Posted on 05/20/2007 10:52:28 AM PDT by John Jorsett
see post 90
One other point...the Doctor in charge of the ER is responsible for everthing that goes on in that ER, they set the tone and policies that the staff including the triage nurses have to operate under....I’ll wager that the triage nurse, if she didn’t seek help for this patient was under implied or official rules about not bothering the doc with such”trouble-some” “nuisance” cases. The Er doc’s like ship’s captains are responsible for everything that happens in their ER’s when they are on shift!
Do I believe this can happen? Yup !!!
16 years ago, my wife met a fresh Vietnamese immigrant (woman), in the country for 8 days. We knew her and her husband 2 whole days when she sent her husband to knock of the door at 2am. We went over and she was doubled up in pain. I thought something was serious so I piled her into my car and drove her to the nearest hospital, where they gave us clipboards. As she screamed in agony the receptionist asked if I could could keep her quiet. After 90 minutes without being seen by even a nurse, I picked her up, carried her back to the car and went to a different hospital about 15 minutes away. The second hospital’s staff examined her and prep’d her for surgury. They took out her infected appendix within an hour of coming through the E-room door.
Except for the fact that these fools on FreeRepublic are clearly the exception; as for DU, these people are the rule.
You make it sound like I said something bad about nurses in general. I am grateful and have great respect for most nurses - they have helped me and occasionally saved my butt by pointing things out. However, this particular nurse did not function as a good triage nurse or a good nurse in general. I agree the rot is widespread - this particular hospital has had a terrible reputation with many horrible incidents over several years, as I said in an initial post.
“Based on my personal experience, Nassau County Medical Center on Long Island SUCKS!”
LOL!!!
This is the hospital I went to while on a weekend trip.
What a learning experience!
Ignorance is not a conservative value.
No, it’s not. Furthermore, they are doing the exact same grouping for which they deride leftists. The idea of the individual is supposed to be a conservative trait.
Rule I learned a long time ago: Complainers die too.
Standard protocol for a patient with abdominal pain is a full workup including CT with contrast. However, while you might think that we can spot a bum appendix using CT, it isn't always the case. Not everyone has an appendix in the right lower quadrant of the abdomen, sticking out conveniently in front.
It's frustrating when I have a patient who presents with all the classic slam-dunk signs and symptoms of appendicitis, only to have a CT report come out that reads, "Appendix not visualized." Here we have spent hours giving the patient antinausea meds so we can make them drink a god-awful oral contrast, stuck a tube up their arses and pumped contrast into their south forty, and the DI radiologist tells me he can't see the patient's appendix.
But that doesn't mean the patient doesn't have appendicitis. If everything else lines up with that Dx, (elevated WBC count, peritoneal irritability, nausea, etc.), we keep them, given them IV antibiotics, and usually end up removing a bad appendix.
If somebody comes in three times in one day with the same complaint, we usually hang on to them. In fact, if they come in a second time, we hang on to them. We take that stuff pretty seriously. But then, I work in the best frigging ER in town. Our practice is to take a patient's complaints seriously until proven otherwise- even if the patient is a known malingerer. Good medical and nursing practice is sometimes built on a foundation of corpses. It's sad but true. But we try to learn from the mistakes of others so that we can avoid doing the same thing.
When a person comes in with gastroenteritis, "pumping the stomach" is not a treatment. It isn't even considered as a treatment for gastroenteritis under any circumstances.
Furthermore, a simple noninvasive abdominal ultrasound would have found a bum gallbladder and stones. Did the ER hold him until the lab results came back? Holding for lab values is standard practice.
This is the worst hospital on the JCAHO list; they haven’t had full accreditation since it was newly formed and now has none at all.
I doubt she was in shape to shop around while her body waste was emptying out into her peritoneal cavity.
An illuminating post as usual.
As an ER nurse, I think that it's critical to stay on my toes. Since everyone is different, everyone responds physiologically to disease in a slightly different way. Not in a spectacularly different way, but sometimes just enough to throw ER professionals a curve.
Then again... we had a heart attack patient a couple of years ago who had none of the classic symptoms. He came in because both of his elbows really hurt. He thought he hurt himself while gardening. Nope. Massive MI. An astute MD trusted his suspicion index enough to do an EKG. Guess what we found? "Marching tombstones," a classic EKG reading for an MI in progress.
We started moving pretty damn quick chop-chop from that point. The guy is fine now. Walks five miles a day. Comes in whenever his elbows hurt. Still scares the crap out of us.
Those are the patients that keep us up at night mumbling to ourselves.
To paraphrase Kissinger: Even paranoids have enemies...
Two and a half months after our discussion on King-Drew Hospital, I’ve finally gotten my hands on the autopsy report.
http://www.latimes.com/media/acrobat/2007-06/30524153.PDF
There’s also word a few hours ago that their ER is shut down tonight due to a “staffing shortage”, with a decision on when it’ll reopen to be made tomorrow.
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