tytuł tego wątku to fragment wyjęty z wypowiedzi Sowy do Kallki
Chciałabym podeprzeć się pewnym artykułem z NYT, który przeczytałam jakiś czas temu, żeby może bardziej jasne stało się, jak zasuwa się w healthcare w USA. Nie jestem jakimś lekarze, ot zwykłym terapeutą w rehabie, ale wszystko to co jest napisane w artykule nie dziwi mnie, wręcz moglabym dopisać jeszcze tysiąc historyjek, jak ta z wypchnięciem pacjentki razem z noszami za drzwi szpitala, opisana w artykule.Np. wysiudanie pana Tadeusza z rakiem mózgu za drzwi i polecenie sanitaruszom transportującym go, aby go wnieśli na jego mieszkania na 4tym piętrze bez windy, bo nie można było wydębić od samotnego, chorego człowieka, który już źle kojarzył, dokumentów bankowych i wynajmu mieszkania. Pan Tadeusz w dniu wypisania go, nie mógł już chodzić. A ja w tym wszystkim robiłam za tłumacza.
Moja produktywność musi być powyżej 110%, co znaczy, że muszę widzieć jednocześnie więcej niż jednego pacjenta, a że oni nie zaczynają przychodzić o 7ej rano do gymu, tak jak ja, obiad muszą zjeść i po poludniu też nie za bardzo, więc w efekcie widzę ich po 3 od razu, kórych muszę sobie znaleźć na rozlicznych piętrach, przywieżć do gymu i odtransportować sama. To tak jakby Rzeka musiała nazrywać truskawek na tort truskawkowy, który ma upiec, a potem złowić rybę dla następnego klienta, który chce rybę. Ja mam ok 30, 45, 50 min max na klienta, łącznie ze znalezieniem go i odwiezieniem. Nie ma żadnego grafiku, kto po kim i takiego grafiku być nie może, bo pierwszy klient ma za niskie ciśnienie w danym momencie, drugi właśnie zwariował, trzeci mówi że mama zaraz przyjdzie, więc teraz nie może, a czwarty właśnie upadł. Piąty i szósty leżą, bo salowe się nie wyrobiły. Trzynasty, czternasty i piętnasty już nie dojadą do gymu, bo jest po obiedzie i im się nie chce. Do tego jeszcze notatki elektroniczne, które zajmują ok. półtorej godziny, które muszę ukraść z czasu przeznaczonego dla pacjentów, albo robić je nieodpłatnie po godzinach. Nikt nie robi tego po godzinach, więc kradzież czasu przeznaczonego dla pacjenta jest nagminna. To tak jakby Rzeka dodatkowo musiała napisać w komputerze, jak i co ugotowała.
Nie piszę tego dlatego, żeby mnie ktoś, broń boże, zrozumiał, bo już dostatecznie długo się rozpisywałam na ten temat. Tylko tak, może fakt, że artykuł opisuje środowisko lekarskie i co się w nim odbywa, uwiarygodni mnie, że nie opowiadam bajek.
A oto rzeczony artykuł
By Eyal Press
Published June 15, 2023
Updated July 14, 2023
Some years ago, a psychiatrist named Wendy Dean read an article about a physician who died by suicide. Such deaths were distressingly common, she discovered. The suicide rate among doctors appeared to be even higher than the rate among active military members, a notion that startled Dean, who was then working as an administrator at a U.S. Army medical research center in Maryland. Dean started asking the physicians she knew how they felt about their jobs, and many of them confided that they were struggling. Some complained that they didn’t have enough time to talk to their patients because they were too busy filling out electronic medical records. Others bemoaned having to fight with insurers about whether a person with a serious illness would be preapproved for medication. The doctors Dean surveyed were deeply committed to the medical profession. But many of them were frustrated and unhappy, she sensed, not because they were burned out from working too hard but because the health care system made it so difficult to care for their patients.
In July 2018, Dean published an essay with Simon G. Talbot, a plastic and reconstructive surgeon, that argued that many physicians were suffering from a condition known as moral injury. Military psychiatrists use the term to describe an emotional wound sustained when, in the course of fulfilling their duties, soldiers witnessed or committed acts — raiding a home, killing a noncombatant — that transgressed their core values. Doctors on the front lines of America’s profit-driven health care system were also susceptible to such wounds, Dean and Talbot submitted, as the demands of administrators, hospital executives and insurers forced them to stray from the ethical principles that were supposed to govern their profession. The pull of these forces left many doctors anguished and distraught, caught between the Hippocratic oath and “the realities of making a profit from people at their sickest and most vulnerable.”
The article was published on Stat, a medical-news website with a modest readership. To Dean’s surprise, it quickly went viral. Doctors and nurses started reaching out to Dean to tell her how much the article spoke to them. “It went everywhere,” Dean told me when I visited her last March in Carlisle, Pa., where she now lives. By the time we met, the distress among medical professionals had reached alarming levels: One survey found that nearly one in five health care workers had quit their job since the start of the pandemic and that an additional 31 percent had considered leaving. Professional organizations like National Nurses United, the largest group of registered nurses in the country, had begun referring to “moral injury” and “moral distress” in pamphlets and news releases. Mona Masood, a psychiatrist who established a support line for doctors shortly after the pandemic began, recalls being struck by how clinicians reacted when she mentioned the term. “I remember all these physicians were like, Wow, that is what I was looking for,” she says. “This is it.”
Dean’s essay caught my eye, too, because I spent much of the previous few years reporting on moral injury, interviewing workers in menial occupations whose jobs were ethically compromising. I spoke to prison guards who patrolled the wards of violent penitentiaries, undocumented immigrants who toiled on the “kill floors” of industrial slaughterhouses and roustabouts who worked on offshore rigs in the fossil-fuel industry. Many of these workers were hesitant to talk or be identified, knowing how easily they could be replaced by someone else. Compared with them, physicians were privileged, earning six-figure salaries and doing prestigious jobs that spared them from the drudgery endured by so many other members of the labor force, including nurses and custodial workers in the health care industry. But in recent years, despite the esteem associated with their profession, many physicians have found themselves subjected to practices more commonly associated with manual laborers in auto plants and Amazon warehouses, like having their productivity tracked on an hourly basis and being pressured by management to work faster.
Because doctors are highly skilled professionals who are not so easy to replace, I assumed that they would not be as reluctant to discuss the distressing conditions at their jobs as the low-wage workers I’d interviewed. But the physicians I contacted were afraid to talk openly. “I have since reconsidered this and do not feel this is something I can do right now,” one doctor wrote to me. Another texted, “Will need to be anon.” Some sources I tried to reach had signed nondisclosure agreements that prohibited them from speaking to the media without permission. Others worried they could be disciplined or fired if they angered their employers, a concern that seems particularly well founded in the growing swath of the health care system that has been taken over by private-equity firms. In March 2020, an emergency-room doctor named Ming Lin was removed from the rotation at his hospital after airing concerns about its Covid-19 safety protocols. Lin worked at St. Joseph Medical Center, in Bellingham, Wash. — but his actual employer was TeamHealth, a company owned by the Blackstone Group.