{"id":298372,"date":"2023-06-06T21:10:12","date_gmt":"2023-06-06T19:10:12","guid":{"rendered":"https:\/\/slf.se\/vastra-gotalands-lakarforening\/?p=298372"},"modified":"2023-06-22T13:15:58","modified_gmt":"2023-06-22T11:15:58","slug":"omojlig-balansakt-mellan-primarvard-och-sjukhus","status":"publish","type":"post","link":"https:\/\/slf.se\/vastra-gotalands-lakarforening\/nyheter\/omojlig-balansakt-mellan-primarvard-och-sjukhus\/","title":{"rendered":"Om\u00f6jlig balansakt mellan prim\u00e4rv\u00e5rd och sjukhus"},"content":{"rendered":"\n

Citatet ”s\u00f6ndra och h\u00e4rska” tillskrivs Julius Cesar.<\/em><\/strong> Som facklig kan jag ofta undra om v\u00e5ra politiker, h\u00f6ga chefer och tj\u00e4nstem\u00e4n mer eller mindre ovetandes applicerar detta p\u00e5 gr\u00e4nslandet prim\u00e4rv\u00e5rd\/slutenv\u00e5rd. Resultatet? Att vi inom v\u00e5rden irriteras \u00f6ver varandras upplevda tillkortakommanden i st\u00e4llet f\u00f6r att uppm\u00e4rksamma att b\u00e5de prim\u00e4r- och sekund\u00e4rv\u00e5rden ofta f\u00e5r om\u00f6jliga uppdrag.<\/p>\n\n\n\n

Trots mycket fagert tal om omst\u00e4llning till ”n\u00e4ra v\u00e5rd” skriver Socialstyrelsen i sin granskning att ”regioner och kommuner inte prioriterar prim\u00e4rv\u00e5rden mer ekonomiskt \u00e4n vad de gjort tidigare.” I VGR har vi exempelvis i flera \u00e5r sett att prim\u00e4rv\u00e5rdens grunduppdrag inte f\u00e5tt uppr\u00e4kning av ers\u00e4ttningar som t\u00e4cker ens f\u00f6rv\u00e4ntade l\u00f6ne\u00f6kningar. Detta trots att nya diagnoser och behandlingar samtidigt flyttas ut i prim\u00e4rv\u00e5rden.<\/p>\n\n\n\n

P\u00e5 ren svenska f\u00f6rv\u00e4ntas en redan underbemannad prim\u00e4rv\u00e5rd<\/em><\/strong> g\u00f6ra mer med samma eller till och med mindre resurser. Samtidigt f\u00f6rv\u00e4ntas sjukhusen \u00e5r efter \u00e5r l\u00f6sa anstr\u00e4ngda budgetar \u2013 motiverade av just den ofta knappt existerande omst\u00e4llningen till n\u00e4ra v\u00e5rd.<\/p>\n\n\n\n

Konsekvensen blir att vi utifr\u00e5n ett fokus p\u00e5 patientens b\u00e4sta ofta blir irriterade p\u00e5 varandra. Som distriktsl\u00e4kare p\u00e5 att remisser nekas, patienter skickas hem tidigare och tidigare, och att jag ska g\u00f6ra mer och mer f\u00f6r patienten, utan att tid eller resurser r\u00e4cker till.<\/p>\n\n\n\n

Sjukhuskollegorna, s\u00e4rskilt p\u00e5 akutmottagningarna,<\/em><\/strong> signalerar att deras arbetsmilj\u00f6 inte h\u00e5ller, en enorm etisk stress n\u00e4r det inte finns n\u00f6dv\u00e4ndiga v\u00e5rdplatser och att de, tyv\u00e4rr ofta med r\u00e4tta, inte upplever att prim\u00e4rv\u00e5rden har m\u00f6jlighet att ta vid snabbt n\u00e4r de exempelvis skickar hem patienter.<\/p>\n\n\n\n

Det finns sj\u00e4lvklart mottagningar och enheter som fungerar d\u00e5ligt eller \u00e4r fast i gamla arbetss\u00e4tt och kan effektiviseras. Jag har sj\u00e4lv m\u00f6tt s\u00e5dana n\u00e4r jag som ST-l\u00e4kare randade mig. Men det \u00e4r inte grundproblemet, vilket blir \u00f6vertydligt n\u00e4r arbetsmilj\u00f6n f\u00f6r l\u00e4kare \u00e4r s\u00e5 pass d\u00e5lig att upp till en tredjedel av yngre l\u00e4kare \u00f6verv\u00e4ger att l\u00e4mna yrket.<\/p>\n\n\n\n

Problemet blir v\u00e4rre av att ledning, tj\u00e4nstem\u00e4n och politiker<\/em><\/strong> i st\u00e4llet f\u00f6r att \u00e4rligt se sanningen i vit\u00f6gat, endast pratar sig varma om digitalisering, ”nya arbetss\u00e4tt” och \u00f6kad tillg\u00e4nglighet som l\u00f6sningar. Trots att vi har en allt \u00e4ldre befolkning, d\u00e4r vi i sjukv\u00e5rden kan g\u00f6ra allt mer.<\/p>\n\n\n\n

Nya arbetss\u00e4tt och verktyg \u00e4r ofta utm\u00e4rkta, men kr\u00e4ver n\u00e4stan alltid n\u00e5gon som fortsatt h\u00e5ller i det medicinska ansvaret, det vill s\u00e4ga l\u00e4karresurser. Ibland till och med mer l\u00e4karresurser till verksamheter p\u00e5 golvet i st\u00e4llet f\u00f6r luftiga projekt mer eller mindre fj\u00e4rran fr\u00e5n verkligheten. Och viktigast av allt, nya arbetss\u00e4tt och digitalisering \u00e4r inget som i rimlig tid kommer kompensera f\u00f6r st\u00e4ndiga krav p\u00e5 ekonomiska ”effektiviseringar” samtidigt som vi kan g\u00f6r mer och mer.<\/p>\n\n\n\n

I st\u00e4llet f\u00f6r att falla f\u00f6r ”s\u00f6ndra och h\u00e4rska” <\/em><\/strong>beh\u00f6ver vi p\u00e5 alla niv\u00e5er arbeta f\u00f6r att resurser i paritet med uppdraget finns tillg\u00e4ngliga. Av respekt f\u00f6r varandras arbetsmilj\u00f6 st\u00e4ndigt argumentera f\u00f6r att v\u00e5ra politiker, tj\u00e4nstem\u00e4n och chefer b\u00f6rjar l\u00e5ta de med den medicinska kompetensen prioritera vad som \u00e4r viktigt f\u00f6r att kunna ge bra v\u00e5rd f\u00f6r v\u00e5ra patienter. Typexempel vore satsningar p\u00e5 kontinuitet i st\u00e4llet f\u00f6r l\u00e4ngre \u00f6ppettider i prim\u00e4rv\u00e5rden och ett rimligt antal v\u00e5rdplatser inom slutenv\u00e5rden.<\/p>\n\n\n\n

Jakob Nyhl\u00e9n
Ordf\u00f6rande
Sektion Prim\u00e4rv\u00e5rd\/V\u00e4stra G\u00f6talands l\u00e4karf\u00f6rening<\/p>\n","protected":false},"excerpt":{"rendered":"

Citatet ”s\u00f6ndra och h\u00e4rska” tillskrivs Julius Cesar. Som facklig kan jag ofta undra om v\u00e5ra politiker, h\u00f6ga chefer och tj\u00e4nstem\u00e4n mer eller mindre ovetandes applicerar detta p\u00e5 gr\u00e4nslandet prim\u00e4rv\u00e5rd\/slutenv\u00e5rd. Resultatet? Att vi inom v\u00e5rden irriteras \u00f6ver varandras upplevda tillkortakommanden i st\u00e4llet f\u00f6r att uppm\u00e4rksamma att b\u00e5de prim\u00e4r- och sekund\u00e4rv\u00e5rden ofta f\u00e5r om\u00f6jliga uppdrag. Trots mycket … L\u00e4s hela<\/a><\/p>\n","protected":false},"author":5804,"featured_media":298274,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"local_restriction":[],"class_list":["post-298372","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"yoast_head":"\nV\u00e4stra G\u00f6talands l\u00e4karf\u00f6rening<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/slf.se\/vastra-gotalands-lakarforening\/nyheter\/omojlig-balansakt-mellan-primarvard-och-sjukhus\/\" \/>\n<meta property=\"og:locale\" content=\"sv_SE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Om\u00f6jlig balansakt mellan prim\u00e4rv\u00e5rd och sjukhus - V\u00e4stra G\u00f6talands l\u00e4karf\u00f6rening\" \/>\n<meta property=\"og:description\" content=\"Citatet ”s\u00f6ndra och h\u00e4rska” tillskrivs Julius Cesar. 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