My hospital(ist) rant
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As I mentioned, Mrs. George has had two ER visits in the last 10 days because of this nasty MoFo of a virus. I won't talk about the treatment of her illness, but the protocols, etc of how it was handled.
I drove her to hospital #1, the place I used to work, 10 days ago. I pulled up to the door, snagged a wheelchair and rolled her in. Admitting staff took her basics, and put her in the waiting area while I parked. This was at 10:30 AM. Sunday AM, ER not too busy. At noon, they called her back to the actual room where she finally got to lie down. Did vitals, ER doc orders bloodwork, etc. At 1PM the ER doc comes by and says it's probably a nasty virus, and they're going to do some breathing Rx after a chest x-ray. He says he's going to hand off care to the PM doc at 3:30. Chest x-ray is at 1:30. Bloodwork is unremarkable other than an elevated white count. PM doc introduces himself and says it's probably OK to go home as long as we have a pulse oximeter to monitor deterioration and to come back if things go south. After instructions, I identify myself as a doc who worked there. He asks me if I know Bob XXXXX - one of my partners. He went to college with Bob. We have a pleasant chat and he calls in prescriptions to Walgreens that we pick up on the way home. We're home by 5 PM.
Mrs. George does OK for several days, but by Saturday, the day D4 comes out of the hospital, things are bad. By Sunday, she's exhausted from the constant, constant coughing. Coughing to the point of nausea and vomiting. Though she's drinking, she's not eating. She doesn't think she can make it down to the car (even with a wheeled walker that we have) so it's a 911 call.
Parmagics arrive, put her on O2 and a stretcher. They ask "Where do you want to go?"
I tell them my preference is where we were last week. I'm told that's too far for them, and my choices are the University Level 1 Trauma Center or the closer community hosptial which is affiliated with the University place. We figure we'll fall into the hell-hole of the big house and opt for #2.
I followed the ambulance there, and by the time I got there, she was in room 5. The doc had seen her, ordered labs and chest x-ray and started a nebulizer. This was about 11 AM. We spent the next 5 hours there with labs and x-ray being unremarkable. Her sats were on the low-ish side so they put her on O2. At about 5 the doc came in, and I met her. She agreed that an overnight admission would be prudent, and while we waited for a bed, I had to go home. D2 had been at home looking after D4 who got discharged the day before and she had to head back north of the Cheddar Curtain.
She sounded pretty shitty when she called, but it was early in the stay.
Fast forward to Monday (yesterday) morning. She had STILL not been seen by a physician, 12 hours after transfer to the floor. No one had examined her, taken a history or discussed a plan of care.
I stopped by yesterday AM at about 10 AM and I spent a couple of hours. The only staff that interacted with her were the nursing care coordinator and the floor nursing staff. I left at noon. Throughout the day, she improved, and nurse commented that she could be discharged in the afternoon with the addition of a couple of medications - an antibiotic and steroids. They were called into Walgreens. We left the hospital at about 5.
This morning, I checked Walgreens, and there were no prescriptions waiting. I called the hospitalist who signed off on it and got voicemail. I called the nursing care coordinator and got voicemail. I found another # for her and told her that although the chart shows prescriptions were called in, there was nothing at Walgreens for her. How should I proceed. She said, "I'm not in the hospital right now, and I don't know what to tell you. Call your PCP."
You're the nursing care coordinator, and you don't know what to tell me?
Why did she not see a physician on her admission?
Another care to "the hospitalist" service went to voicemail.
I ended up calling Mrs. George's primary at Northwestern, and they're working on it. As of 8:30, no response.
At NO TIME during her stay on the floor was she seen by a doctor.
At. No. Time.
THere's a note from an APRN that details a physical exam at 11:18 am. I was there at 11:18. No such exam happened. She claims that her observations were referred to the hospitalist.
I am beyond disgusted.
I don't care how fucking sick I am....never let me go to this place again.
Note the times of these notes.
In the APRN notes, she comments that husband is at bedside....I NEVER WAS THERE during the exam.
The alleged call-in to Walgreens
Strongly worded letter to follow.
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What really pisses me off is that the APRN notes that she saw Mrs. George at 11:18. I was there and it didn't happen. Perhaps she put the note in at that time and saw her earlier - I was there at 9:15.
Regardless, NO DOCTOR saw her.
No. Doctor. Saw. Her.
I am beyond furious. This is just shitty, shitty care.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@George-K said in My hospital(ist) rant:
What really pisses me off is that the APRN notes that she saw Mrs. George at 11:18. I was there and it didn't happen. Perhaps she put the note in at that time and saw her earlier - I was there at 9:15.
Regardless, NO DOCTOR saw her.
No. Doctor. Saw. Her.
I am beyond furious. This is just shitty, shitty care.
No, that's negligence, malpractice and fraud.
Always remember, Operation Valkyrie was an act of sedition.
Warning: I post things that interest me. Read and comment at your own discretion. -
Is there enough for a
ambulance chaserlawyer to take up a case on contingency basis?Where else can you complain? Some sort of state regulatory body, professional ethics board?
Srsly, what’s the recourse for the regular people when sh!t like this happens to them?
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@Axtremus said in My hospital(ist) rant:
Is there enough for a
ambulance chaserlawyer to take up a case on contingency basis?Where else can you complain? Some sort of state regulatory body, professional ethics board?
Srsly, what’s the recourse for the regular people when sh!t like this happens to them?
I think there's a malpractice claim in there, but harm would have to be proven. I know there's a CMS complaint (once they get the EOB showing that Medicare paid for care not given) in there, which should lead to a CMS investigation.
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"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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George, sorry to hear of this. You're juggling (or you're the glue?) holding lots of family together, and while there is no one better... it sucks it's on your shoulders. I was hopeful during the 2nd visit that she was seen so quickly as compared to the first hospital, but after she was brought to a room... nothing. Aside from rage, I am genuinely curious what their story is. Why wasn't she seen? Why was it written that she was?
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@89th said in My hospital(ist) rant:
I am genuinely curious what their story is. Why wasn't she seen? Why was it written that she was?
It's possible she was seen before I got there and the note was entered at 11:18.
But I doubt it.
Also, the only person to speak to her before discharge was the floor nurse who assured us that all the prescriptions had been called in to Walgreens.
I was hopeful during the 2nd visit that she was seen so quickly as compared to the first hospital,
I really can't complain about the 1st hospital. We drove in, and they saw that she wasn't acutely ill, and had us in the waiting area. It was uncomfortable, but not horrible. The second place, she came in on a stretcher from the bambulance, on oxygen... triage is what they do.
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@Jolly said in My hospital(ist) rant:
No, that's negligence, malpractice and fraud.
Yes. The doctor and nurse should be punished in some way for lying. It is fortunate that Mrs George did not have any bad consequences from their neglect, but if they did it once, they will probably do it again (or they probably have already done it before). Boo!!!!
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@George-K said in My hospital(ist) rant:
No harm was done.
You know the triad - injury, cause of injury, standard of care.
There's no malpractice here - it's just shitty medicine.
Seems to me, care denied on purpose is care not given. Care not given results in a longer illness with the associated effects of such, which is harmful to the patient.
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So sorry, George - this sounds like an awful experience
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After spending the entire morning yesterday, trying to get these prescriptions filled from Hospital #2, I gave up.
I sent an email to her primary doc at northwestern explaining everything. I also called and explained the situation. I was told they'd try to get back to me same day. They didn't.
I got a call this AM (about 10 AM) and the nurse said that they are not comfortable prescribing the medication without seeing the patient - totally correct.
So, we have a video visit this PM at 2:40 for some steroids and antibiotics.
Well done...
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Another note - hospital #2 has had a bad reputation for decades. In fact, it's been a standing joke of a place for a long time. When I went into private practice (at hospital #1) I was, overall, impressed with the quality of care. We had some surgeons come from #1 to do cases, and some of the internal medicine guys did as well. They were, for the most part, competent. Gradually, the more I worked with these guys, my impression of #2 started to change.
It can't be that bad, can it?
And then a large teaching hospital bought #2. Teaching hospital has a good reputation and some of my partners trained there. If you recall, our transportation options were teaching hospital (unknown duration of stay in ER) or #2, with the likelihood of being seen quickly higher.
It can't be that bad, can it?
Boy were we wrong. @kluurs can relay some stories about #2.
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Back in the day (45 years ago), I worked for the National Cancer Institute. My position there let me know a lot about the various hospitals in the state. There were two where we just heard stories that meant we'd never let any family member go there. We had a staffer who lived near #2 - and would come in with horror stories.
Fast forward a couple of decades and my FIL was having a cardiac event, and MIL decides to drive him to #2. My spouse says "NO!!!" - take him to #1 - a major trauma center. But...it's easier to park at #2 - and "don't argue with me!" Get there - and while they didn't kill him, they came close. Fortunately, out-of-state BIL is a pathologist and called to say "get him the F out of #2" - so, he got transferred - went into arrest at #1 - but was successfully cared for - and lived 15+ more years.
Driving by #2 hospital a while back and noting the new Major Hospital Medical Center on the sign, I was wondering if this meant hope for hospital #2.
We had a B- kind of hospital in my town which become affiliated with a different Major Medical Center a while back - and has improved dramatically - to maybe an A-. I thought, well - maybe this means #2 may have improved. Based on George's experience, clearly, the 45 year reputation remains. If you get shot by a drive by while standing on the steps of that hospital, might be worth your while to Uber over to Hospital #1.
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These sound like the horror stories you occasionally hear about British hospitals, which is normally blamed on the NHS being hopeless. My own personal experience with NHS urgent care was that it wasn't that bad at all (non-urgent care is a somewhat different matter, with waiting lists going back to the time of the dinosaurs), so maybe that is more hospital based as well.
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Nurse called at noon, "Can you do a 2:40 appointment?"
"Sure! This is a telemedicine visit, right?"
"Er, no. You can't come in?
"Nah, too much of a trip and wait in the waiting room."
"No worries. 2:40 telemedicine it is."
Doc called about 40 min late (we would have been sitting in a waiting room all that time). Pleasant conversation, and she called in the scripts.
Easy.
She said that hospital #2 has a rep for being "sloppy."
