Why RR Says Stay Away From The Hospital

April 7, 2008 on 9:48 pm | In Hospitals |

Helping you and your loved ones stay alive and stay healthy is a passionate mission for me to bring to members of the Baby Boomers Retirement Club. And I’m not sure why, but I seem to have a fanatical desire to spare other people from all the various unnecessary traumas and suffering that I’ve gone through.

So let me share with you a crusade I’ve been on since my mother died suddenly and unexpectedly at age 79, one sunny Sunday afternoon in early December, after a series of misdiagnoses, malpractices, missteps, and negligence that occurred at a large community hospital in Henderson, NV.

I don’t ever want this to happen to you. Or to someone you love. So I urge you to heed the warnings I’m about to give you. My mother was not in the hospital due to a life threatening situation. She had simply began to have a fever, and had become very bloated in her stomach. She seemed to have a lot of gas, and possibly constipation or an intestinal blockage. So on the telephone advice of her primary physician, she was rushed to the emergency room, where it was determined she might need abdominal surgery to identify and remove the blockage, and she was admitted to the hospital, on a Thursday evening.

I don’t know when the last time was that you were in a hospital, but a lot of things have changed in the last 20 years. Under today’s methods of medical practice, most of the doctors and specialists at hospitals are hired hands. They’re not “on the staff.” They are specialists who operate their own practices, and they come and go from the hospital on an almost random basis. Some of them are basically like temps, working on a contract basis, or even by the hour.

Their schedules and rounds are very unpredictable. They rarely know or speak with the other physicians who service the hospital, but rather communicate with the other generalists and specialists through patient charts and emails. You may think it is still like the old days, where your doctor knows you, and your case, and coordinates the other practitioners and technicians. But in reality, the whole thing today is little more than an impersonal assembly line.

On top of that, there is a severe shortage of experienced nurses. So there are all kinds of orderlies and junior nurses running around with little experience, just trying to do a job and stay out of trouble. It’s hard to find any reliable continuity in the process of care (but not impossible–see the tips in the attached article).

Many assessments and judgments are made with poor or spotty information; and there is a rigid hierarchy, where the underlings are very reluctant (and not required to) second guess or question the physicians, surgeons, anesthesiologists, etc. This is especially true on nights and weekends, when coverage is spotty, and often inexperienced or not well oriented to the hospital, and the handoffs to night and weekend staffers are often feebly done.

As a result, many mistakes are made, and an estimated 219,000 people die from these mistakes every year. Unfortunately, my mother was one of them.

When I visited my mother on the Saturday night before her death, she was cheerful, bubbly, and very lucid. She had a heart monitor on her to make sure that any glitch in her vitals would be immediately noticed by the nurses on duty. She was comfortable, and my wife and I helped her with various positional adjustments and even put chapstick on her lips, which were dry from the desert dryness. She needed some water, which we gave her. She said she was “dying to see the girls,” meaning her granddaughters, my then 4-1/2 year-old twin daughters, who hadn’t seen their grandma in almost a year. We left her happy and comfortable at about 9pm, to return the next day with the girls. We were assured that no procedures would be done until Monday.

By 2:30 the next afternoon, she was dead. My elderly father, who is ill with Parkinson’s disease, his caregiver, my mother’s home caregiver, and my brother had all visited my mother Sunday morning and noted that she was having difficulty and nausea because of the noxious preparation liquid for a colonoscopy that was being given to her on Sunday by force feeding, under orders of the remote gastroenterologist. This was after my wife and I were assured by a nurse she would not be given more of this fluid, because it was making her violently nauseous. But they were unaware of this agreement, and assumed that despite observing that my mother was struggling, “the professionals knew what they were doing.” Big mistake.

On Sunday by midday she was turning pale and having difficulty breathing. But, the heart monitor that had been in place when we visited Saturday night, had been removed Saturday night after my wife and I left.

Why? Because her vital signs were so good, the monitor was not necessary, according to the weekend attending physician (who picked up the case Friday night from the admitting attending physician, who was off for the weekend). Of course, he didn’t know that the preparation fluid had been re-ordered by the absent gastroenterologist, who didn’t know that the night nurse had been told to stop the liquid because it was causing distress to the patient and had agreed to do so. A new nurse on Sunday was just following orders that came in by email Sunday morning, and the weekend attending physician was nowhere to be found during this time until he was called in after my mother had already died of heart failure. By the time I was called by a staffer to come down to the hospital urgently, that my mother had “taken a turn for the worse,” (we had been planning to bring the whole family to visit her later in the afternoon), she was dead.

The weekend attending physician showed up shortly after I arrived, and his first words were, “I can’t imagine what happened–she was doing really well last night.” It turned out she had died from a massive heart attack due to the stress of the nausea and toxicity of the colonoscopy prep liquid, combined with the aggravated stress of what it turned out (on autopsy) she actually had been suffering from: kidney stones. The entire diagnosis had been wrong from the beginning. At least four physicians were directly involved in these mistakes.

But there is no recourse for malpractice in Nevada when the patient is 79 years old. Even if two loving 4-year old granddaughters have been robbed of their most important grandmother, who had patiently waited for so long until they could be brought into the world….

So what’s the lesson from all this? Here are the threefers on hospitals, for you and your loved ones.

1. Avoid hospital stays if at all possible. Much better to go in, come out, and have care at home.
2. If you have to stay in a hospital overnight, unless it’s an absolute emergency, try to avoid the weekends (such as for an elective treatment or surgery).
3. If you or a loved one has to stay in the hospital overnight or on a weekend, have a knowledgeable relative, friend, or caregiver stay in the room with the patient. Don’t ever hesitate to raise a concern, ask a question, find the floor nurse in charge, or demand a physician’s attention. Even threaten to call 911 if necessary (or do so, as a last resort if you are not getting the attention you need). Many omissions, unclear instructions on charts, drug interactions, overdoses, misprescribed medications, and other screw ups happen in hospitals due to the many factors discussed above. Have an advocate on hand to observe, demand, and protest if necessary. The life that’s saved may be your own, or your loved one’s. Yes–so many of these unnecessary family traumas can be avoided by following these threefers.

Also, check out this article from Readers Digest about night and weekend shifts at hospitals. It’s enough to scare you well! http://www.rd.com/healthy-living/health/night-shift-nightmare/article38715-3.html

To your health–

Richard