This will be a repost for anyone new to the blog. It is basically a repost of April 9's post:
For anyone new here who doesn't want to go looking for what happened to my husband at Northside, I'm going to repost what happened here:
Wedneday, Oct. 18, 2006
P__ requested that I call 911, as he was having trouble breathing. We wanted him to go to Bayfront Medical Center as P__ had received good care there in the past, as well as the fact that Bayfront has the only Trauma Center in Pinellas County. Instead, P__ was taken by ambulance to Northside Hospital, an HCA hospital.
Once at Northside’s Emergency Room, the staff responded quickly, within minutes. Dr. T___ was on-call at the time. (I’m not sure if he is a resident, intern, or if he has completed residency.) Dr. T___ attempted to use a facemask to assist P__ with his breathing, but when it became apparent that this was not helping, P__ was intubated. P__ was placed on Diprivan to keep him sedated. The RN assigned to P__ (A.) mentioned that, since many people are sensitive to Diprivan, he would keep a close watch on how it affected P__, which he did. As soon as P__’s blood pressure started to bottom out (at one point, down to 52/35), A. backed off the Diprivan to bring P__’s B.P. back, saying that once the BP came up, he’d try to find a happy medium.
Meanwhile, P__ started to regain consciousness, becoming combative. Dr. T___ came in and, with his face literally inches from P__’s, started screaming at P__ to calm down. At that point, A. came in and physically had to move Dr. T___ out of the way to administer medication. Later, when I asked, Dr. T___ said that he yelled at P__ because “P__ is deaf.” When I asked how he figured that, he stated that he “knew” this because “he has white hair and he’s 71, therefore, he’s deaf.” He never bothered to ask if P__ was deaf (he wasn’t), just assumed. This assumption was not a big deal, but it begs the questions: What else does he assume about his patients? How does this affect their treatment?
P__ was brought up to the CCU later the same day.
I requested both in the Emergency Room and the CCU that P__ be transferred to Bayfront Medical as soon as possible for two reasons: (1) it was our preference (due to better care), and (2) our insurance, United Health Care (Medicare Complete) didn’t have a contract with HCA hospitals at that time.
Thursday, Friday October 19, 20
Both days are unremarkable. P__ slowly got better, to the point where he was allowed to regain consciousness by Friday morning; the tube was removed several hours later. Nursing care in the CCY was as good as it should be: caring, competent, good nurse-to-patient ratio.
Saturday October 21
I visited for 1 ½ - 2 hours in the early afternoon, then went home for 1 ½- 2 hours. During this time, the hospital called and said that P__ had been transferred—NOT to Bayfront Medical, but to room 243, bed 2 (B?).
When I came back to visit him, the nurse assigned to P__ seemed very unsure of herself about giving him some medication by inhaler. It was a type of inhaler that we were unfamiliar with. P__ has used what is referred to as “rescue inhalers”, as well as a nebulizer in the past, and had received breathing treatments in the CCU as well as when he’d been in Bayfront. We were not familiar with the kind that the nurse was getting ready to use. According to the nurse, it was supposed to crush a pill so that P__ could inhale it. The nurse kept asking me, “Do you know how to use this?” When I told her I didn’t, she said that she would figure it out. I suggested she find someone on the floor who knew how to use the inhaler; she stated that she didn’t think anyone on the floor knew how to use it. I then mentioned that maybe she should contact Respiratory Therapy and get a Respiratory Technician up to the room either to administer the medication or to show her how to do it. At that point, the nurse stated, “No, that’s alright. I’ll figure this out." After having P__ breath twice into the inhaler, the nurse opened the inhaler, looked inside, and stated, “The pill is gone. I guess it worked."
While this nurse was in the room, I discovered through small talk that (1) she’d been an RN for 20 years, and that (2) she was nearing the end of a 12-hour shift.
My point is that if she was unsure of how to use this inhaler—or how to do any procedure—she should have asked for help. The pill in the inhaler may have been inhaled properly—or it could have lodged in any part of P__’s air passages.
Sunday October 22
Before I left home to visit, P__ called and asked if I would call the nurses’ station. When I asked why, he stated that he had gotten up to use the portable commode and that when he got up, his nasal canula had become disconnected from the oxygen supply. He stated that he had pulled the cord for the call-light and waited for 10 minutes for a nurse to arrive while trying to reconnect the tube.
I immediately called the nurses’ station and told the person who answered that someone needed to check P__ and why. That person told P__’s nurse, “You need to check room 243. He needs help reconnecting to his oxygen,” to which I heard the male nurse reply, “I was wondering why the light was on for the past ten minutes!” Ten minutes—and the nurse hadn’t checked? P__ could have been having chest pains, a possible heart attack, stroke—any number of problems.
Thing is, P__ was always fairly accurate about time; I kidded him about this over the years. I had watched him keep an eye on the clock on numerous occasions, to the point that if he told me he had waited 10 minutes, it was (fairly reliably) somewhere between 9 1/2 and 10 1/2 minutes. Also, I had overheard the nurse reply about the light being on "...for the past ten minutes."
Monday October 23
I received a call in the morning from P__ that he was to be discharged that day. He also mentioned that his hip was hurting. When I inquired if he had fallen, he denied falling. (He had broken his shoulder after a fall in May, so I was concerned about possible osteoporosis.)
I arrived around noon and was informed (by P__) that he had had nothing to eat that day. There was a food cart in the hallway, and other patients were observed to have lunch trays. I asked P__’s nurse why he had not received any meals that day, as he was diabetic and required both food and medication to keep his blood sugar levels in check. The nurse told me that since he was scheduled to be released, no meals had been ordered. I had to ask several times to have a meal brought up before one was finally ordered.
During this time, P__ continued to complain that his hip was bothering him. When I inquired about the possibility of having an X-Ray done, I was informed that one wasn’t necessary. “After all,” I was told, “we can’t X-Ray everyone for every little ache and pain.” This was said after I mentioned my concern over possible osteoporosis, both because of his age and the broken shoulder several months before.Between 2:45 and 3:00 p.m., P__ said he needed to use the bathroom. He stated that he had used the bathroom earlier (with the help of a walker), that his hip had hurt when he had walked to the bathroom, so I asked his nurse if it was okay for him to attempt to get up and go to the bathroom and was told it was okay.
However, when P__ attempted to get out of bed, he fell. I pulled the cord for the call-light. When no one came, the family of another patient in the room ran out and got the nurse. She came in and stated, “Somebody put the bed too high. That’s why he fell.” After helping me get P__ back into bed, she took his blood pressure, which was elevated. She then reiterated that there had been several tests run on P__ that day and that “one of the technicians must have raised the bed and forgot to lower it.”
Note: The other patient in the room was only there for part of one day and signed himself out of the hospital AMA after P__’s fall. I overheard him tell his family that he didn’t trust Northside.
Around 3:30, the nurse came back into the room with a syringe. When I asked her what it was and what it was for, she told me that it was for the high blood pressure and that I didn’t need to worry about what it was. I told her that she really needed to take another blood pressure, as it had been 30-45 minutes since the one elevated one, and that that one had been taken immediately after a fall, that there was a good probability that the BP had come down enough to either not need the medication at all or, at the very least, a lesser dose of the medication. However, she informed me, “I don’t have time to take another blood pressure right now” as she injected the medication into P__'s arm.At 4:30, the nurse stated she was almost done writing the incident report on the fall and that as soon as she was done, she’d give us the discharge papers. She also told me, "His doctor is on the floor. Please don’t tell him about the fall, as then he might want to keep P__ in the hospital longer.” At that point, I simply wanted to get P__ out of Northside so that I could bring him to Bayfront Medical.
Around 5:00, the nurse brought me the discharge papers and a wheelchair. She asked that, since they were extremely understaffed, would it be possible for me to please bring P__ down to the main entrance and help him leave? Again, I simply wanted him out of there. (At this point, she still had not taken another blood pressure--or any other vitals--even after giving the still unknown blood pressure medication!)
I got in touch with a friend of ours who drives for cab. K. arrived at approximately 5:30. I wheeled P__ out to the cab. K. stated, "I thought the hospital was supposed to have someone here to help him out!"
At this point, P__ stood up and immediately collapsed onto the ground. K. came around to help me pick P__ up but we were unable to do so. I ran inside and told the girl who was working the front desk what had happened and asked that she call for help, STAT. She assured me she’d get help right away. Five minutes later, when no help had arrived, I went back inside and asked where our help was.“I’ll call Security back and see what’s taking them so long,” she informed me. Security. For a medical problem. Of course.
I then ran around to the Emergency Room and told the Triage Nurse what had happened and that we needed help. She informed me that if I would simply put P__ back into the cab and drive around to the Emergency Room door, they’d help us. At that point, I picked up the nearest phone and dialed 911 to get help. After being assured that help was on the way, I hung up. The Triage Nurse asked who I’d called; when I told her, she asked me if I didn’t think that was “overkill” (her words).
By the time I got back to the front of the hospital, where K. was still trying to keep P__ as comfortable as possible, a nurse and a woman from Security were out front. The nurse never once made an effort to help, but kept asking why we had P__ on the ground. She then heard the sirens in the distance and said something about someone coming to the ER. I told the nurse I’d called 911. Her response was to ask if I could call them off; the woman Security Officer told the nurse that once 911 is activated, they couldn’t be called off, to which the nurse made a comment about my calling 911 “ridiculous”.
When the paramedics arrived, they were able to bring P__ around to the ER, where he was readmitted. It wasn’t until after the paramedics arrived that the nurse who had come out made a show of helping; before then, she wouldn’t call for help or make any attempt at helping.
After P__ was readmitted to the ER, one nurse worked on him for several hours. Periodically, the nurse mentioned P__’s blood pressure being very erratic.
Tuesday October 24
Shortly after 2 a.m., while still in the ER, P__ suffered a heart attack...After being moved to the CCU, P__ was hooked up to seven or eight bags of medicine. I was told that four of the bags were for medication to bring P__’s blood pressure back up, and that the medications were being pushed to the limit. He was also in the Trendelenburg position to help bring the blood flow to his brain and heart.
That same afternoon, his primary care physician came in to check on him and to talk with me about P__'s prognosis. The last time I talked with Dr. ___ face-to-face was shortly before 6:00 p.m. on the 24th. I was getting ready to head home. The visiting hours in the CCU ran until 6:00 p.m., then resumed from 8:00-10:00. This way, the staff could finish charts, do end-of-shift care while the new shift came on and everyone could get a complete run-down on the patients. Very necessary, somewhat time-consuming (I imagine), very hectic. Also, I had only gotten an hour's worth of sleep the night before, so I figured I'd forgo coming back in that evening, opting for seeing P__ the next morning.
Dr. ___ arrived shortly before visiting hours were over. Around this time, a technician came in to run an EEG on P__ which a neurologist had ordered. The technician told me that he would run the EEG after I left, then immediately get the results to the neurologist. The tech was kind, asking me if I had any questions, giving me a brief run-down on the procedure. Meanwhile, Dr. ___ proceeded to tell me, "We need to pull the plug on your husband."
"Why?" I wanted to know.
"He has no chance at all of any kind of recovery or meaningful life. He is brain-dead. We need to pull the plug now."
Hey, wait a minute. Who let him into this nightmare?
"Excuse me," I told him. "You're expecting what from me?"
"We can't pull the plug without your permission. And we need to pull the plug on him now. Tonight."
I informed him that, first off, I wanted to see what the EEG showed.
"That won't change anything. He's brain-dead."
"I want to check with the neurologist."
"That won't change anything. We need to pull the plug. You need to give me permission to pull the plug." Meanwhile the two or three others (I really don't know who they were) pulled closer around him. There's strength in numbers, they seemed to be stating.
I pointed out that I needed to sleep on this and to talk with P__'s sister. Also, I was going to talk with the neurologist first. Also, if Dr. ___ couldn't pull the plug without my permission, he was not going to get it that night. End of discussion.
Sometime between 7:30 and 8:00, I called the CCU and talked with P__'s night nurse, C__. C__ mentioned that Dr. ___ had made more noise about pulling the plug. "However, the neurologist did look at your husband's EEG. If you'd like, I can page her for you so you can talk with her." I thanked C__ and told her that I wanted to talk with the neurologist.
"Good," she told me. "I promise, we won't do anything except to continue our care for P__ until after you talk with Dr. (neurologist)."
I only had to wait a few minutes for the neurologist to call back. While she said that the EEG showed little, if any, activity, she did offer me this much hope: four (4) days. As she relayed to me, "After an incident like your husband experienced, it's not uncommon to see very little brain activity." However, in her experience, the first four days after such an incident held the key: either the patient would expire on his or her own (frequently within the first 24 hours), or they would stabilize, after which it would become clear that the patient was being kept alive by machines (in which case, letting the patient go was probably the kindest thing to do), or there would be some sign of improvement. She likened it to stories most of us hear on the news during the winter months: a person will fall through the ice, remain submerged for half an hour before being pulled out, and walk out of the hospital a week later, missing only the memory of that week. "Personally, if it were my loved one," she stated, "I'd give him the four days."
After being assured that she would call the CCU immediately, I thanked her. Five minutes later, I talked to C__ in the CCU; she had just hung up with Dr. (neurologist) and agreed that I had done what she felt was best for P__: given him a chance.
When P__ finally died at 10:44 p.m., the nurse working on him said that when he died, his blood pressure suddenly went haywire.My problem with Northside Hospital is that: 1) P__ wasn’t transferred to Bayfront Medical once he was stabilized, 2) the care (or lack thereof) contributed to P__’s death. Yes, he was in his early 70s and had had two previous heart attacks... However, while P__ was in N.side, several doctors wrote that his heart sounds were good. The heart attack that figured into the death happened after the administration of the medication to drastically bring his blood pressure down—and this was for a one-time BP reading taken immediately after a fall and not monitored thereafter.
Labels: avoid this hospital, HCA Northside, HCA Northside Hospital, hospitals to avoid, Northside Hospital - Florida, Northside Hospital - St. Petersburg, Northside Hospital (Tampa Bay)
