Nurse Confessions: Don’t Get Sick in July

[RandySF]

Every year in teaching hospitals at the start of July, medical students become interns, interns become residents and each successive class of residents moves up a level. These new doctors are immediately thrust into direct patient care. As the National Bureau of Economic Research reported, “On day one, new interns may have the same responsibilities that the now-second-year residents had at the end of June (i.e., after they had a full year of experience).”

This upheaval causes what health care workers call “The July Effect” in the United States and “August Killing Season” in the United Kingdom (where the shift happens in August). The changeover harms patient care, increasing medical errors, medication mistakes and the length of hospital stays. In July, U.S. death rates in these hospitals surge between 8 and 34 percent—a total of between 1,500 and 2,750 deaths. UC-San Diego researchers found that fatal medication errors “spike by 10 percent in July and in no other month.” In Britain, August mortality rates rise by 6 to 8 percent as new doctors are tasked with surgeries and procedures that Britons say are “beyond their capabilities.” Patients in English hospitals have a higher early death rate when they are admitted on the first Wednesday in August than patients admitted on the previous Wednesday.

The residents who know enough to know what they do not know—and therefore listen to and seek out nurses for advice—are not the problem here. But too many residents, enamored of their M.D., won’t ask for help. “Nurses are correcting every error and preventing major mistakes every day,” said a Maryland solid organ transplant nurse.

If you must be hospitalized in July for particularly complex procedures, you might consider avoiding teaching hospitals.


http://www.politico.com/magazine/story/2015/05/dont-get-sick-in-july-and-other-advice-from-from-americas-nurses-117876.html#ixzz3aQW0oTt7

[Scuba]

1. Also weekends and holidays.

[Aerows]

18. Between 5:45 am and 6:30 am

because shift change is at 6 am. Unless you throw up all over the emergency room waiting area (Had that happen once with a case of food poisoning), you will sit there until everyone has their coffee, reads their email and says hello to everyone. I was the only one IN the emergency room waiting room

Throw up all over everything, though, and suddenly, a person in the emergency room is ... an emergency. I made sure it was nice and juicy, since I already knew it was coming again, after I sat there for 10 minutes about to die. I had been throwing up for 24 hours. They couldn't wait to put their coffee down, stop chit chatting about what everybody did over the weekend, and get me into triage.

I'm pretty sure that it would have been illustrative if I had made it to the desk and just barfed all over everything there, but it is my fondest wish that anyone that goes into the emergency room with extreme emetic responses and gets ignored walks up to the desk and lands a huge one all over everyone and everything that is sitting there taking their sweet time like they aren't working in the emergency room.

[Donald Ian Rankin]

2. Isn't this outdated, at least vis a vis the UK?

It certainly used to be the case that August was a particularly dangerous time to get ill here, but I think (although I'm not sure) that nowadays new doctors starting work is staggered around the year, to avoid this.

[VA_Jill]

15. I'm told

that in the UK it occurs in August. That's the major difference.

[FLPanhandle]

3. I try to never go to the doctors, but now I'll really avoid the summer.

Maybe it's a bad move for a man over 50 who hasn't had a physical in 20 years to keep avoiding doctors, but so far so good.

[gvstn]

4. I'm the same.

It is probably wiser to get the physical and their assessment. But because all care seems to be "take this drug for the rest of your life" as a preventative , I think I will skip that. Way too many drugs being taken. If my eyesight were at risk then I would take some drops, other than that or something like insulin dependent diabetes (where you will die if you don't take the drug every day)--they can keep their drugs and their side effects.

[FLPanhandle]

5. Yep

I won't go on life time blood pressure pills, or whatever else they want to give me.

I exercise, eat somewhat healthy, keep my weight down, and feel fine.

Haven't spent a dime on health care in 20 years.

[erronis]

9. And I think you're on to the right formula

As long as you don't end up with some unexpected diseases or accidents, stay away from hospitals above all.

If you can find a friendly doc who will take a small cash payment (50-100) for a once-a-year go-over and just tell you what s/he sees, I recommend this.

Many of the best independent health-care professionals will warn you away from any extra tests and would never suggest you go to one of the big testing centers.

Docs in thrall to income/medical centers have a moral (and fiduciary) duty to tell you that you should get anything that ails you fixed. After all, they are so worried about the litigiousness of today's society. They are so worried that they'd like to drain your bank accounts so you won't have anything left to sue them with if they suture your eyeball to your scrotum.

[gvstn]

13. Doctors are great for a broken arm or similar traumatic injury.

But anything less concrete than that I really don't cotton to them unless they can tell me the proper ointment to put on a wound.

If you:

exercise, eat somewhat healthy, keep my weight down, and feel fine.

That is the best any of us can do. I really hate ads for drugs that say something like we think this drug works this way but we don't really know. If you don't know how the drug works then how do you know about side effects? Any drug can get approved for a particular purpose as long as it works for at least 50% of the persons in the trial. That means it may not work on 49% of people taking it. I can't accept that as a reasonable analysis. Blood pressure, thyroid ect. medicines that nobody really can prove work to improve lifespan are just crap when prescribed wantonly.

[magical thyme]

14. I'm the same as well

I work p/t as a med lab tech. That's the *only* time I'm in a hospital or urgent care center. Unless I break a bone or something.

I eat healthy, exercise a ton, grow a lot of my own veggies and fruits, try to get enough sleep, cuddle with my critters, listen to meditation tapes and happy music, and try to stay in the moment. That's getting easier now that I've quit the p/t shit job, lol.

I don't seek a doctor's help for every little ailment. I just get plenty of rest and fluids and let my body heal. Most of the time when you get sick, your body is trying to tell you something. I try to listen to my body and give it what it needs *before* I crash and burn.

I also take good care of my teeth and do get them checked & cleaned twice/year.

So far it's working.

[Divernan]

6. Surgeons placing bets on outcomes of risky procdedures.

Some doctors and nurses are placing bets about you. Several nurses around the country confessed that hospital staffers have wagered on patients. “Guess the Blood Alcohol” is a common game, where actual money changes hands. Other staff members try to guess the injuries of a patient arriving via ambulance. And surgeons have been observed playing “games of chance” during operations, placing bets on outcomes of risky procedures.

Read more: http://www.politico.com/magazine/story/2015/05/dont-get-sick-in-july-and-other-advice-from-from-americas-nurses-117876.html#ixzz3aQpQQ87g

[L0oniX]

7. Ah ...medical hedge funds? or medical death derivatives?

[Divernan]

8. Most hedge fund traders would jump at the opportunity.

Scum sucking , useless wastes of air.

[Major Nikon]

10. Another interesting jewel...

DOCTORS ON STRIKE

Whenever medical doctors go on strike, a most interesting phenomenon occurs - death rates go down! In 1976 in Bogota, Columbia medical doctors went on strike for 52 days, with only emergency care available. The death rate dropped by 35%. In 1976 in Los Angeles County a similar doctors' strike resulted in an 18% drop in mortality. As soon as the strike was over, the death rate went back to normal. A 50% decrease in mortality occurred in Israel in 1973 when there was a one month doctor's strike!

http://www.qcc.cuny.edu/SocialSciences/ppecorino/MEDICAL_ETHICS_TEXT/Chapter_3_Moral_Climate_of_Health_Care/Reading-Death-Rate-Doctor-Strike.htm

[Dont call me Shirley]

12. I know a person who died because of that. The surgeons were racing and left a sponge in him.

[Ms. Toad]

11. I've known this for years . . . n/t

[VA_Jill]

16. Actually seen the "July effect"

in some teaching hospitals, but come on, folks, let's not freak out here. The interns and residents have a system and they are all answerable to someone up the ladder. The main thing is that they all have to answer to a senior resident, in the case of interns and junior residents, or the chief resident, in case of residents...as well as to the staff physicians. With any luck at all the senior residents are very good at what they do and know their stuff, and they keep the kiddos from getting too far off track. I have seen this in action. Any good senior resident knows how to yank a knot in the tailfeathers of an intern who is getting off track....and the nurses will be damn sure to let that senior know who that intern is, let me tell you! Also, most of the "baby docs" are unsure enough of themselves that they *will* listen to the nurses, and the nurses will generally gently, or in some cases not so gently, guide them along right paths. Those that don't listen are the ones that find themselves the beneficiaries of occasional nasty tricks. But...most docs will admit that it's the nurses who taught them how to be the doctors they are; they know they'd never have made it without us. The best compliment I ever got when I was working was for a doc to hand me a page full of orders and ask me if I thought s/he might have forgotten anything.

[Warpy]

17. We were encouraged to be mean to them in Boston

because we were told flat out that they had every bit of arrogance Harvard could pump into the them and we were their last hope to become human again. We were also charged with going over orders to make sure they weren't going to kill the patients.

July was scary. By late September, most of them had the stuffing kicked out of them.

I was a patient here one July and I had to shoot a couple of them down when they tried to medicalize something that wasn't a problem. Unfortunately, I couldn't schedule being critically ill and the teaching hospital in town was the best place to go for what ailed me.

But yeah, if you can delay your surgery or other complex problem, don't go to the hospital in July if it's a teaching hospital. The cologne alone will knock you flat. It takes them a few weeks of getting puked on to stop wearing that shit.

[LibertyLover]

19. I had a friend who was a nurse on the cardiac care unit in a local teaching hospital

and the stories she told about July were enough to make me decide never, ever go to one during that month. During July and into August the nurses in the hospital were told to double and triple check medications being handled by the interns, among other things. She once caught a new intern trying to medicate a patient. Problem was that the intern had misread the dosage and was trying to give said patient 10 times the prescribed amount. The amount the intern was trying to give would have killed the patient. My RN friend had to literally grab the intern's arm. Then she pointed out the problem. You'd think the intern would have been relieved that the problem had been caught. You would of course be wrong. It wasn't until the attending came over and provided the intern with a new orifice to discharge solid waste material that the intern backed down. My friend said after that they had virtually no trouble with that particular intern and she went on to become a very good cardiac care specialist who listened to the nurses and other professionals about the people in her care.