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Apr 12, 2004 It has only been since I have worked in the medical field that I have learned the devastating truth about who really controls a human beings health. One would think that if you go to see an physician about an illness that you have or an injury that you have sustained, your ailment will be fully address by an individual who’s primary focus is to analyze and evaluate your symptoms. Think again! I have been in the medical field for 14 years and started out very naive but since the inception of my career, not only have things changed dramatically in the health care industry, but also, I have repeatedly been exposed to truths that would shock and appall the common public. Let me begin by saying that I am a registered nurse and that nurses have year after year been identified in this country as the number one most trusted professionals for their honesty and integrity. Secondly, one must realize that nurses, like doctors and lawyers, police officers and politicians, protect one another when faced with scrutiny by the public or employers. That is not to say that their reputation for being trustworthy is not warranted, it is just that over time, and as things have changed in the healthcare industry, nurses time after time have been the scapegoats for hospitals, doctors, lawyers, insurance companies and more often than not, the families and patients they care for. This has caused nurses to evolve in their way of thinking. Allow me to give a true case scenario. I worked for a hospital for five years. In that time, I saw this facility work their nurses to the bone day after day. In that time, many patients died under circumstances that if the truth be known, the facility would have been closed down. Now, I have worked for many hospitals and not one of them has operated any differently in the way they handle their patients, or now referred to as clients. Anyway, let us refer to the patient that I will be talking about as Mr. Smith. Mr. Smith was a 65 year old otherwise healthy male whom had come to the rehab facility that I worked for following a serious bout with pneumonia which required him to be mechanically ventilated for an extended period of time. Being that his only medical issue was his respiratory state and the acute care facility was no longer being paid to house him in their hospital, he was transferred from an acute care facility to a long-term care respiratory rehab hospital. Reimbursement from insurance companies and/or the State change when a patient is sick for an extended period of time unless one develops an additional acute illness. Mr. Smith did not. He was alert and oriented with all organs in good shape except his lungs. Another factor to consider is this; once a person is placed on mechanical ventilation, no matter how healthy they are, the body becomes dependant on that ventilator and requires a great deal of time and consideration to adjust to independent breathing. This unfortunately was Mr. Smith’s case. One day, this patient needed a x-ray. X-rays were performed in house but he needed to be transported downstairs. Because the ventilator was not portable, it was necessary to take this man off of the ventilator and with an ambu bag oxygenated manually for the entirety of the time he was off of the ventilator. Easy enough you may think and it was, I thought too. This was how it happened: the respiratory supervisor, nursing supervisor and x-ray technician readied Mr. Smith. They came to his room, disconnected the circuitry from his tracheostomy, placed the mechanical ventilator on standby, which preserved all settings, and attached an ambu bag to the man’s artificial airway. Immediately, one of the individuals aiding in his transportation began the ventilation of Mr. Smith by squeezing air into his lungs via the ambu bag. Downstairs he went and without incidence received his x-ray. Meanwhile, his nurse, who had 7 or 8 other patients on mechanical ventilation but whom where much more complicated than Mr. Smith, was running around frantically just trying to deliver all of the morning medications. She knew that Mr. Smith was scheduled for a x-ray on that day but was not directly informed that he was leaving the floor. When the x-ray was complete, the same three people and once again I will point out that two of them were supervisors for their department, transported Mr. Smith back upstairs still manually squeezing air into his lungs via the ambu-bag. Once back in his room, the mechanical ventilator that had been placed on standby, was reattached to this mans’ trache. Unfortunately, the staff members that had been accompanying this man and whom were responsible for his care while with him, neglected to press the few buttons that would make the ventilator resume operation. The staff members then left the room leaving Mr. Smith to suffocate. As it was, the nurse that was assigned to Mr. Smith that day, was not notified that he was back on the floor and continued to care for all of her other patients without checking on Mr. Smith as she thought that he was still in x-ray. Well, as it goes, Mr. Smith reached the call light and pressed. 15 minutes later and without the call light being answered, a doctor was making rounds and found Mr. Smith lifeless and blue. A full code was performed and they were able to get the patient’s heart to beat but only by using a drug whose sole purpose is to beat a heart that is so damaged that it can never beat on its own. They estimated that the man had been deprived of oxygen for approximately 15 minutes and after extensive testing, found that his brain had no activity at all. The length of time that he had been without oxygen destroyed every brain cell in his head. Subsequently, the hospital authorities called the family and told them that poor Mr. Smith had “taken a turn for the worse” implying that at no fault of the facility or staff, Mr. Smith’s body had just given out. It may come as a shock to you readers but situations like this and worse happen every day. If you are not educated in medicine and are not with your family members at all times you and your family members are at risk of having this happen to you or yours. When something like this happens, hospital protocol states that an incident report be filed but guess what? That incident report is never made part of the record and laws protect hospitals from having to disclose any or all details of such a happening. Therefore, if you suspect or even know that you poor Uncle Joe or Aunt Millie was killed by the staff at a hospital, chances of you ever gathering proof are slim to none! An incident report, a nurse is told, is never to say what really happened. It is only to state the basics like patient name, patient room number, condition of the patient (objectively) when you found them, who was notified, what interventions were applied and how those interventions affected the patient. All the other details like how the patients’ condition came about are discussed only verbally with hospital authorities and behind closed doors. Now, let us discuss how it happened that hospitals gained such protection. Who stands to lose if the truth be known? Insurance companies and stockholders. If Mr. Smith’s family finds out that the staff forgot to turn the ventilator on, then they will sue. Oh yes, and by the way, the laws have changed about medical malpractice and negligence in that you as a family member cannot sue unless you are the son or daughter of the patient and are under the age of 18 and recently ridiculous caps have been placed on the amounts of awards making it only advantageous for attorneys in the suits. Otherwise, the estate of the patient can sue for pain and suffering of the patient but one would be hard pressed to find supporting documentation of pain and suffering as staff members are instructed never to chart such things and if they do, most likely the hospital will fire them. Let’s look at why Mr. Smiths call light was not answered. Studies by various reputable agencies have revealed that for every patient a nurse has over the number of 4 on a medical/surgical unit (much less complex that ventilator dependant patients), mortality and complication rates are increased by 7%. Mr. Smiths nurse, on that day had 8 or 9 patients on ventilators, an unmanageable assignment. Even if she had known that he was on the floor and saw his call light beckoning for attention, most likely, she would not have had time to answer it right away. The hospital knew this but nevertheless did nothing to change the nurse to patient ratios and they figure that with legal protection against loses through lawsuits, it is cheaper to lose the lives of patients and run the risk of being sued for small sums of money than to pay for an adequate amount of staff on a regular basis. Politicians that were lobbied by and funded by insurance companies and the American Hospital Association put the laws that protect hospitals and the laws that govern the caps on dollar amount awards into place. There was a time when HealthCare’s focus was the patient with the bottom line always being a consideration but not the sole purpose of being in business. Nowadays, HealthCare is a thing of the past and could almost be considered an oxymoron. The doctors and the nurses’ hearts and minds are still in the right place but they are controlled. If they want to work they must abide by the rules of their employment or find themselves unemployed. Insurance companies, the most guaranteed profitable organizations in the world are squeezing the life out of everyone. Their reimbursements to hospitals and doctors offices are so low that the only way for a hospital or doctors office to continue operating is to cut overhead yet insurance companies rates continue to climb upwards with an almost guaranteed 100% increase yearly to its customers. Costs to institutions have to be cut to afford to operate and those cutbacks inevitable wind up being the staff leaving patients in extremely unsafe conditions. I will end this with a bit of advice to the readers of this; educate yourself about medicine, ask a million questions, and never leave your loved one alone in a hospital. Nurses no longer have the time to care for patients; they are merely task masters at their profession. It is not the way we want it. As a matter of fact, we as nurses hate this. But, alas, we have no choice if we want to be gainfully employed. Furthermore, if you are ever approached by nurses wanting your support politically, listen to them, I beg you, listen to them and vote accordingly so that we as the public can take back our healthcare industry and once again make it safe! ------------ About the author: Christi Palmeri is a RN, freelance writer, and recent unpublished novelist of a vampire romance entitled "The Lost One". Email: cpalmeri@gte.net Tell a friend about this site! ------------ |
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