Mothers during and after birth

[Pawz4me]

20 minutes ago, TechWife said:

DH’s surgeon asked us that same question and there were only three of us, myself, our son and my SIL. 
 

I think they're usually asking that as code for "is it okay if I talk about the patient in front of these people." And they do it whether there's two or twenty.

[TechWife]

4 hours ago, Melissa in Australia said:

I have been very confused for a while. It is so completely out of my understanding of hospitals. 

Some of the terms used like

Being at delivery to me equals present at delivery.. In the room. Watching the actual person have the baby. (here 20 or so people wouldn't fit in a tiny delivery cubical) 

Being at surgery... in theater... People watching the actual surgery (do they have a glass panel like on a movie for the audience to watch through for infection control I wonder) 

Being in recovery room.. This one really has me even more confused..(it must mean something completely different there) Here the recovery room Is where all still unconscious  patients are wheeled and their tubes are removed. And they are brought back to consciousness. Rows of beds side by side with just room for a nurse between each bed. Before the patient is taken back to the ward. Nobody at all is allowed in there. 

If someone told me they were at the delivery, I , too, would think they were in the room when the baby is born. I think there’s a limit on the number of people who can be in the room at once,  but it might vary by hospital. The groups of people described in this thread are in a waiting area or lobby. When a patient is allowed visitors and wants them, they take turns going in, one or two at a time. 

Most OR’s don’t have observation areas and when they do, access is severely restricted.  I don’t know if family can watch. Usually it’s students or other physicians. I’ve only seen one observation area and it’s like I saw on tv, but much smaller. I don’t know what the standard is, though. 

Our recovery rooms are exactly as you describe- a row of stretchers with a curtain pulled between them. Usually only one family member is allowed into recovery after the patient is settled there (here there’s usually a one hour observation time after anesthesia is discontinued, then the patient is discharged or moved to an patient room).

Patient rooms are pretty small, though ICU rooms are bigger to allow for more equipment and more staff to be taking care of the patient at the same time. 

[TechWife]

3 minutes ago, Pawz4me said:

I think they're usually asking that as code for "is it okay if I talk about the patient in front of these people." And they do it whether there's two or twenty.

Exactly. 

[kathyl]

14 minutes ago, Pawz4me said:

I think they're usually asking that as code for "is it okay if I talk about the patient in front of these people." And they do it whether there's two or twenty.

The same thing happened when I had my surgery.  Dh and some of our grown kids were there for the surgery and for different appointments.  Whichever doctor was there always looked at everyone questioningly and sometimes asked about all the people.  I usually just quickly said something like "They're my kids.  They're fine to hear everything" and then the doctors just started doing their thing.  

I guess they needed the confirmation.

Edited September 23, 2023 by kathyl

[Idalou]

I suppose some of you must think it's weird, then, when a police officer or firefighter gets shot or hurt and the entire department shows up to stand around in the waiting areas to make sure he's ok or not. When my uncle needed surgery several years ago, there were over 20  family members  there to see him before surgery and to sit with his wife. We were quiet for over 5 hours. I've never experienced rude or loud people in a hospital but I can picture it in today's society. When a nurse asked us to move to a smaller room we knew that he didn't survive the operation. I know that every single person there was glad they were allowed to be there.

I don't understand the confusion and piling on. We all know, even Scarlett!, that a mom has a right to set the rules. Most of us know that huge crowds don't gather and wreak havoc or disrupt the hospital, we all can probably agree that an operation to remove tonsils  won't necessitate a big # of visitors, but major heart surgery or brain surgery could. I can't be the only one that believes the visitors are there even more so for the spouse or child of the patient, and that they, just like the new mom, get to set the rules, because it's not too common for a patient to be allowed visitors straight out of surgery.

[Sneezyone]

11 minutes ago, Idalou said:

I suppose some of you must think it's weird, then, when a police officer or firefighter gets shot or hurt and the entire department shows up to stand around in the waiting areas to make sure he's ok or not. When my uncle needed surgery several years ago, there were over 20  family members  there to see him before surgery and to sit with his wife. We were quiet for over 5 hours. I've never experienced rude or loud people in a hospital but I can picture it in today's society. When a nurse asked us to move to a smaller room we knew that he didn't survive the operation. I know that every single person there was glad they were allowed to be there.

I don't understand the confusion and piling on. We all know, even Scarlett!, that a mom has a right to set the rules. Most of us know that huge crowds don't gather and wreak havoc or disrupt the hospital, we all can probably agree that an operation to remove tonsils  won't necessitate a big # of visitors, but major heart surgery or brain surgery could. I can't be the only one that believes the visitors are there even more so for the spouse or child of the patient, and that they, just like the new mom, get to set the rules, because it's not too common for a patient to be allowed visitors straight out of surgery.

I don't think it's weird. I'll be honest tho, as a military family, DH and I have talked about this and we don't want any of those people around for our most intimate family moments. Graveside, sure, hospital? HELL NO.

[Melissa Louise]

5 hours ago, gardenmom5 said:

It made me sad too..  Sad that was such as their relationship.

And angry his parents had so little respect for him, and my daughter.   And were only interested in the boys for "grandparent bragging rights".    I was there to see it . . . 

Oh, I have seen this up close and personal. You know, you can really tell who is trustworthy and who isn't by who can abide by a simple request for no visitors. Or who can use their common sense and ask first, and be the kind of person a new mom can say no to without fear of a huff or a tantrum.

I gave my in-laws every chance (and my own mother too, if it comes to that) but they showed over and over again (in-laws in particular) that they only cared about their bragging rights. They reaped as they sowed - none of my kids have a relationship with them now.

And really, the steamrollering over boundaries from birth predicted it.

 

 

 

[Kassia]

8 minutes ago, Melissa Louise said:

 

I gave my in-laws every chance (and my own mother too, if it comes to that) but they showed over and over again (in-laws in particular) that they only cared about their bragging rights. They reaped as they sowed - none of my kids have a relationship with them now

 

Same

[Melissa Louise]

2 minutes ago, Kassia said:

Same

Yeah, some people just see babies as an extension of themselves. It offends their self-concept when mother-baby have needs that differ from their own.

It never augurs well for the future. 

[ktgrok]

22 hours ago, Melissa in Australia said:

Here nurses take patients to the toilet. H with showering, Make the beds and if needed feed the patient. The hospitals also have personal care assistants and student nurses doing their learning rounds that help with these tasks. 

yeah, you will be waiting a while if you need to wait for a nurse to help with getting to the bathroom, etc. It is advised to have someone with you if you are not able to do these things on your own. 

[ktgrok]

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"

Edited September 23, 2023 by ktgrok

[Melissa in Australia]

The city hospital I was in for several weeks had 1500 beds. No paediatric or Maternity.. It is a trauma hospital. 

I am In a rural hospital now, 150 beds 

[ktgrok]

Just now, Melissa in Australia said:

The city hospital I was in for several weeks had 1500 beds. No paediatric or Maternity.. It is a trauma hospital. 

I am In a rural hospital now, 150 beds 

Gotcha. So I'm guessing more waiting rooms/places for family at the big hospital? 

[Melissa in Australia]

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. 

Edited September 23, 2023 by Melissa in Australia

[kathyl]

5 minutes ago, 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"

And they probably each have their own cafeterias?  The medical facilities I use now has eating facilities in each building.  One appointment I had was in a building that had cafeteria style eating and the food was better than most restaurants I've been to.

[KungFuPanda]

On 9/21/2023 at 7:21 PM, bolt. said:

Wow. Not in my local Canadian hospitals there isn't!

 

On 9/21/2023 at 7:22 PM, Melissa in Australia said:

Not here either. Only waiting room Is in emergancy for ill people waiting for treatment

 

 

 

On 9/21/2023 at 7:27 PM, Melissa in Australia said:

And each of those people would walk. In a hallway, go in a lift, take a car park spot, possably ask questions or directions of staff. Each one of them. Possably hundreds  of people if there is lots of surgery happening 

It's been my experience that even rural hospitals have sizable waiting rooms.  Usually there is a help desk/reception area where people ask questions and get visitors' badges so nobody is actually asking medical personnel these questions.  Unless you are a care partner or parent, there are specific visiting hours when you are allowed to be there.

In the hospitals we used in Baltimore and D.C. there were large common waiting rooms, cafeterias, coffee shops, playrooms, chapels,  and outside spaces like gardens and balconies.  There were often volunteers roaming around with little toys and crafts for kids who were waiting for appointments or their bored siblings.  Televisions are standard and they are usually showing cartoons in a pediatric ward or HGTV in other areas (unless it's a local team's game day).  Most of the rooms have phone chargers now.  There are little side meeting rooms where medical personnel can have a private conversation with the family without the whole waiting room overhearing.

[Scarlett]

2 hours ago, annandatje said:

I think my last surgery was typical for a larger regional hospital in same general section of USA as original poster.  Surgery had to be done in hospital instead of ambulatory surgical site because of serious issues.  We reported to hospital surgery waiting room; one person was allowed/required to stay entire time.  Any additional family members had to find another place to wait.  The waiting room was staffed with a couple of monitors/receptionists and security officers to escort out those extra people or prevent them from entering.  I only recall one patient bringing two people with them; of course, one was told to leave.  This was prior to pandemic.

I am not sure where you are but I have never encountered a surgery waiting room that only allows one family member. Recovery usually only allows one family member.

I am 58 years old and I have waited at many many surgeries. 

[Melissa Louise]

City hospitals have waiting rooms here for the ED and  day surgery - for the patients and one or two family members or carers. 

They are not for vague 'emotional support of the  family' reasons, but for reasons like: waiting to take a day patient home, waiting for a child or baby to have surgery, waiting to find out if someone will be admitted and where, accompanying a non-local patient.

If you are admitted and having surgery, someone can visit bedside before hand, and either in recovery or after coming back from recovery as per ward rules.

The hospital will call you to let you know the patient is out of surgery. 

The only time groups gather are when a patient is actively dying. Depending on the hospital, there may be a family lounge. 

~

There was a kitchenette and small lounge at the birth center I gave birth at. It was for birth partner/s.

During the day there was a cafe if someone was desperate to hang out. Otherwise, wait for a call! 

 

 

 

 

 

 

[itsheresomewhere]

10 minutes ago, Scarlett said:

I am not sure where you are but I have never encountered a surgery waiting room that only allows one family member. Recovery usually only allows one family member.

I am 58 years old and I have waited at many many surgeries. 

It is coming your way.  These large corporations are buying/merging hospitals and the waiting rooms are being cut in size.  Suddenly, they need more offices for the people I call the bottom liners and taking from the waiting rooms size is an easy fix.   The major medical center once they merged near me cut in half the ER waiting room to make a couple of office, storage spaces. And every time they redo a floor, those waiting rooms are cut in size.  

[KungFuPanda]

On 9/21/2023 at 9:50 PM, Murphy101 said:

It is my and many other older women’s observation of both ourselves and other women. It’s not even a bad thing so much as a typical thing.  This topic was a hotly debated mother topic 30 years ago too.

Which is why I said that I might be sad to not see my son or daughter at the hospital for any reason, but everyone I know would be genuinely concerned if it’s not just that I am not there, but no one else is either.  And we do see that a lot more these days. And new mom isolation depression and couple stress is a real thing too.  So let’s not gloss over the real hardships of going too far in the other direction on this issue of new parents feeling they have to do it all on their own and ending up just feeling they are failing each other.

 

 

23 hours ago, Melissa in Australia said:

The hospital I am in at the moment has about 120 beds. It also has an attached nursing home. it is a regional hospital in a small city that coveres the whole eastern end of Victoria. The waiting room  In emergancy has exactly 20 chairs.. That is as big as the room is. And as many chairs as it can hold.  There are no other waiting rooms 

The hallways are about 3 metres wide. If a bed is being moved through the hallway people need to back against the walls. 

I have never worked out what a lobby is. It is one of those words that I have never been able to translate 

 

23 hours ago, Melissa in Australia said:

That could mean thousands of people with no medical reason filling the hospital every day. 😲😲😲

To me this is completely mind blowing  

Here is a visual.  The lobbies, coffee shops, and gift stores are in separate areas from the medical staff and patient rooms.  They serve as a holding pen for people waiting their turn since the number of visitors in the patient's room is limited.  Small children, unless they're siblings, aren't always allowed to visit, so the lobby is the place parents would take turns watching the child then switching off to visit the patient.  A main lobby is usually a large room with several seating areas and a reception desk.

This is where we took DS for all his appointments.  They'd stack the appointments so that we could do 2-3 in a day, but it was a long day and it was good to have places to rest and get food.  DH sometimes worked in the lobby (they all have free wi-fi) or took a meeting on the patio.  As you can see, there are extremely wide hallways and banks of elevators.  The public use area and the medical emergency areas would be in different places and not share hallways or elevators.

 

[Melissa Louise]

We have big hospitals, lol

Melissa just spent weeks in one!

 

[Melissa Louise]

I think I worked out the disconnect. 

We have a public-private system. Private makes $$, does the lower risk stuff and offers bells and whistles.

Public does everything, but no bells and whistles. 

Doctors work across both systems. 

If we paid big bucks, we'd probably have more waiting rooms.too. 

[KungFuPanda]

9 minutes ago, Melissa Louise said:

We have big hospitals, lol

Melissa just spent weeks in one!

 

I just posted the video because she said she couldn't imagine what we meant when we said "lobby."  It's just easier to see something than hear a description.

 

[Heartstrings]

28 minutes ago, Melissa Louise said:

I think I worked out the disconnect. 

We have a public-private system. Private makes $$, does the lower risk stuff and offers bells and whistles.

Public does everything, but no bells and whistles. 

Doctors work across both systems. 

If we paid big bucks, we'd probably have more waiting rooms.too. 

I'd love to trade.  I'd be more than happy to have no waiting rooms and not spend thousands when we need the hospital.    (discontented American, don't mind me....

[Melissa Louise]

19 minutes ago, Heartstrings said:

I'd love to trade.  I'd be more than happy to have no waiting rooms and not spend thousands when we need the hospital.    (discontented American, don't mind me....

I am very grateful for no cost at the point of service hospital care. 

[Melissa in Australia]

3 minutes ago, Melissa Louise said:

I am very grateful for no cost at the point of service hospital care. 

Me too

By the time I am discharged it will be 10 weeks of hospital stay. All at absolutly no cost at all to me. 

Edited September 23, 2023 by Melissa in Australia

[Scarlett]

2 hours ago, Heartstrings said:

I'd love to trade.  I'd be more than happy to have no waiting rooms and not spend thousands when we need the hospital.    (discontented American, don't mind me....

I mean….this is a different conversation, right?  If someone asked me if I would trade a waiting room for 20 of my friends for free health care I imagine I would be asking my friends to come visit me when I am home. As someone said maybe no waiting rooms is coming soon  to my area…with no promise of free health care.

That really has nothing to do with the topic at hand.

[Laura Corin]

6 hours ago, 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. 

I think that's similar to the hospitals I have been to in the UK. When my mum was in a mixed geriatric ward, there were visiting hours and I saw one or two people visiting each patient. I don't know if there was a visitor limit as my brothers are not local and couldn't visit. 

Outpatient clinics and A&E had waiting rooms. Apart from that, there was a cafe downstairs with maybe fifty seats?

Family members are not expected to take patients to the loo, etc., unless they happen to be there during visiting hours.

[Melissa in Australia]

Family members are actively discouraged from taking family members to the toilet.. No staff wants a patient to fall on their watch. Aparently it is hours of paperwork if it happens. 

[Melissa in Australia]

3 hours ago, Scarlett said:

I mean….this is a different conversation, right?  If someone asked me if I would trade a waiting room for 20 of my friends for free health care I imagine I would be asking my friends to come visit me when I am home. As someone said maybe no waiting rooms is coming soon  to my area…with no promise of free health care.

That really has nothing to do with the topic at hand.

I think it is the same conversation 

[Pawz4me]

8 hours ago, Heartstrings said:

I'd love to trade.  I'd be more than happy to have no waiting rooms and not spend thousands when we need the hospital.    (discontented American, don't mind me....

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.

Edited September 23, 2023 by Pawz4me

[Happy2BaMom]

2 hours ago, Pawz4me said:

I 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.

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.

Sigh.

The *lack* of good insurance - for tens of millions of people in this country (including millions of children) - is THE issue. The *lack* of *affordable* health care for tens of millions more (including millions of children) is an even larger issue. YOUR ability to access vast resources of consumer-driven care not available in other countries is a direct result of our profit-driven, insurance-controlled system being able to limit or deny care to other US citizens.

The closest we can come to your second paragraph would be to have universal coverage (not that we'll ever do that) with private options for those who can pay for it. But, again, who is the *we* you refer to? Obviously, the haves. Because tens of millions of have-nots do not have care or "choices".

*******

As for the topic at hand, I'm in the "new family gets to set the rules of engagement". There's a whole slew of people who are tiring to have around, even if they mean well and even (sometimes) if they are good people. Parents with new babies don't need to accommodate other people's expectations during this stressful (however wonderful it may be) time.

Edited September 23, 2023 by Happy2BaMom

[Pam in CT]

[just noting for those in other parts of the world - this is among the very-very-very best hospitals in the US]

11 hours ago, KungFuPanda said:

Here is a visual.  The lobbies, coffee shops, and gift stores are in separate areas from the medical staff and patient rooms.  They serve as a holding pen for people waiting their turn since the number of visitors in the patient's room is limited.  Small children, unless they're siblings, aren't always allowed to visit, so the lobby is the place parents would take turns watching the child then switching off to visit the patient.  A main lobby is usually a large room with several seating areas and a reception desk.

This is where we took DS for all his appointments.  They'd stack the appointments so that we could do 2-3 in a day, but it was a long day and it was good to have places to rest and get food.  DH sometimes worked in the lobby (they all have free wi-fi) or took a meeting on the patio.  As you can see, there are extremely wide hallways and banks of elevators.  The public use area and the medical emergency areas would be in different places and not share hallways or elevators.

 

My husband chairs our local hospital and they are in the midst of a major capital renovation and this is basically the model. The first two floors of the new building will be "public space" -- several cafes, play areas for kids, gift shops, a flower shop, reading areas with comfy chairs, little conference rooms, a large quiet room like college libraries with work cubbies with charging outlets where people can do work, a nice terrace with sun and shade, shower rooms for visitors staying overnight, places where the various volunteers can stage their work, etc.

And that's where visitors will hang out. You hang out there, out of the way of medical professionals.  Waiting areas outside particular zones of the actual working hospital -- surgery, ICU, NICU, maternity -- are being eliminated everywhere except oncology. Go downstairs, we'll send you a text when the patient is able to see you.  It alleviates the burden on nursing staff of streams of visitors asking directions to the bathroom/ where is a vending machine/ is there an update on my person etc, it physically gets visitors out of the way in urgent situations, it lessens the risk of contagion, and just generally enables more peace in the working areas of the hospital while, also, providing more comfort and better food to the visitors.

 

It is ABDOLUTELY related to the business model.

10 hours ago, Melissa Louise said:

I think I worked out the disconnect. 

We have a public-private system. Private makes $$, does the lower risk stuff and offers bells and whistles.

Public does everything, but no bells and whistles. 

Doctors work across both systems. 

If we paid big bucks, we'd probably have more waiting rooms.too. 

Those lower floors are REVENUE GENERATING.  The cafes are for-profit enterprises, renting commercial space for access to an extremely inelastic demand curve. The gift shop and florist are crazy high end, overcharging visitors for unplanned gifts.  The public rooms are free to use but the shower facilities charge as in airport lounges. And etc.

The idea is that these public spaces subsidize the operations of the hospital at the same time as improving care on the wards by getting visitors out from immediately underfoot the professionals. The economics don't work everywhere -- in places like NYC the $/sq foot of real estate are too high; in smaller rural hospitals there isn't enough volume for the math to work. But in the sweet spot -- fairly dense population, enough specialists to draw patients and families from some distance, those back-to-back whole day appointment schedules that KungFu describes -- this is where US hospitals are headed.

[Pawz4me]

3 minutes ago, Happy2BaMom said:

Sigh.

The *lack* of good insurance - for tens of millions of people in this country (including millions of children) - is THE issue. The *lack* of *affordable* health care for tens of millions more (including millions of children) is an even larger issue. YOUR ability to access vast resources of consumer-driven care not available in other countries is a direct result of our profit-driven, insurance-controlled system being able to limit or deny care to other US citizens.

The closest we can come to your second paragraph would be to have universal coverage (not that we'll ever do that) with private options for those who can pay for it. But, again, who is the *we* you refer to? Obviously, the haves. Because tens of millions of have-nots do not have care or "choices".

 

That's also largely a fallacy that I learned about once we were enmeshed within the health care system. There are so many available grants that most people don't know about. And you don't have to be poor to qualify (although many poorer people do, of course--being poor is certainly not an exclusion!). Yes, it takes a lot of knowledge to learn how to navigate the system. It's needlessly way too complex, and that hurts the poorest/least educated the most. But I personally "cyber know" dozens of "have nots" with the same type of cancer DH has who are, by their own reports, receiving excellent care at an affordable-to-them price via the many grants that are available. It's something I would have had no idea about before our experience.

And do note that I am not arguing that our system doesn't have tons of flaws. It does, I thought I tried hard to make that clear in my previous post but perhaps I failed. But I suspect many of our non-US members don't have any real grasp of all the benefits there are, too. I I know before I got deep into things that I, as a privileged person who has always had good insurance, was firmly of the opinion that we needed nationalized care like Canada, Australia and others have. But now having seen so much more first hand, I will restate -- I didn't know what I didn't know. As I said in my previous post, I still think we need some sort of Medicare-for-all. But my hope is that we could somehow manage to do that while preserving a lot of the care/treatment options we have that many other countries with nationalized health care most definitely don't have.

[ktgrok]

12 hours ago, Heartstrings said:

I'd love to trade.  I'd be more than happy to have no waiting rooms and not spend thousands when we need the hospital.    (discontented American, don't mind me....

yeah...I've muttered stuff about this when walking through a giant lobby with sky high ceilings and pianos and giant sculptures. 

[SKL]

I'm blessed to live in a location with many excellent health care options.

I hate the way billing is done.  I don't understand why it's legal to charge multiple times as much to people who aren't insured vs. people who are insured.  If that problem was fixed, the number of people struggling with health care costs would be much less.

But health care costs money, just like heat in the winter.  We're all paying regardless.  Might as well be transparent about it.

People need to be educated about how to manage health care access before bad stuff happens.  There are accessible options for people in every circumstance, but planning helps to make the options fit with the individual's financial situation.

My folks have had millions of dollars "billed" for healthcare for my mom's cancer situation, but their out-of-pocket was about $20 total.  My folks are working class (at the time they were below retirement age).

We have room for improvement, but our health care system is excellent by world standards.

Edited September 23, 2023 by SKL

[historically accurate]

9 minutes ago, SKL said:

I'm blessed to live in a location with many excellent health care options.

I hate the way billing is done.  I don't understand why it's legal to charge multiple times as much to people who aren't insured vs. people who are insured.  If that problem was fixed, the number of people struggling with health care costs would be much less.

But health care costs money, just like heat in the winter.  We're all paying regardless.  Might as well be transparent about it.

People need to be educated about how to manage health care access before bad stuff happens.  There are accessible options for people in every circumstance, but planning helps to make the options fit with the individual's financial situation.

My folks have had millions of dollars "billed" for healthcare for my mom's cancer situation, but their out-of-pocket was about $20 total.  My folks are working class (at the time they were below retirement age).

We have room for improvement, but our health care system is excellent by world standards.

I would guess that the bolded is not typical for Americans.

 

I, as a breast cancer survivor, have what I like to refer to a multi-million dollar chest due to billing amounts LOL, and $20 was not even a drop in the bucket of our out-of-pocket and my cancer was fairly uncomplicated. We had fantastic insurance at the time (it's gotten worse over the years), but we only recently paid the cancer bills off, and I'm 13 years out from treatment. I kid you not. 

I'd guess the average falls somewhere in the middle of your mom's and my experience.

Edited September 23, 2023 by historically accurate

[KSera]

On 9/21/2023 at 5:41 PM, bolt. said:

If there were any remaining large visitor spaces in our hospitals, they would be converted to patient care spaces tomorrow. We lack patient care spaces.

In the US we lack staffing. Converting space into more beds (if the beds were approved) doesn’t help without staffing for those beds. During the biggest Covid surges, it has consistently been lack of staff that limited capacity. And my understanding is the lack of staffing traces back to our education system not having enough training spots— nursing is still a highly competitive field for example, but we’re not turning out enough nurses because there aren’t enough spots to train them.

1 hour ago, Pawz4me said:

And do note that I am not arguing that our system doesn't have tons of flaws. It does, I thought I tried hard to make that clear in my previous post but perhaps I failed. But I suspect many of our non-US members don't have any real grasp of all the benefits there are, too. I I know before I got deep into things that I, as a privileged person who has always had good insurance, was firmly of the opinion that we needed nationalized care like Canada, Australia and others have. But now having seen so much more first hand, I will restate -- I didn't know what I didn't know. As I said in my previous post, I still think we need some sort of Medicare-for-all. But my hope is that we could somehow manage to do that while preserving a lot of the care/treatment options we have that many other countries with nationalized health care most definitely don't have.

I agree with your posts and think there’s a lack of acknowledgment that both systems have their pros and cons. Knowing what I know from lots of family members who live outside the US in countries with national healthcare, neither system is ideal. I’d love to see a blend that gives healthcare for all without losing the aspects that currently provide better care for many in the US than they would get elsewhere. I honestly don’t know if that’s doable though. 
 

I don’t think anyone can fault someone like Pawz though for being grateful for the current system here in the face of a very ill family member who has benefited it. If you never have a truly huge medical crisis in the family, it’s easier to say you’d give up the care you have for the benefit of all. If you have a family member with a life threatening disease? A child perhaps? I think most would be hard pressed to not want the best care they can get. 

[marbel]

17 minutes ago, ktgrok said:

yeah...I've muttered stuff about this when walking through a giant lobby with sky high ceilings and pianos and giant sculptures. 

I'm not disagreeing with you, but sometimes those beautiful lobbies, pianos, etc. are there due to specific donations. That's why one of our local hospitals has an area called the "[insert donor name] Pavilion." It's a beautiful, comfortable space that houses the main information desk, gift shop, coffee shop, comfortable chairs and couches, and leads to the cafeteria (not as luxurious) and the medical areas. 

My husband used to work for a nonprofit (not a hospital) and they were often given designated gifts. Sometimes it caused frustration because there were more pressing needs and they could not use the money for those. but in the end, the money was a gift and used as desired by the donor. 

ETA: I am not making a universal statement that this is the case with all hospitals with nice amenities. Just my experience.

Edited September 23, 2023 by marbel

[Catwoman]

28 minutes ago, marbel said:

I'm not disagreeing with you, but sometimes those beautiful lobbies, pianos, etc. are there due to specific donations. That's why one of our local hospitals has an area called the "[insert donor name] Pavilion." It's a beautiful, comfortable space that houses the main information desk, gift shop, coffee shop, comfortable chairs and couches, and leads to the cafeteria (not as luxurious) and the medical areas. 

My husband used to work for a nonprofit (not a hospital) and they were often given designated gifts. Sometimes it caused frustration because there were more pressing needs and they could not use the money for those. but in the end, the money was a gift and used as desired by the donor. 

ETA: I am not making a universal statement that this is the case with all hospitals with nice amenities. Just my experience.

Yes, and as someone who has spent an inordinate amount of time in hospitals over the years with my parents and my dh, I always really appreciated those amenities.

Being able to eat lunch or just take a few minutes to relax in a beautiful atrium or lush garden can really brighten up a day that is otherwise spent in a patient's hospital room. I also really liked having multiple dining and shopping options instead of just a hospital cafeteria, yet that inexpensive cafeteria was also great when time was more limited and I just wanted to grab something quick, or it was 3:00am and I got hungry.

Our hospitals offer a lot of amenities to visitors, including things like art classes and educational seminars. Those things may seem frivolous to people who are just there for a day, but when a patient is in the hospital for quite a while, it's great that their regular visitors have some interesting ways to occupy some of their time without having to leave the hospital.

[itsheresomewhere]

37 minutes ago, KSera said:

In the US we lack staffing. Converting space into more beds (if the beds were approved) doesn’t help without staffing for those beds. During the biggest Covid surges, it has consistently been lack of staff that limited capacity. And my understanding is the lack of staffing traces back to our education system not having enough training spots— nursing is still a highly competitive field for example, but we’re not turning out enough nurses because there aren’t enough spots to train them.

I agree with your posts and think there’s a lack of acknowledgment that both systems have their pros and cons. Knowing what I know from lots of family members who live outside the US in countries with national healthcare, neither system is ideal. I’d love to see a blend that gives healthcare for all without losing the aspects that currently provide better care for many in the US than they would get elsewhere. I honestly don’t know if that’s doable though. 
 

I don’t think anyone can fault someone like Pawz though for being grateful for the current system here in the face of a very ill family member who has benefited it. If you never have a truly huge medical crisis in the family, it’s easier to say you’d give up the care you have for the benefit of all. If you have a family member with a life threatening disease? A child perhaps? I think most would be hard pressed to not want the best care they can get. 

It’s more than a lack of educators for the job  but also burn out and the lack of wanting to hire more nurses, cna, etc.  And the nurses are starting to fight back in some areas with strikes demanding more staff be hired as it is ridiculous the patient to nurse ratios. The hospital has the means to hire but doesn’t as it is all down to the profit numbers.  One of the hospitals nurses in NY just won for more nurses. 

Then when you add in burnout and how they can do another job without the stress and hours.  I understand why enrollment in some of the nursing programs near me is down. It all needs to be fixed  before the bottom completely drops out.  But until it affects those who could actually change it, it won’t. 

Edited September 23, 2023 by itsheresomewhere

[Happy2BaMom]

2 hours ago, Pawz4me said:

 There are so many available grants that most people don't know about. And you don't have to be poor to qualify (although many poorer people do, of course--being poor is certainly not an exclusion!).

 

My understanding is that grants are tied to research. With something like cancer, I would think there would be grants fairly available due to the research is going on.

I am curious (& doubtful) if there are any grants for people trying to access primary care, or standard surgeries, or other non-research oriented care.

I agree that the system in the US for things like cancer research is cutting edge. Like everything else in this country, the system is widely diverging. For specific people, the health care system works very, very well. For others, it doesn't work very well at all.

38 minutes ago, KSera said:

I don’t think anyone can fault someone like Pawz though for being grateful for the current system here in the face of a very ill family member who has benefited it. If you never have a truly huge medical crisis in the family, it’s easier to say you’d give up the care you have for the benefit of all. If you have a family member with a life threatening disease? A child perhaps? I think most would be hard pressed to not want the best care they can get. 

I agree. Which is why I won't be silent about those who don't have a hard time getting care for their child or family member, or who face certain financial devastation if they do.

[bolt.]

30 minutes ago, KSera said:

...If you never have a truly huge medical crisis in the family, it’s easier to say you’d give up the care you have for the benefit of all. If you have a family member with a life threatening disease? A child perhaps? I think most would be hard pressed to not want the best care they can get. 

I think your observation is quite right and very relevant. I also think there is a need to differentiate felt-care differences and outcome-measurable-care differences when defining something as "best" or "better" medical care.

I'd be more inclined to agree that some amount of "care" had been given up in universalized systems if evidence could be provided that the care *outcomes* were measurably different under the two types of treatment model.

I hear lots of people relating the experience that that well-insured US care is more responsive, often faster, with more variety of options to choose among and more out-of-the-box approaches available. It leaves me wondering: are those differences relevant primarily to how patients feel during treatment, their amount of discomfort, their impatience, their desire to feel in-control (all good things!) or are they also relevant to the outcome -- What-percent of patients are what-percent better when their treatment is considered concluded?

For some factors that's probably true. In other cases maybe not.

On the one hand: Did treating someone in a more timely fashion help in the end? Maybe sometimes, yes, prompt attention means something didn't have time to get worse before it was attended to. Or maybe just on the face of it, fewer months of suffering before treatment is equal to less overall suffering just on the face of it.

In the middle: Does providing psch care in a space with lots of light, good sound design, tasty food services, and pleasing interior decoration improve patient outcomes... I'm inclined to say probably yes. Do those things have the same impact on getting well from other conditions, experiences, or proceedures -- I don't really know.

On the other hand: Discussing a greater number of available treatment 'options' (or the feeling of options) I find that more questionable. I like the idea that doctors should follow standards and protocols as outlined by their medical associations, and that the treatments that are found by proper testing to help the most people in the best way should be offered first, and other options should follow that, in order of general efficacy, unless there are unique factors (which should be factored into the protocols). In many cases, think it's odd to have patients being asked what they want (in situations where the options are not on-par medically with one another) and/or being followed blindly when they ask for specific treatments that they want. I don't know that having "more treatment options" leads to better outcomes. If it did, you'd think that the protocol would be changed in order to include whatever options those are.

But perhaps I'm being naieve. I haven't walked closely with anyone through cancer, and have limited experience with observing others and myself and the care available to us. It just usually seems like it's the doctors that know the right thing to do, or at least, they should -- it's one of the things they are there for.

My main point is that ( a ) having a more pleasant experience when one is unwell, and ( b ) getting measurably better medical care for the problem -- are not quite the same thing. And they do overlap, and it's messy to sort them out... but just, they're not quite as similar as they might seem on the surface.

[Catwoman]

2 hours ago, Pawz4me said:

That's also largely a fallacy that I learned about once we were enmeshed within the health care system. There are so many available grants that most people don't know about. And you don't have to be poor to qualify (although many poorer people do, of course--being poor is certainly not an exclusion!). Yes, it takes a lot of knowledge to learn how to navigate the system. It's needlessly way too complex, and that hurts the poorest/least educated the most. But I personally "cyber know" dozens of "have nots" with the same type of cancer DH has who are, by their own reports, receiving excellent care at an affordable-to-them price via the many grants that are available. It's something I would have had no idea about before our experience.

And do note that I am not arguing that our system doesn't have tons of flaws. It does, I thought I tried hard to make that clear in my previous post but perhaps I failed. But I suspect many of our non-US members don't have any real grasp of all the benefits there are, too. I I know before I got deep into things that I, as a privileged person who has always had good insurance, was firmly of the opinion that we needed nationalized care like Canada, Australia and others have. But now having seen so much more first hand, I will restate -- I didn't know what I didn't know. As I said in my previous post, I still think we need some sort of Medicare-for-all. But my hope is that we could somehow manage to do that while preserving a lot of the care/treatment options we have that many other countries with nationalized health care most definitely don't have.

Thank you for posting this!

I know the US system is far from perfect, but I get a little tired of people (particularly those who don't even live in this country) acting as though it's terrible here. The fact is, at every large medical center we went to when my dh was ill (and we went to several, all over the country, over a period of several years,) a large percentage of the patients had actually traveled to the US from other countries for treatment, because they believed we have the best and most advanced health care here, and because their own countries lacked many of the treatment options we can find here in the US.

National health sounds like a great concept, but it certainly doesn't guarantee prompt or excellent diagnosis and treatment, and -- because we have clients all over the world -- we have heard a lot of stories about how long it can take to get appointments with specialists and to schedule necessary surgeries in several other countries. A few of our clients have returned to the US for major medical care, because they felt it was lacking in the countries to which they had moved. (I'm not going to mention the countries, because there are people on this forum from those places and I don't want to single anyplace out.)

I have to say that I resent the level of US-bashing whenever health care is discussed. 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... 🙄

[bolt.]

We're not resentful about your waiting rooms. We just think they are a stupid use of limited resources, because we are used to seeing healthcare services and spaces as limited resources.

The only reason people "bash" US healthcare is *because* it is very good, uncrowded, prompt, and excellent. (If that's something I've misunderstood, I'm sorry. I've mostly learned it here, and learning off social media is *not* the best practice for educating one's self.)

Your country, as a whole, has approximately the same number of hospital beds per population as the other comparable countries (Canada, UK, etc.) If your system is *not* crowded and stressed it's not because it's 'not good' (for the people who are able to access it). It's because lots of people aren't able to access it. That's simple math. You have space and short line ups because of the people who aren't there.

If your whole population had full and free access to your hospitals, your system would have stresses and wait times too. It lacks stresses because it lacks people filling it up to the stress point.

Edited September 23, 2023 by bolt.

[Pawz4me]

6 minutes ago, Happy2BaMom said:

My understanding is that grants are tied to research.

No, not necessarily. Most people on the cancer board I belong to who receive grants to help cover the cost of their treatment are doing so outside of studies or other research. For example, many pharmaceutical companies have foundations or provide grants to third party foundations that cover the cost of oral cancer medications. (Don't get me started on the "why" of that--to my way of thinking it's ultimately all about increasing the profits of the pharma companies in a very convoluted way. But nevertheless--the grants are there, and not hard to get.)

Quote

 

I am curious (& doubtful) if there are any grants for people trying to access primary care, or standard surgeries, or other non-research oriented care.

There are people on my cancer board have received grants to help with surgery costs (various types of surgery). I don't know what a "standard" surgery would be considered, though. These are all people who need surgery to preserve or extend their lives.

Quote

Like everything else in this country, the system is widely diverging. For specific people, the health care system works very, very well. For others, it doesn't work very well at all.

 

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.

[Pam in CT]

re health care rationing takes different forms

2 minutes ago, bolt. said:

We're not resentful about your waiting rooms. We just think they are a stupid use of limited resources, because we are used to seeing healthcare services and spaces as limited resources.

The only reason people "bash" US healthcare is *because* it is very good, uncrowded, prompt, and excellent. (If that's something I've misunderstood, I'm sorry. I've mostly learned it here, and learning off social media is *not* the best practice for educating one's self.)

Your country, as a whole, has approximately the same number of hospital beds per population as the other comparable countries (Canada, UK, etc.) If your system is *not* crowded and stressed it's not because it's 'not good' (for the people who are able to access it). It's because lots of people aren't able to access it. That's simple math. You have space and short line ups because of the people who aren't there.

If your whole population had full and free access to your hospitals, your system would have stresses and wait times too. It lacks stresses because it lacks people filling it up to the stress point.

In broad strokes, I'd agree with this.  Our system is very good for well insured people * .

Within our system, the principal form of rationing is that so many people lack good insurance.

 

 

 

*  though even for those lucky ones with very good insurance, the time and bandwidth it takes to navigate and often negotiate with insurance companies and their intermediaries is beyond the capacity of many people who are sick, disabled or elderly.

[Corraleno]

n/m

Edited September 23, 2023 by Corraleno

[Pawz4me]

59 minutes ago, bolt. said:

 

If your whole population had full and free access to your hospitals, your system would have stresses and wait times too. It lacks stresses because it lacks people filling it up to the stress point.

But our system does have stresses and wait times. I really don't know how people get the idea that it doesn't.

 From what I understand in my area there's currently a one year wait for newly diagnosed patients to see a rheumatologist. Yes, a year. Short supply, high demand. One can work around that if they're willing and able to drive for an hour or so, but still . . it's one example of system stress and wait times.

And when DH needed his cancer surgery his surgeon wanted to do da Vinci robotic surgery. But the wait time would have been several weeks longer than for more traditional surgery, and the surgeon said nope, you don't have that time to spare. So he had a "less than" (but still very acceptable) surgery method because of system limitations.

Of course we're a very large country with lots of variation. But I think it's fair to say that most areas do almost always have some sort of health care stress.

Edited September 23, 2023 by Pawz4me

[SKL]

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.

Edited September 23, 2023 by SKL