay to support you.

I just simply don’t understand why people don’t think things through.  Neither one of these positions makes any sense to me on the face of them; I would love to sit down with both of these individuals and ask them why they take the positions they do.  It seems so directly against self interest in both cases to make these statements!

I feel like a mad scientist!

All those visions we have of witches from the middle ages — Shakespeare’s ‘boil boil, toil and trouble…” — I know what they were about now.

Soap making!!!

Mr. TinFoil Hat and I made our first batch of castille soap the night before last; he was quite dubious but supportive of his wife’s zany ideas as usual.  And it turned out!  We now have 10 pounds of soap, 40 bars, curing in our back closet.  In another week or two I’ll smear some of them with essential oils of various types for scent and wrap them in plastic so they get nice and smelly before the holidays.

Well, we’ll see how this works…

My husband has been telling me for well over a year to get a blog, but I was happy with my little blog on  Well, that seems to be going the way of my summer garden, so I decided to start one elsewhere.  This is it — for now.  I don’t know how well wordpress will work, or how much it will end up costing for me to use it if I publish regularly.

I live in semi northern Arizona, in a subdivision that went bankrupt in the 70’s so the originally intended senior living isn’t.  It’s mostly middle to lower income families, many of whom have less than a high school education, and the opportunities here aren’t many if you don’t own a car that gets decent gas mileage.  Still, it’s quiet, it’s about an hour drive to everywhere I go, and I can do what I like with my house.  I have good neighbors, and the climate is pretty mild.