OLYMPIA, Wash. - El trabajo de quienes brindan cuidados en los asilos de ancianos es muy demandante, y en Washington algunos afirman que la escasez crónica de personal es una de las principales razones de que haya tanta rotación. Es por eso que los encargados de brindar atención piden a los legisladores estatales que regulen y establezcan niveles mínimos de personal indispensable.
Hasta la fecha Washington carece de una ley estatal que establezca ese mínimo de personal para los asilos, algo que durante la presente sesión legislativa intentan cambiar los encargados de brindar atención en estos lugares. Citan tres razones para que se legisle sobre la proporción mínima de trabajadores para cuidar a los pacientes: mejor atención para los internos, menor rotación por fatiga de los trabajadores y mayor seguridad para ambos.
Shelly Hughes tiene cinco años como Auxiliar de Enfermería Certificada en Washington (CNA por sus siglas en inglés) y también pertenece a la (Unión Internacional de Empleados de Servicios) SEIU Healthcare 775 Northwest. Asegura por su experiencia que rara vez hay tiempo suficiente, o manos suficientes, para atender a los residentes con el cuidado debido.
“Una de las cosas más tristes de mi trabajo es ver a magníficas personas con buen corazón y muy trabajadoras, que se van –no sólo de mi lugar de trabajo, sino de toda la industria– porque se frustran con el nivel de atención que podemos dar a nuestros pacientes.”
Explica que, bajo las condiciones actuales, una CNA (Auxiliar de Enfermería Certificada) puede atender de 15 a 20 residentes. Agrega que los asilos saben con anticipación cuándo llegarán los supervisores del estado a inspeccionar, y entonces los gerentes se apuran para tener suficiente gente programada. La investigación de la AARP indica una rotación anual del 52% entre los trabajadores de asilos en el estado.
Hughes comenta que la propuesta de la Unión Internacional de Empleados de Servicios (SEIU) establecería reglas para el personal en un lapso de tres años, y los asilos tendrían que presentar reportes mensuales al estado con registros de la nómina, para confirmar que estén cumpliendo. Ella y otros cuidadores del SEIU Local 775 han compartido sus casos personales con legisladores de Washington, y ella piensa que creación de una ley estatal es sólo cuestión de tiempo.
“Creo que tomará tiempo, pero todavía no conozco un legislador que esté en desacuerdo con lo que le expongo. Creo que la voluntad ya está – sólo hay que encontrar un camino.”
Agrega que Oregon y California ya tienen establecido el mínimo requerido de personal para la atención directa en los asilos. Los prestadores de cuidados de Washington presentarán su caso en Olympia el 29 de enero, día de cabildo.
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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.
Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.
Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.
"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."
Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.
Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.
"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."
Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.
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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.
Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.
"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained
Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.
Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.
"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.
Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.
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New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.
The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.
"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.
Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.
Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."
"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.
Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.
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