I worked in a nursing home that used 3 local (big city) hospitals ( and a couple smaller comunity hospitals within the same city) for acute care, and the care, or lack there of, I see coming out in comparison to going out goes from adequate to apalling (sp?) and i do believe it relates to the concerns brought up by this article
I have seen a resident retun p weeks of wound care for stasis + diabetic ulcers but they did not treat her diabetis at all, and her isulin was listed on her transfer sheet, and IDDM was also listed as a Dx, when I called the floor she was on to ask how they were treating her Diabetes I was INFORMED she was NOT a Diabetic, their own labs show >400 FBS (on more than 1 occasion >650) and 2 Endocrin consults
I have seen them transfer someone with an ADVANCING pnemonia to our care because the infection had "cleared up"
I have had them send a patient to a nonsubacute, but still skilled facility with a central line, NOTHING in report about it
I have had patients returned when a bedside debredment was done with NO anasthesia while the transpot waited in the hall and watched from the door, no dressing, no treatment, and NOTHING in report (again)
I have heard nurses (when giving report to the ER) ask whether someone has REAL insurance, because they were busy that night (not that they would refuse care, but it was an ODD ?? nonetheless
then there is the 2 times a hospital "lost" a patients advanced directive when they went bad (one time the person eneded up on IV fluids in ICU with a crash cart next to the bed) *again* all this was on the transfer form, they were MY patients, I wrote or reviewed the trasfer forms, and I only worked there 6 months
Then there was my 49 year old coworker who died of an embolus from a work aquired injury that was treated at one of these ERs and told to just "go back to work" with a fractured hip and a DVT, both of which showed up on the ER X-Ray, but she was told it was in her head, and D/C sheet said she was able to go back to work on Tylenol, no other Therapy.
These are not all from the same hospital, but the worst instances I can remember from each.
I should stop i am getting outraged again, but i get over it, because there is NOTHING i can do other than complain to the hospitals, and report the GROSS neglect (that is a different set of criteria than my setting) to the athorities when my boss would not.
*** May we all have the serenity to accept what we cannot change, and the determination to change what we cannot accept. ***
[This message has been edited by ecb (edited November 28, 1999).]