RNMD

Oops Laura and Abby accidentally partnered with Nurse Blake and wrote a petition for IMPACT that has (at time of recording) 390,000 signatures.

Instagram: 

⁣⁣@RNMDPodcast⁣⁣⁣⁣⁣

This week on RNMD:

New season, new cohost.⁣

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣

⁣⁣@RNMDPodcast⁣⁣⁣⁣⁣

References:

EMRs contribute to HCW burnout, are disruptive to workflows, contribute to alarm fatigue, decrease patient contact time, and are a way for hospitals to bill. But also... EMRs are better at trending care, reduce prescribing errors, measure social determinants of health. Do Laura and Abby like the EMR? Do they hate the EMR? is the EMR Laura and Abby's frenemy? No one knows, but they definitely have a lot of questions like:

Is the EMR a billing software?

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣

⁣⁣@RNMDPodcast⁣⁣⁣⁣⁣

Robertson SL, Robinson MD, Reid A. Electronic Health Record Effects on Work-Life Balance and Burnout Within the I3 Population Collaborative. J Grad Med Educ. 2017;9(4):479-484. doi:10.4300/JGME-D-16-00123.1

https://www.nature.com/articles/s41746-020-0221-y

https://www.hcinnovationgroup.com/clinical-it/electronic-health-record-electronic-medical-record-ehr-emr/news/21229777/research-ehr-nudges-on-deprescribing-went-unread

https://www.annfammed.org/content/15/5/419 Annals of Family Medicine 2017 

https://pubmed.ncbi.nlm.nih.gov/29649458/ American Journal Of Medicine 2018

https://www.forbes.com/sites/brucelee/2020/01/13/electronic-health-records-here-is-how-much-time-doctors-are-spending-with-them/?sh=95293b65172a

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371290/

https://www.aafp.org/journals/fpm/blogs/inpractice/entry/effectiveness_of_scribes.html

Abby and Laura discuss how non medical folks can be there for their healthcare workers. Featuring: A dead dog story (RIP Ginkgo), bad dating stories, and Laura yelling at her mom and then writing an essay. In the beginning we said this was a bonus episode because we got extremely ambitious and planned to record a ton so we would have extra episodes this week.... but then we took a nap instead.

Don’ts:

- gaslighting

- pretend it’s fine

- pretend it’s over

Dos: 

- memes

- donuts

- vaccines

New season, new cohost.⁣

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣

⁣⁣@RNMDPodcast⁣⁣⁣⁣⁣ 

@TheNocturnalNurse

References: 

https://www.kevinmd.com/blog/2022/01/i-cant-make-you-care-but-you-should.html

Abby and Laura talk about what got them into policy (villain origin stories!), how it all ties back to for-profit healthcare, and why healthcare workers need to get involved. Featuring: does saying the Q word increase volumes? And what should our mantra for the year be?

New season, new cohost.⁣

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣

References:

https://www.bmj.com/content/bmj/367/bmj.l6446.full.pdf

https://www.athenahealth.com/knowledge-hub/practice-management/expert-forum-rise-and-rise-healthcare-administrator

Laura and Abby discuss where communication breakdowns happen and how we try to address them, and how systems issues underlie most of them. Including: What do HCW not understand about each other? How can we make each other’s lives easier? What differs in our approaches? What do we need to change about the system to make the system better? How does med ed and the patriarchy drive most of these issues? How can we work together better to provide patient care? Should we all just be nicer and respect each others’ concerns more?

New season, new cohost.⁣

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣⁣⁣

References:

Abby and Laura talk about California staffing ratios, unions, lobbying groups, and grassroots activism. How did California pass their nursing ratio legislation? Why did it fail in Massachusetts and New York? Why should patients care about staffing? 

New season, new cohost.⁣

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣⁣⁣⁣

References:

https://www.nationalnursesunited.org/ratios-california-experience

https://www.chcf.org/wp-content/uploads/2017/12/PDF-AssessingCANurseStaffingRatios.pdf

https://jacobinmag.com/2021/01/nurses-covid-19-pandemic-safe-staffing-legislation-california

https://www.modernhealthcare.com/article/20181004/TRANSFORMATION02/181009945/mandated-nurse-to-patient-ratios-spark-high-costs-few-savings

Abby went to a nursing symposium this week, where instead of safe staffing they asked questions like… can hypnosis fix your moral injury?⁣

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Obviously, this sent Laura and Abby into a texting rage spiral while everyone else was eating cake and making  appropriate small talk. ⁣

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In this episode, Laura and Abby talk resilience and wellness. What is burnout vs moral injury? How much pizza does it take to make your workplace safer? Can Florence fix it? Is self-care accessible to everyone? How does John Wayne’s approach to westerns correlate to patient care? Also, a very brief Peggy update. New season, new cohost.⁣

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣⁣⁣⁣

Referenced Articles:

Welcome to Season 2 of RNMD! New season, new cohost! Welcome, Dr. Laura!

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣⁣⁣⁣

Doctor Dan visits us for an episode that's sure to make you cry all the way to the bank! Despite rising healthcare costs, hospital CEOs at non profit systems continue to receive massive salaries and raises⁣. In 2017, top executives at six of the nine largest Chicago area non-for profit healthcare systems pocketed substantial raises. Their average pay hike was 37% easily outpacing national trends⁣. A non-for profit hospital is generally organized as a charity under the IRS section 501(c)3 with the mission of delivering affordable healthcare to their communities.⁣ Nonprofit hospitals do not pay property, state, federal income, sales tax⁣. Salaries for hospital CEOs are not always easy to find, as there is little regulation for financial transparency in these organizations. These figures are from 2017. Some of these salaries had differing reports of about 1 million dollars. Even with this margin of error the data is still clear, hospital CEOs are making huge bloated salaries. What are these nonprofit hospitals doing with all their cash on hand? Certainly not reducing prices for patients. This is reflected by the medical debt incurred by Americans in 2017. ⁣We are regularly told that the cost of healthcare will not support Medicare for all. I would argue that if we eliminated the large salaries within our hospital systems we could serve our patients without bankrupting them and safely staff our units⁣

Notes: Peter Fine's base salary in 2017 was $1.3 million. His compensation was boosted by a bonus and incentives, deferred pay and a payment of $17 million from a Supplemental Executive Retirement Plan — a program that was put in place early in Fine's tenure⁣. Dan Woltermandan received a supplemental executive retirement package in 2016, not 2017, which provided for an annual contribution for each year of service (17 years). When he retired early at the age of 60. His name is sometimes shortened to Wolterman in text.⁣ Anthony Tersigni’s (13.2 million) company website states, “Ascension’s Mission to care for those who are poor and vulnerable.

I𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:⁣⁣⁣⁣

References:

https://www.azcentral.com/story/money/business/health/2019/10/23/banner-health-ceo-peter-fine-arizona-nonprofit-health-system-topped-salary-list/3779681002/

https://projects.propublica.org/nonprofits/organizations/741152597

https://www.erieri.com/blog/post/top-10-highest-paid-ceos-at-nonprofits-2020

https://www.forbes.com/sites/adamandrzejewski/2019/06/26/top-u-s-non-profit-hospitals-ceos-are-racking-up-huge-profits/?sh=67a93bcf19df

https://www.erieri.com/blog/post/top-10-highest-paid-ceos-at-nonprofits-2020