Friday, July 25, 2008

The 3R's

I am pretty into reducing, reusing and, of course, recycling. I can't bear throwing away a piece of paper that has writing on only one side of it- I keep it in an incredibly large "scrap paper bin" and try, in vain, to write as many notes and checklists as possible. (I feel like I have saved at least half a tree in my lifetime due to this incredibly inefficient, drawer-cluttering process). I am a huge proponent of reusable shopping totes and washable lunch bags; and I force this practice on others. I take short showers every 1-2 days. Although my boyfriend thinks this is more out of laziness and bad hygiene, I'd like to think the few liters saved per month could be the very ones putting out a brush fire in California. I eat gluten-free, not by choice, but I think that it might have fewer additives and pesticides, so that has got to count for something. All in all, I consider the carbon foot-printing of my personal life pretty respectable.
In my professional life, however, I am creating a shocking amount of poorly-disposed-of waste. And I am not really sure what to do about it. I see possibilities for reducing and recycling everywhere (reusing is not such good idea in the hospital setting). Here is an example from the Labor and Delivery unit at a particular hospital. Immediately before a Cesarean Section begins, the circulating nurse pours the contents of three plastic liter bottles of sterile fluid into basins. These clean bottles, having touched only a nurses gloved hands, are then usually thrown in the medical waste bin. In this OR, there were apparently issues with (highly educated) health care practitioners mistakenly throwing bodily-fluid-saturated OR waste into the regular trashbags. Complaints were made by the Environmental Services staff regarding this misdisposed waste, and the decision was made to remove all regular (white) trashbags from the OR so that all OR waste would be disposed of in red (Regulated Medical Waste) trashbags. According to the NY Department of Health, RMW must be autoclaved, which may cost a hospital 10-20 times more than the disposal of non-regulated waste. For the life of me, I can not imagine who would approve this egregious waste of the hospital's money. Before each case, a tech must construct the operating table, which entails the opening of anywhere from 20-50 packages (all individually wrapped for sterility). This may be done minutes or hours before the patient enters the Operating Room. All the sterile wrappings are, by default, thrown in the medical waste. At the start of the operation, in this particular OR, there is usually already a full red trashbag of perfectly clean wrappings.
I have been unable to locate a reliable source of statistics about medical waste, but the Internet consensus is that US hospitals generate 2 million tons of medical waste annually. Certainly, any piece of material saturated with blood should be disposed of in the hazardous waste bags, for the protection of the people who handle the garbage. However, in the above example, empty bottles could be recycled the in the same way as empty bottles of drinking water. Trash generated before the surgery begins, having never touched the patient, can be safely disposed of in the same way as office trash. Some education, common sense and conscientiousness on the part of health care professionals could probably save a hospital a substantial amount of money. And maybe- just maybe- a portion of the savings would trickle down to make American health insurance more affordable?

1 comment:

Science Among Friends said...

Bravo! There is often more to consider than safety and efficiency, even in the life-and-death backdrop of hospital care. This blog entry gives me hope that the green culture so treasured these days by advertising moguls can filter - in a responsible manner - into our hospitals.