There was a study done several years ago in a large hospital system on the east coast. They measured the amount of time nurses actually spent taking care of patients in a single shift; data showed about 12% was dedicated to actual patient care. After all the charting, paperwork associated with tasks like looking up the correct CPT code associated with the correct charge for the correct diagnosis (one example), they had little time to make rounds, check on patients, or spend time talking with them. I have worked in nearly every area throughout my career, but for years I have been a Director of Surgical Services. For the last 9 years, I have acted as an Interim Director and or consultant in several places in various states. It is no different in the world of surgical services. The pressure to improve turnover, complete the EMR, maintain safety, and deal with impatient frustrated surgeons has overwhelmed nursing and created an unsafe environment in which the patient is lost. For-profit environments particularly, continue to stress volume and time reduction. This reaches out to other departments like PACU, and SPD as well which ultimately affects safety. I have watched this increase gradually over the years, and now I question, like so many others if this is the working environment to continue in. Most nurses are terrified thinking about going in for a procedure without being able to hand pick their caregivers. I realize the regulatory agencies and government have created some of this monster that seems to be like a boulder rolling down a steep slope. However, these provisions were created because of serious errors that may have caused injury and even death. We are responsible for some of this, and certainly, physicians have contributed their fair share. This is not even touching the cost of health care that continues to climb. It saddens me that much of bankruptcy filed now is health care bills. Basically, if you had a catastrophic illness or injury and you are middle income, you may be saddled with enormous bills you will never be able to pay off. All because you needed healthcare.

We could go back to a time when the patient submitted medical bills to their insurance company themselves. Pay at time of service if it is not an emergency. Eliminate a lot of paperwork, extra staff and reduce costs. I believe in the effort to protect against litigation, most industries have doubled up on paperwork and forms. I\\\'ve seen this towards the end of my husband\\\'s business in the automotive industry and even for fun events like Doggie Dip Day at the community pool.

You blame government regulation for the red tape that the medical equipment company and the hospital policies subject you to? I fail to see how that isn’t a strawman. Sure, when the state comes in and imposes regulations on healthcare facilities that can be difficult- but what about the facilities that refuse to adapt in constructive ways to these regulations? The institutions themselves seldom choose to support the very staff which bear the brunt of it. They don’t hire more nurses because of more paperwork, they don’t accommodate the physicians who are grossly overworked, nor do they create and support new positions that could alleviate some of the burden on the staff. Often times, the policies that create so much strife are the products of the hospital itself and their lawyers to abdicate them of as much legal responsibility as possible. The effort and resulting minutia of the policies aimed at decreasing the healthcare facilities’ liability often falls on the healthcare providers. I believe what is more to blame is the for profit structuring of healthcare institutions that squeezes the staff involved in patient care because that is what makes economic sense- especially the nurses. Why? Because nurses are the biggest cost to the facility and make them no money in return- unlike physicians. Meanwhile, hospitals seem to have no trouble creating more and more levels of middle management not involved in patient care, executive bonuses, and hiring consultants. Of course, the Medicare requirements can be expansive and I don’t mean to mimize it. But it’s also terribly simplistic to blame “government regulation” for the brunt of what is happening to healthcare. In fact, I would argue it is a lack of regulation by a more well structured and well funded public sector over healthcare business practices that contributes to the madness that is currently going on in the healthcare industry. I want to point out as well, if the nurse staffing was what it needed to be I’m sure those 3am calls about a skin tear would minimize substantially. Nursing homes are notoriously understaffed and underfunded, so that is equally if not more to blame than whatever “regulation” was imposed on the facility to take extra precautions. That is just the facility not addressing the root cause.