Three years and counting...But not down for the count

I have been in a funk for the better part of the week: I haven't slept as well as I usually do (which really hasn't been great of late, but now it's more disrupted), I've felt somewhat unmotivated, I'm having trouble concentrating. But I know what's happening: today is the third anniversary of when P__ went into the hospital. Saturday, the 24th, will be the third anniversary of his death.

Last year, I met someone who had lost her husband. Not in that hospital, mind you, but she did mention that while it had been several years since she'd lost her husband, she still found herself withdrawing a little at the anniversary time. (She also said that she started dating about two years after her husband died.) I'm not sure how long it had been that she'd been widowed, except that it was only a few years longer than I've been there.

In some ways, I envy her. She has gotten on with her life. But I feel like my life is in a holding pattern. Why? Because of the lawsuit.

Do I regret bringing on the lawsuit? No. I'd file it again in a heart beat if the circumstances re-presented themselves. What I am angry about is why I had to file: because of blatent disregard for human life by those in the medical field. If others--enough others--had fought when their loved ones had been harmed at this particular facility, then maybe P__ would still be alive.

Which is why, after three years, I'm still fighting, so that others might have a fighting chance.

Another dissatisfied patient

If you've read through this blog thus far, you may have noticed the list of patients who've mentioned problems with Northside Hospital thus far. (Note December 19, 2007's posting.) This, along with the mention by one of the comments (listed under the first posting) by an RN who brought her ex-husband home rather than subject him to one of the "non-critical" (ie, ICU, CCU, et al) floors, is just a small fraction of Northside's former patients who are unhappy with their care (or lack thereof) recieved at Northside, I'm sure.

One of the patients mentioned in December 19's post now has my attorney's name, phone number, and email address, as well as the phone number for the Agency for Healthcare Administration. He is planning on filing suit, also.

I'm sure that if enough people complain and/or raise a stink over the treatment of this hospital, someone has got to listen.

Christmas--Merry or not, here it comes...

Christmas after the death of a loved one is rough.

When it could have been prevented...

The week from H@#L

Wednesday

P__ requested that I call 911, as s/he was having trouble breathing. We wanted him/her 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/her breathing, but when it became apparent that this was not helping, P__ was intubated. P__ was placed on Diprivan to keep him/her 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 moved 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 “s/he has white hair and s/he’s 71, therefore, s/he’s deaf.” He never bothered to ask if P__ was deaf (s/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
Both days are unremarkable; not needed here.

Saturday

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/her, the nurse assigned to P__ seemed very unsure of herself about giving him/her 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. When 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.

Remainder in the next post.

Most nurses are good...

I read (and reread) a comment on my first post and I feel the need to clarify one or two things. Here they are:

First of all, I honestly feel that the majority of those in the medical field are in their chosen field for all the right reasons. Most of them want to make a positive difference in this world by making a positive difference in their patients' lives. Granted, the pay is better than in many other fields, true. But in many cases, the pay is not nearly what it should be, especially for those working as nurses (both RNs and LPNs), nurses' aids, paramedics and EMTs.

Example: In the early 1980s, I had left a local fire department as an EMT. Loved the job. I seriously considered putting in an application with the local ambulance company. (It is not the same company that currently serves Pinellas County.) However, upon finding out what EMTs were paid with the ambulance service at the time, I decided against it: the pay was slightly above minimum wage; I could have made more flipping burgers at a fast food restaurant. Thankfully, paramedics and EMTs are paid better now--as well they should be. As well as most people in the medical field should be.

My sister is an RN, and worked in Pinellas County for approximately 20 years. She absolutely loved her job. She has now moved out of state and is weighing her options to either get licensed in her new home state or to retire. It's a call only she can make.

Which brings me to my next point: In every job, one can point to people, both male and female, who should not be working in their field. Either they're in the wrong field completely or they have been in the field to the point that they have burned out. In the latter situation, sometimes simply taking a leave-of-absence is all that is needed: three to six months of recharging one's internal batteries and they're "good to go". Other times, though, it is best to simply admit to yourself, "That's it. I've given all I've got. Time for something else." Maybe teaching skills to a new generation is a good call; other times, a more drastic change is needed.

Also what may have been a problem in Northside (heck, "may have" nothing; I saw it as a definite problem) is not enough staff. While the CCU amazed me in Northside, with their 1-1 nurse to patient ratio (2-1 patients to nurse for the "better" pateints) and the caring the CCU nurses showed, the floor was nothing short of atrocious. Okay, so Northside, as with other HCA hospitals, is a "for-profit" hospital. To increase the profit margarine, costs have to be trimmed somewhere. But to trim costs by not hiring enough nurses and other medical personnel is unconsciounable.

I truly feel that most nurses would not treat P__ as s/he was treated at Northside. But the fact that even one or two did makes me question what is more important in the eyes of the personnel and CEO of the hospital as well as that of the entire HCA system: money or people?

You decide.

Next time, I'll include the beginning of the notes I sent an attorney who is considering taking the case. (Enough people, it may become a class action suit. But that may be getting ahead of myself.)

Not the only one...

Several years ago, I was having chest pain. It was a Friday evening and I was getting ready to fix dinner.

"How 'bout we go to the ER?" P__ asked. I agreed and told my younger two, both in their 20s, that they shouldgo ahead and fix themselves something to eat.

Since Northside Hospital was the closest one, P__ drove me there. As soon as I signed in, I told the triage nurse that I was having chest pain.

"Okay. Go have a seat. We'll call you."

"But I think I may be having a heart attack."

Not even a look up as the nurse reiterated, "Fine. Now, go sit down. We'll call you."

Several minutes later, a young man on crutches was called in. I looked at P__ quizzically. Someone on crutches called in before a possible heart attack?

An hour passed, during which time, P__ and I talked to the triage nurse several times; we were told we had to "wait your turn." One woman, who'd arrived before us, mentioned that an elderly woman had waited an hour and had been taken in just before we arrived. The elderly woman had been brought in by ambulance for a heart attack. "According to someone who was here when she came in, she only had to wait an hour before being brought back," the woman told me. The elderly woman later died. Did the wait kill her? Possibly; we'll never know.

In the end, I waited an hour-and-a-half. It might have been longer, but several people ahead of me, angry that a possible heart attack had to "sit down and wait", told the triage nurse to take me next. Pathetic that several lay-people had more medical common sense than a triage nurse in an Emergency Room.

At the other end of the spectrum, I brought P__ to Bayfront Medical Center for a heart attack in early 2005. I took P__ by cab, as I didn't want him/her to wait forever in Northside. From the time I signed him/her in and the time s/he was brought back was less than five minutes. Was Bayfront's ER empty? Hardly. There were probably 10-15 people waiting to be seen. But while Northside ER's protocal seems to be a "what-your-turn" attitude, Bayfront's is truly one of Triage: critical patients are seen ahead of less critical ones; chest pain trumps sprained ankles any day of the week, any time of day.

Since what turned out to be my non-heart attack, I have become a magnet for horror stories about Northside.

1. Jack P., one of my neighbors, went to Northside by ambulance for a heart attack. He went into full cardiac arrest twice on the way to the ER. There, a nurse put a shunt into Jack's arm and gave him some morphine. "As soon as you wake up from this, we'll take care of you," she told him. When he woke up an hour later, he was laying in a pool of his own blood; the nurse had forgotten to cap the shunt. When he managed to get her attention, she came over and stated, "Oh, it's a good thing I saw this. A little while longer, you might've died!" It was another hour before they started work on him. This, on someone who had two cardiac incidents on the way to the hospital!

2. Jack's mother also was a patient in Northside. She went in for relatively minor problems and came out with, among other problems, a systemic staph infection and pneumonia.

3. A cab driver who picked my son and me up a year ago stated he was back after being in the hospital for several weeks. "My doctor sent me to Northside. I guess they were okay. Of course, I did have to wait six hours in the ER." What was he in for, I wondered. "I was throwing up blood. They had to empty one of their trash cans a couple of times while I waited in the ER because of the blood." While he waited six hours!!!

4. Another driver who knew both P__ and me told me last week that his father went into Northside with breathing problems; N.side's incompetence nearly killed his dad.

Little wonder that I wanted to take P__ to Bayfront instead of Northside.

I did contact the Florida Agency for Health Care Administration. They were able to confirm most of my complaints from P__'s stay there. On one of the two complaints that they could not confirm, I have witnesses: the cab driver who came to pick us up when P__ was discharged, and the run sheet from the responding Fire Department (as a result of calling 911 when P__ collapsed).

I will not be silenced. I will be heard. And I will do so legally, as that is the way to see a moral win here.

But then, I'm sure that, as a for-profit HCA hospital, Northside knows nothing about morals.