woman dies in ER waiting room (article)

Nurses General Nursing

Published

http://www.latimes.com/news/local/la-me-king20may20,0,6057993.story?page=1&coll=la-home-center

the first few paragraphs, click link for rest of story (too long to cut/paste)

In the emergency room at Martin Luther King Jr.-Harbor Hospital, Edith Isabel Rodriguez was seen as a complainer.

"Thanks a lot, officers," an emergency room nurse told Los Angeles County police who brought in Rodriguez early May 9 after finding her in front of the Willowbrook hospital yelling for help. "This is her third time here."

The 43-year-old mother of three had been released from the emergency room hours earlier, her third visit in three days for abdominal pain. She'd been given prescription medication and a doctor's appointment.

Turning to Rodriguez, the nurse said, "You have already been seen, and there is nothing we can do," according to a report by the county office of public safety, which provides security at the hospital.

Parked in the emergency room lobby in a wheelchair after police left, she fell to the floor. She lay on the linoleum, writhing in pain, for 45 minutes, as staffers worked at their desks and numerous patients looked on.

Aside from one patient who briefly checked on her condition, no one helped her. A janitor cleaned the floor around her as if she were a piece of furniture. A closed-circuit camera captured everyone's apparent indifference.

Arriving to find Rodriguez on the floor, her boyfriend unsuccessfully tried to enlist help from the medical staff and county police — even a 911 dispatcher, who balked at sending rescuers to a hospital.

Alerted to the "disturbance" in the lobby, police stepped in — by running Rodriguez's record. They found an outstanding warrant and prepared to take her to jail. She died before she could be put into a squad car.

interesting. says she was in for abd pain 3x in 3 days,but never what they did for her test wise, or what they suspected her diagnosis was, etc.

Specializes in Nothing but ER.

okay two posts in a row. Perhaps we as ED nurses should learn spanish. Too many of out patients do not understand english and this presents a major barrier to safe and effective care. I do not get the comments regarding the poor not recieving appropriate care either. We see more "poor" people in the ED than "rich" people on a day-to-day basis. Everyone recieves unbiased treatment.

We see more "poor" people in the ED than "rich" people on a day-to-day basis. Everyone recieves unbiased treatment.

*very dryly*

Not according to non-ER nurses......according to them we are the worst nurses around

okay two posts in a row. Perhaps we as ED nurses should learn spanish. Too many of out patients do not understand english and this presents a major barrier to safe and effective care. I do not get the comments regarding the poor not recieving appropriate care either. We see more "poor" people in the ED than "rich" people on a day-to-day basis. Everyone recieves unbiased treatment.

Huh?

Yeah, you treat that poor person. And then they leave and have no way to afford follow-up or prescription refills.

Geeze, don't read that nonsense into my posts.

Specializes in ER, ICU, Infusion, peds, informatics.
yes, the doctor is at fault for missing a perf'd bowel, but the triage nurse did not triage as she was supposed to. she carries some of the blame here.

do you really think so, tazzi??? i hope you don't mind that i'm quoting your post here, because i'm actually going to respond to a couple of different posts.

my intent isn't to come off argumentative, because i usually agree with what you write, and i do see your point here. but, i'm going to look at this from a little different view, mostly because i read a different article in the begining, so my initial thoughts were a little different. i know that hospital has a horrible reputation, so maybe i'm "reaching," but....

from what i have read, (and it isn't clear), but it sounds like the patient was in the waiting room for about 45 min. i don't know about anyone else here, but i've been more than 45 minutes behind in triage before. doesn't happen all that often, but especially right around 6pm or so, there can be a huge influx of patients signing in. suddenly, you look up, and there are 15, 20 people waiting to be triaged. even if you are flying, and can triage each in 5 minutes (which is unlikely, at best). you are looking at longer than 45 minutes until you see the last person. and even if she checks in c/o severe abd pain, she had just been seen. unless my instincts are dead-on that night and i have "funny feeling" about her, i'm not going to bump her to the front of the triage line. as canoehead said in the other thread, she was just discharged. i'm going to be thinking that i need to see the other patients, those who haven't had a mse yet, first, before i see the one that was just discharged.

honestly, some of that would depend on what kind of work-up she had in the earlier visits. if she'd had a full work-up (lab, ct, etc), there is no way i'd see her first (unless something in the first one had been suspicious). if she hadn't had a full workup, i'd have been a little more concerned. however, i'd only know what kind of workup there was if i had time to look. if i was really busy, i don't look at the old records. i just write down what they tell me.

as for the staff ignoring someone rolling on the floor in pain.....often times we have to, because there are many patients that do it all the time, even when they arn't in pain. it loses its impact after a while. how do we know they arn't in pain? well, we don't, but it is a pretty good bet when they only do it when they know someone is watching. kind of like the "seizures" that are "cured" when a foley catheter come into the picture.

we have a frequent flier that comes in every night. he is homeless. every night, he is triaged and seen and discharged. and then he won't leave, so we often have to call security to get rid of him. but, he does get triaged, and he gets his mse. yeah, if we are busy, i'm probably going to see other patients before i see him. but, i'm still going to see him.

i definatly agree with angel that there is info missing in the article. i'd especially be interested in what kind of work-ups she'd had in her previous visits.

i also think it is easy to pass judgement on the triage nurse, especially since she apparently resigned after the incident. but we don't know what was going on in that waiting room that night. and, if i had been her, i probably would have resigned as well even if i hadn't been ignoring the patient, but was planning ot get to her as soon as i had triaged the people that had come in before her. if that had happened to me, i would be devistated, and would have wanted to get out of that situation (king/drew er) as soon as possible.

i am open to the possibility that i am way off base here, and that maybe the waiting room was empty, and the triage nurse was just being craky, lazy, and mean, and just flat-out refused to see the patient. i am also open to the possibility that it was somewhere inbetween (busy er, though not packed, and the traige nurse was avoiding seeing the patient until she got done with lunch, or whatever). i just wanted to point out, though, that we don't know all the facts.

Specializes in Nurses who are mentally sicked.
I don't think the nurse is entirely to blame here. You have to remember she was discharged by a DOCTOR only 3 hours prior!

Also, the police were the ones who brought her to the ER in the first place to be examined. obviously they thought her complaints were warranted at some point.

Sad, very sad for all involved. I hope whoever inspects the place in the next 6 weeks goes over the place like a toothbrush on tile grout!

Hi Kukukajoo!

It is you again....

Let's go straight to the point...

Yes, indeed, the nurse is responsible for it, and she is entirely to blame here.

If the doctor discharged this patients a few hours ago, and based on your assessment skills; you found out the patient was not supposed to be discharged...then the nurses had to speak up....even she might have to confront the doctors. If we the nurses do not speak up for the patients, then who else is doing it for them. I hope that nurse will lose her license for good, inasmuch as she did not care about the patient, nor do I think she has the assessment skills.

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Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.
okay two posts in a row. Perhaps we as ED nurses should learn spanish. Too many of out patients do not understand english and this presents a major barrier to safe and effective care. I do not get the comments regarding the poor not receiving appropriate care either. We see more "poor" people in the ED than "rich" people on a day-to-day basis. Everyone receives unbiased treatment.

Mrs. Rodriguez was a native Californian, according to the article. Apparently, there was no language problem. The woman had her ER discharge instructions which said for her to return if she had more pain, nausea, or vomiting. She had been to the ER 3 times in as many days. The triage nurse told her she had already been seen and there was nothing else they could do for her. Perhaps if the triage nurse had bothered to take her temp....But this is exactly what I mean about ER nurses who are so judgmental. You see a person you have dubbed a frequent flyer and your normally excellent assessment skills go out the window and are replaced by "WHAT YOU ALREADY KNOW IS WRONG" with the frequent flyer.

Of course you don't do this, but from what I've seen in my own family member visits to ER, many nurses do exactly this.

Specializes in Assisted Living Nurse Manager.

What a horrible, horrible story. Each and every person deserves quality care regardless of thier ability to pay.

My husband and I have had something like this happen to us when we had no insurance. To make a long story short, I had my husband in the ER 3 times in a week for abdominal pain and sent home each time with no work -up. Just told to come back if the pain gets worse. Well it did and if it was not for a friend of mine who is a RN my husband would be dead right now from a ruptured appendix. It had been ruptured for 48 hours before anyone would listen to us. I chalk that up to having no insurance.

I hope this family takes action against those who just stood by and did nothing.

Just my 2 cents.

Specializes in Acute Care Psych, DNP Student.
LEOs are not doctors.

They frequently see citizens who are agitated & histrionic.

The police normally wouldn't remove an apparently distressed patient from the ER unless someone on the staff indicated she was ok to go & they weren't going to treat her.

Ok, you are probably correct. I'm just temporarily biased against cops.

the nurse is responsible for it, and she is entirely to blame here.

If the doctor discharged this patients a few hours ago, and based on your assessment skills; you found out the patient was not supposed to be discharged...then the nurses had to speak up....even she might have to confront the doctors. If we the nurses do not speak up for the patients, then who else is doing it for them. I hope that nurse will lose her license for good, inasmuch as she did not care about the patient, nor do I think she has the assessment skills.

- did the nurse have adequate assessment skills?

- or poor judgment?

- the well-being of this patient is not a choice - she died unnecessarily - this is serious!

- and what about the doctor's skills?

The woman who died was not adequately assessed by the health care professionals.

The health care professionals are responsible for this happening.

They failed to meet this woman's needs.

Specializes in Nothing but ER.
Mrs. Rodriguez was a native Californian, according to the article. Apparently, there was no language problem. The woman had her ER discharge instructions which said for her to return if she had more pain, nausea, or vomiting. She had been to the ER 3 times in as many days. The triage nurse told her she had already been seen and there was nothing else they could do for her. Perhaps if the triage nurse had bothered to take her temp....But this is exactly what I mean about ER nurses who are so judgmental. You see a person you have dubbed a frequent flyer and your normally excellent assessment skills go out the window and are replaced by "WHAT YOU ALREADY KNOW IS WRONG" with the frequent flyer.

Of course you don't do this, but from what I've seen in my own family member visits to ER, many nurses do exactly this.

Not. We have a incredably frequent flyer . She came in one day with an MI. Due to use NOT throwing away our assessment skills and not judging her even though she sometimes comes in 2x a wk and in lower income etc.-We listened to her AND SAVED HER LIVE. And yes she still visits us frequently for minor cc especially on holidays. This is not an isolated incident. Thats what makes ED nursing such an art form YOU CANT EVER KNOW WHAT IS WRONG. Because the minute you do that something will bit you in the rear badly and people will sufer. Sorry, i work in a busy ED. Im in the enviroment. I am sorry for the aparently horrible experiences you have suffered during your ED visits.Whatever you have experienced, please note it is unfair to judge us all. Thats called generalizing and I was taught NEVER to do that in nursing school.

Specializes in Nothing but ER.

Sorry for the spelling errors in the above post. I really do know how to spell.

Specializes in Nurses who are mentally sicked.
Not. We have a incredably frequent flyer . She came in one day with an MI. Due to use NOT throwing away our assessment skills and not judging her even though she sometimes comes in 2x a wk and in lower income etc.-We listened to her AND SAVED HER LIVE. And yes she still visits us frequently for minor cc especially on holidays. This is not an isolated incident. Thats what makes ED nursing such an art form YOU CANT EVER KNOW WHAT IS WRONG. Because the minute you do that something will bit you in the rear badly and people will sufer. Sorry, i work in a busy ED. Im in the enviroment. I am sorry for the aparently horrible experiences you have suffered during your ED visits.Whatever you have experienced, please note it is unfair to judge us all. Thats called generalizing and I was taught NEVER to do that in nursing school.

"Generalizing....I was taught NEVER to do that in nursing school."

Didn't Ms. Edith Rodriquez died from it...

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