[CanuckStudent]

Originally Posted by Audrey28

Horrible. You would think if something were to happen to you the safest place to be would be in the hospital- even in the waiting room- apparently not...

I have gone to the emergency room before with really bad chest pains- I was about 20- and all they said was I was too young to have a heart attack- they were really rude to me and didn't even want to check me out- [I didn't have insurance at the time]-I hope that we can improve the medical service- aren't we here to HELP people? Instead of pretending nothing is wrong? That is just horrible- I couldn't even imagine- I will keep her family in my prayers....
~Audrey

"Too young" to have a heart attack? Did the idiots on duty realize that there are other forms of MIs that are NOT due to typical "lifestyle" factors and aging? Infants, children and teenage athletes can have an MI. A percentage of MIs are in fact caused by a spasm of the blood vessels, NOT a physical blockage induced by atherosclerosis. Also, certain medical conditions (long duration of Type 1 diabetes, idiopathic hypertension, etc.) can cause MIs in young(er) people.

Not to mention that there are numerous other causes for chest pain, many potentially serious, that would need to be check out in a timely manner regardless. Student or not, I would never let a coworker tell a patient they are "too young" to be having a medical issue. That's unprofessional and medically incorrect.

Sorry, had to comment...



It is very unprofessional

[CanuckStudent]

To continue my above post...My point was that I agree with you. *If* insurance was the issue, the staff should have had the decency to admit how screwed up the U.S. healthcare system is instead of lie to your face. I am so lucky to live in Canada, and I know it. Sure we complain, but in most cases, our healthcare is great. If you have a real issue, you get timely care, top notch diagnostics and treatment, and you don't have to worry about how to pay for your hospital bill. It just never comes.

Sure we pay more taxes, but that's life. You can't get something for nothing. I'd rather help a sick young person live (who would be insurable in the U.S.) than buy another car or boat. Maybe that's just me.

There are some *serious* issues with the U.S. model of care, I think.

[Vito Andolini]

Originally Posted by NRSKarenRN

Kings' psych chief, security boss ousted over woman left on floor to die





Posted on 07-02-2008
The head of psychiatry at Kings County Hospital was among the six people fired after a Brooklyn woman was left to die on a waiting room floor last month.

I wouldn't be surprised if they grieve or sue and get their jobs back, quietly, a ways down the road, after the public furor dies down. You know how it goes.

[earle58]

Originally Posted by Vito Andolini

I wouldn't be surprised if they grieve or sue and get their jobs back, quietly, a ways down the road, after the public furor dies down. You know how it goes.

termination is still insufficient.
they need to be charged as accomplices in this woman's death.
(i don't know the formal/proper term/charge)

i suppose those w/the most money, will obtain the best lawyers:
precedents will be set and all will walk away w/a slap.
that is just my

leslie

[Fan of 4 points]

Originally Posted by multicollinearity

I'm going to play devil's advocate for a minute. Let's say this psych hospital is so routinely over-crowed that it is common to see psych patients, who are known for acting inappropriately, laying on the floor.

Let's say nobody witnessed her falling from her seat and moving around. What if they only actually observed her laying there, quietly? Only later did they see the tape, which showed her struggling.

Let's say after years of working with over-crowded conditions, they have become hardened, and just see a 'crazy' sleeping woman on the floor, and turn their attention to what they perceive as more pressing patient situations?

Not saying I think this - just trying to imagine the other side here. Not much I can say about the false charting, though.

Exactly, although having delt with crazy pts faking numerous things before I must say I at least check for the rise and fall of that chest and make sure they respond, at least. But like you said maybe there were other more urgent matters that was keeping the triage nurse at bay, I would imagine that she would be the only nurse in the immediate area. All in all it is a horrid incident BUT hospital administration must be held accountable for understaffing and poor judgement when hiring staff. Security deserved the harsh treatment, it is their job to ensure that pts and visitors behave in an acceptable manner, and I know there is no way to make a psych pt behave. He could have at least told her to get her ass up and maybe then he would have noticed she was unresponsive.

[Fan of 4 points]

You are right to say a basic assessment, but how many times can you stop during your shift, do and EKG and serial enzymes for your pt crying chest pain for attention(for example)? But I didn't see someone notify the nurse, cuz I totally agree, no matter what you are doing a pt down must be assessed and ANYONE can be tied to a chair in view of a nurse

[herring_RN]

All patients must be triaged. If the triage nurse determines that the patient needs to be assigned to a nurse the facility must make that happen.
Staffing must be safe.
WE THE PEOPLE need to ensure that this happens.
I think it is our moral duty as human beings to respect our fellow humans.

Do we not have the right to LIFE?

[fenders]

Seems like there were numerous factors involved in this incident. I agree with babs previous mentioning of how a staff ratio is no excuse for this.

I also worked in a busy er and our triage was facing the waiting area (with plexi glass of course) but we also took blood and did assessments int he wating room. Our security are updated on their training , defribilations and cpr. We would never leave a psych patient sitting for 24 hours. They do wait sometimes, not that long and that is all wrong. We try to get our high risk psych patient's in right away. I only know what I saw on the camera but it is still unacceptable. Can't blame the patient's they are not well and dont know what to do.

I asked one of my co-workers here in Canada who worked in the states (cali) about this and he said that county hospitals are public hospitals and are usually understaffed and terrible to work in as opposed to private hospitals. Is this true?

SAd sad sad

[Fan of 4 points]

<B>pagandeva2000 (Female)
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Re: OMG! Hospital video shows no one helps dying woman on floor of waiting room
permalink
Originally Posted by multicollinearity

I agree, leslie. Remember, I'm playing devil's advocate. I'm always a bit troubled when people denounce someone when they've only heard one side of the story.

I am horrified about this video because of the circumstances of this poor patient. However, what I know as well, is that the media has a way of splicing up videos to make things look even worse. I am also playing devil's advocate because I worked in psych as a tech. Now, as a nurse, I know differently, but the scenerio can be the same...patients laying on the floor; sometimes, because they just want to. I remember once, working in psych, I had to go to a hospital to monitor one of my patients on a 1:1. She was really not in her right mind, and kept wishing to lay on the floor rather than the nicely made up bed provided for her. Several times, I tried to get her to go to bed, to the point where she hit and kicked me several times. Eventually, the nurses that worked at the hospital told me "forget it" and brought a mattress into the room for her, since she was so determined to remain on the floor. I was worried about how bad it would look that I am there to monitor this patient, but she is laying on the floor. And, most of the time, when we leave our facility to go monitor in another, we are made to look really bad, and no one is there to have our backs.

Many of the patients that use that particular facility are homeless people that are conditioned to laying down in worse environments, and will fight for the kill for their little corners on the floor. Now, keeping that in mind, nurses have to adjust our thinking along with this to STILL check on them, and document if this person prefers the floor rather than an appropriate seat/lodgings. Since this is a place that is connected to my place of work, I have to say, yet again, that it shows me how I have to be. I am sorry it happened, for sure, but we can't let this person die in vain without learning from this and improving ourselves for the better.
amen!!!!</B>

[pagandeva2000]

From what I have seen working in psych for city hospitals is that the patient is triaged first in the medical ER, and then is taken to psych as recommended by the triage nurse, even those brought in by EMS have to stop at medical triage first. Once being brought to the psych ER, the techs, nurse and clerk begin a search. Where I work, they change the patient into gowns in order to better obtain contraband, property is locked up. Then, the attending psychiatrist, RN and maybe a Physician's Assistant interview the patient, labs are drawn, and they see if the patient has been there before so they can obtain a better history. After that, they are basically there to be observed, and if the psychiatrist decides that the patient should be admitted, how fast this happens depends on the availability of beds on the in patient psych units, and they go in the order they came in.

Where the problem comes in is usually the weekends and holidays, when there are almost no discharges happening from the inpatient psych units. EMS continues to drop patients (these are the acutely ill patients) and walk ins come as well, which, will back up the ER, because there is no place to move them to. It can easily get to where there are not enough beds to accomodate the incoming patients and stretchers have to be brought down from transport in order to have a place to lodge them for the night. And, the stretchers have to be taken back by 7am because transport needs them to function for day time use. My hospital only has enough room to lodge 10 patients. Anything more than that will lead to more patients laying on anything they can find once the stretchers are gone.

I'm sorry to say it, but, I don't see how they will be able to decrease the patient load to 25 people with the system being what it is (ESPECIALLY weekends and holidays, such as the 4th of July), especially in a poor neighborhood and many of the patients are frequent flyers. Of course, the answer will be to build more space, but that takes time.

I don't work at the facility this happened at, but I have a basic idea of the set up and challenges because I work for a city hospital as well. Can't speak for Kings County, but I remember our nurses do a GREAT deal of arguing about safety issues and the lack of staff. Another thing I noticed about many of the psych nurses that work in city hospitals-many do not remember how to deal with medical emergencies because they don't come up as often as the regular ER. It would be beneficial to retrain these nurses to act when a medical crisis occurs. My heart is breaking each time I read about it because of the poor patient that is caught up in such a perpetuating horrible situation.