Northside Hospital FL problems

Where failure to care has the potential to maim--and more.

Name: feminist writer
Location: Tampa Bay, Florida, United States

I am a freelance writer with a BA in Mass Communications from the University of South Florida St. Petersburg. (Go, Bulls!) One of my favorite quotes (thank you, Finley Peter Dunne): "...Comfort the afflicted and afflict the comfortable." Some things inspire me: people who strive to make a positive difference; sunrise or sunset--especially at the beach. Some things that make me angry: those who can't be bothered to do what's right; the fact that the medical and legal system frequently looks at people's finances before deciding whether or not that person should have access to their services...I could go on...

Sunday, January 20, 2008

Contrast

Talk about a difference in care. I spent the weekend at Bayfront Medical Center (1/11-14), then for a "pit-stop" in their ER this past Friday. I figured I had the option of going early enough to have a friend drive me there or wait until later, call 911, and end up at N.side.

Okay, here's the deal. First off, Bayfront's ER seems to have a grasp on what triage means. Yes, people are seen on a first-come,-first-serve basis, with a definite change: If someone has been sitting in the ER with, say, a probable sprain, broken toe, etc., and someone comes in with chest pain, altered neuros, etc. before the sprain is seen, the chest pain is seen first. This is how is should be.

While spending the weekend there, from what I observed, whenever a call light is pulled, if a nurse or Patient Care Tech is nearby, they'll pop in and ask what is needed. Otherwise, within a matter of seconds, the room's intercom will come on and whoever is manning the nursing station full-time will ask what's needed. If no response, or if a response that is urgent, someone is in the room STAT. Flip side is that if it's not an immediate emergency, it may take a minute or two, especially if there is an emergency elsewhere on the floor. However, I never saw anyone, even in a non-emergency, have to wait long. Certainly not ten minutes, and definitely not ten minutes without checking on the patient, which is one of the complaints I had with P__'s stay at N.side.

Another issue at Bayfront: Everyone seemed to know what he or she was doing. The only time it looked like someone might have a problem was when my IV had to be changed. I've got veins that like to roll, move, and otherwise do "the funky chicken" when they see a needle. This is on good days. After several days of being stuck, they were even funkier. The nurse assigned to my room told me that she'd get the charge nurse, who was a pro at hitting hard-to-get veins. When in deep, call for help. This is different from the nurse at N.side who told P__ and me, "I'll figure it out," when she had to use an inhaler she was unfamiliar with. I have more respect for someone who knows they have a problem and asks for help, especially on something as important as someone's health.

Finally, when I was discharged, I had K__ (my cab driving friend who was going to help pick P__ up) waiting downstairs for me. The nurse had a wheelchair waiting and said that, no matter what, they always insist on having someone discharged from the hospital in a wheelchair with a nurse wheeling them down. This, of course, is another difference with N.side's treatment of P__.

Which begs the question: Why can't N.side take a few lessons from a hospital? They sure need it!

Labels:

Friday, December 21, 2007

Wednesday's meeting

This past Wednesday, my attorney and I met with an attorney from N.side, along with someone from risk management for unsworn depositions. Of course, I can't go into detail on what happened. But I will state: N.side's people did not seem happy.

Which is fine with me.

Now comes the wait-and-see.

Saturday, December 15, 2007

First Meeting

My attorney and I are scheduled to meet with N.side's attorneys on Wednesday, December 19, 2007. It won't be sworn depositions--not yet, anyway. But this is where N.side's attorneys hear our side of the case.

Should be interesting.

I wish I could write more. But those of you who have followed this blog thus far can understand why I can't, at this point in time.

Let's just say, things are heating up.

Wednesday, November 07, 2007

Another recap of the hospital stay

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.

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, her 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.

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 she helped 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 brought me the discharge papers and a wheelchair. She informed me that since they were extremely understaffed, would it be possible for me to please bring P__ down to the main entrance and help him to leave? Again, I simply wanted him out of there. (By now, she still had not taken another blood pressure--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.

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.

And the clock is ticking...

I received a letter from the attorney today; it was a copy of the letter sent to N.side, putting them on notice. The hospital now has 90 days in which to either respond to the attorney. If they don't respond, it looks like we'll then request a court date.

I would love to share every little detail in the letter from the lawyer. However, at this point, it would be better for me to remain silent. The truth will come out soon enough, without my jeopardizing the case.

I did, however, want everyone who has followed this saga thus far to know what is happening, that, indeed, things are now really progressing. When I can reveal more, I will.

Sometime in the next few days, I may repost the timeline of P__'s hospital stay. Anyone wishing to read (or reread) it, please be advised it was originally posted in December.

One last thought: Those who've had problems similar to what has been revealed on this blog, be assured that, if one follows through legally, you have a chance of making a difference for those around you. You may not bring your loved one back, but you can make a difference for others. Please keep that in mind.

Tuesday, October 23, 2007

First Anniversary

Tomorrow is the first anniversary of P__'s death. He died at 10:44 p.m., Eastern time. I contacted the St. Petersburg Times's obit department; there'll be a short "In Loving Memory" for him.

If only...if only...

Does the term "for-profit hospital" seem like a conflict of interest when it comes to treating a patient?

Tuesday, September 11, 2007

AHCA reports

Friday, I recieved the last of the AHCA reports from my attorney. She had forwarded the main batch earlier. With the last batch, though, was a note saying we needed to talk. The appointment is set for tomorrow. Wow, do we have a lot to talk about.

At this point, it's probably not the best thing to release all the notes I've written in response to N.side's version that they gave AHCA. Suffice it to say that I found error after outrigtht indications that N.side was practicing more than their share of CYA.

For anyone else who has had problems with N.side who hasn't contacted an attorney, please be advised that it's my understanding that, in most cases, you have two years to file suit. There may be a loop-hole, time-wise, but don't count on it. Try finding an attorney. If the first one turns you down, contact another. And another. But you have to be the one who decides whether or not it's a problem which needs to be brought to the attention of a lawyer. Did the ER give you one bandaid rather than two? A nurse took 45 seconds to respond to a call light rather than 30 seconds? I wouldn't bother. But a medical screwup? That's another thing.

Will keep everyone posted...

Sunday, August 19, 2007

In Response

There is a recent comment posted to my August 7th entry ("Well, it's about time...") from a nurse who worked at Northside. I wanted to respond.

First of all, thank you for your condolences.

Now, for the nitty-gritty here: FOR-PROFIT HOSPITALS!!! Nurse, you hit the nail square on the head. I want to thank you for telling it from a nursing stand-point. My sister was a nurse for a number of years in one of the local HCA hospitals (no, not Northside, but that's as much as I'm saying, unless I have her permission to state which one). I knew that there were other HCA hospitals in the area.

From what I have read/studied/discovered, when a hospital is a for-profit facility, the profit-margin (or bottom-line) becomes the Most Important Part of any decision. Why? Profits. (No brainer here.)

For example: Let's say you have a ward with 30 rooms, 2 beds each, for a possible 60 patients. Well, if the hospital can get by with 2-3 nurses for that ward (rather than 6-8), then have them work 12-hour shifts (rather than 8), look at the savings. Now, say we're paying the RNs an average of $25/hour. Three nurses per twelve hour shift times two shifts per day comes to $1,800 (3 X 12 X 2), while having eight nurses for each of three-eight hour shifts comes to $4,800 a day. There's a salary savings of $3,000/day/ward--and that isn't even figuring in the benefits, such as health and life insurance, worker's comp, etc. (Therefore, better for profits if you have two-12 hour shifts, rather than three-8 hour shifts per day.)

What does this mean for the nursings staff? Rapid burn-out. Why? It's simple: if a person is over-worked in a facility that is understaffed, expected by doctors, management, etc. to do the majority of the hands-on patient care, while trying to keep up with the demands of the patients, you're going to find yourself chronically exhausted and, in the end, burned-out.

True, we need hospitals, but to put profits above patient care is inexcusable.

Then, there's the toll that it takes on the patients. If the theoretical 30-room-2-bed-per-room ward is full and there are only three nurses working the floor for a 12-hour shift, what kind of care can a patient expect at the end of that shift?

That said, there were definite screw-ups on my husband's care. How much was from exhaustion, how much from burn-out, how much from a simple "I don't care" attitude, I don't know.

According to a paper I did this past spring for an expository writing class, if you have two hospitals across the street from each other, identical in every way--same services, same types of wards, same out-patient services, etc--except that one hospital is a For-Profit facility, the other is a Not-For-Profit facility, your chances of dying in the For-Profit is between 5-25% higher than the Not-For-Profit (depending on whose statistics you look at). We're not looking at critical-care-patients vs. patients in for a simple X-ray; we're comparing similar patients. And while 5% may not seem like a big deal, that's still 5 people out of 100; 50 out of 1,000.

Nurse, while your hot-button issues are taken from the front-lines of the hospital and mine (at least here) are from the patient/patient's family's point-of-view, it sounds like we have the same complaint here: FOR-PROFITS are a death waiting to happen.