Am I wrong?

[emmy41lgpn]

Hi, everyone:

Ive belonged to allnurses.com for a couple of years, but this is my first real post--I'm a reader, not a poster.

I was an LPN for 20 years---had to give it up after rupturing my L-4-L-5 disc on the job.A laminectomy and 8 years fixed that. I miss nursing terribly, but don't think I could hack it the way things are today.God bless all of you who keep at it.

I am writing to ask a question about , I guess, medical ethics.

I have Barrets Esophagus, a hiatal hernia, and long standing gastritis.

No, I dont drink.

I had an upper endoscopy done on July 8th.By a gastroenterologist.

He took 40 biopsies, 4 per centimeter for each of 10 centimeters.

I had stopped taking Plavix on July 3rd.

I was okay until July 12th--nothing I could put my finger on, just felt lousy, slept all day.

At 10 p.m. that night, I vomited a large amount of black coffee ground material.I I called the Dr.s number, assuming that he had an answering service. Dummy me! The hospital operator came on the line, told me that he was not on call and there was no-one covering for him. She advised me to call my family Doc, which I did. He was on vacation at the beach, but called me back, anyway.He advised me to go have a CBC at the hospital in the morning.

I vomited again at 1:30---at 3 I had a tarry stool---another at 6--I called my family Doc at 7--he told me to go to E.R..

I was a little dehydrated, my hemoglobin was 10.2.

E.R. Doc tried to call the gastroenterologist--took 5 calls for him to respond.

He ordered I.V. Protonix---this is getting much too long--I was admitted

-he had ordered blood if my hemoglobin fell below 8---it hit 7.2. I got 1 unit of packed cells.

My REAL complaint here, I guess, is that he never came in to see me until my family Doc had written my discharge---then siad that the bleeding was from the EGD, which I had already surmised. SO--from Saturday night until Tuesday afternoon, he , essentailly ignored me.

I called the hospital today and lodged a compaint.

Am I right?

ALL replies welcome--thanks!

Emmy41lgpn

[chenoaspirit, ASN, RN]

Well, the GI doc wouldnt have seen you unless (until) a consult had been placed. I would assume that the doc covering for your primary did visit you daily in the hospital. Where I work, it is required for a visit daily to see the patients by whoever is covering each day. Im so sorry you had to experience such a terrible situation. I hope you are feeling better. Please dont stop posting. Welcome to allnurses!

[chenoaspirit, ASN, RN]

Oh and where I work, GI do not admit, they are consulted. You need to find out who actually took you on as a patient on admission to see if you were "ignored" during your hospitalization. I would have thought though that a GI consult would have taken place within the first 24 hours of admission if they felt it necessary.

[MagsMom]

In my opinion, the GI doctor (who performed the EGD which caused the subsequent bleeding requiring hospitalization) needs to be replaced. I imagine that with a chronic condition such as Barrett's Esophagus you need to feel comfortable that you can count on your GI doctor and it seems that he has blown it - I say find someone else and make sure that this new doctor has coverage when he is out of town - the same goes for the PCP.

[MeJane19]

In my opinion, the GI doctor (who performed the EGD which caused the subsequent bleeding requiring hospitalization) needs to be replaced. I imagine that with a chronic condition such as Barrett's Esophagus you need to feel comfortable that you can count on your GI doctor and it seems that he has blown it - I say find someone else and make sure that this new doctor has coverage when he is out of town - the same goes for the PCP.

Why should the GI doctor be on call just because she had a complication? That's what ER's are for. The doctor who performed the EGD didn't cause the complication.

You're going to throw the GI under the bus because he has a life? Are you on call for your patients 24/7 or isn't that what the next shift is for? And then throw the PCP under the bus with him? If these doctors had been on call and didn't respond I could understand but please people they deserve to have their off time just like anybody else.

[chenoaspirit, ASN, RN]

Duplicate post.

I thought she said that the bleeding was caused by the EGD performed previously? I dont know if its the same GI doc.

[Pocahontas98_21]

Ok so I don't get why your upset? You being a nurse know something is wrong when u 1) felt something was wrong 2) had vomited coffee ground emesis. 3) had been given written d/c instructions after procedure (I assume) 4) u don't need an order to go to the ER if u thought something was wrong u don't need permission.

[MagsMom]

Yes, I am going to throw both of them under the bus! The OP said that she felt "ignored" and, in my opinion, a patient should not feel this way, especially when dealing with a chronic condition. No, I do not think that people should be on call 24/7 and I understand that is what the ER is for - however, I do think, especially when someone has a chronic condition, it is important to feel comfortable with the health care provider and from my interpretation of the OP she no longer feels this way. I suppose another alternative is to express to the GI doctor her feelings of the situation and everything could work out.

[MeJane19]

The OP said that she felt "ignored" and, in my opinion, a patient should not feel this way

The EGD was 4 days prior to the vomitting of coffee ground material. It wasn't the same day (not that I think that makes any difference).

If she feels "ignored" it is not the doctors problem. She is obviously a stickler for details with every symptom and detail written down with finite detail. I don't know that she would be satisfied with any doctor.

[Tweety, BSN, RN]

I agree that you should have complained.

What kind of doctor gives orders (IV protonix) and then doesn't see the patient for days later, even if he isn't the admitting doctor. What kind of doctor does a procedure and doesn't follow up when he's told there was a recurrence of symptoms days later?

You have a right to be angry, I would too. You were having GI symptoms, you GI doc was notified and gave orders, and then dropped you. That's wrong.

[emmy41lgpn]

Tweety---thank you, thank you, thank you!

More to come----------

[emmy41lgpn]

Maaybe I need to tell you more about WHY I might be a stickler for details, which I am not.

In November. 2004, I was diagnosed with cecal adenocarcinoma, stage 2, with lymphovascular invasion.I had 18 inches of my colon removed, and had 27 5FU and Leucovorin chemo treatments.

I had 3 Docs at the time--my family Doc, a cardiologist, (had a triple by-pass in 2002 for unstable angina, then a "mild M.I. 5 weeks later), and a pulmonologist for C.O.P.D. and sleep apnea.

I had been telling all 3 of them that I was so S.O.B. that I had to lie down after walking across my living room.

I suppose they all assumed it was my heart disease and C.O.P.D. causing it.

Or, that I was one of those famous middle aged, anxious females we hear so much about.

In October , 2004 , the pulmonologist finally ordered some blood work---my hemoglobin was 6.2. my hematocrit was 22.

I was admitted through the E.R., given 3 units of packed red blood cells, started colonoscopy prep, had a CT scan, etc.

Had my hemi-colectomy, went home after 10 days.

I could have died----------one little blood test saved me.

I trusted my Docs to look out for me--they let me down.

It has been almost 4 years ---so far, so good.

This experience taught me to always be your own advocate---if that makes me a person who would not be satisfied with ANY Doctor, and a stickler for details, so be it.

All of you will, one day, be a patient. Look out for numero uno.

When I realized that the endoscopy had caused a G.I. bleed. I of course went a little off the deep end. Wouldnt you?

Especially when your hemoblobin hit 7?

[emmy41lgpn]

MeJane19----------I sincerely hope that you have more compassion for your patients than you do for me.