Greetings! Awoke yesterday morning to a call from the hospital where I work announcing that Joint Commission, the agency that accredits hospitals, had arrived for our survey. Finally! For months we have worked, "drilled", prepared, and collected data to show ourselves a safe and capable place to care for sick folks. In my 32 years as a nurse I have experienced many surveys. Sometimes it seems the surveyors are intent on finding something- anything- they can make a big deal over and other times they come in a teaching and supportive role. I think this time we may have the latter. My intent is never to be political about any given subject but health care surely is a hot topic now that deserves some discussion. My comments are related to my experiences caring for the rich, poor, old, young, insured, uninsured,ect.... You get the idea. We work in a system that is far, far from perfect. I get frustrated with limitations and hoops that insurance companies force us to jump through. I appreciate how difficult it is to provide safe appropriate care for patients when a practitioner must practice law suit prevention and not just sound medical care. I have seen how catastrophic illness can change a family's entire way of life. I could go on and on but I think you can see that I haven't missed much of the reality of health care we live in today. A word of caution, however. More involvement from non-medically oriented people telling doctors, hospitals, and other health care environments how to run their practices, is like asking the health care folks to make decisions about banking or car repairs. Surely changes need to happen but we must be careful that we don't mistake health care as only a business. Of course money must be made to provide services and safe nets must be in place to care for indigent and incapable folks but we should make our decisions based on providing the best care available for all patients and remember that all of us must be responsible people. None of us deserve anything without somehow involving ourselves in our on wellness. Surely we must all take responsibility for our poor choices that often lead to preventable illnesses. (Preaching to myself here!) We must answer some questions that were not even asked in the past. Must someone always be "liable" for our illnesses and poor outcomes? Is it realistic to think that there will never be an honest mistake made that may have a negative outcome? Is it too much to ask a practitioner to talk to his/her patient and form a trusting relationship? Can we not expect a safe, friendly, caring environment in hospitals, nursing homes, hospices, and other facilities? The questions go on and on and I nor any one person has all the answers; but, here's my final thought. Can we all put aside our own personal agendas, come together to do what is best for ALL of us, and formulate a plan for this country that reflects all the principles and beliefs that we say we hold dear? Surely we can put aside our egos, political differences, and personal preferences and just do the right thing. As I have said many times, The Emergency Room is the great equalizer. It's a place all of us may find ourselves one day. Is doesn't matter how rich, poor, old, young, smart or stupid you are there. When you need health care, you are at the mercy of "the system". Should we not have the best system in the world? Come on people. This ain't rocket science! It's taking care of those we love and ourselves. We can do better! Now. I feel better.