Official Review: Broken System by Tally Adams

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bluegreenmarina
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Latest Review: Broken System by Tally Adams

Official Review: Broken System by Tally Adams

Post by bluegreenmarina » 11 Jan 2019, 15:27

[Following is an official OnlineBookClub.org review of "Broken System" by Tally Adams.]
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3 out of 4 stars
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Broken System by Tally Adams exposes the often-overlooked realities of the U.S. healthcare system. It is told from the perspective of a nurse with many years of experience in a variety of medical settings. Much of the text focuses on nursing homes and elder care, though hospice, acute care hospital settings, and surgery are also discussed. The author makes the general assertion that the system has moved away from a focus on effective patient care and has become centered around profit, to the detriment of nurses and patients alike.

Nursing homes are some of the sites with the most egregious examples of mismanaged care. The rehabilitation equipment is often minimal and outdated, most care is provided by overworked CNAs who receive little training, and many patients’ insurance policies do not pay for all the services the home theoretically provides. Because staff are treated as expendable and held to standards that are unrealistic (given the number of patients assigned), many are forced to bend administrative rules and requirements to get their tasks completed. Though administrators sometimes require documentation of additional safety measures, often the only changes that occur take place on paper, whereas live patients are left sitting in their excrement, or lying in their beds long enough to develop sores. The author includes several real case examples of well-meaning nurses and CNAs who inadvertently provided substandard care due to their insufficient training and/or resources.

The remainder of the book outlines additional problems in healthcare practices such as placing patients on “hospice” designations prematurely due to financial incentives, leading to a hastened demise. According to the author, hospitals are not immune to management issues, and nurses frequently find themselves in competitive and cliquey environments, where workload is sometimes directly related to the relationships one builds. Furthermore, they are subjected to murky legal situations in which administrative policies sometimes conflict with the knowledge imparted in nursing school. At times, nurses are even forced to risk their career by making life-and-death decisions without the backing of the medical institution. Even the surgery ward is far from immune from malpractice, and several anecdotes included in the text were shocking and scary in their implications of what goes on behind closed curtains.

I found this book fascinating, and quick and easy to read. The issues were outlined in simple terms, with moving examples provided to illustrate the dire nature of the situation. Each section was capped by a brief discussion on practical changes administrators and medical facilities should make to improve the conditions mentioned, as well as examples of steps patients and their families can take to protect themselves. I found these suggestions quite informative and believe almost any reader would benefit from reading this book because we all navigate the healthcare system at some point in our lives. Understanding that the facilities in question often have far different (financial) interests than the interests of the patient, and understanding what to look for to ensure safe and effective care are crucial to the provider selection process.

There were a couple of minor negatives that resulted in my rating this book 3 out of 4 stars. I found a handful of spelling and grammatical errors throughout, though these were not overly distracting. However, I also felt that some of the statements made by the author were oversimplified or overgeneralized, implying that every facility that fit under a certain descriptor operated in the same way. I would guess there is much variation by geographical region, among other factors. Similarly, some of the solutions proposed by the author also seemed overly simplistic, or even unachievable. Of course we would all benefit if medical corporations and their administrators focused less on lining their pockets and more on providing exemplary care, but the steps to achieving this are less clear than the problems with the status quo. Certain sections of this book read like an idealistic college essay – full of valid “best case scenario” proposals that unfortunately sound too good to be true. Nonetheless, it was a highly educational and motivating read, and I appreciate the opportunity to navigate the system from a more knowledgeable and empowered standpoint. Any reader with aging parents who are considering nursing care would certainly benefit from reading this book, but as I mentioned above, any healthcare consumer in this country would likely find this information useful.

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Post by kandscreeley » 12 Jan 2019, 18:38

Well, I certainly agree that the medical system is more focused on making money than actually helping a patient. Still, I'm not sure the solutions the author presents sound completely realistic. I'm curious, though, what she does offer. Thanks.
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Post by Amanda Deck » 12 Jan 2019, 20:26

Something I've seen is that there is a major shortage of medical personnel. That leads to lower standards of care even when everyone wants the best. Not only that, all the concern about profit may be true, but the medical care needed is very costly and there are very high operating costs to consider.

I remember seeing an old man in a nursing home fall out of his wheelchair once and asked why he didn't have a seatbelt or something. I was told in a very sarcastic tone that, "They have the 'right' to fall out of their chairs if they want to, didn't you know?" She calmed down and continued, "We're not allowed to restrain them." Navigating the thin, sometimes non-existent, line between treating patients humanely and legally caring for the incapacitated who don't believe they're incapacitated is impossible.

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Post by Darlynn_Tebogo » 13 Jan 2019, 02:21

Amanda Deck wrote: ↑
12 Jan 2019, 20:26
Something I've seen is that there is a major shortage of medical personnel. That leads to lower standards of care even when everyone wants the best. Not only that, all the concern about profit may be true, but the medical care needed is very costly and there are very high operating costs to consider.

I remember seeing an old man in a nursing home fall out of his wheelchair once and asked why he didn't have a seatbelt or something. I was told in a very sarcastic tone that, "They have the 'right' to fall out of their chairs if they want to, didn't you know?" She calmed down and continued, "We're not allowed to restrain them." Navigating the thin, sometimes non-existent, line between treating patients humanely and legally caring for the incapacitated who don't believe they're incapacitated is impossible.
This sounds so heartbreaking. The nurses have some really tough choices to make.

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Post by Darlynn_Tebogo » 13 Jan 2019, 02:25

This book highlights the fact that people need to pay attention to their loved ones in the hospital or nursing homes. It's better to be referred to a good home rather than being alured by the nice brochures and presentations given by the staff. Sounds like an eye opening read.

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Post by T_stone » 13 Jan 2019, 03:09

I like that this book is simple to read SBD understand. It's also a book that educates the public about things that happen in the health sector. Gone are the days when healthcare was as serious as it comes. Now, its profit based which is quite sad. This review is engaging and detailed. Thanks.
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Post by Onyinye Excel » 13 Jan 2019, 06:24

I appreciate the author's insight. The health care sector is becoming more profit oriented than life saving.I'm open to this author's ideas in this book.

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Post by Anthony__ » 13 Jan 2019, 09:22

Great review! Hospitals actual have management issue. I agree with the author. I also love the examples that backed up his points.

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Post by kdstrack » 13 Jan 2019, 20:11

I appreciate your recommendation of this book as a tool to learn more about the healthcare system. We need to know to truth if we want to advocate for positive changes. Thanks for your excellent and enlightening review.

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Post by nonamer_miss » 14 Jan 2019, 05:59

We have 2 nurses in the family so this seems to be interesting. Thanks for the review!

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Post by Jessacardinal » 15 Jan 2019, 14:40

After merely reading the title on the cover, I am willing to bet this book is a real eye-opener!
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