American Medical Care: Self-Tested

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On the night from Sunday to Monday, with an acute attack of pain, I got into the emergency room, and from there to the operating room. On my own experience I want to tell you how the hospitals in America are arranged.

American medical care is one of the most professional and expensive in the world. The bulk of the money spent on health care is not public, but private money, that is, the amounts that ordinary Americans pay insurance companies. This money not only pays all the costs of treatment, but also stays in the hospital.

As a rule, multidisciplinary hospitals and emergency medical care (ER - emergency room) is located on the first floor with a separate entrance. If you come to ER It’s not a fact that doctors will take care of you immediately (we arrived at five in the morning, the doctor came up to seven). Therefore, in really emergency cases, it is recommended to call paramedics on 911 - this is a kind of ambulance, and not only paramedics, but also firefighters can come to the call.

Do not be surprised, they are all trained in the methods of first aid, the pressure in the car will be measured, the temperature will be given an oxygen mask if necessary, and with a special signal they will be taken to ER.

Photos from personal archive

Park your own car at the entrance ER it is impossible - you can disembark the passenger and drive off to the central entrance, which, as a rule, has a large parking lot.

Photos from personal archive

Reception rooms ER organized as homely as possible. In “our” hospital, for example, not only a TV set and machines with water, ice-cream and chips, but also a huge aquarium were installed.

Photos from personal archive

At first they ask, with what, actually, you have come. If you are at the hospital for the first time, you need to fill out all the papers (first name, last name, home and work address and telephone numbers, insurance data, family information, family history, a description of what is currently hurt). The last couple of years have wondered if you traveled to African or South American countries - no one has yet canceled Ebola and Zika.

They put a bracelet with your information on your hand, and then again you sit and grieve in the armchair, staring at important fish. Then the nurse calls you to a separate room, where he asks for all the data you have previously indicated, checks them with the data on the bracelet, measures pressure, pulse and temperature, clarifies what is allergic (in such cases, another bracelet is worn, usually red colors). Then you again sit in the waiting room and wait, while this nurse will process the data and give it to the nurse already in the department ER.

It is clear that the smaller the town, the shorter the waiting time.

In New York, an hour and a half is practically “the norm” (even when I brought in ER we waited for our little son, who swallowed a piece of sharp plastic, from nine o'clock in the evening to five o'clock in the morning), so it’s almost pointless to complain here.

In general, after half an hour I was taken from the emergency room to the emergency room. There are both separate chambers where really heavy patients are taken, as well as common rooms in which patients are separated from each other by curtains.

Photos from personal archive

Apparently, I was impressed by the simulator, since I was completely laid on a gurney in the corridor, but right in front of a medical post. So, while I was waiting for the doctor, I had time to look at everyone - and yes, the medical series in something lie, Georgie Clooney in ER do not work (although a couple of nice doctors still was).

Nurses and doctors do not rush at tremendous speeds, do not cry “we lose it” and do not take delivery at the same time with a direct heart massage right there. So it’s necessary to watch TV shows less.

In general, the doctor came up to seven o'clock in the morning and wrote out a referral for additional examinations. The pictures were to be done with contrast, so they brought me special “cocktails” that I needed to drink two hours before the examination. They come in different flavors - berry, banana, vanilla, they brought me with the taste of “mokkachino”. As for me, it was more like a thick vanilla yogurt with a weak coffee flavor, sugary-sweet.

Photos from personal archive

At ten o'clock, finally, they were taken to pictures (from the moment they entered the hospital until they left her gate, the patient could not move himself, only in a wheelchair or gurney. That is, even if he can physically, that’s all Equally not allowed by hospital rules - what if it falls and then sues the hospital?).

The wheelchair is transported not by a nurse or nurse, but by a specially trained “worker of the transport department” who must be separately called and waited. While we were also waiting for the results of the survey, we were approached in turn: a nurse who had changed overnight, an administrative officer of the hospital and a volunteer who was encouraging patients. Everyone had to clarify the name and date of birth, written on the bracelet, and tell them what exactly is of concern. In general, there was no time to miss.

At about eleven in the morning (I remind you that we arrived at five in the morning and we are talking about the emergency room!), The doctor on duty “pleased” that I had “bad appendicitis” and called the surgeon. In general, “cut without waiting for peritonitis!”.

The surgeon turned out to be a very nice emigrant from India, one of the best specialists in our district, the owner of a heap of professional awards, and most importantly - a very calm and with a pleasant smile. He told about the course of the operation, then said: “It would be unfair to keep silent about other options, for example, you can try to do without surgery, antibiotics, but this is a big risk.”

In general, the doctor here is obliged to tell everything in detail and report on all options. Therefore, I signed a consent for the operation and began to wait until they took me to another floor in the operating room.

By the way, if you do not speak English, the hospital is obliged to provide you with an interpreter in your language (at least in the state of New York, that's exactly it).

The surgical department is located on a separate floor and consists of several absolutely sterile units - preoperative, operating room and reanimation (recovery room). Before you are taken to the surgery, you change your clothes, pack them in bags, write your name and give them to relatives who stay outside waiting (or leave things as a nurse).

Of course, I don’t remember the operating room, but preoperative and reanimation are like giant aquariums - glass windows and doors with curtains.

Photos from personal archive

In the preoperative procedure, the same procedure is repeated: name, surname, date of birth, presence of allergies. Once again explain the course of the operation. Two nurses come in - one fills the map, the other ensures that you put the cap on correctly.

An anesthesiologist is sure to come. “My” was a cheerful African-American, whose name was Mark, and I was delighted to say that my father’s name was the same - and we decided that it was a great sign! He told me everything again, and then he injected Valium - after all, I was nervous, no matter what. Valium led me to such indescribable delight that I immediately informed Mark about my love. I don’t remember anything else - I woke up already in intensive care, and the nurse on duty sat by the bed and watched my monitors. After the operation, Mark checked me and agreed to transfer to the ward.

The operation to remove appendicitis is not considered particularly serious and the patient is usually discharged the next day (for comparison, after a cesarean section, I lay in Moscow for seven days, and in New York for three days).

Day in the American hospital are very expensive: according to Kaiser Foundation, in New York it costs $2,5 thousand, in California – $2,8. In the states that are not so expensive - from a thousand to two.

Postoperative wards, as a rule, double, patients are separated by curtains. Who was brought earlier - to that “trump” window seat: there is more space, more light, closer to the air conditioner. I was brought later, but I was closer to the toilet and bathroom, which is important when it hurts to walk, but it is necessary.

Photos from personal archive

Each patient is given a “gift box”: toothpaste, brush, moisturizing creams, soap - all in individual packaging. All this can be taken home with you.

Photos from personal archive

In front of each bed there is a blackboard on which you can write your name, a diagnosis, which medications you receive, the name of the doctor and your names on which you can use the washable marker of the nurse. It is much more convenient and clearer than a new shift to scroll through the entire history of the disease.

Photos from personal archive

After surgery, appendicitis is fed a lot, but gently: chicken broth, fruit jelly, tea, cranberry juice, and for some reason still carbonated ginger ale. On the back of the “menu” are all the details of the products.

Photos from personal archive

But my neighbor, who was lying with an infectious disease (which struck me, of course - how to put a postoperative patient next), asked what she wanted for breakfast. The usual menu of three courses: pancakes or waffles, fried bacon or turkey patties, fried eggs or scrambled eggs, and for dessert - a cupcake or chocolate pudding. In general, the food in American hospitals is excellent!

By the way, I still remember how I was struck by a chicken baked with potatoes and Provencal herbs, which I was fed here after caesarean - unlike the mashed potatoes with sauerkraut and cucumbers in the Moscow maternity hospital.

Relatives and friends can come to the ward in unlimited quantities, and no one is required to change into hospital gowns or change their shoes. Depending on the hospital, your relatives may even be allowed to stay with you for the night.

Near each bed, in addition to monitors and droppers, there is also a TV. The nurse's post is located in the center of the floor, and the nurses come several times during the night - they check the pressure, temperature and pulse.

Photos from personal archive

Before discharge, the patient is visited by either his doctor, or the doctor's assistant or the doctor on duty in the ward. My surgeon was so wonderful that he visited me personally, after which he gave me a go-ahead for discharge. They are discharged in an ordinary wheelchair — they are taken out of the door of the hospital and wait until the parking staff drives the car.

You can’t drive yourself, so a hospital employee must make sure that your relative or friend is driving, and you sit comfortably in the passenger seat (by the way, during the discharge from the maternity hospital, they must also make sure that your car is safely installed and secured car seat).

Photos from personal archive

If they brought you to the emergency room, they take you through the main entrance. Here in American hospitals there is a checkpoint and an indispensable souvenir shop (flowers, cards, plush toys and health wishes Get well soon! - Mandatory attributes of the hospital and convalescent process).

Photos from personal archive

Home is written out with all accompanying explanatory papers, which will then need to be discussed with your therapist, the prescriptions for the necessary medicines are sent to the computer at your pharmacy. In general, the full feeling that you were not in the hospital, but in a good expensive hotel.

A few days later, an invoice from the insurance company arrives in the mail.

Both poor and rich Americans receive the same medical care, but if you do not have insurance or its limit is exhausted, you will have to pay for treatment from your own pocket.

At each hospital there are special services that help arrange payment in installments, if there is such a need.

There are no bulletins in America either. If in your company you are supposed to have a certain amount of paid “sick days”, then this is generally a personal matter, when you take them - no one will check. But if you have exhausted them all and then got sick and did not return to work - this will be taken into account when reducing jobs or wages.

So, be healthy and do not get sick!

Victoria Averbukh

Original article published on the site America roads and reprinted with permission of the author.

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