Tuesday, August 23, 2016

Monday, August 22, 2016

Preventing pressure ulcers has been a nursing concern for many years. In fact, Florence Nightingale in 1859 wrote, “If he has a bedsore, it’s generally not the fault of the disease, but of the nursing”4 (p. 8). Others view pressure ulcers as a “visible mark of caregiver sin”5 (p. 726) associated with poor or nonexistent nursing care.6 Many clinicians believe that pressure ulcer development is not simply the fault of the nursing care, but rather a failure of the entire heath care system7—hence, a breakdown in the cooperation and skill of the entire health care team (nurses, physicians, physical therapists, dietitians, etc.). From: Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 12 Pressure Ulcers: A Patient Safety Issue Courtney H. Lyder; Elizabeth A. Ayello.

Thursday, May 19, 2016

'Dear potential wheelchair patient'

The process is causing me anxiety, and I'm not even the person who needs a wheelchair. After calling and being transferred no fewer than seven times, getting voicemail twice, and calling back for two weeks, I finally reached someone who was supposed to be making appointments for Wheelchair Clinic. Apparently at this famous rehabilitation center, disabled persons are first believed to be guilty of fraud and they have to go through scrutiny and screening even with a prescription in order to get an appointment to get a wheelchair. In America. Where even those charged with a crime are innocent until proven guilty in an appropriate court of law. Can you imagine being paraplegic? You cannot walk. You cannot move. You cannot feel any sensory stimulus below the injury. You cannot go from here to there or there to here -- even in the same room -- without a wheelchair. And it has to be a properly configured wheelchair. It can't just be any wheelchair or you might not have enough support and you might flop out of the wheelchair and hit your head. Or your limbs might be at risk of injury. Imagine you spent nearly two years ill in hospitals and skilled nursing facilities and deteriorating and experiencing reduced muscle tone so that your paralyzed legs are now falling off the sides of your eight year old wheelchair and people routinely knock into your feet injuring you. Can you imagine then going about making appointments with doctors, getting prescriptions from your Physiatrist for a Wheelchair Clinic because you are paraplegic from spinal cord injury T-6 complete, that is, you cannot move or feel stimulus below the T-6 level of your spine, and then when you contact one of the most famous centers to make an appointment, you cannot make an appointment because according to the person who is the Coordinator of the Wheelchair Clinic, there is so much fraud in the wheelchair clinic that you have to go through a formal screening process to see if you might perhaps be committing fraud by trying to get a wheelchair. I just can't understand why on Earth a disabled person who is already on Social Security Disability and Medicare for the permanent spinal cord injury and paralysis and who already has prescriptions from a Physiatrist at one of the major Spinal Cord Injury Centers in the United States would have to first be considered to be guilty of fraud and then pass some process to prove he or she is not committing a crime -- in order to make an appointment for a wheelchair clinic. It wouldn't be so bad if the phone call or the form made any sense at all. But during the conversation on the phone, the intake person said she doesn't know anything about how the screening and decisions are made. Yet when I received the forms, the person I spoke with is listed as the Coordinator of the Wheelchair Clinic. How is it possible that there is a person who is the Coordinator, and who tells the caller all about the fraud, and then provides an anecdotal story to prove that insurance won't just pay for wheelchairs -- she tells the story of a person with CP who walks 12 city blocks and therefore is considered by the insurance company to be unqualified for a wheelchair. What on Earth does that have to do with an individual case? There is also no way to know from the description on this form how long if ever you will ever hear back from any of these people. They tell you to keep the form and to call with questions, yet I already called and the person who takes the calls and who is the Coordinator of the Wheelchair Clinic didn't know the answers and then provided information about a different situation, so why would anyone think there should be a reason to call again? If she didn't know anything the first time you called, why would you think she would know anything the second time you call? The other Center in the area, Kessler which is famous for having the Christopher Reeve Center, is scheduling people for wheelchair clinic six months and longer from now. That makes the process useless. If you need a wheelchair and you have to wait six months, you might as well have absolutely no services whatsoever. This is the terrific medical care people brag about in the United States. Really. Saying the American healthcare system is the best in the world. No wonder being paralyzed is a risk factor for suicide. Why are rehabilitation facilities permitted to lump disabled patients into a category where they must be systematically screened to determine whether they might be criminals committing fraud before being given appropriate and necessary services?