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Tag Archives: quality

A deadly bedpan?

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I came across a horrible news story today.  It’s a nursing home story that involves a bedpan. Apparently a nursing home resident was left on a bedpan for 24 hours.  He developed a sore that ended up killing him.  Oddly, the person who put him on the bedpan is the owner of the nursing home.  I find that very odd.  In nursing homes the aides do pretty much everything.  While there has to be a registered nurse on staff, the nurse does very little patient care.  When a nurse does interact with a patient, it’s usually to do something that aides are not certified to do such as give a medication or do a physical assessment.  So why is the owner, of all people, putting a patient on a bedpan at all?

According to the article I read, the incident occurred on Christmas Day. Perhaps they were so short on staff the owner had to come in?  Were staffing levels dangerously low?

The owner was convicted today of felony abuse.  It won’t bring back the patient, but it’s a step in the right direction.

Ridiculous Case

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The New York Times reports on a very disturbing case in Texas.  A doctor allegedly engaged in all sorts of malpractice.  When a nurse reported him to the medical board, she lost her job and he kept his.  Sad but not that surprising.  What’s surprising is that she is now being prosecuted for reporting him even though investigators and hospital administrators admit that the doctor engaged in malpractice.

The prosecutor claims that she was trying to diminish his reputation.  Really? It’s not like she went to the newspaper.  She reported him to the medical board who could then open an investigation on their own.  Hopefully this prosecutor will wake up and drop the charges.  Nurses should always feel free to report unsafe behavior.

Is Sunday a Day of Purgatory?

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Hospital administrators are fond of saying, “The hospital is a 24 hour, 7 day a week business.”

Some nurses, on the other hand, say, “If you’re having chest pain and it’s Monday, go straight to the Emergency Department.  If it’s Friday, take a Tums and aspirin and stay home until Monday.”[i]

The reason is, despite our supposed 24/7 availability, little gets done on the weekends.  For example, if you come in on Friday afternoon with chest pain and you might be having a heart attack, count on getting some emergency treatment such as taking an aspirin, getting blood drawn to check for certain enzymes,  and getting an EKG.  Also count on getting a stress test and other needed care—on Monday.  And to make your long weekend in the hospital more pleasant, we won’t let you eat or drink (or smoke)—all weekend.

Or suppose your daughter has a g-tube that is not working and she cannot get proper nutrition.  Regardless of your daughter’s current nutritional state, expect to get the new g-tube placed—on Monday.

While Sunday is supposed to be a day of worship, in hospitals it’s often a day of purgatory.  Patients end up in a state of limbo wondering when and if they will be able to get their needed procedures, wondering if they will be okay, wondering how serious their condition is, and wondering when they will be allowed to eat next!

It’s great that health employees can have Sunday off, but certainly there has to be a way to provide better care on Sundays.  Babysitting patients, without taking care of them, drives patients and staff crazy. It also means we are wasting a huge amount of money as procedure and operating rooms sit empty and beds remain scarce.  Granted extra staff would have to come in to work, but surely their salaries would be offset by the fact that it can cost ONE MILLION DOLLARS PER DAY to run a hospital. Further, patients can be paying about $8,000 a night at the hospital.  Keeping them in the hospital for extra days can cost patients and their insurers a huge amount of money.  If we were able to do stress tests, radiology procedures, etc. during the weekend, we will save money, make patients happier, and perhaps even save a life through intervening earlier.

Wouldn’t it be nice to spend fewer unneeded days in the hospital?  Wouldn’t it be nice to save yourself and the system some money?  And if we get you through your procedure and home on Saturday or Sunday, you can truly have and appreciate your day of rest.


[i] Please don’t take anything on this site as medical advice. It is for entertainment purposes only.

 

Addendum: My father would like me to point out that if you come to the hospital and you are indeed having a heart attack and not indigestion, you will be treated very quickly.  In fact, hospitals track how long true heart attack patients have to wait before receiving emergency care.  My point is only that if the first few tests come back negative, you will spend a lot of time waiting around.  If the first few tests come back positive you will receive emergency care and probably don’t need a stress test at that point anyway!