"Nurses, it's time to look out the window."At 6AM, another announcement:
"Nurses, it's time to look at the ceiling."Later, another:
"Nurses, it's time to look out the door."All day, all night, 24-7-365.
This is not a reference to psychological wellness for nurses, but rather state-regulated instructions for pressure sore care that are happening now in the new outback of medicine: long term care facilities.
One of the key strategies of current health care reform to control costs are "bundled payments:" a single payment to hospital systems based on national norms for treatment that place the onus to save costs on the facilities and physicians. Through "comparative effectiveness research" strategies it is argued, "best practices" for care can be developed and disseminated to reduce costs. As these under-funded "bundles" are deployed, hospital systems will increasingly look to ways to shorten length of stays to remain fiscally solvent. As a result, patient census at long-term care facilities will only grow.
And from this group research strategy, comes group care.
Just like it's happening now.
"Nurses, it's time to look out the window."