醫院對於病人不見得是個適合的地方。

如果逼不得已住院盡量趕快出來

作者：Vernon Coleman

這段影片點到重點，

生病是住院好？

還是在家休養好?

內容提到曾有實驗顯示住院與在家休養的致命率類似。雖然不是絕對，但是個觀點可思考看看。有時候踩在自己家裡的地板更加踏實自在有安全感，這對養病應該是加分。

醫院是蠻危險的。

我先就個人的觀察與感受快速整理，特別加上當下的疫情：

(1)沉重的病氣與痛苦的呻吟或哀嚎，交織成一個往下拖拉的環境

(2)有時空調很冰冷，有時很暖而濁，都對休養扣分

(3)醫生是權威，大部分時間無法交換意見，只能任憑投藥與處置。

(4)有時候不知道是病本身致命，還是投藥所產生的致命

(5)新冠疫情期間，我們讀到的投藥與治療方向疑似有意圖使人不癒的傾向。

等於住院以後，病人的命在醫院手裏，大部分的病人與家屬會默默聽話。很少有人敢在病人還在醫院時跟醫院對幹的，這不符合台灣人的性情。

(6)文中所講的過度使用抗生素造成嚴重感染。這其實眾所周知。

(7)文中所講的不必要的手術，想想國標舞女王只為了開一個尋常的心臟微創手術(聽說)，竟然致命。

(8)一定要有人照顧陪伴，原因就是以上所說的種種。一方面是照顧，一方面是壯聲勢，呵呵。

所以標題很有道理值得思考。再講一次

#醫院對於病人不見得是個適合的地方。

#如果逼不得已住院盡量趕快出來

===

🌹以下影片內容🌹

(有些依照國情不同，台灣不盡然有他所講的狀況，但他提出的這個議題很具參考價值，也讓人思考。)

一項針對心臟病人所做的研究顯示待在在家休養可能比住院更安全。

參加試驗的病人被隨機安排住院或待在家裡休養。報告顯示，#兩組的死亡率相似，住院的人身邊雖然有機器，醫生，護理師隨侍在側具有優勢，但也有住院相對的危險。

🌹古早的醫院

工業革命以前，醫院佈置地像天主教堂一樣，為的是提升住院病人的靈魂與放鬆心情。醫院會裝飾一些雕刻品、藝術品、鮮花與環繞的香氣。

現代的醫院不太考慮心靈之眼或靈魂這些因素，裝潢的比較像在監獄，讓人的注意力容易聚焦在疼痛、恐懼與死亡。

🌹護理師的角色很重要

古早，大部分是有抱負理想的人走入這行被雇用培訓，大多數但不完全是女性，他們受到啟發想要照顧人，治癒人。

護理是個崇高的職業，照料是關鍵字，由病房姊妹與護理長擔任，在同業中很具力量。他們與患者有密切的日常接觸。

可悲的是，今天的職場護理師之所以想成為護理師，哪怕伴隨那麼一點點企圖心想短時間內有升遷機會，他們花很少的時間去照顧病人。真正在做的都是菜鳥護理師。

🌹醫院的制度與管理

這是我擔心的現代醫院如此糟糕的原因

在英國，醫院的管理階層幾十年來每年都在增加，但護理師、輔助人員和清潔工的人數卻在不斷下降，現在醫院的管理人員甚至比床位、護士和清潔工還多。他們花大量時間填表格運轉制度並不奇怪。

有一點，有嚴重致命感染的病患持續在飆升。

更早幾十年前，在醫院被照顧的病人由護士長、病房姐妹以及護理師在負責，她們知道怎麼幫病人翻身，整理病床，以及清空便盆。

很多病患沒有印象醫院的效率曾經有多高，所以會不知道該期待怎樣的品質，他們覺得所受到的醫療照護已經很好了。

在很多國家，全科醫生和駐院醫生現在嚴格限制工作時間，很少在週末看到醫生。病人只好整個週末都待在床上，沒人，似乎去處理靜脈血栓或褥瘡。

如果有人是週末住院，那死亡的可能性比一周其他天高出8%到26%。

 🌹對抗生素產生抗藥性的超級細菌感染

另一個問題是，與其他任何地方相比，在醫院更容易感染致命的嚴重感染。當然，很大的危險在可能有對抗生素產生抗藥性的感染。

這不令人意外。

筆者在1977年所寫的書中就提到，其實這是可避免的。

醫院衛生狀況惡化和過度使用抗生素，這些超級細菌在醫院對健康造成重大威脅。

醫院工作人員似乎不是很在意，即使發生抗藥性金黃色葡萄球菌(簡稱MRSA)感染，例如，幾乎所有的褥瘡和大多數深靜脈血栓形成都是護理不當的直接證據，即使現在已知醫療記錄筆和電腦鍵盤也可能被超級細菌感染。

🌹無法挽救生命的手術

再來就是手術……

手術顯然是危險，潛在是危險，最好盡量避免。

在英國，每年手術死亡的人數就數萬人，10個有9個的手術只為了改善生活而不是挽救生命。代表很多手術的人死於不必要的手術。

很少針對這部分的現象做研究，找出手術是否真的改善生活品質，這些病人冒著風險去承受。

太多時候我覺得醫院對病人並不是個適合的地方。如果你逼不得已必須住院，那要想辦法趕快出來。

誰是Vernon Coleman?

曾是醫生，主要撰寫人類健康，政治和動物問題的相關文章，他的醫學主張被廣泛抹黑。也曾寫過報紙專欄。(維基百科)

影片出處

https://m.youtube.com/watch?v=ZsFJORqMxyM&feature=youtu.be

A major study of patients who have heart attacks showed that staying at home maybe safer than going into hospitals. The patients in the trial were allocated at random either to a hospital or staying at home. The author of the paper reported that the mortality rate for the two groups were similar to whatever advantage patients might have had through going into hospital and being surrounded by machines, doctors, and nurses was matched by the hazards of going into the hospitals.

Before the industrial age, hospitals were built like cathedrals in order to lift the soul and ease the mind. Hospitals were decorated with carvings, work of art, flowers and perfumes.

Modern hospitals are built with no regard for the spirit eye or soul, they bear more like prisons and the temples designed to concentrate the mind on pain, fear and death.

In the old days, nurses were hired and trained to nurse aspiring nurses mostly but not exclusively female were inspired by the desire to tend and to heal.

Nursing was a noble profession, and caring was key word, the most powerful jobs in the profession were occupied by ward sisters and matrons. All of whom had close daily contact with patients.

Sadly todays career structure that nurses whose desire to nurse is accompanied by even the slightest ambition must quickly move up the ladder to a point where they spent very little time or probably no time at all with patients. The actual hands on nursing is done by junior staff.

This is the reason why i fear why modern hospitals are so bad 

In the U.K, the numbers of senior managers in hospitals has risen every year for decades, at the same time, the numbers of nurses, auxiliaries, and cleaners keep falling, there are more administrators in hospitals now than beds, nurses and cleaners. Its not surprising that the staff spend much of their time filling in form to satisfy the bureaucrats.

Well the numbers of patients contracting seious deadly infections continue to soar.

Hospitals are designed and built around the need of the staff to the architect who design the hospitals to the managers ,who run them patients are, it seems something of a nuisance.without whom, everything far more smoothly.

Signs of administrators ay work are everywhere.

A few years ago, decades more likely, patients were cared for in hospitals which were run by matrons and ward sisters and nurses, who still know how to turn a patient, make a bed, and empty a bed pan.

Many patients cant remember how efficient hospitals were in those days, and so because they dont know what to expect or what to look for, they think theyre being well looked after.

In many countries, doctors both in general practice and in hospital are now working strictly limited hours, as a result, its rare to see a doctor in a hospital at weekends. Patients are left lying in bed all weekend, no one, it seems has heard of deep vein thrombosis or pressure sores.

You are between 8%~26%more likely to die, if youre admitted to hospitals at weekends than you are if you are admitted to hospital during the week.

Another problem is that you are more likely to catch a serious life threatening infection in hospital than anywhere else. The great danger, if course, is that you may catch an antibiotic resistant infection.

Such infection are predictable a long time ago.

I predicted their development in 1977 in a book called a paper doctors, and they are avoidable.

Ive explained how they could best be avoided in the same book, but, as a result of worsening hospital hygiene and the overuse of antibiotics, these resistant bugs are now a significant health threat in hospitals.

Hospital staff seem surprisingly unconcerned at this, even though every incidence of mrsa infection, for example, is like nearly all bed sores and most deep veins thrombosis is straightforward evidence of poor nursing, even medical records pen and computer keyboards are now known to be infected with super bugs.

And then the operation…

Now the operations are obviously potentially dangerous procedures and are best avoided whenever possible.

Surgical deaths numbers tens of thousands a year in UK alone, but 9 out of 10 operations are done to improve life rather than save life. This means, many of the patients who die as a result of surgery didnt need their operation.

Little research has been done to find out all those operations actually do improve the quality of life for the patients who have them and take the risk.

Too often, Im afraid hospitals are not suitable places for sick people. If you need to go into one, you should get out as quickly as possible.