Do docs really even care about their patients anymore?

[jnette]

AAAAAAAAAAAAAARRRGH !!!

What IS it with doctors these days??? Have they just stopped CARING about our elderly population altogether? Do they just want to rake in the $$ but brush off legitimate c/o's ? How many times does a nurse have to fax and/or call before they take seriously what you are telling them about their patient, and choose to intervene, and intervene appropriately???

Of course, coming from the dialysis arena, I'm not too used to dealing with many docs... just one..our nephrologist..and who was also the medical director.

But now in HH I'm seeing things that make me want to spit! :angryfire

I had one patient taken to the ER last night, AFTER I had already done an unscheduled visit with her in the afternoon, as requested by her pleading dtr. Over the past week her mother has been having what I considered to be TIA's... never had these before, getting worse, longer and longer periods of "zoning out", stuttering, unresponsive to visual or tactile stimuli, and even drooling during these times.

Some would last up to 15 minutes or more, according to the dtr. When the dtr. first called the doc about these episodes, the doc simply told her to DC her xanax.. nothing more... did not ask to see her, nothing. Just brushed the daughter off. Of course I faxed the doc with my findings as well.. to no avail. When I went in to see her again yesterday, the pt. was just stuttering up a storm, trying so hard to get the words out. Eyes pleading to be heard and understood. Left upper extremity pitting edema, body hurting all over according to dtr.

VSS all stable, PERRLA, but just stuttering and blubbering. Went back to the office and faxed all my findings once again, stating that this was NOT the patient I had been introduced to only three weeks ago. The dtr. had called hte doctor office three times in this week asking for bloodwork orders for us to draw... never a response. Finally yesterday, after I called from the pt. home, they gave us an order for a CMP and CBC.

Last night (I had call) the dtr. calls me stating her mother was not able to hold a cup, or even drink from a straw... would reach for them and miss every time, and when she attempted to feed her, the liquid or food would just roll out of her mouth. Her gaze was far off and she was just "out of it". I told her to get her to the ER stat. Sure enough, this morning they tell me she was having TIA's and LOTS of them.. did a cat scan, etc. Mentioned carotid surgery, etc.

So tell me WHY would her doc not see her before this, after both her dtr. and I calling, faxing, doing everything in our power to get her attention?

What about my sweet little lady with CHF, hx. of Afib, severe mitral insufficiency.... who can NEVER give me an adequate O2Sat? In the seventies and low eighties EVERY time, SOB episodes leading to frequent falls. I spend nearly an hour with her alone, just trying to get those sats up to 90.. massaging her arms, fingers, etc. Doc merely says for her to wear her 02....well, she HAS been ! 24/7. This has been going on for nearly two MONTHS! He sees her, nothing changes, except diddling with her fluid pill a bit here and there. She has no adventitious breath sounds, no pedal edema... she is simply severly hypoxic, dang it !

Is there any reason for her not to be on digoxin? She used to be and says felt better then, but it was DC'd back in January before I got to know her. Any reason with her medical hx. she would not be a candidate? You guys no more about this stuff than I do. Just curious.

I have called and faxed her doc over and over as well.... they check her out, send her home, and "come see me in another month or two..." Her son is livid. This is one precious, spunky, life-loving little woman, who loves to be active, and now spends most of her time avoiding falls d/t hypoxia.

I say she needs another thorough cadriac work-up at a REPUTABLE institution with some docs who actually give a hoot. GRRRRRRRRRRRRRRRRRRRR !!!!! :angryfire

What say you? I'm foaming at the mouth here. Truly.

[lamazeteacher]

Jnette, in my new job only a month, and thought I was the only one finding that physicians really do not seem to give a hoot about anyone in a LTC facility.

Can't tell you how many times I've faxed, re-faxed, called, re-called, re-faxed - all in vain. And not about minor scratches. Issues that I'm certain would get almost immediate attention if the patient were in their 30's.

It does indeed seem as though docs are tired of problems associated with advanced age and just want all the old folks to just roll over and die.

And with our census at well over 100, we're dealing with almost as many docs. Don't know whether to pull out my hair, scream, or just go and screech in their faces.

What a shame it has all come down to money. Forget 'First do no harm' - nowadays its 'First check the insurance benefits'. :angryfire

THAT'S WHY "SINGLE PAYER" IS THE WAY TO GO, THEN ALL PATIENTS WILL HAVE THE SAME PAYMENT!!!!! :balloons:

[lamazeteacher]

If money is everything, have the family put a lawyer on the trail.

That could put her in a fix, as well as her Home Health company. Our role is to care for the patient. If the family hasn't already gotten that the physician isn't giving good care, and what they need to do about it - like change to another doc - all the legal representation they could get wouldn't help the patient now. I don't know many MDs who will assume care when the patient is suing the former doc..........:uhoh21: