Quote:
Originally Posted by texasfal
I went to the ER around 11pm with chest pains, backache and copious vomiting last Wednesday. The nurse ran an EKG around 11:30 and told me to wait in the lobby. After no attention from anyone, at 4 am my husband told the nurse that we were going home. Suddenly a doctor was available and he told me I had together admitted to run tests to figure out the chest pain. The nurse told me they had a bed for me she had a bed for me. My husband went home because he had to be at work at 7am. The nurse wheeled me into the ER and put me on a gurney in the hall in the er. I stayed on that gurney for 16 hours flat on my back with a heart monitor on. Finally at 6:30 pm Thursday I was put in a room in the cardiac unit. The rest of my stay was fine but I'll never go to The Villages ER again.
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I apologize for the length of this post in advance, but having read most of the threads concerning TVRH over the last year, I think we need to put some perspective on the issues.
First of all, if I were a lay person, my impression of TVRH would be horrible. Many of the stories,
IF they occurred as posted, would be open and closed malpractice if there was any injury to the patient. But as you know, there are always 2 sides to any story. No one has to be lying, they just relate the story as they remember it, or as they heard it second hand. Just ask any LEO what they get when interviewing "eyewitnesses" and it's really the same thing. Also, someone who feels they had a "bad" experience is probably ten times more likely to post than those who had a "good" experience
Next, please remember that it is NOT the ER doctors and nurses who are creating a jammed ER and a long wait, it is the volume of patients. The nature of ER medicine is that you can be twiddling your thumbs one minute and overwhelmed the next. Someone above posted that no ER should be allowed to operate if they cannot handle the load. Ridiculous. No ER can staff for peak volume any more than a restaurant or grocery store. All ERs get stuck with 30-40% of patients showing up with non-emergent and non-urgent problems. Those patients will be triaged and have the longest wait. Everyone feels that THEIR problem is the most important case in the ER, but that is most certainly not true
Here are the top 5 patient complaints to hospital administration in Central NY:
1) too long a wait in the ER
2) too long to get a bed if admitted
3) too long a wait for the nurse to answer the call bell
4) the nurse/aide/MD was discourteous
5) the food is bad/cold
Sound familiar? Seen it on TOTV regarding TVRH?
I hope no one thinks that the purpose of opening TVRH was to provide the worst patient experience and the most sub-standard care imaginable?
When I evaluate a post with a complaint, I'm looking at it differently. Was the evaluation appropriate to the complaint? Were the correct tests ordered and correct treatments rendered? Was the standard of care followed? If something went wrong, then why? And what was the medical thinking?
This is called quality assurance, and every hospital has a QA committee. I know something about it having chaired one for many years.
The QA committee get tons of information to evaluate. ER wait times are tracked, so is the wait time for a bed, both in the context of # of patients signed into the ER and # of beds available. All medication "errors" are tracked, all patient complaints are evaluated, even the temperature of food leaving the kitchen and on arrival at the room is looked at. Now, you may get a letter that says something along the lines of "We're sorry to hear you were dissatisfied with your recent hospital experience and we are continually looking at problems and ways to improve them", but behind the scenes these complaints are taken seriously. The QA committee is responsible to report this information and suggestions for improvement to the Executive Committee--which by the way I have also chaired---and the Executive Committee along with the Board of Governors --which I also been a member of---is legally responsible to the State Health Department. All hospitals undergo a periodic review either by JCAHO or the State Health Department or both, and trust me, these are VERY SERIOUS evaluations.
So, to look a little closer at the post I quoted. As posted, this is unacceptable, but I would have many follow up questions, since it is impossible to evaluate the quality of care from the information given:
1) How long were the symptoms present before going to the ER?--if they were constant for 3 days, and the EKG was normal, it is highly unlikely to be cardiac in origin. More likely to be digestive in nature, Did they do pancreatic enzymes?, or a RUQ ultrasound? On the other hand, if the symptoms started within the hour, this is ACS (acute coronary syndrome) until proven otherwise
2) what did the EKG show, and was it looked at immediately by the doctor?
3) Did they run immediate Troponin I (cardiac enzymes), and since the patient was there 24 hours, 2 more sets and serial EKGs?
4) Did they give the patient an aspirin to chew on arrival. Did they give NTG? MSO4-?
5) I am a little confused by a cardiac unit admission after 24 hours. Everything that would be done in the CCU in the first 24 hours should have been done, then a determination of whether the patient is stable for a stress test or needs cardiac cath would be made. So, did it turn out to be cardiac, or was it cholelithiasis, or pancreatitis, or gastritis? Was it a kidney stone? Was it a herniated disc?
As you can see, there's a lot more that goes into this than the waiting time
In a perfect world, we all could walk into an ER, or urgent care, or a doctor's office and they would be waiting for us to arrive and instantly diagnose and treat us. Not happening, not in this world
Lastly, as far as never going to the TVRH ER again, beware of absolutes. If you have a life threatening injury or medical event at Spanish Springs, guess where you'll be happy to go, and be happy that it's there