My instructor, let's call her Betty, is southern and in her late 50's or early 60's, I'd wager. I first spoke with her when I took an all-day CPR course as this whole NAC class got into gear. I ran into her in the bathroom as I was leaving, and she told me "you know what, with all this MRSA (Methicillin resistant Staphylococcus aureus) and other stuff around, you should just open the bathroom door with your back." I love her accent--it reminds me of a certain kind of southerner I really miss. She sounds like my maternal grandmother, and she has a fantastic laugh. The first day of our actual class she got kinda defensive about a crappy powerpoint thing going on, but she wisely abandoned it altogether and went back to lecturing, and she's great. She's been a nurse since 1974, when she was thrilled to be getting a little over $5/hour. She's been a hospital nurse and a nurse in longterm care facilities, and prefers hospitals because they're faster-paced.
We've had 6 class meetings (all about 2.5 hours long) so far, and at least three times she's brought up the phenomenon of hospitals being obliged to provide care to people in the E.R., and mentioned a few hospitals who have to subsidize 40% of what they do, because it's free, with the other 60% of what they do, which of course makes the costs of the 60% that much more. She said people get sent home sooner and sicker than they used to because of something called DRGs, diagnostic-related groupings, started by Medicare, that determine how much will be spent on a patient's care based on the original diagnosis that put them in the hospital. Sort of makes sense, seems like it might cut down on abuses of piling up procedures to make money. But instead, it sounds like it just forces MDs to send patients home that shouldn't be. A student asked about that, and Betty said that the doctors "are good people, they don't want to do it, they're just trapped by the system." At this point, I raised my hand and asked whether there are organizations for nurses who have opinions on how the healthcare system should work, and do they practice advocacy... she looked at me and said "I teach." True. But it seems like approaching the problems from the wrong direction, so I said "what about policy"? She didn't really answer me the second time. I'll push harder later. :)
I did find out after class today that she's had cancer 4 times; she said she's living on borrowed time.
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ReplyDeleteI agree, the Master's program will be full of people who care at least a little about policy, and taught by people who care a lot.
ReplyDeleteBut I am not sure questions like this are a bad choice. Sure, you don't want to prevent the learning of the essential skills, but a few questions like this sprinkled throughout the classes, and a few more on breaks or other nonstructured time might be good.
If you only talk about policy with people who are like you, you miss the opportunity to hear what people who aren't like you think, right? Granted, direct questioning isn't the only (or most effective) way to learn what people think, but it is one tool in your toolbox.
A thing I both love and hate about you, Ms. Costsinker, is that you are so utterly invariably yourself with all different kinds of people. It's annoying, at times, when someone seems to get the completely wrong message from you because you didn't modulate your manner of communicating enough to connect. Other times, though, you say something I think is unlikely to make sense to someone (due to education, class, culture, context, social situation, etc.) and they reply in a way that clearly demonstrates they're pickin up what yer puttin down, and I feel like a total snob.
I edit myself way more than you do, and I think it leads to lots of missed opportunities to communicate more deeply (and occasionally, to a sense of condescension).
Another example of how I think you are more fundamentally egalitarian than the average bear.
Hey! I am the average bear! But, I must confess "Ms. Costsinker" is definitely more egalitarian than me.
ReplyDeleteNeither of you worry. I have _not_ asked too many questions of that type--I asked that one in particular because other students were pressing her on "how can they be sending sick patients home?" and "doesn't anybody care?" and she was responding that it's terrible, they don't want to, they're in a bind. Anyway, it really was apropos.
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