A Happy Hospital Story

For background, see here, here, and here

This morning, my father, brother, and I met with several St. Michael’s staff, including the director of the medical staff and the director of the nursing staff. It was a very cordial and informative meeting for me, and I hope it was for everyone else. We all left the room on the same side, so I’d call that success.

Of course, one thing that helped from our point of view was that the St. Michael’s staff was obviously very upset that such things had happened and were anxious to tell of us ways they’d already worked on to prevent such in the future. This, basically, is what we wanted.

The nursing supervisor on duty when my step-mom fell was devastated that something like that had happened on her watch.

We, as patients, learned a lot about how some hospital systems work. For example, we learned that when we need to call a nurse to be sure to say what we need, as they can get the message to the right person more quickly.

The director of medical staff explained some of the problems they were having implementing a hospitalist program and contracting with a separate firm for ER physicians. It was quite honest of him to say that these two groups of physicians do not always cooperate in a timely manner and explained how the hospital was working on this problem.

When we asked whether charges for the x-ray after the fall would be included in the bill, we were told it didn’t matter whether they were or not. Now this was upsetting at first – it seemed like the hospital was not taking responsibility for something they admitted was their fault.

But we were oh so wrong. That’s not it at all. My step-mom has Medicare and no matter what tests or procedures or how long she was in the hospital, they were going to paid the same, based on her problem at admission. To my way of thinking, that just ain’t right.

The final conclusion I have come to is that if the hospital staff had all got together and planned to have my father and step-mom treated as they were, they could not have planned it to be quite as bad as it was. These episodes are likely random ones and we were the unlucky family that lost the coin flip twice in a row.

Another Sad Hospital Story

See update here

A few weeks ago I wrote about an excruciating and medically scary 24 hour adventure my father experienced in an unnamed hospital. Read here and here, for that background. It’s time to name the hospital now:

Christus St. Michael in Texarkana TX.

I mentioned in that story that my step-mom was in the same hospital that my Dad was transported to. She’d had a hip replacement and was in rehab. She got out of rehab a few days after the ER fiasco and was doing pretty good getting around the house with a walker.

One morning a little over a week ago, she woke up with chest pains and too dizzy to stand. At the ER, it’s discovered she’s got a blood clot in her leg. It takes hours and hours (just like with my Dad) after the decision to admit her to actually get her admitted and out of the ER.

When she’s in her room and settled, my father goes home. Talking to him a few times that day, I chuckled at the thought that he was having some very mild PTSD symptoms from memories of his recent visit.

My step-mom is, of course, labeled a fall risk and she’s instructed by the doctor (not the same one my Dad had) to not try to get out of bed herself. Later that evening she has to go pee and presses her buzzer for assistance. And presses it and presses it and nobody answers.

She’s soon faced with a decision: Do I wet the bed or do I try to get up by myself? I don’t think anyone will be surprised that she decided to get up. And she fell. Fortunately, she wasn’t injured worse than a nasty bruise on her shoulder, but the hospital did x-ray her shoulder to make sure.

And then they addressed the issue of why no one answered when she buzzed. It was simple to fix — all they had to do was plug the buzzer in. The initial neglect in not making sure it worked when my step-mom was moved to the room is bad enough, but it was fixed now so there should be no problem, right?

When I wrote about my Dad’s experience, I made sure to compliment all the staff except the arrogant doctor and the maintenance people who didn’t show up in a timely manner. Now I don’t know whether my Dad was really lucky or whether my step-mom was just really unlucky. She didn’t get the same quality of care from the staff. Nowhere near it.

You’d think that after her falling the first night there, that the staff on that floor might have been a little extra-vigilant about answering her buzzer and responding to her requests to go to the bathroom. But that wasn’t the case. The buzzer was answered and she was told somebody would be there, but often no one showed up in what could be called a timely manner and sometimes no one showed up at all.

This hospital uses a blackboard to note patient information. In addition to noting she’s a fall risk, there’s a notation about warm packs to be placed on her legs three times a day and this was not ever done during her week long stay. Perhaps the doctor changed his mind, but the blackboard was never updated.

Shortly after coumadin was started, my step-mom started having stomach pains. She described her stomach as being on fire. Four days later, this pain was finally addressed and eased. I can’t imagine what took so long.

For two days, she and Dad pointed out to nurses that her IV was no longer working. While they all looked at it, no one did anything to fix it.

I’m not quite sure what all the problems with her bed were, but it was not comfortable. She used multiple folded blankets to try to make it better, but finally got to the point where she demanded a new bed. She got it and was then given medication to help her sleep. Or, as my Dad suspects, to “knock her out and make her shut up.”

Anyway, they tried to use the IV she’d been telling them wasn’t working for this medication, but of course it wasn’t working. They crushed a pill and gave her the medication orally. I don’t know what it was and am wondering why it needed to be crushed. She’d been taking other medications by mouth.

Ah… wait. Let’s back up a little bit. Before demanding a new bed last night, my Dad called the customer service representative that we (my sister and I) have emailed and talked with concerning the problems my Dad had while he was there. He got voice mail, of course, and left a message requesting she call him or come up to the room and talk with them.

She called him back a short time ago, approximate 20 hours after his request and five hours after my step-mom was released.

This morning when the doctor told my step-mom that her coumadin levels were good enough to be released, my Dad packed up her stuff and took them to their car. He got a wheel chair on his way back to her room and told the nurse she could mail the release paper work to them. She asked him to wait and talk to her supervisor about their problems. A half hour later, the supervisor got there and listened to their complaints and said the problems would be addressed. By that time the paper work was done and they left.

So, maybe we should just drop this right now, but we’re not. One reason is that my parents (and many many other folks) rely on this hospital. They’ve been going there for years and the problems seem to be getting worse.

My father had a stent inserted there (I’m guessing) 8 years ago. While I was sitting with him, his monitor started flashing bright colors and beeping. I looked at it and noticed his blood pressure was low. It went back up a little and the beeping stopped. But it started again soon and didn’t stop. The door to his room was open and his bed was less than 10 feet from the nurses station where his nurse was chatting with her co-workers.  I had to walk up to her to get her attention, and could clearly hear the beeping while standing beside her.

Frankly there are many other little incidents I could post about, enough to make me wonder if there’s a “systemic” problem with patient care there. Enough to make me want it further investigated before any more of my relatives are hospitalized there.