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Old 01-10-2018, 04:32 AM   #4915
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Good advice and note on health care continuity. I recently went to ER, in four hours saw four Drs and six nurses as well as an EMT, who actually did virtually all my care. When here in Pittsburgh and using UPMC everything is "in the system" when it's done, all tests notes etc and everything is accessable on a patient portal by patient or anyone with user name and password. My wife could track everything, every test on her phone. Take care Maggie, patience, our best.
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Old 01-10-2018, 05:33 AM   #4916
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I have heard that ďan acceptable level of errorĒ. is now so high in hospitals that it is equivalent to the airline industry losing two or three airplanes a week to major accidents. Unacceptable.

Two years ago when my husband died, the ER doctor looked at only part of his records from a brief hospital admission two weeks before and then lit into my daughter with a "You should have expected this..." diatribe. I was out of town, and it took me three hours to get there. By the time I did, my daughter had been convinced that I left town knowing that John was likely to be stricken while she was responsible for his care.

The doctor had failed to look at the subsequent CT scan that showed all was OK. The gas in his GI tract that showed in the first CT scan was from soda pop he'd been drinking, against doctor's orders.

I'm still struggling to repair the damage to my family. When grief turns to anger, it can be hard to overcome.
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Old 01-10-2018, 05:56 AM   #4917
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Thanks, Bud.

While I without exception felt I had very skilled and knowledgeable caregivers, and received excellent care, there is now a very strong feeling of being not completely “safe” in this new kind of medical care...having to do with things that were missed when I was admitted, and something critical I was not advised of during my stay...an issue not part of my discharge instructions, nor relayed to my pcp for follow-up.

But for my pressing my pcp on a related issue on Monday, the problem would still be hidden in test results in my electronic file...my care now transferred out of the hospital and back to him.

No collective memory, continuity fragile, and many cooks in our healthcare kitchen.

Used to be, test results and interpretations came to your physician in hard copy, looked at by them before being filed. That is no longer the case, and the conga line practice of pseudo-pcp’s passing thru your care whilst you are in the hospital is by its very nature ripe for error.

I’ve now allowed my medical social worker daughter access to my electronic health record, should there be a time when I can’t look at it and speak to things myself...she in coordination with my son would be my medical advocates.

We are not naturally geared to look at test results and ask questions about our medical care, ourselves, I don’t think...but we need to be.

It’s a whole new medical care world out there.

Maggie
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Old 01-10-2018, 06:10 AM   #4918
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We are not naturally geared to look at test results and ask questions about our medical care, ourselves, I donít think...but we need to be.
I make a point of asking for test results in hard-copy before I leave the doctor's office. And when I travel I make a point of taking a copy of at least SOME of the results (blood work requested by my endocrinologist, for one) with me when I travel.

If I encountered a physician who wouldn't provide hard-copy test results directly into my grubby hands, I would be looking for a new physician. Being an informed patient is the best possible way for anyone with medical issues to live a long and healthy life.
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Old 01-10-2018, 07:32 AM   #4919
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Don't forget the LAWYERS; note all the ads on TV planting ideas for a GET RICH QUICK.
These days, doctors practice defensive medicine. They order extensive tests to C Y A and still treat the patient. Than they get in trouble with the payer for over charging. Next, there is the thing of keeping the patient in the hospital too long. The patient has tried to self treat and by this time the problem has got to the critical point. Each situation has a length of stay and $ amount tied to it.
I could keep going, but... The whole thing comes down to $$$$$$$$$.
though not a physician, I worked in and out of the hospital and saw it.
Sorry for the rant, Maggie
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Old 01-10-2018, 10:33 AM   #4920
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Dear Maggie, get well soon! I can't quite imagine you with a pirate patch. How about making a tiny crocheted doily in the shape of a rose?

I never mastered crochet or I'd make it for you...

Please let us know how you are progressing.

Paula

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Old 01-10-2018, 10:36 AM   #4921
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Even with double vision, I have managed to bake a loaf of Dutch Oven Rye Bread...
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Old 01-10-2018, 10:44 AM   #4922
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Dear Maggie, get well soon! I can't quite imagine you with a pirate patch. How about making a tiny crocheted doily in the shape of a rose?

I never mastered crochet or I'd make it for you...

Please let us know how you are progressing.

Paula

Paula, thawed out at Travelers Rest, Dade City.
Thank you, Paula.

I have been puttering around the house without the patch the last few days...it seemed more needed in the early days ambulating at the hospital, and the first few here, but I am managing pretty well lately without it.

My vision has not improved, but I see my opthalmologist tomorrow and am looking forward to what he has to say.

The bleed has to absorb into the tissue, before I am considered healed, and the neurologist said that will take 3-6 weeks....itís not yet been two, so I need to be patient.

Iíve just ordered dog food and paper products online.

Maggie
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Old 01-10-2018, 12:09 PM   #4923
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Good morning, Maggie. I hope your eye MD visit gave you some good news. My latest analogy of you..... THE ENERGIZER BUNNY!

You are very correct in your opinion of hospital care. It all comes down to $$$$! as far as the hospital, the "interim doctors", who sometimes make a minimal appearance in one's hospital room....(I wonder, if intention to get their visit on the record, to get paid for setting one foot into the room....some did exactly that on my last hospitalization, and in my opinion, offered exactly nothing of value for my care)!

Even when there is a valid reason for proper care, the insurance has the bottom line of what care you may or may not receive. Patient centric care is a phenomenon these days, it appears. Hospitals import "nurses" from other countries, most of whom speak little if any understandable English.....all to save a few bucks! You are lucky if you do get a well educated American nurse who is truly dedicated to giving the best patient care possible. I had some of these kind of nurses as well, but, other ones show up on the next shift who I would not want to care for my dogs!

It most certainly behooves the patient and family to be their own advocate, educate themselves as much as possible, question if something does not seem right....don't be a sheep and follow blindly, assuming they know "what the h*#l they are doing! Case in point... The nurse who tried to convince me that my IV was not infiltrated, when it obviously was. She was about to shove a medication in, without double checking if IV was still intact, a rule any nurse should know, the med could have caused serious tissue damage in an infiltrated IV. I refused her attempts., and asked for an IV THERAPIST TO BE CALLED TO MY ROOM, STAT. The IV team nurse arrived, confirmed my assessment, removed the IV, and inserted a new IV, before administering the meds.

My last time in hospital was so stressful, trying to assure my care was accurate, refusing some obviously, terrible instructions, monitoring what medications the poorly educated nurses were giving me, correcting their mistakes, etc., that I was begging to be released home so that I and my daughter could provide adequate care for me.

In November, I contracted a serious form of bacterial pneumonia that rapidly affected all four lobes of my lungs. My MD, whom I have great confidence in, told me to go to ER, as the illness exacerbated to a critical level, on a Saturday. I bargained with him to supply the medicines I needed so that I could care for myself at home. We agreed that I would go to ER if I felt I was in a situation that I would want my daughter to go if it were her health at risk. On Monday, my daughter took me in to my MD, where he ordered an IV placement at their clinic and I was sent home with potent IV antibiotics + other meds, where my daughter and I provided the proper care till I was well.

True, everyone cannot do this for themselves, but, as a well trained RN, with all my abilities intact, and my daughter's care, who also has a medical background, I was able to heal without the stress of my prior experience.

My advice to all..... Speak up for yourself, ask questions, know what is going into your body and why. Keep with you, copies of your current medical care, and make sure it is actually read by those who may interact with you. Hospital professionals do make mistakes....some lead to worsened health care, even death. Not meaning to scare you....just be aware and prepared!
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Old 01-10-2018, 01:30 PM   #4924
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Goodness, Evelyn, that sounds like a really scary situation, and glad you were able to successfully take over your own care.

Maggie
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Old 01-10-2018, 02:25 PM   #4925
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One of the reasons I'm moving is to be near my daughter who works in a hospital. If I get sick, I want her nearby to monitor my care.
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Old 01-10-2018, 07:08 PM   #4926
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Good move, Mimi! Family and you are your own best advocates. Maggie, I am so glad for you that your son is close by. Knowing someone is looking out for you is especially important when your only choice is to go into hospital.

There was a time when patient care was the most important issue in a hospital. There have been such drastic changes in the hospital and medical systems, and greatly impacted by the control of the insurance industry. I have learned through experience, something that I was beginning to fear about 9 years ago. Such drastic changes, especially in the care and impact of the elderly population, seemed to demonstrate in the less aggressive treatment one receives as one ages.

It seems to be a loosely held "secret" that when one reaches an advanced age, perhaps it is not worth the money invested in an old person. I found that when I do go to hospital for tests, etc., I am questioned as to whether I want to be resuscitated and at that time, I assure them that my life has value, I have many years ahead, and that I lead an active life.
Upon hearing this response, I have been asked what do I do with my time, in my retirement years?

I load them up with my lifestyle activities, including use of my motor home, travel, outdoor activities...and that I do it all without help from anyone. Their response is always one of surprise, and I insist that they give me the proper care they would want for themselves. You would be surprised at the difference it makes. I also let them know I am a nurse and know what is going on, and that I require the best patient care possible.

There is a huge difference in the care a nurse or doctor receives, no matter how old.
I am not the least shy in telling a young nurse how to do the task, if they appear to be inexperienced or hesitant. It is my body, my health at stake, after all.
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Old 01-10-2018, 08:55 PM   #4927
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Oh my gosh, Maggie! I'm just now reading your recent posts. So sorry to hear about your incident. I hope that time will restore your proper sight and that you will soon be back to your normal self. Sending healing thoughts your way!
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Old 01-11-2018, 05:33 AM   #4928
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Thank you.

I was asked in the ER whether, should my condition deteriorate and I require intubation, etc., did I want this and other life saving measures performed.

I was more than a bit taken aback, just finally into a room and not even yet having had the first ct nor diagnosis of the “pontine bleed”...and being otherwise alert and in good health.

I responded that I am only 68, so of course want everything done possible unless I am determined brain dead, in which case my children will make decisions accordingly.

I have heard from friends in the medical field the same loosely-held secret in the health industry, driven by the insurance companies, that health services may not be “worth it” for the elderly.

I don’t consider myself “elderly”, for one, and find it disturbing that there could be out there such an overall attitude and approach to medical care for the aging.

I don’t recall any such qualifiers in my insurance documents, that less than optimal care may be provided beyond a certain age....this may actually be a passive practice and approach, hidden within the “acceptable level of error” standard.

That is pretty darned scary.

Maggie
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