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Showing posts with label stupid people. Show all posts
Showing posts with label stupid people. Show all posts

It's a democracy, so why are they taking away our asthma choices

Warning!!!! There are people who want to decide for you what is good for you.  They will say that you have a choice.  Yet what they will not tell you is it will be a choice between fewer options.  It will be a sort of control over you, yet you won't even see it, or feel it, or even know it's coming.

These people, many of whom already exist all over the world -- including right here in the good old United States of America -- think most people are not capable of making the right decision for themselves. They believe the American Experiment has failed.

So what is this American Experiment anyway?  Well, allow me to define it:

American Experiment:  Can man rule himself?

The American Dream:  Everyone has a chance to succeed no matter color, creed or station in life.  We are all smart enough to make our own decisions.  We are all smart enough to weigh the rewards against the risks.  We all have an equal opportunity to improve our lot in life.

Then there are two different types of people in this country:

1.  Equal justice:  These are those who believe in the American Dream, and believe the answer to the American experiment is YES.  They believe you are smart enough to rule yourself.  That you, asthmatics, are smart enough to make the right choices no matter how tough.  You are equally smart.  You are intelligent.

2.  Social Justice:  These are those who believe in the American Dream, yet believe the answer to the American Experiment is NO.  They believe you are not smart enough to rule yourself, and therefore not smart enough to make the right choices.  Their experts, therefore, must nudge you in the right direction.  One of the ways to do this is to limit your choices.  You are stupid.

They both call their system of government a democracy (they say this even though we are a republic, not a democracy).  The main difference is in equal justice you are allowed to weigh all your asthma medicines and decide what ones work best for you, and in social justice your choices are limited so you don't make the wrong one.

For the first 160 years of this Nation we were a democracy (republic actually)  run under equal justice, yet ever since about 1895 there have been people by insidious means who have been working hard to change this.  They believe that the Industrial Revolution brought about change in society that would require change in the way society was run.

Today, those who believe in social justice have gained much power not just in America but around the rest of the world.  Hitler ruled by the extreme measures of social justice, and so did Stalin and Mussolini.  Yet what few people know is that the term was coined right her in America during the term of President Woodrow Wilson. 

It has been a slow process.  After early failures they decided it was best to take baby steps.  They slowly worked to change the minds of Americans and those of the rest of the world.  After Wilson, FDR was their next great leader.  While Wilson planted the seeds, FDR created the regulations that allowed those seeds to grow into full, flourishing trees. 

They are trying to create a healthcare system that limits your choices, yet they will tell you otherwise.  They will trick you into believing that you have many choices, yet they know the choices are limited.  You will have fewer doctors to choose from, and fewer health insurance companies.  And you might even have fewer options of how you die and when you die.  Yet you won't know it until it's too late.  They'll just kind of slip by unnoticed.

They have already limited our asthma medicinal choices.  Remember when I wrote this:  Seven Classic Asthma Medicines To Be Discontinued.  The medicines you no longer get to choose from are:  Tilade, Intal, Alupent, Azmacort, Aerobid, Combivent, and Maxair.  You did not decide, they did for you.

These are all your CFC inhalers.  CFC destroys the ozone they say.  The ozone is more important than human life.  You aren't smart enough make and purchase medicines that don't destroy the ozone, so they had to "nudge" you in that direction. The market did not make this choice.  You did not make this choice.

I know you didn't because I read your cries that HFA inhalers don't work as well, or that you want to continue taking Intal and Combivent, medicines that have worked so well to control your asthma, or your COPD, or your cystic fibrosis for years.  You want control.  You want to decide what medicines you take.  Or you want your doctor to decide.

Yet in the new America, the new world, the one where social justice supersedes equal justice, and where you are "nudged" to make the "right" decision, you no longer get to decide.  It doesn't matter what works best for your disease, because the planet is more important than you. 

It doesn't matter whether you agree or disagree with theories that say man is causing global warming and destroying the ozone.  I'm in no way saying I don't respect these theories.  What I'm saying here is the government shouldn't be deciding what's best for you, YOU should be deciding what's best for you.  You are SMART.  Yet they think you are not smart enough to make the right decision.

A few years ago they tried to take away Serevent.   They even tried to take away -- or thought about it -- Advair and Symbicort.  They were scared about these drugs based on the belief that Serevent and Foracort were believed to make asthma worse, or kill asthmatics.

Yet even the FDA says Advair and Symbicort are safe for use, and that the benefits outweigh the risks.  Basically what this means is that your risk of dying of an asthma attack are far greater if you do nothing than if you take Advair and Singulair.  Yet YOU decide.

While I think Primitine Mist is a bad asthma choice, it has been available over the counter for years.  Many ashtmatics live by it.  It's their choice.  Yet recently the FDA banned all CFC over the counter asthma medicines, and any chance these will ever be available OTC again. 

I say they will never be OTC again because Primitine Mist has been on the market so long it was grandfathered in as an OTC medicine.  Yet any new HFA Primitine Mist will have to be prescribed, something no doctor will do.  Therefore it's not worth the investment to make an HFA Primitine Mist.

The market didn't decide this -- they decided it for us.  They had to because they believe we aren't smart enough to make the right decision.  They nudged you so now you have to see your doctor to get the best care.  You SHOULD in my opinion see your doctor and have a Ventolin in my opinion and the opinion of most asthma experts -- yet in a world of equal justice I wouldn't get to decide what's right for you.

More recently some wanted the FDA to ban Singulair  (also check these links).  It didn't matter what you thought.  They decided if you took it you were at an increased risk of suicide.  It didnt' matter there were no scientific studies to show this. 

The FDA did an extensive study on the Sinulair suicide risk, and decided there was no evidence.  They even reported this: FDA concludes there is no Singulair suicide risk.  Yet those who believe in social justice didn't care about the evidence, and there is a big black box warning on Singulair to scare people away from it, and perhaps from getting their asthma under control.

That's what black box warning do, you know, they scare people away from getting their asthma under control. 

Another example is more recent.  As of March 2, 2011 the FDA is ordering companies to stop making and shipping over 500 allergy and cold medicines.  Obviously since these are on the market they were being purchased by people like you, and I never heard one drop of a cry that these medicines were linked to any problems.  So why all of a sudden limit our choices?   Fishy, hey?  At least I think so.

In fact,  according to Web MD, Doctor Harold Nelson of National Jewish Health had this to say about this recent effort by the FDA:
"These are well-recognized drugs that have been used for decades and there is no reason to suspect that there is a risk involved. If there were risks such as hypertension or stroke with oral decongestants, it would be more appropriately addressed by eliminating the ingredient from all products whether those that are grandfathered in, available OTC, or FDA-approved.  These drugs haven’t cleared certain safety hurdles yet, but that doesn’t mean they are unsafe."
New medicines are studied intensely.  The FDA has such a rigorous screening process for approving new medicines that the chance of an unsafe medicine being approved is near zero.  I'm not implying mistakes can't be made.  That doesn't matter to those who believe in social justice:  YOU MUST BE NUDGED.

I'm not implying we shouldn't be careful when taking new medicines -- or old medicines for that matter.  Yet what I am implying is we need to make smart decisions, do our own research, and weigh the advantages with the disadvantages on our own, and not be pushed, bullied or forced into making a "choice" that is not truly democratic.

Yet that seems to be the direction we are going in.  It's scary to me.  I see it.  I hope other asthmatics do too, asthmatics with good, strong voices and pens that are willing to stand up and fight.
 
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Signs that assume we are all stupid and lazy

Signs.  Notes.  You see them everywhere, especially at your work or office.  Most of them are written by choleric people who love rules and must have everything done their way.  And, yes, there is usually at least one choleric in every office.

They put signs up like the following:
  • We do not have a maid service, clean up after yourself.
  • Please shut off coffee pot when not in use
  • This is a garbage, not a recycling bin
  • This is for cans only, this is not a garbage!
  • This room for employees and patients only! 
  • This room is in use/ not in use
  • Meeting this month is mandatory
  • Label and date all food containers in refrigerator
  • All unlabeled food will be tossed every Monday
  • No drinking by computers
  • No food in office
You get the drift.  These are signs written by people who have to have control.  Yet they don't realize that we are all people, and we all have different personalities, and we get busy.  These are signs written by people who think most people are stupid and lazy.

Some of us are lazy for sure, but the majority of us have more important things to think about than whether or not we leave a cup of water lying next to the computer, or have a container that's been in the fridge for two weeks.  Some people are clean and organized (the cholerics and melancholy) and some people aren't (sanguine and phlegmatic). 

I think a few signs or a few rules are good, but when you start to get a collection of them they become too hard to follow and too hard to enforce.  It's better just to have one really important sign, like this:
  • Work hard
  • Do your best
  • We respect your hard work
  • We know who the hard workers are, and we appreciate you
Yet communication in this positive way is rare and far in between, and usually comes just prior to communication that relays something you did that was wrong, such as a charting error that has nothing to do with the patient/ customer.

Signs are dumb.  I'd like to rip them down, and sometimes I do. Likewise, few of these prodigal signs say please and thanks.  I'd like to put my own sign up (just one) to put an end to such frivolity:
  • Quit putting up stupid signs!  And Thanks
None of these signs are necessary.  If you're anal retentive and want to clean the fridge, clean it.  You'll be more respected that way anyway. 

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Signs that assume we are all stupid and lazy

Signs.  Notes.  You see them everywhere, especially at your work or office.  Most of them are written by choleric people who love rules and must have everything done their way.  And, yes, there is usually at least one choleric in every office.

They put signs up like the following:
  • We do not have a maid service, clean up after yourself.
  • Please shut off coffee pot when not in use
  • This is a garbage, not a recycling bin
  • This is for cans only, this is not a garbage!
  • This room for employees and patients only! 
  • This room is in use/ not in use
  • Meeting this month is mandatory
  • Label and date all food containers in refrigerator
  • All unlabeled food will be tossed every Monday
  • No drinking by computers
  • No food in office
You get the drift.  These are signs written by people who have to have control.  Yet they don't realize that we are all people, and we all have different personalities, and we get busy.  These are signs written by people who think most people are stupid and lazy.

Some of us are lazy for sure, but the majority of us have more important things to think about than whether or not we leave a cup of water lying next to the computer, or have a container that's been in the fridge for two weeks.  Some people are clean and organized (the cholerics and melancholy) and some people aren't (sanguine and phlegmatic). 

I think a few signs or a few rules are good, but when you start to get a collection of them they become too hard to follow and too hard to enforce.  It's better just to have one really important sign, like this:
  • Work hard
  • Do your best
  • We respect your hard work
  • We know who the hard workers are, and we appreciate you
Yet communication in this positive way is rare and far in between, and usually comes just prior to communication that relays something you did that was wrong, such as a charting error that has nothing to do with the patient/ customer.

Signs are dumb.  I'd like to rip them down, and sometimes I do. Likewise, few of these prodigal signs say please and thanks.  I'd like to put my own sign up (just one) to put an end to such frivolity:
  • Quit putting up stupid signs!  And Thanks
None of these signs are necessary.  If you're anal retentive and want to clean the fridge, clean it.  You'll be more respected that way anyway. 

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Yet another example of what's wrong with healthcare

It was kind of a culmination of all I've written about on my blog the past year was when our hospital Quality Analyzer came into the office and said, "I need to speak with Rick."

I spun around my chair and said, "Hi, Gerri, what can I do for you?"

"I was just wondering if you gave any breathing treatments to the kid in 310 today?"

"Um," so what was the right answer? The truth perhaps?  The kid in 310 was admitted with croup yesterday and was ordered to get racemic epinepherine breathing treatments prn. After an awkward moment of silence I settled on the truth.  "I didn't give one."

"Oh, I was hoping you did one and forgot to chart." She smiled. "The patient was discharged and now his insurance is refusing to pay for today because we didn't do anything today. If you did a treatment..."

"Do you want to to go in and chart a treatment I didn't do so we can get paid."  A provided her with an eerie smile.

She gave me the thumbs up.

Of course she was joking and so was I. Yet this is a perfect example of what is wrong with the healthcare industry. A patient needs to be admitted for observation, and yet because we didn't do anything the patient's insurance won't pay.

"Well," I said, "I guess for now on we'll be giving Q4 breathing treatments on all of Dr. Kipper's patients."

"Sure thing," she said, giving me the thumbs up signs again.

Dr. Kipper was new. The other pediatricians had already learned to order Q4 ventolin and racepic epi prn. That order makes no sense medically, and is a complete waste of time and money and results in RT apathy.

Yet that person sitting in a chair in Washington who makes all the laws was smiling somewhere in a leather chair in Washington as she unwrapped her paycheck.

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Yet another example of what's wrong with healthcare

It was kind of a culmination of all I've written about on my blog the past year was when our hospital Quality Analyzer came into the office and said, "I need to speak with Rick."

I spun around my chair and said, "Hi, Gerri, what can I do for you?"

"I was just wondering if you gave any breathing treatments to the kid in 310 today?"

"Um," so what was the right answer? The truth perhaps?  The kid in 310 was admitted with croup yesterday and was ordered to get racemic epinepherine breathing treatments prn. After an awkward moment of silence I settled on the truth.  "I didn't give one."

"Oh, I was hoping you did one and forgot to chart." She smiled. "The patient was discharged and now his insurance is refusing to pay for today because we didn't do anything today. If you did a treatment..."

"Do you want to to go in and chart a treatment I didn't do so we can get paid."  A provided her with an eerie smile.

She gave me the thumbs up.

Of course she was joking and so was I. Yet this is a perfect example of what is wrong with the healthcare industry. A patient needs to be admitted for observation, and yet because we didn't do anything the patient's insurance won't pay.

"Well," I said, "I guess for now on we'll be giving Q4 breathing treatments on all of Dr. Kipper's patients."

"Sure thing," she said, giving me the thumbs up signs again.

Dr. Kipper was new. The other pediatricians had already learned to order Q4 ventolin and racepic epi prn. That order makes no sense medically, and is a complete waste of time and money and results in RT apathy.

Yet that person sitting in a chair in Washington who makes all the laws was smiling somewhere in a leather chair in Washington as she unwrapped her paycheck.

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Doctors should treat patients, not insurance company

The doctor wanted to have the patient admitted for observation, yet the patient didn't meet criteria according to the insurance company. Still, the doctor didnt' feel comfortable sending the patient home.

So, what he did was write on the chart, "Recommended patient be kept for observation for best interest of patient."

That way, he said to me, the insurance company is liable if something happens to that patient and now the doctor. He also wrote on the chart, "Patient was sent home against my better judgement."

This is a perfect example of how cook book medicine does not work, and how doctors and nurses should be able to do what's best for the patient, and money should not be a factor.

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Doctors should treat patients, not insurance company

The doctor wanted to have the patient admitted for observation, yet the patient didn't meet criteria according to the insurance company. Still, the doctor didnt' feel comfortable sending the patient home.

So, what he did was write on the chart, "Recommended patient be kept for observation for best interest of patient."

That way, he said to me, the insurance company is liable if something happens to that patient and now the doctor. He also wrote on the chart, "Patient was sent home against my better judgement."

This is a perfect example of how cook book medicine does not work, and how doctors and nurses should be able to do what's best for the patient, and money should not be a factor.

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Fake side effects

It's funny how some people come up with the lamest side effects of drugs.

The most recent was when I finished a breathing treatment the patient said, "I don't want any more of those."

He belched.

"They make me burp," he continued. "It gives me gastric problems." He patted his stomach as to show me.

Of course we know that nausea is not an allergy symptoms, although more often than not when you ask someone why they are allergic to a medicine, they say it makes me nauseous.

Ventolin, for example, does not cause the allergy symptom of nausea. Although I've been ordered not to give it for this reason from time to time. Silly isn't it?
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Fake side effects

It's funny how some people come up with the lamest side effects of drugs.

The most recent was when I finished a breathing treatment the patient said, "I don't want any more of those."

He belched.

"They make me burp," he continued. "It gives me gastric problems." He patted his stomach as to show me.

Of course we know that nausea is not an allergy symptoms, although more often than not when you ask someone why they are allergic to a medicine, they say it makes me nauseous.

Ventolin, for example, does not cause the allergy symptom of nausea. Although I've been ordered not to give it for this reason from time to time. Silly isn't it?
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Smoking cessation good, but not if you don't smoke

At my hospital smoking cessation education is something we take very seriously. In fact, the order to do smoking cessation comes up on any patient admitted with CHF, COPD, MI, pneumonia, asthma and just about any other diagnosis under the sun.

This might sound like overkill, and it is. Yet our medical director wants us to do smoking cessation even if a person doesn't smoke. Thus, if they don't smoke, we're supposed to encourage them not to start, and we're supposed to inform them of the danger of not smoking.

I don't think this is a bad thing, yet where is the time do do all of this? If we're going to do smoking cessation on every patient, it's going to get to the point where the therapist dumbs down his presentation just to get it done and over with. In the end, a poor job will be the result.

Likewise, even while smoking cessation is deemed so important, we RTs have received no formal training to make sure we are providing the best education. Most RTs in my department that I talk to don't even know why we are doing it. I know because I ask around.

In fact, while smoking cessation is deemed so important, the hospital won't even splurge on a good smoking cessation packet. All they give us to give to the patient is a single sheet of paper with some basics about quitting smoking.

It's frustrating to me. It's frustrating because most of the patients who are ordered to get smoking cessation education have never smoked, or quit smoking years ago. So it seems quite frivolous and a waste of our time to HAVE to educate these people.

One man said to me, "I quit 75 years ago."

One patient has been admitted 4 times in the past month, and every time the order comes up automatically. I finally got irritated and started charting, "Smoking cessation done last visit." Yet I still, by hospital policy, have to bill the patient.

Of course the real reason we are doing all this education is not to help the patient. That's what we say, and that's what's said to us. But I know for a fact the real reason is because CMS reimburses for it, and when a patient is given smoking cessation, that helps to qualify the patient for reimbursement.

You see, everything in the new healthcare system comes down to money. No, it's not about saving the hospital money, because they (CMS) already only pay one lump sum regardless of how many things are done to the patient. In fact, it actually costs the hospital more money.

Yet our hospital wants to make sure the patient meets criteria and that the hospital is reimbursed for the patient's visit, and by charting smoking cessation for every patient admitted this is a step in assuring reimbursement criteria is met for that patient.

This is another perfect example of stupidity that results when we put the government in charge of anything.

Look, smoking cessations are good. Yet doing smoking cessations on people who never smoked or have already quit more than 6 months ago is a waste of time. IMO! Smoking cessation is good, but not if you don't smoke.
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Smoking cessation good, but not if you don't smoke

At my hospital smoking cessation education is something we take very seriously. In fact, the order to do smoking cessation comes up on any patient admitted with CHF, COPD, MI, pneumonia, asthma and just about any other diagnosis under the sun.

This might sound like overkill, and it is. Yet our medical director wants us to do smoking cessation even if a person doesn't smoke. Thus, if they don't smoke, we're supposed to encourage them not to start, and we're supposed to inform them of the danger of not smoking.

I don't think this is a bad thing, yet where is the time do do all of this? If we're going to do smoking cessation on every patient, it's going to get to the point where the therapist dumbs down his presentation just to get it done and over with. In the end, a poor job will be the result.

Likewise, even while smoking cessation is deemed so important, we RTs have received no formal training to make sure we are providing the best education. Most RTs in my department that I talk to don't even know why we are doing it. I know because I ask around.

In fact, while smoking cessation is deemed so important, the hospital won't even splurge on a good smoking cessation packet. All they give us to give to the patient is a single sheet of paper with some basics about quitting smoking.

It's frustrating to me. It's frustrating because most of the patients who are ordered to get smoking cessation education have never smoked, or quit smoking years ago. So it seems quite frivolous and a waste of our time to HAVE to educate these people.

One man said to me, "I quit 75 years ago."

One patient has been admitted 4 times in the past month, and every time the order comes up automatically. I finally got irritated and started charting, "Smoking cessation done last visit." Yet I still, by hospital policy, have to bill the patient.

Of course the real reason we are doing all this education is not to help the patient. That's what we say, and that's what's said to us. But I know for a fact the real reason is because CMS reimburses for it, and when a patient is given smoking cessation, that helps to qualify the patient for reimbursement.

You see, everything in the new healthcare system comes down to money. No, it's not about saving the hospital money, because they (CMS) already only pay one lump sum regardless of how many things are done to the patient. In fact, it actually costs the hospital more money.

Yet our hospital wants to make sure the patient meets criteria and that the hospital is reimbursed for the patient's visit, and by charting smoking cessation for every patient admitted this is a step in assuring reimbursement criteria is met for that patient.

This is another perfect example of stupidity that results when we put the government in charge of anything.

Look, smoking cessations are good. Yet doing smoking cessations on people who never smoked or have already quit more than 6 months ago is a waste of time. IMO! Smoking cessation is good, but not if you don't smoke.
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