Friday, September 26, 2008

You can't tell a Chinese Restaurant by its egg roll

OR ... Our E.R. scares me.

The conversation I expect to have in a couple of weeks with our genuinely Very Sweet Nurse Practitioner:

VSNP: I'm so sorry that you had to go to the ER. That's too bad. I hope the wait wasn't too long.
VSNP, I need to tell you this, because I need you to understand --

It's not about the wait. That's to be expected. It's about FEAR. I feel confident that most of your patients' parents who have taken their children to the ER at this hospital would echo my sentiments--taking our kids to this ER scares us to bits. If we judged this hospital by its ER, we would not come here.

Here is my experience: I drove into the parking garage here at 2:00 in the afternoon. I sprinted to the elevator with LW in my arms, but you know what the elevator situation is like ... when I got here, to the clinic, they said it was about 2:15. They called back and spoke to your nurses. They did not tell me to go to the ER, they said to wait. I waited. At 2:30, you and a nurse came out and said so sorry, but I didn't make it in time, so I needed to go to the ER.

In the ER, a couple of nurses came to our little room to access LW's port. They asked what size needle to use. Whaaaattt? This is not information given to parents. I held LW down while they put a needle in her port. They couldn't get a blood return. They removed the needle. They changed gloves, changed equipment. I held LW down again, her crying. They put another needle in. Still no blood return. There is a big bubble in the line, which, thankfully, they notice, so they decide not to push the saline. They remove the needle. My daughter is, understandably, more than a little upset. Finally, a third nurse comes in, an expert from the TPN department. She puts the third needle in through LW's skin into the port, as I hold her down, my heart crying as I whisper, "I'm sorry, I'm sorry" into her ear as she screams.

Instant blood return. I ask if it's slow. The TPN nurse wrinkles her forehead. "No, not at all." She looks at the ER nurses. They begin telling her that they think there was still contrast in LW's line from the day before. She asks why they think that. She looks dubious. She asks why I didn't just go through the clinic. I tell her that you said we were too late by 15 minutes. She shakes her head. She knows what the ER is like.

LW is hooked up to IV, her blood taken for testing, her standard Xray done. I take her to the bathoom a couple of times and it is filthy. I am afraid for her feet or more importantly, her IV line, to touch the floor. We are in the ER for 7 hours. The bathroom never gets cleaner.

At some point in the middle, the "doctor," (my guess is an intern) comes to give us the news that her counts are good enough for us to go home but um, erm, they screwed up and gave her the 8 hour antibiotic rather than the 24 hour antibiotic, and no, we can't go home and come back, and no, we aren't going to be admitted to a hospital room, but instead, we need to stay there til the 8 hour antibiotic runs its course, which will be around 1 am, then we'll get the 24 hour antibiotic, and when that's done, probably about 2 am, then we can drive home! Whoopie!

And it is at this point that I am thinking ... because we got to the desk at 2:15, rather than 2:00, we will be here until 2 in the morning.

And I am further thinking ... I think I would feel safer being treated by the doctors at (the local hospital for indigents).

We got lucky, if that's what you want to call it, because the ER actually called the doctors who do hematology/oncology and told them of their nefarious plan and the hem/onc doctors, God love 'em, said, No, just go ahead and give her to 24 hour antibiotic now.

(They've been pumping her full of chemicals for 6 months that could fell a cow, what's a bit of extra antibiotic?)

And that is why, VSNP, that is why you saw me look quite upset when you said that we were too late for triage, and had to go to ER. It wasn't because I was worried about the wait and being bored. Bored? Ha! It was because I was worried about the level of excitement I would be under, a fear that, once again, proved to be true.

15 minutes. Well ...



ogre said...

Another great American health care story.

I'm just going to bite my lip until it bleeds, rather than rant.

I'm so sorry.

ms. kitty said...

Oh, man, what an awful experience, LE! I'm so sorry. When will health care be about the patient instead of the system?

Chalicechick said...

I so feel this. When I got to the ER Sunday night, all they would tell me about my husband was that he was in "Trauma 3" and having a "procedure."

Now this is more understandable than what you went through, but it was still a slice of hell.


Chalicechick said...

Ps. I would seriously consider putting that post in letter form and sending it to the head of the ER, CCing the Nurse practitioner.


plaidshoes said...

What an awful experience! We have been to the ER several times with my daughter, and only once did we really have a positive experience. It is horrible you had to go through all of that because of 15 minutes - it is just pathetic that they couldn't be a little flexible.

Kari said...

Can't get that dirty bathroom floor image out of my brain. And having to hold her down; just so hard.

My Brand Of Crazy... said...

Yep, we live in the land of the free and The American Dream, and the best hospital I have ever had a pleasant stay at...was in Dubai. I'm so very sorry this happened to LE and yourself. I hate when 'they' act ignorant, they knew exactly where and what they were sending you to. Sigh.
Hope she's feeling better:)

Kristina said...

I found your blog through Kari's blog. I cried as I read this post, and I am so sorry that you had to endure that whole awful mess. I'm a cancer patient, and a mother, and I understood all too well the things you were speaking of, though from the perspective of an adult patient....which is very different. I feel so ANGRY that a child would be asked to endure such...such....I don't even have the words.
I am grateful that your daughter has you to speak up for her, and to hold her, and to guide her even when the experiences are "wrong."
Please, write this in a letter and send it to your hospital. The way you were treated is unthinkable, and they need to change. You have such a powerful voice - I really think that they would listen. In my cancer journey, I've met with some "wrong" stuff as well, and letters have actually helped - the hospitals have a formalized process for handling complaints and they are taken very seriously. You have a right to speak up - not only does it help to vent but it also changes your future experiences AND the future experiences of otehr patients.

Wishing you peace, NED, and love...

Anonymous said...

We had a similar traumatic experience in a Children's Hospital emergency room with our 1 year old. Long story, but a lot of mistakes and not so great treatment and not listening to parents- led to some heavy duty surgery and 9 months of recovery while the baby and at least one parent could not go anywhere. If I hadn't been working PT, I would have had to take a leave of absence from work. It was horrible, and made worse by knowing that if we could have gotten the docs to listen to us, the surgery and recovery time would have been more like a matter of a few months.

I did end up contacting the hospital ombudsman (patient advocate) and told them about the situation. I told them I wasn't interested in suing; I was interested in the staff getting feedback in hopes of better treatment of parents and patients in future.

I wrote a long letter and cc'd the hospital President; don't know how much good it did, but if no one speaks up, nothing can change.

As part of accreditation, hospitals are required to document patient/customer complaints and responses. Give them something to chew on for the next accreditation review!!

Just find out who the patient advocate or ombudsman is, and forward your email. No need to rewrite. Your voice needs to be heard.

Wishing you all healing and healthy time and the happiest of halloween celebrations.

Cinci mom