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Audio for this story from Morning Edition will be available at approx. 9:00 a.m. ET

May 25, 2012

 
Some fear that with rising medical costs and an aging population, the country's nursing staff will be stretched even more thinly.
Enlarge iStockphoto.com

Some fear that with rising medical costs and an aging population, the country's nursing staff will be stretched even more thinly.

Some fear that with rising medical costs and an aging population, the country's nursing staff will be stretched even more thinly.
iStockphoto.com

Some fear that with rising medical costs and an aging population, the country's nursing staff will be stretched even more thinly.

Nurses are the backbone of the hospital — just ask pretty much any doctor or patient. But a new poll conducted NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health finds 34 percent of patients hospitalized for at least one night in the past year said "nurses weren't available when needed or didn't respond quickly to requests for help."

Since nurses provide most of the patient care in hospitals, we were surprised at the findings. We wanted to find out more. We wanted to know what was going on from nurses themselves. So we put a call-out on Facebook.

We received hundreds of responses and read them all: piles of stories about nurses feeling overworked, getting no breaks, no lunches and barely enough time to go to the bathroom. Even worse, many nurses say breaks and lunchtimes are figured into their salaries and deducted, whether they take them not.

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Audio for this story from Morning Edition will be available at approx. 9:00 a.m. ET

May 25, 2012

 
Becky Cole was eight months pregnant with her son Ryan when she passed out. Her husband performed CPR for six minutes with the help of a dispatcher before medics arrived.
Courtesy of Medic One Foundation

Becky Cole was eight months pregnant with her son Ryan when she passed out. Her husband performed CPR for six minutes with the help of a dispatcher before medics arrived.

Your chances of surviving a sudden heart attack may depend on where you live; some American cities have survival rates five times higher than others. One difference can be 911 dispatchers.

If they coach someone over the phone to give CPR, the chance of surviving goes up. There's now a push to make it universal, but some cities are slow to implement the necessary training.

Becky Cole was eight months pregnant with her fourth child when she collapsed against the bathroom door. It was January 2011 in the Seattle suburb of Woodinville.

"I got up to go brush my teeth, and that's the last thing I remember," she says.

Her husband, Jon, heard the loud crash and called 911.

"She's fallen down, and she doesn't look like she's breathing. I need an emergency ambulance right now," he told the dispatcher.

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Patients continue to complain that physicians don't spend enough time examining and talking with them.
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Patients continue to complain that physicians don't spend enough time examining and talking with them.

Patients continue to complain that physicians don't spend enough time examining and talking with them.
iStockphoto.com

Patients continue to complain that physicians don't spend enough time examining and talking with them.

To physician Larry Shore of My Health Medical Group in San Francisco, it's no surprise that patients give doctors low marks for time and attention.

"There's some data to suggest that the average patient gets to speak for between 12 and 15 seconds before the physician interrupts them," Shore says. "And that makes you feel like the person is not listening."

A doctor's impatience, though, is often driven more by economics than ego. Reimbursement rates for a primary care visit are notoriously low, and Shore laments the need to hustle patients in and out.

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Did they talk first?
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Did they talk first?

Did they talk first?
iStockphoto.com

Did they talk first?

Forgive me, if you're suffering from PSA policy fatigue.

But there are a few more things I thought you might want to know about the new guideline from the U.S. Preventive Services Task Force that says men of all ages should forgo routine blood tests to detect prostate cancer.

Research from Johns Hopkins suggests the chances that doctors will listen aren't great.

In case you missed it, which I doubt is possible, the influential task force concluded that the harms from PSA testing outweigh the benefits when it comes to routine use. The recommendation left the door open for men and their doctors to talk things over and go ahead with the test if they agreed it would be worthwhile.

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A Pakistani man wheels Jamshid, an 8-year-old girl with polio, around the outskirts of the capital Islamabad last July.
Behrouz Mehri/AFP/Getty Images

A Pakistani man wheels Jamshid, an 8-year-old girl with polio, around the outskirts of the capital Islamabad last July.

The drive to wipe polio from the face of the earth is in jeopardy.

Afghanistan, Nigeria and Pakistan are the only three countries left where poliovirus remains endemic. But work to put the paralyzing virus on the ropes there is in danger of failing. Cases in all three countries jumped last year.

Weak public health systems, armed conflicts and corruption have hurt vaccination efforts. Now leading public health officials have proposed an emergency plan of action to get things back on track..

"Polio eradication is at a tipping point," says a report published by the World Health Organization today. "If immunity is not raised in the three remaining countries to levels necessary to stop poliovirus transmission, polio eradication will fail."

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Even if students have a prescription for pot, marijuana remains illegal under federal law. Colleges that let students self-medicate on campus could jeopardize their federal funding.
Enlarge Jeff Barnard/AP

Even if students have a prescription for pot, marijuana remains illegal under federal law. Colleges that let students self-medicate on campus could jeopardize their federal funding.

Even if students have a prescription for pot, marijuana remains illegal under federal law. Colleges that let students self-medicate on campus could jeopardize their federal funding.
Jeff Barnard/AP

Even if students have a prescription for pot, marijuana remains illegal under federal law. Colleges that let students self-medicate on campus could jeopardize their federal funding.

Medical marijuana is legal in 16 states, and that number is expected to grow. But these state laws put colleges in a bind. That's because under federal law, marijuana is still illegal. So colleges that let students make use of their pot prescription on campus risk losing their federal funding.

For 25-year-old University of Maine junior Robyn Smith, this situation has led to a new kind of "reefer madness": Even though he has his doctor's authorization to use medical marijuana, when he self-medicates, Smith either goes home or retreats to his SUV, which he parks across the street from the university so that he doesn't violate school policies on smoking and drug use on campus.

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  • Patient Bob Berquist with Gregory Wagner, a doctor in the emergency department. Berquist, who volunteers at Fauquier Hospital, was admitted for low blood sugar when another nurse noticed he seemed dizzy.
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    Patient Bob Berquist with Gregory Wagner, a doctor in the emergency department. Berquist, who volunteers at Fauquier Hospital, was admitted for low blood sugar when another nurse noticed he seemed dizzy.
    John Rose/NPR
  • Fauquier Hospital was among the first five hospitals in the nation — and the only one in Virginia — to meet a specific list of criteria that qualifies it as providing truly patient-centered care.
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    Fauquier Hospital was among the first five hospitals in the nation — and the only one in Virginia — to meet a specific list of criteria that qualifies it as providing truly patient-centered care.
    John Rose/NPR
  • Lisa Spitzer, a registered nurse, is a Planetree program manager and concierge at Fauquier Hospital. She visits patients and offers a friendly ear and a helping hand.
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    Lisa Spitzer, a registered nurse, is a Planetree program manager and concierge at Fauquier Hospital. She visits patients and offers a friendly ear and a helping hand.
    John Rose/NPR
  • The organic garden outside the hospital supplies the kitchen with fresh vegetables and herbs. Even the wood used for the trellises is untreated so that chemicals don't leach into the garden soil.
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    The organic garden outside the hospital supplies the kitchen with fresh vegetables and herbs. Even the wood used for the trellises is untreated so that chemicals don't leach into the garden soil.
    John Rose/NPR
  • The chefs in the cafeteria try to buy whatever food they can't grow in the garden from farms as close to home as possible.
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    The chefs in the cafeteria try to buy whatever food they can't grow in the garden from farms as close to home as possible.
    John Rose/NPR
  • Twice a week, local seniors in Warrenton, Va., flock to the hospital's cafeteria, called The Bistro, for a meal, a great view and musical accompaniment by a retired piano player from a nearby Nordstrom's.
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    Twice a week, local seniors in Warrenton, Va., flock to the hospital's cafeteria, called The Bistro, for a meal, a great view and musical accompaniment by a retired piano player from a nearby Nordstrom's.
    John Rose/NPR
  • Family and friends are welcome at the hospital anytime, day or night, and each of the 97 patient rooms is designed as a single-occupancy room with a bed for caregivers to spend the night.
    Hide caption
    Family and friends are welcome at the hospital anytime, day or night, and each of the 97 patient rooms is designed as a single-occupancy room with a bed for caregivers to spend the night.
    John Rose/NPR
  • Each birthing suite is designed for the newborn to remain in the room with the mother, and there is an additional bed in the room for dad, or other care partner.
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    Each birthing suite is designed for the newborn to remain in the room with the mother, and there is an additional bed in the room for dad, or other care partner.
    John Rose/NPR

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No one likes to go to the hospital.

But some hospitals around the nation are trying to make their patients' stays a little less unpleasant.

They're members of an organization called Planetree, which was founded by a patient named Angelica Thieriot, who had a not-so-good hospital experience back in the 1970s.

"She herself became very ill and was hospitalized," says Planetree President Susan Frampton. "And while she felt she got good clinical quality care, she was really horrified by the human experience that she had. So she founded Planetree with a very lofty goal: to change the health care system to be more patient- and family-centered. And that has been our mission ... for the last three and a half decades."

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Dr. Otis Brawley, chief medical officer of the American Cancer Society, predicts that doctors and patients will continue to be "unscientific" when deciding on testing for prostate cancer.
Chris Hamilton/American Cancer Society

Dr. Otis Brawley, chief medical officer of the American Cancer Society, predicts that doctors and patients will continue to be "unscientific" when deciding on testing for prostate cancer.

The dust is nowhere near settled over advice that men of all ages should forgo a routine blood test to detect prostate cancer.

The harms, such as false alarms and unnecessary surgeries that leave some men impotent and incontinent, outweigh the benefits of the PSA test, according to the U.S. Preventive Services Task Force.

So the influential group this week made an official recommendation against a regular PSA.

To be sure, if doctor and patient want to go ahead with a PSA test, that's OK, as long as there's been a frank discussion about the pros and cons. "The decision to start or continue screening should be an informed one that reflects an understanding of the possible benefits and harms and should respect an individual man's preferences," as a summary for patients puts it in the Annals of Internal Medicine.

Love or hate the recommendations, will they stick?

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A U.S. postage stamp from 1998 promotes donations of organs and tissue for transplant.
iStockphoto.com

When we first kicked around the idea of asking people to share their opinions about compensating organ donors, it was pretty clear that we were on to something. Everybody in the newsroom seemed to have a strong feeling about it.

Our NPR-Thomson Reuters Health Poll found that about 60 percent of Americans would support modest compensation in the form of credits toward future health care needs of people who made donations while alive of kidneys, bone marrow and portions of liver.

Bioethicist Dr. Stuart Youngner, from Case Western Reserve's med school, and I joined Neal Conan on NPR's Talk of the Nation Tuesday to chat about the findings and hear from people across the country.

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Colonies of Clostridium difficile look awfully nice, but they're definitely something you'd be advised to keep at a safe distance.
CDC

Colonies of Clostridium difficile look awfully nice, but they're definitely something you'd be advised to keep at a safe distance.

Infections with the bacterium Clostridium difficile hit record numbers in recent years. Now there's evidence the hard-to-treat infections are becoming a problem for children.

The infections often strike the elderly, especially those who've been taking antibiotics that clear out competing bacteria in people's intestines. People sickened by the bug have persistent diarrhea that can, in severe cases, lead to dehydration.

C. diff, as it's known, is resistant to common broad-spectrum drugs and used to lurk mainly in hospitals. But as NPR's Rob Stein reported in March, more and more people are contracting C. diff elsewhere.

Mayo Clinic researcher Sahil Khanna and his colleagues have found that children are contracting the disease at ever-higher rates, too. And most of them are being infected outside of hospitals. He presented the findings at the annual Digestive Disease Week medical conference ending today.

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