For anyone who has ever moaned or cried about substandard care in an ER; anyone concerned about the area of pain management(or lack of), etc. -- You need to read my personal account with both.
A little background before this ER horror story:
In 2001 I had suffered multiple injuries all in one accident which included a slightly displaced T7 wedge fracture(was very obvious on x-ray), compression fractures at levels T8 and T9 and an end plate fracture at T11 - and that was just the vertebrae, so that doesn't include the two posterior 7th & 8th rib fractures and sternum which was fractured in multiple areas. Both lungs were severely contused, and I possibly had a concussion as I was not wearing a helmet. Upon impact with the ground, I discovered my severe allergy to gravity and what seemed like 10 minutes, but in reality was easily 30 second to 2 min where I was unable to get a breath in or out and unable to move. I had that impending feeling of doom and actually thought I was going to die.
Now in my prior training, MOI(mechanism of injury) was always an important consideration. Witnesses to this accident noted I was about 25 feet in the air, on a snowboard and going at a high rate of speed before crashing on the bullet proof ice below. It's interesting how my mind replays and remembers that moment in the air in slow motion. I speculate that I must have been very convincing that I thought I was okay, as ski patrollers did not backboard me, but took me down on a tobaggon and helped me into my car. In their defense, I think us medically minded folk do make the worst patient's at times like this. On the approx. 16 mile drive down the mountain, I had considered going home, but with the increased difficulty breathing and pain, I decided I better get myself to the L2 Trauma Hospital in the area ASAP. At this point to even be this potentially morbidly injured and mind still intact, I think I was running off of my body's natural endorphins. I made it to the ER, of course this was certainly 10/10 pain. I pulled up right outside the emergency room door, but couldn't even get myself out of the car. Some nurses had to help me out of the car and into a wheelchair. Their non-chalant attitude was not very impressive, but I'm sure they would have never expected someone with that magnitude of injuries to drive themself, etc.
Upon getting there, I gave them my spouses number since I was pretty sure I wasn't going home that night. I had the unfortunate luck of a doctor on duty who seems to literally take the term "practicing" medicine to heart. *The only reason I don't post Dr. Incompetent's name or the facility is so that site admin here do not receive any repercussions given the gross negligent nature of what happened. If you are curious, PM me.
Interestingly enough, this particular was in a 'smaller' city, so not an overly crowded urban area, plus it was a slow weekday evening. I didn't have to sit in the waiting room for too long before being taken back to the exam room. I was in excruciating pain to where sitting up and moving was difficult and having trouble getting my jacket off. Dr. Incompetent ordered 1 milligram of Morphine. Perhaps my mistake was being interested in my own care and asking how much; hence, something a "drug seeker" would ask - It's ashame how jaded the world has become on pain management. My spouse showed up and between a couple of nurses and spouse, got my jacket off and a gown on before being sent over for an x-ray. That practical placebo of a dose makes me wonder if they just gave saline, though I speculate obviously not enough.
I was sent for x-rays and then back to the exam room. I was still complaining of pain (ya think?) so what does Mr Dr Incompetent give me- two 5 mg Vicodin tablets. Did it help, well, yeah, but a punch in the face would have helped me just as much. They took the x-rays by helping me from the gurney on to some type of a slider board to get me on the x-ray table. Upon returning to the exam room, my spouse and myself BOTH saw the x-ray, showing a clear deformity at the T7 level; any layman could have looked at that film and it was obvious there was a problem.
The part that would drop anyone's jaw to the floor-- minutes later, Dr. Incompetent walks in the room, handed me a sheet with the diagnoses of....... *drum roll please*...... "back sprain". ***!?!?! When we asked about the x-ray, he just got all huffy and stormed out of the room. I have no explanation for his behavior, but I do still possess the sheet on "care of back sprain" with that date of the accident. I was subsequently discharged home and given a nice "generous" supply of ten 5 mg Vicodin. I've heard of people getting more than that for a papercut, so perhaps Press-Grainy is a good thing where it's enacted, as I would never have been left in this dire condition otherwise. It's this very incident which has caused me to be fearful of being left in pain to the point I'd rather die or risk dying than ever be left in pain again. To this day, I am still shocked about being sent home to die.
But discharged home!?!?!? Excuse me! It hurt to breathe, I ccouldnt move, and I was being sent home? I had excellent full coverage medical insurance at the time, so that certainly could not have been the case for such. What really is amazing is how the hospital mysteriously has no record of this particular x-ray, especially since the fracture and spinal misalignment was clearly evident. The hospital and/or doc obviously covered there ars on this one disappearing. After seeing the x-rays, the doc ordered 1 mg more of Morphine. 2 mg Morphine, two 5mg Vicodin's, I would say clearly was an inadequate form of "treatment." I do speculate if Dr. Incompetent is a closet-type junkie and possibly wrote an order for more medicine and used the rest for himself. Will never know for sure because the records obviously were adjusted to cover their misactions.
My dear ex helped me home and into bed where I layed for two days, short of breath and it was painful to/I could not breathe well, and was in intense pain. I was hurting so bad, I could not even get up to help myself to the bathroom. At one point,my spouse helped me to the side of the bed so I could void in a bucket. Even that was quite challenging and I remember the pain. After two days of this painful torture of slowly deteriorating right there in our own bed, we decided we better get me back to the hospital, as I obviously was doing WORSE with each passing hour. About 6:30-7:00 p.m. that evening he pulled the car up close as possible to the front door and after medicating much as possible of 2 tablets (it's difficult to stretch ten tablets of vicodin by day #3 with these kinds of injuries and pain). At this point, I was in the middle between not wanting to go back, but having such a hard time both with breathing and pain that I saw no other option and felt like for sure I was going to die.
Two days later after the accident, we re-arrived at the hospital at 7 pm-ish (we lived about a 10-15 min. drive away). I was clearly doing much worse. I'm certainly not saying all nurses are bad, but the particular one I had the misfortune of seeing was also a very non-chalent group who acted like they could have cared less and had a quite brash attitude that I was in a crisis helped, my spouse get me out of the car and into a wheelchair, but were being mean trying to tell me to walk, and that sort of thing, but I couldn't. I was wheeled to the triage desk and tried to tell the stupid b**ch of a triage nurse (you'll understand why this is a generously polite description as you read further) what happened.
After awhile, I was wheeled to the FAST TRACK room. Heck fast track room is where they put people who generally don't belong at the ER in the first place for ailments such as the common cold, etc. To really add icing to the cake on this pathetic ER, my spouse and I overhead and it turns out they triaged a kid with conjunctivitis who arrived later than me. It wasn't until 3:30 a.m. on this relatively slow weekday evening the ER doctor, after seeing the conjunctivitis kid and a guy with tooth pain before ever checking on me came in. A little math here, and this wasn't a busy weeknight like some ER's in larger cities -- 7
m and sit then lay suffering without meds until 3:30 am -- 8 hours.
I don't remember the exact spelling
of the doc's name that night, but ironically, name was "Dr. Mercy". When he came in at 3:30, we explained what had happened to him. He looked at the chart; remember that evil triage nurse I was mentioning above? She had written "fell out of bed" -- talk about a nurse with both poor bedside manner and poor listening skills.
That does explain why I was sent to fast track, since from a medical perspective, an otherwise healthy 20-something year old is not going to have morbid injuries from a fall out of bed. In retrospect, I'm certainly not angry with this doctor of mercy, as he had no way of knowing the seriousness of the situation based on the misinformation he was given before seeing me. It was that wicked incompetent triage nurse who failed at her job in a big way. When we explained to this doc what happened - a 25+ foot fall onto ice from a snowboard jump with landing gone very wrong, he went to go review my records from a couple days prior and during that time, sent a nurse in to give me an intramuscular shot of morphine. (as opposed to IV, so didn't work real fast, but even that much was a relief and I think a closer to appropriate dose than the first night two days prior). It wasn't the best relief, but after being sent home to die and suffering for a couple days, anything was surely better than nothing.
Dr. Mercy came back in the room and even commented on the "back sprain" as being the diagnosis written in the chart the couple days before. Mysteriously, it was even at that point the x-rays were not available/no record of, an obvious case of a certain prior bad doc covering their rear. Dr. Mercy immediately ordered a CT scan and did give another intramuscular shot of Morphine. Based on the inaccurate records and my nightmare those couple days before, plus a poor triage person, I can understand where Dr Mercy was probably skepitcal until getting some scans.
I was sent off for a CT scan. They used a slider board to help me on that table, and even before putting me back on the gurney and taking back to the ER, the tone of everything suddenly changed. It was no longer a case of trying to torture me, trying to make me move, doing things that were too excruciating for myself. Suddenly, I was being told to "lie still, do not move", etc. Dr. Mercy ordered a PCA. An IV was started, PCA hooked up, and suddenly, I discovered nurses in the ER and a doctor could actually be human beings and decent people.
In the aftermath of all this, I was hospitalized, immobilized for several weeks plus rehab. Unfortunately, I still have chronic severe pain in the thoracic area which has produced even more ongoing sequelae as evidenced in my response to http://allnurses.com/forums/f8/curre...ml#post1983824
or my person recent story from 2006 at http://www.painreliefnetwork.org/prn/jessicas-story.php
Since all this took place I've had people ask why I didn't get an attorney -- we did talk to a couple of attorneys, but it would have been a minimum of $25,000 cash up front to even start a malpractice case. While just trying to avoid weekly eviction notices because we couldn't even afford rent at this point and me being out of work due to injury, we had no assets and certainly no way of coming up with the above. No lawyer would do a contingency case for such. Due to "statue of limitations" I think there is no ground to stand on. Most frightening is I know I'm not the only one who has endured a negative ER experience.
From here, all I can say is feel free to comment, make suggestions, and feel free to pass my personal stories on. Living on 8+ tablets of sodium naproxen(Aleve) and toxic doses of acetominophen(Tylenol) per day currently - the narcs I get are very limited and I can't exceed those knowing the potential repercussions, I highly doubt I have a long life expectancy as a result. I haven't given up and someday hope my words and experiences reach congress or whoever can do something so that other patients do not need to needlessly suffer.