Mothers during and after birth

[marbel]

I did a quick search on the idea of beautiful spaces in hospitals and effect on recovery. Here is one of many results: 

https://hbr.org/2015/10/better-healing-from-better-hospital-design

A snip:

Today, many hospitals feature gardens of various types, and their impact on care has been studied more rigorously. One study reports that 95% of people who walk through hospital gardens report a therapeutic benefit from simply being in them. Contact with nature not only speeds patient healing, it also helps family members and hospital staff more effectively deal with the stress of providing care. And that enables them to better serve their recovering loved ones and patients.

But what if your geographic location makes having a beautiful outdoor garden impractical? That was the challenge posed to Bronson Methodist Hospital in Kalamazoo, Michigan. Because it is located in the “snow shadow” of Lake Michigan, it receives an average of 80 inches of snow each winter. So they created a giant, drum atrium “full of nature” in the middle of the hospital. The wings of the hospital radiate out from it, making it easily accessible to everyone.

Edited September 23, 2023 by marbel

[wendyroo]

59 minutes ago, Pawz4me said:

I totally agree. It's just that my perspective has been widened beyond thinking that the disparity is all due to having good insurance or not. It seems to me it's just as often due to not knowing, or not being capable of, navigating a hopelessly complex system. It reminds me a little bit of college costs--few people really pay the full price, many scholarships are out there, but you have to know how and where to go looking for them. Both systems are needlessly complicated, and the complexity of it keeps many people from benefiting.

I think it can also largely depend on what type of care you and your family require.

Our insurance fully covered my weight loss surgery. I didn't pay anything for pre-op appointments, hospital stay, surgery or post-op.

OTOH, we have four kids with chronic mental health and developmental concerns, and those are bleeding us dry. Of the four plans offered to DH through his employer, we choose the most expensive. But on top of that, for the last 10 year we always hit our out of pocket max. This year, we met our deductible in February, and hit our OOP max in June.

So, on one hand, our insurance is "working". It is doing its job as a safety valve and stepping in to protect us from the sky-high costs of a medical crisis. Except, our medical "crisis" is chronic, so no one year of medical costs is bankrupting us, but year after year after year of paying over 10% of our income toward healthcare is putting a significant strain on our finance.

And for how much we pay, we also have to deal with HUGE amounts of red tape and stress. DH or I spend about 2 hours a week on the phone with the insurance company (or the insurance company's mandated pharmacy) trying to get services or prescriptions covered. It takes a situation that is incredibly difficult physically, emotionally and psychologically on its own, and makes it also bureaucratically and financially treacherous.

[Mrs Tiggywinkle Again]

All the talk about hospital space:  the hospitals in my area have plenty of space. They have plenty of actual beds and patient rooms.  Removing a lobby to build more patient bed space does nothing because they already have two wings with empty patient rooms and beds and medical equipment that are closed because there isn’t enough staffing.

Our local nursing program is not particularly difficult to get into, has around 80-90 seats, and always has a waitlist. Like everyplace else, they struggle to attract nursing instructors because bedside nurses are easily making 100K and instructing at the college level pays crap.  The issue most of the faculty is worried about though is the attrition rate.  Students are struggling with the basic sciences of human biology, basic chemistry(which is really high school level chem) and A&P.  The ones who make it through struggle with the rigorous nursing program. It is especially evident in the recent high school graduates who didn’t have lab sciences due to Covid.  

As far as instructing, I just left a full time paramedic job and am accepting a full time college faculty position as a lead paramedic instructor/program coordinator. I am taking a 50% pay reduction. 

[gardenmom5]

6 hours ago, Pawz4me said:

I used to feel the same way, until DH was diagnosed with cancer and I joined a very large support board with patients from all over the world. Many from Canada, Australia, New Zealand, Malaysia, Europe, India, some of the African countries, and so many more. The American patients are envious of the "free" (we know it's not really free) care many of them get. They are super, super, super envious of the choices of doctors, medical facilities and (especially) unlimited lines of treatment available here. Our system definitely has many issues, but after learning what I have the past few years -- if I had a serious condition there's absolutely no other place I'd rather be. That is assuming good insurance, of course. Until our experiences over the past few years I really did not appreciate the absolutely outstanding care we get here and especially the choices we have compared to many other countries with nationalized care. I didn't know what I didn't know. Now I know somebody's gonna step in and say "but outcomes, costs, etc." And yes, those are important. Definitely. But when you're a scared witless patient who just wants to have faith in the system, to feel like you're being well cared for and matter and have access to all the treatments available for your condition -- from what I've seen no other country comes remotely close. Yes, I know. Somebody's gonna disagree. And that's fine and expected. I'm just relating my perception from having read the in-depth, continuing experience of many others around the globe.

And all that I say with the caveat that I'd still love to see a Medicare-for-all type situation in this country if we could have that and continue to get the same level of care and have the same choices. The Medicare people (whether they got there via age or being declared disabled) who have a regular supplement plan (NOT Medicare Advantage, no way never never never) are the ones who seem to have it the best--they can get the top notch care and the easiest ability to see different specialists in any area of the country with the least amount of hassle and OOP cost. We need that for everybody. How we would do it is beyond my pay grade. I don't know what we'd have to give up. But I can say I'm pretty sure I would have had a nervous/psychotic breakdown long ago if we lived in another country, DH has the diagnosis he has, and I knew it was a three strikes and you're out type of situation. I don't have to worry about that here.

I've had similar experiences.  I have thyroid issues, as well as Epstein Barr Virus. (Even autism boards) and am on boards for those that have an international draw - the complaints (and frustration, tears at times) about lack of access to needed health care/testing because it's out of the standard from brits is well known on those boards.

Then there was researching TIAs with my mom (that was scary, NHS patients wouldn't get in for follow up for 6months to a year, they'd have patients die before they could be seen.  My mom was always in within two weeks) -  I recently read a case about a woman (retired nurse, who used to work for the NHS) who was hospitalized in the UK - her alarms kept going off.  The nurse finally came in and turned them off (so they wouldn't bother her.).  She looked up the alarm code, which was a big concern.  She had to call 999, while she was a patient in the hospital.  Don't know what happened to the nurse, but it did get escalated to the doctor and she received the life-saving treatment she needed.

and 'geriatric' pregnancies (such was my surprise at being pregnant) left me with my eyes bugging out of my head, and glad to be in the US.
We had no income (unemployment, and start-ups) during my last (complicated) pregnancy - I received excellent care through gov't benefits, and dudeling had six days in the hospital as a newborn nursey with hyperbilirubimia - and it was all "free".  (yeah, I know taxes paid for it.  Now business is doing well, and we pay taxes.)

 

[Pam in CT]

re therapeutic effect of open airy interior spaces, terraces and courtyards

36 minutes ago, SKL said:

Regarding pretty facilities - I'd like to add that these aren't just for visitors.  They are also used by patients who are briefly able to leave their hospital rooms - including children.  And a little respite from the yuckiness of the hospital room is good for their health.

In my city, we have a world-class hospital that received a $100 million anonymous donation in someone's will.  I don't have a problem if, in the process of building an even more modern hospital facility, the designers are asked to include some pleasant spaces here and there to help folks in an otherwise really unpleasant situation....

Yes, there's a lot of research to support this. 

And watching my own elders' individual response to being restricted for days/ weeks in a room with a single tiny sealed window, versus having access to a courtyard or terrace with fresh air and some pretty plants... I'm a believer.

[Catwoman]

23 minutes ago, marbel said:

I did a quick search on the idea of beautiful spaces in hospitals and effect on recovery. Here is one of many results: 

https://hbr.org/2015/10/better-healing-from-better-hospital-design

A snip:

Today, many hospitals feature gardens of various types, and their impact on care has been studied more rigorously. One study reports that 95% of people who walk through hospital gardens report a therapeutic benefit from simply being in them. Contact with nature not only speeds patient healing, it also helps family members and hospital staff more effectively deal with the stress of providing care. And that enables them to better serve their recovering loved ones and patients.

But what if your geographic location makes having a beautiful outdoor garden impractical? That was the challenge posed to Bronson Methodist Hospital in Kalamazoo, Michigan. Because it is located in the “snow shadow” of Lake Michigan, it receives an average of 80 inches of snow each winter. So they created a giant, drum atrium “full of nature” in the middle of the hospital. The wings of the hospital radiate out from it, making it easily accessible to everyone.

I completely agree with this.

I am all in favor of the movement toward addressing overall wellness. It's great to get good medical care, but adding other amenities and comforts can go a long way toward making hospital stays far less psychologically stressful for both patients and their families (and other support people.)

[Heartstrings]

11 hours ago, Pawz4me said:

be. That is assuming good insurance, of course. Until our experiences over the past few years I really did not appreciate the absolutely outstanding care we get here and especially the choices we have compared to many other countries with nationalized care. I didn't know what I didn't know. Now I know somebody's gonna step in and say "but outcomes, costs, etc." And yes, those are important. Definitely. But when you're a scared witless patient who just wants to have faith in the system, to feel like you're being well cared for and matter and have access to all the treatments available for your condition

Except those people who can see all of that through the glass then get to go back to crap healthcare that will bankrupt them. It’s great that it’s available to the few that can afford it.  It might as well not exist for the rest of us.  

 

Edited September 23, 2023 by Heartstrings

[KungFuPanda]

33 minutes ago, Mrs Tiggywinkle Again said:

All the talk about hospital space:  the hospitals in my area have plenty of space. They have plenty of actual beds and patient rooms.  Removing a lobby to build more patient bed space does nothing because they already have two wings with empty patient rooms and beds and medical equipment that are closed because there isn’t enough staffing.

Our local nursing program is not particularly difficult to get into, has around 80-90 seats, and always has a waitlist. Like everyplace else, they struggle to attract nursing instructors because bedside nurses are easily making 100K and instructing at the college level pays crap.  The issue most of the faculty is worried about though is the attrition rate.  Students are struggling with the basic sciences of human biology, basic chemistry(which is really high school level chem) and A&P.  The ones who make it through struggle with the rigorous nursing program. It is especially evident in the recent high school graduates who didn’t have lab sciences due to Covid.  

As far as instructing, I just left a full time paramedic job and am accepting a full time college faculty position as a lead paramedic instructor/program coordinator. I am taking a 50% pay reduction. 

This is kind of nuts.  Why aren't the major hospitals who need staffing subsidizing instructors? A lot of nurses would gladly leave their jobs if they could make the same amount teaching.  Since one instructor can produce hundreds of nurses to replace herself I don't understand why this is so hard to address.  The students are there.  The need is there.  It's a very little amount of money in the grand scheme of things.  If they can charge differential tuition for some majors why can't they award differential salaries for instructors.

I think it's over simplistic to say we should just change our system to be more like other developed nations.  People outside of the US are definitely benefiting from the care and innovations that come out of this imperfect system.  Patients and doctors are traveling to work here and be treated here. Without a profit to be made, some procedures and medications would not exist.  Less expensive systems rely on SOMEONE paying for these innovations.   Once they do exist, it's easy for other countries to benefit from the knowledge and still look down on our business model.  Everything costs less when you have a low R&D budget.  If we could get someone else to pay for this, that would be great for our bottom line, but who's going to do it? 

As it stands, rich people are fine.  Poor people have their medical care covered.  The middle and upper middle class largely manages to figure out how to acquire and pay for decent health insurance and enjoy a decent overall standard of living despite the cost. (re: posts about the number of bathrooms and typical square footage of homes) It's the lower middle - middle middle class that feels the crunch when healthcare and college gets expensive.  

We're TRYING.   Most of the people on this board are likely voting for these changes.  I think we'll get there.  We might pull it off by our 300th birthday, which isn't THAT bad compared to other nations with universal healthcare and inexpensive university options.  I just hope our Let Them Eat Cake tipping point is bloodless.

I don't see why we can't have affordable care AND beautiful spaces to wait. That whole argument sounds like peasants arguing over crumbs. The lobby has to be the least expensive part of an entire hospital complex anyway.  It doesn't even take up more land if you're building up.  These nice spaces also attract workers to a facility.  I don't know WHY an Emirati Sheik donated so much to Johns Hopkins, but if billionaires would do that instead of playing with their rockets we'd all be better off.  

[Corraleno]

50 minutes ago, gardenmom5 said:

I've had similar experiences.  I have thyroid issues, as well as Epstein Barr Virus. (Even autism boards) and am on boards for those that have an international draw - the complaints (and frustration, tears at times) about lack of access to needed health care/testing because it's out of the standard from brits is well known on those boards.

Then there was researching TIAs with my mom (that was scary, NHS patients wouldn't get in for follow up for 6months to a year, they'd have patients die before they could be seen.  My mom was always in within two weeks) -  I recently read a case about a woman (retired nurse, who used to work for the NHS) who was hospitalized in the UK - her alarms kept going off.  The nurse finally came in and turned them off (so they wouldn't bother her.).  She looked up the alarm code, which was a big concern.  She had to call 999, while she was a patient in the hospital.  Don't know what happened to the nurse, but it did get escalated to the doctor and she received the life-saving treatment she needed.

and 'geriatric' pregnancies (such was my surprise at being pregnant) left me with my eyes bugging out of my head, and glad to be in the US.
We had no income (unemployment, and start-ups) during my last (complicated) pregnancy - I received excellent care through gov't benefits, and dudeling had six days in the hospital as a newborn nursey with hyperbilirubimia - and it was all "free".  (yeah, I know taxes paid for it.  Now business is doing well, and we pay taxes.)

 

Those problems exist in the US as well, especially if you're poor. I know of a case where nurses turned off the alarms on a toddler with a severe respiratory illness; he died and the hospital tried to cover it up. I know plenty of other horror stories from friends and relatives who've been hospitalized in the US, including my father who recently spent several weeks in the hospital and needed friends and relatives to push really hard for him to get even adequate care.

I lived in the UK for 10 years and was always able to see specialists within a reasonable time. And I know people in the US who have had very long waits for specialists.

I'm not sure what it is about "geriatric pregnancies" that made you so glad to be in the US rather than the UK, but I was 41 when DS was born and had excellent care in a top teaching hospital, and the total cost for a C-section and 4 days in a hospital bed was $0. And I know plenty of people in the US who paid huge amounts OOP for their births, on top of high monthly premiums.

 

[Melissa in Australia]

Just saying.. All 4 hospitals I have been in with this illness all had multiple courtyards with gardens. I unable to walk couldn't access them, but they were there. I could get glimpses of them through windows as I was being wheeled around to various tests. And the room I am in right now has one out the Window. 

The children's hospital in Melbourne has a huge what I guess you must call a lobby, a big open area several stories high, with a giant tropical fish tank. It also has a huge  Mercat enclosure, a small supermarket and other shops. And is right beside the city zoo

 

[Pawz4me]

1 hour ago, gardenmom5 said:

I recently read a case about a woman (retired nurse, who used to work for the NHS) who was hospitalized in the UK - her alarms kept going off.  The nurse finally came in and turned them off (so they wouldn't bother her.).  She looked up the alarm code, which was a big concern.  She had to call 999, while she was a patient in the hospital.  Don't know what happened to the nurse, but it did get escalated to the doctor and she received the life-saving treatment she needed.

 

 

But . . those are the types of stories I'm leery of drawing conclusions from WRT other countries' health systems. We all know the media thrives on outrage, and to a big extent we're the ones responsible for that--outrage drives more clicks than feel good stories. So that's just one person's experience, one snap shot in time. It would be easy to get a bad view of the NHS from that, but I'm positive it works quite well in many other instances and that it, like our own system, is probably quite nuanced.

I feel the same way about my lifetime experience with our own health care system, where I'm openly admitting that I really didn't know as much as I thought I did until I was forced into the deep end. And what I found out was that while there's plenty of justification in the criticisms, there's also a ton of nuance and "buts." I mean we've all read the horror stories about insurance denials and GoFundMes, and many of us have certainly dealt with insurance denials and figuring out how we're gonna pay for things ourselves. But how often do we read stories about the uninsured or underinsured person who thought there was no way they could afford their very expensive surgery or medication but then found out there's a grant for that, or co-pay assistance, or whatever? Those things happen too, and I think more than most people maybe realize. Criticizing and outrage are somehow more rewarding than feel good stuff, but that doesn't mean they're presenting the true, big picture story.

For the past few years I've been learning from the board I belong to, where it's like here--I can get to know people, learn who's a reliable narrator (or not), where most of the people are well educated and as capable of navigating their country's system as anyone likely could be, etc. To me that's been a much more valuable experience than random news articles that are just maybe only trying to get clicks and aren't interested in presenting the big picture.

Edited September 23, 2023 by Pawz4me

[Corraleno]

The idea that the only healthcare options are an incredibly expensive profit-driven system where insurance companies charge huge premiums and then do everything possible to deny service, or a universal healthcare system where there are long waits, poor service, limited treatment, no choice, etc., is really untrue.

There are other systems, like France, where medical care is just as "advanced" as it is in the US, you can choose any doctor you want, there aren't long waits, etc., but if you are working or retired 80% of your medical costs are covered by the government and you can buy very inexpensive insurance to cover the remaining 20%. If you're self-employed the govt covers 50% so you need insurance for the other 50%, and if you're wealthy enough not to have to work then you pay for your own insurance.

I'm less familiar with the healthcare systems in Germany or Scandinavia or Japan, since I've never lived there, but they somehow manage to provide excellent healthcare to their populations and have better outcomes than the US. If we have the most advanced healthcare system in the world, why do we have the WORST infant and maternal mortality rates in the developed world???

Edited September 23, 2023 by Corraleno

[Pawz4me]

5 minutes ago, Melissa in Australia said:

It also has a huge  Mercat enclosure

 

That's seriously awesome. I'd go in the hospital just to see if (if that's allowed).

[Catwoman]

2 minutes ago, Pawz4me said:

That's seriously awesome. I'd go in the hospital just to see if (if that's allowed).

I would, too!!!

[Corraleno]

Just now, Pawz4me said:

But how often do we read stories about the uninsured or underinsured person who thought there was no way they could afford their very expensive surgery or medication but then found out there's a grant for that, or co-pay assistance, or whatever? Those things happen too, and I think maybe more than most people maybe realize. 'Cause criticizing and outrage are somehow more rewarding than feel good stuff. 

But to me that's really not "feel good stuff." The fact that some poor people — the ones who are literate enough and savvy enough and have the time and energy and access to do the research to find all these hidden financial helps — might be spared from the crushing debt and bankruptcies that so many other people face, is not evidence that our system actually works. The "free" or subsidized healthcare that some people are able to get through grants or by hospitals writing off debt is just paid for by other consumers, it's not like the CEOs of the insurance companies are foregoing their multimillion dollar annual bonuses to cover healthcare for poor people.

And ultimately it becomes another way to blame the poor and working classes for not taking care of their health and/or for getting into debt and/or not pulling themselves out of poverty, because they could have just navigated the byzantine system of finding and applying for grants so they could have accessed and paid for healthcare.

It really shouldn't be that hard for people who are sick and poor to access decent healthcare, and somehow every other developed country in the world manages it.

[Pawz4me]

1 minute ago, Corraleno said:

 is not evidence that our system actually works

Correct. Which is exactly what I've said over and over already--that our system absolutely has problems but that it's not *just* due to insurance disparities. I honestly don't know how I can repeat that part any more so people will hear it.

[KungFuPanda]

19 minutes ago, Corraleno said:

I'm less familiar with the healthcare systems in Germany or Scandinavia or Japan, since I've never lived there, but they somehow manage to provide excellent healthcare to their populations and have better outcomes than the US. If we have the most advanced healthcare system in the world, why do we have the WORST infant and maternal mortality rates in the developed world???

I'm guessing we start with the least healthy mothers, so that has to complicate it even further.

[Melissa in Australia]

People also travel from other countries for medical treatment to Australia ..  I would suggest It is a thing that happens at any specialist treating hospital with leading edge medical treatment not country specific. 

 The city hospital I was just at is one of the leading lung and heart transplant hospitals. They do a lung transplant every 2 days.  People from the whole pacific region including New Zealand come there for this surgery. Australia has medical agreements with those countries for this life saving procedure that cover the medical expenses.

I was in the respiratory ward for a while. 

 

[Melissa Louise]

1 hour ago, Melissa in Australia said:

Just saying.. All 4 hospitals I have been in with this illness all had multiple courtyards with gardens. I unable to walk couldn't access them, but they were there. I could get glimpses of them through windows as I was being wheeled around to various tests. And the room I am in right now has one out the Window. 

The children's hospital in Melbourne has a huge what I guess you must call a lobby, a big open area several stories high, with a giant tropical fish tank. It also has a huge  Mercat enclosure, a small supermarket and other shops. And is right beside the city zoo

 

I'm really not sure how 'twenty people hanging out at your surgery' turned into the rest of this thread, where people are offended we are glad we don't have the stress of paying for life saving care at point of service, but yes, big city hospitals have amenities! Entrances! Places for staff and ambulatory patients to get coffee! Overpriced pharmacies selling essentials you forgot to pack before being admitted! Chapels! 

Now I know that people in the US can have their twenty family members gathered in what sounds like a mall attached to a hospital, it makes more logistic sense. No emotional sense to me, but logistic, fine. 

Still, don't ignore the boundaries of a new mom. Even from the lobby. It's really rude.

[Melissa Louise]

Because I woke up irritated, I'm going to add, yes, green gardens aid healing 

You know what else reduces stress? 

When someone gets rushed off to ICU or whatever, and you don't once have to think about money. Not once. 

Public systems do many things poorly, imo, but one thing they do well is save your life in emergency situations (often) without creating any form of money stress, even 'just'  the stress of navigating grants or insurance. 

I have known many people with cancer here. Some died and many didn't. It's probably true we don't have access to the most cutting edge of the cutting edge in all areas. Still, I've known people getting eg gene therapy. It's not like the payoff for lack of money stress is 'here, we can give you Aspirin, and if that doesn't fix it, oh well, guess you died in the cause of universal health'.

OK, now I am slightly less irritated.

I think the mental image of my ex MIL being able to camp out in a lobby to 'support' aka come and take over my baby has done my head in. 

 

[SKL]

29 minutes ago, Melissa Louise said:

I'm really not sure how 'twenty people hanging out at your surgery' turned into the rest of this thread, where people are offended we are glad we don't have the stress of paying for life saving care at point of service, but yes, big city hospitals have amenities! Entrances! Places for staff and ambulatory patients to get coffee! Overpriced pharmacies selling essentials you forgot to pack before being admitted! Chapels! 

Now I know that people in the US can have their twenty family members gathered in what sounds like a mall attached to a hospital, it makes more logistic sense. No emotional sense to me, but logistic, fine. 

Still, don't ignore the boundaries of a new mom. Even from the lobby. It's really rude.

Yeah I'm confused kuz I thought I was hearing "your country is wasteful to have pretty spaces at hospitals" and now I'm hearing "our hospitals have pretty spaces too."

Anyhoo.  Probably just not understanding each other.

As for the cost stuff, there's always too much hyperbole / selective reporting in these threads for any discussion to make actual sense.

[SKL]

1 hour ago, KungFuPanda said:

I'm guessing we start with the least healthy mothers, so that has to complicate it even further.

I think this too.  For one thing, we seem to have more moms choosing to have risky pregnancies (for example, choosing pregnancy at an advanced maternal age).  For another thing, we have significant demographics with the combination of high poverty rates, high pregnancy rates, and below-average education levels.  And another factor is the high obesity rate in our country.

[Melissa Louise]

11 minutes ago, SKL said:

Yeah I'm confused kuz I thought I was hearing "your country is wasteful to have pretty spaces at hospitals" and now I'm hearing "our hospitals have pretty spaces too."

Anyhoo.  Probably just not understanding each other.

As for the cost stuff, there's always too much hyperbole / selective reporting in these threads for any discussion to make actual sense.

Nah fam.

We don't have waiting rooms in the hospital/on the ward for twenty family members to congregate.

We do have fish tanks and sculptures* 

Can twenty family members congregate for Aunt Sally's knee replacement by the fish tank? Probably not.

*In the big, new city hospitals. Not in my old grungy city hospital**. No fish tanks for us. 

** Teaching hospital - best treatment.

No fish. No room for Aunt Sally's goddaughter's MIL. Not much pretty. 

 

 

 

 

Edited September 23, 2023 by Melissa Louise

[Heartstrings]

4 hours ago, Catwoman said:

Americans freely admit that we have both good and bad hospitals and doctors, and we know our system needs improvement, but it seems like a few people keep misrepresenting the way our system works because they have no personal knowledge of it and they are imagining things entirely incorrectly. I mean, for heaven's sake, some people even seem resentful that we have nice waiting rooms and other amenities..

I AM an American, with a stack of doctor bills despite having good insurance.  What I resent is the “can we afford it” conversations we have to have around health care.  My husband and I both currently have medical needs we aren’t attending to.  Maybe I am just ignorant of the secret ways to get free physical therapy or perhaps Im imaging the need for it, or the cost of it? 
But complaining about it makes me un-American, ignorant and delusion.   God Bless the USA.  

[kathyl]

3 hours ago, SKL said:

Regarding pretty facilities - I'd like to add that these aren't just for visitors.  They are also used by patients who are briefly able to leave their hospital rooms - including children.  And a little respite from the yuckiness of the hospital room is good for their health.

In my city, we have a world-class hospital that received a $100 million anonymous donation in someone's will.  I don't have a problem if, in the process of building an even more modern hospital facility, the designers are asked to include some pleasant spaces here and there to help folks in an otherwise really unpleasant situation.

My mom's surgery was in a nearby but different (also very good) hospital.  It was walking distance to some of the best museums in the area.  I walked with some of my sibs to the art museum while my mom was in surgery.  It was nice to be able to do that.

We also have Ronald McDonald Houses that provide free housing for families when children have to be in hospital for a long time.

A lot of people don't live close enough to the best hospitals to just drive home, have lunch, and come back.

That's what I was thinking as I was reading about the waiting areas.  I've been to 2 different large teaching universities for my cancer treatments and follow-ups.  Those waiting areas make a significant difference to me, personally. 

In the first uni where I had the chemo and radiation the waiting areas were dark, old, and dank.  They looked like someone needed to come in and rip out all the ancient carpet and everything else in there and put in something at least with some brighter color to it??  A few windows maybe???  Or I don't know what.  Just do something so it doesn't make me feel like I'm descending into the depths of hell when I go for my chemo or radiation appts because it does make a difference - to me, anyway.

In the second uni where I have my follow up treatments - scans, exams, labs, etc. - the waiting areas are bright and sunny and larger than the first uni's.  It's a whole different atmosphere and I love it.  I'd rather not have to go, of course, but if I have to be there, then at least I can sit in the waiting areas without feeling like my next stop is the morgue. 

 

2 hours ago, KungFuPanda said:

 .......

I don't see why we can't have affordable care AND beautiful spaces to wait. That whole argument sounds like peasants arguing over crumbs. The lobby has to be the least expensive part of an entire hospital complex anyway.  It doesn't even take up more land if you're building up.  These nice spaces also attract workers to a facility.  I don't know WHY an Emirati Sheik donated so much to Johns Hopkins, but if billionaires would do that instead of playing with their rockets we'd all be better off.  

This.  

[Heartstrings]

2 hours ago, KungFuPanda said:

Why aren't the major hospitals who need staffing subsidizing instructors?

Most of our hospitals are for profit, there’s no profit motive to fix the issue as long as they can keep bandaid ing it.   There would need to be a direct benefit to the hospitals bottom line to funding instructors and so far they aren’t seeing it that way.  

[Melissa Louise]

12 minutes ago, Heartstrings said:

Most of our hospitals are for profit, there’s no profit motive to fix the issue as long as they can keep bandaid ing it.   There would need to be a direct benefit to the hospitals bottom line to funding instructors and so far they aren’t seeing it that way.  

OK, with the caveat that in our public-private system, we also have for-profit hospitals - health care being for profit will never not shock me. No matter where in the world it takes place.

What a weird species we are, that we see opportunities for profit anywhere, even in sickness. 

 

[popmom]

50 minutes ago, Heartstrings said:

Most of our hospitals are for profit, there’s no profit motive to fix the issue as long as they can keep bandaid ing it.   There would need to be a direct benefit to the hospitals bottom line to funding instructors and so far they aren’t seeing it that way.  

In the US? I know most of the hospitals in my area are non profit. Almost all of them. That doesn’t mean they aren’t still managed based on sound business practices… the ones that aren’t non profit are university, so they definitely have a vested interest in attracting students and instructors.

“As of 2017, about 59 percent of all hospitals registered in the U.S. were nonprofit, and 21.3 percent were for-profit hospitals, with the remainder state-owned.”

google

Edited September 23, 2023 by popmom

[TravelingChris]

50 minutes ago, kathyl said:

That's what I was thinking as I was reading about the waiting areas.  I've been to 2 different large teaching universities for my cancer treatments and follow-ups.  Those waiting areas make a significant difference to me, personally. 

In the first uni where I had the chemo and radiation the waiting areas were dark, old, and dank.  They looked like someone needed to come in and rip out all the ancient carpet and everything else in there and put in something at least with some brighter color to it??  A few windows maybe???  Or I don't know what.  Just do something so it doesn't make me feel like I'm descending into the depths of hell when I go for my chemo or radiation appts because it does make a difference - to me, anyway.

In the second uni where I have my follow up treatments - scans, exams, labs, etc. - the waiting areas are bright and sunny and larger than the first uni's.  It's a whole different atmosphere and I love it.  I'd rather not have to go, of course, but if I have to be there, then at least I can sit in the waiting areas without feeling like my next stop is the morgue. 

 

This.  

I have two choices for mammograms.  I first went to an awful waiting room. and super long waiting times for mammograms.  After several years, I decided to try the other place.  Very nice and comfortable.  Did one cost the insurance more than the other>  No.  

[TravelingChris]

Just now, popmom said:

In the US? I know most of the hospitals in my area are non profit. Almost all of them. That doesn’t mean they aren’t still managed based on sound business practices…

“As of 2017, about 59 percent of all hospitals registered in the U.S. were nonprofit, and 21.3 percent were for-profit hospitals, with the remainder state-owned.”

google

The hospital I like better is for profit.  It is owned by doctors.  The  place has better management.  BUrt the bigger hospital is non-profit.

[ktgrok]

6 hours ago, bolt. said:

 You have space and short line ups because of the people who aren't there.

 

This. Every single time people say that universal healthcare leads to longer wait times, this is what I point out. Having short wait times because some people cant' access care at all, and never get into the line, isn't a GOOD thing. 

[Pawz4me]

3 hours ago, KungFuPanda said:

Why aren't the major hospitals who need staffing subsidizing instructors?

I'm guessing there are probably multiple reasons. But as someone said, most hospitals (and this applies even to the not-for-profit ones) aren't in the habit of funding things that don't directly benefit their bottom lines. I don't know how they would fund nursing instructors and do that? I'm pretty sure if it was a matter of paying students' tuition and fees then yes, they could do that in return for requiring the person to work for their hospital system for X years after graduation. But I don't know that any sort of requirement like that would be possible from funding instructors. So a hospital system could fund nurse educators at Whatever College and, because nurses are in such high demand (and likely will continue to be for the foreseeable future) they could take jobs anywhere after graduation. They wouldn't be obligated to the hospital system(s) that funded the nurse educators. But I agree that it seems like something should be able to be worked out.

[Mrs Tiggywinkle Again]

1 hour ago, Heartstrings said:

Most of our hospitals are for profit, there’s no profit motive to fix the issue as long as they can keep bandaid ing it.   There would need to be a direct benefit to the hospitals bottom line to funding instructors and so far they aren’t seeing it that way.  

The hospitals I am most familiar with are non for profit, but hemorrhaging money.  They’re in places with large populations of patients on Medicaid/Medicare and reimbursement barely covers cost.

According to this there are no for profit hospitals in my state.  It was interesting to look at the differences between states.

https://www.kff.org/other/state-indicator/hospitals-by-ownership/?currentTimeframe=0&sortModel={"colId":"Location","sort":"asc"}

Almost all offer tuition repayment/student loan repayment or tuition reimbursement to become an RN if you’re a CNA or LPN.  That’s a pretty common benefit at least locally. And as  they are not-for-profit I know several nurses who have taken advantage of the public service loan forgiveness and had it granted in the last for years.

Edited September 23, 2023 by Mrs Tiggywinkle Again

[Catwoman]

2 hours ago, SKL said:

Yeah I'm confused kuz I thought I was hearing "your country is wasteful to have pretty spaces at hospitals" and now I'm hearing "our hospitals have pretty spaces too."

Anyhoo.  Probably just not understanding each other.

As for the cost stuff, there's always too much hyperbole / selective reporting in these threads for any discussion to make actual sense.

Yeah, these threads always seem to start out informational and then turn into some sort of bizarre and somewhat bitter competition between the countries and even between Americans among ourselves, and a bunch of people end up getting all offended.

I'm out. 🙂 

Meanwhile, @Scarlett is probably wondering what any of this has to do with her OP. 😉 

[Melissa in Australia]

I thought it was an informative discussion. I learned a lot. 

[Melissa Louise]

39 minutes ago, Melissa in Australia said:

I thought it was an informative discussion. I learned a lot. 

Same.

As I don't want twenty people waiting on me in surgery, the lack of waiting rooms for those twenty people is not something I feel bitter about. 

[TechWife]

On 9/22/2023 at 9:22 PM, Melissa in Australia said:

There would be a waiting room in emergancy  that is all. It is always  full of people seeking treatment 

No waiting rooms for families in the hospital at all. No family groups waiting. It isn't done here.  The whole concept is completely foreign. strict visiting hours, only 2 visitors allowed at a time. 

This must be so stressful on everyone concerned. The general “rule of thumb” at area hospitals is 4 visitors max for a regular room. Visiting hours are usually 6a-9p. Family can come and go at any time, they just have to be aware which doors get locked at night. For ICU it’s one immediate family member and one support person for that family member. Nurses have some leeway with that on regular floors - we’ve had family come in to bring birthday cake for a patient. Teens often have a small gaggle for a little bit right after school lets out for the day. But, as I said earlier, each patient is allowed to have one person with them 24/7. End of life patients & families don’t have limits on # visitors or any visiting hour limitations.

Another difference in terminology is that family members that are there to stay with the patient aren’t considered visitors. So in peds, a child can have both parents present and also have four school mates over. Now, the rooms are small and it doesn’t always work out that they have a lot of room, but they’re very good for our patients’ spirits. We close the room door and if they get loud they get one reminder. If they’re loud again, they’re asked to make their way out and come back another time. 

[Melissa in Australia]

Oh for minors 1 parent can stay. Like when twin 2 had his medical emergancy a few months ago I stayed with him day and night.. But that is only for minors. 

[prairiewindmomma]

8 hours ago, Melissa in Australia said:

Oh for minors 1 parent can stay. Like when twin 2 had his medical emergancy a few months ago I stayed with him day and night.. But that is only for minors. 

That’s how it’s been during influenza season and through much of COVID here. Currently 2 parents can stay with minors or 1 adult with adult patients. Visitor max is 2 per patient, though you can rotate pretty quickly (ie leave some family in the parking lot and rotate through). Exceptions might be made for siblings/kids of hospitalized parent but I don’t know. I only see the posted signs at entrance since we haven’t had a kid hospitalized since 2019.
 

 

[busymama7]

19 hours ago, Corraleno said:

 If we have the most advanced healthcare system in the world, why do we have the WORST infant and maternal mortality rates in the developed world???

Ooh ooh ooh, I'll play! We are one of the few if not only who use surgeons as the primary care for normal routine pregnancy.  They are very well trained in how to do safe surgeries and less well trained in normal pregnancy and nutrition etc.  Midwives, even in the US and certainly in other countries, get better outcomes with less intervention.( and those interventions lead to a higher morbidity and mortality, which is worth it when they are needed but not when they are over applied) But change is slow.  Midwives were nearly wiped out here and have made a slow come back but most people still believe that a surgeon is necessary for their uncomplicated pregnancy and birth.  We will probably never have enough CNMs if we can't get enough nurses as referenced upthread unfortunately.  

[Condessa]

I’m on a Facebook page for parents of kids with low-grade gliomas that has members all over the world.  Observing the differences in care and navigating medical systems for the same condition has been an interesting side note.  
 

Every state in the U.S. has programs to fill in the gaps and provide care for people that might not be poor enough to qualify for Medicaid but who need help with the costs of these severe medical conditions.  But most people don’t know this.  It is a regular occurrence on the page to have U.S. parents who are suddenly dropped into the terror of their kid’s diagnosis and treatment also frightened that they are going to be bankrupt and unable to get the care they need.  The experienced parents reassure them that will not be the case and direct them to their hospital’s social worker to find out what their state’s process is.  No one is going without care for lack of payment, but it is a frustrating and convoluted system, and frightening before you learn to navigate it.  I have certainly felt some envy for the British parents on there dealing with the NHS who never gave a thought to that side of things when they were dropped into the nightmare.

On the other hand, the end-of-the-line plan for the NHS parents, the one they turn to when their kids have failed every treatment protocol available to them there, is to fight the bureaucracy to try to get their kid approved to be sent to the U.S. for treatment, and to try to make it happen in time before their growing brain tumors cause too much irreparable brain damage.  I have seen them swapping advice on wading through the appeal process.  And during the pandemic when some paper-pusher at the NHS made a blanket decision that all monitoring scans for all low-grade tumors were suspended until hospitals were less overwhelmed with Covid patients, I saw their terrified scramble.  They were all searching desperately for somewhere they could travel with their children to pay out-of-pocket for necessary monitoring to know when their kids needed to resume that free cancer treatment.  (In most tumors, low-grade=benign, but all central nervous system tumors are considered cancerous and can cause permanent life-altering damage or death without careful monitoring and intervention.)

All in all, both systems have major strengths and major weaknesses.

Edited September 24, 2023 by Condessa

[Condessa]

8 hours ago, Melissa in Australia said:

Oh for minors 1 parent can stay. Like when twin 2 had his medical emergancy a few months ago I stayed with him day and night.. But that is only for minors. 

That’s how it was here during ds’s diagnosis and subsequent surgery and long hospitalization, during the pandemic.  It was the worst experience of our lives.  It was pretty rough never being able to be with dh to support each other during those weeks.

[Frances]

17 hours ago, Heartstrings said:

Most of our hospitals are for profit, there’s no profit motive to fix the issue as long as they can keep bandaid ing it.   There would need to be a direct benefit to the hospitals bottom line to funding instructors and so far they aren’t seeing it that way.  

That might be true in your state, but I don’t think it’s true overall on the US. A minority of hospitals in the US are for profit. In my state, I don’t think the unions who represent public community college and university employees would support paying some instructors more than others, regardless of the need. I suppose it could happen at private universities, but those are generally quite a bit more expensive way for a student to get a nursing degree.

It’s my understanding that another impediment to increasing nursing training slots, besides lack of faculty, is not enough practicum sites. With staffing shortages so many places, it’s just another huge burden on existing staff to help train and supervise nurses in training.

[Drama Llama]

4 hours ago, Condessa said:

That’s how it was here during ds’s diagnosis and subsequent surgery and long hospitalization, during the pandemic.  It was the worst experience of our lives.  It was pretty rough never being able to be with dh to support each other during those weeks.

This was so hard. 

[Scarlett]

Y’all went down a big rabbit trail while I was visiting with my new great niece Saturday.  
 

Everything went fine.  We felt very wanted and had a good visit talking turns holding the sleeping newborn.  We got there about noon and went into town on the way to pick up a couple of pizzas.  My SIL (nephew’s mother) brought the 6 year over so we were able to see him as well.  

[HS Mom in NC]

On 9/19/2023 at 8:43 PM, Scarlett said:

 Is there not a mid ground of everyone in delivery room vs no one is allowed on hospital grounds?

 

Equating wanting someone to visit after they're settled at home with cutting family completely out is absurd.

Your world is the US in the 21st century.  That's a pluralistic, individualistic society with empowered women. Women decide what they do and don't want as it relates to visitors when giving birth.  Individual patient preferences trump all subcultural norms when it comes receiving visitors in hospitals.

How is it that after all these years at this board with thousands of discussions like these that it still needs to be explicitly stated that different people feel differently about things, so plan accordingly,  and traditionalism for its own sake is an outlier. Whatever was the norm of yesteryear that you knew, it's no longer applicable. Update your reference point and move on without a fuss for everyone's sake, especially your own. 

This board is like Ground Hog Day sometimes.  We've been here before and covered these cultural themes at length again and again.

[Ausmumof3]

This thread might have moved on. I think one thing to keep in mind when discussing issues with public health care in the UK and Australia is that there’s currently a very cynical attempt to move us toward a more US model with bare minimum public health care. The UK is worse, from what I read there serious cut backs etc. So public health care that is right now is not what was, or what is possible but that is a created issue. (And the pandemic doesn’t help even if we want to pretend it’s over. Every Covid wave our hospitals still hit code white. Media reports on it with no mention of Covid. 

[Ausmumof3]

On 9/23/2023 at 10:42 AM, ktgrok said:

To clarify for those not in the US, some of our hospitals are HUGE complexes. I know a hospital was mentioned in Australia with 150 beds. Here, ONE campus of Orlando Health, their main downtown hospital, has 850 beds. Mind you, that doesn't have any pediatrics or maternity beds - the same hospital system has the Arnold Palmer Hospital for Children a few blocks away that has another 158 beds, and then there is also in the same system Winnie Palmer Hospital for Women and Babies across the road that has another 285 beds. And they have other hospitals around the metro area. PLUS separate free standing emergency rooms in addition to the ones at the actual hospitals. PLUS there is a competing hospital system, Advent Health, that just in Central Florida has 18 hospitals with 4,700 beds. 

These places have valet parking and huge parking garages, and each hospital will have MANY waiting rooms. One for the ER, one for surgical, one for imaging, one for ICU, one for maternity, etc etc. 

Duke Medical Center, where my mom had her surgery, has, according to their website: "1,048 licensed inpatient beds and offers comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center; a major surgery suite containing 51 operating rooms; an endosurgery center; a separate hospital outpatient surgical department with nine operating rooms, an extensive diagnostic and interventional radiology area and an eye center with five additional operating rooms. In fiscal year 2021, Duke University Hospital admitted 41,274 patients and had 1,305,938 outpatient visits"

I think the biggest one in my state is 800, but we are one of the lower population states so I imagine Sydney/Melbourne are different.

My closest one I have most recent experience with is 257 beds. I think there’s a separate mental health part on top of that.

That does have gardens, cafeterias etc. They’ve been renovating the emergency for ages and we had to wait outside due to Covid last major trip we had there.

Its not so much that there isn’t gardens and cafes it’s that they’re there for patient use, so not open to the general public to just go and hang around in. You can visit and meet people during visiting hours but you have to sign in/out, talk to people at the desk etc. And mostly it’s just not the cultural norm. Although I’ve noticed as with recent visits there have been some large family groups from other cultures so I guess that might be changing.

DH always finds it surprising with his work that if there’s a car accident, with some cultures the whole family will turn up. Often in multiple separate cars. It becomes a total nightmare for traffic management. And police have trouble because other family members will try to talk for the victim even when they weren’t there to see what happened (particularly men for the women ) I’m not sure if it’s a language barrier thing or a cultural thing or what. 

Edited September 25, 2023 by Ausmumof3

[Ausmumof3]

On 9/24/2023 at 7:11 AM, SKL said:

Yeah I'm confused kuz I thought I was hearing "your country is wasteful to have pretty spaces at hospitals" and now I'm hearing "our hospitals have pretty spaces too."

Anyhoo.  Probably just not understanding each other.

As for the cost stuff, there's always too much hyperbole / selective reporting in these threads for any discussion to make actual sense.

Yeah it’s kinda confusing. 
 

So labour and delivery or areas where surgery happens are in a different area to recovery. Recovery areas have cafes and gardens for patients to have family and friends although there’s a limit on how many at some hospitals. Whereas the guts of the hospital where stuff actually happens, surgery, don’t. It’s not wasteful to have waiting areas in a context where they will be used but typically here the culture isn’t like that so that’s why hospitals don’t have them I guess.

There’s also both massive and small hospitals here and there’s a huge amount of variation in what they have: the small local hospital near me only has a couple of vending machines, the big one has several cafes and a couple of shops and gardens etc. Those areas are kinda distant from other areas though. The kids ward has a play area and there’s a garden but it’s a fair walk away.

 

 

Edited September 25, 2023 by Ausmumof3

[Scarlett]

6 hours ago, HS Mom in NC said:

Equating wanting someone to visit after they're settled at home with cutting family completely out is absurd.

Your world is the US in the 21st century.  That's a pluralistic, individualistic society with empowered women. Women decide what they do and don't want as it relates to visitors when giving birth.  Individual patient preferences trump all subcultural norms when it comes receiving visitors in hospitals.

How is it that after all these years at this board with thousands of discussions like these that it still needs to be explicitly stated that different people feel differently about things, so plan accordingly,  and traditionalism for its own sake is an outlier. Whatever was the norm of yesteryear that you knew, it's no longer applicable. Update your reference point and move on without a fuss for everyone's sake, especially your own. 

This board is like Ground Hog Day sometimes.  We've been here before and covered these cultural themes at length again and again.

Well ok then.