TV emergency room

[Sage327]

IT sounds like they should be reported. I'm not sure who you would contact but these horror stories should be brought to some official's attention. In this day and age this treatment is unacceptable..

[twinklesweep]

Just last week, the Florida Legislature decided not to expand medicaid to almost one million uninsured Floridians, thereby passing up 51 billion dollars in federal dollars over the next ten years.

Those federal dollars, paid by Floridians in their income taxes, will now go to other states. Think about that the next time you pay your income taxes. Your tax dollars are going to pay for healthcare in other states. How does that help the healthcare situation in Florida?

Outrageous! I was not aware of this. We can use the ballot box to fix this. But will we?...


great post! and while i am not a subscriber to the single payer system philosophy, i, too have a healthcare fantasy......

would that those who are truly concerned about health insurance and health care would eliminate the waste, fraud and abuse in each of those industries. having worked a good number of years in both industries and then in a state office that licenses the professionals and technical employees in those professions - i am confident that such an effort would result in the fiscal wherewithall to provide quality care for all!

adjunct efforts to the elimination of waste, fraud and abuse that are required are the changes in tort law and in the mindset to sue! but that is another issue for another thread!

These are certainly worthwhile fantasies to consider. However, even with the elimination of "waste, fraud and abuse in each of those industries" and tort reform, we are still left with INSURED and UNINSURED. I still feel that the best way to get rid of the latter is to eliminate INSURANCE as the structure for providing health care....

[Moderator]

A reminder, the topic is TVRH Emergency Room, not national health insurance/health care issues.

Timely since today's paper discusses future expansion plans for TVRH and doubling the number of ER beds.

[JB in TV]

Announced in this morning's Daily Sun:

"$50 Million HOSPITAL EXPANSION" Addition will double size of emergency room.

[OnTrack]

"TOTV members discussions, spur action to address emergency room shortcomings."

I like it! :D

.

[graciegirl]

On the Front page of Today's Daily Sun there was a story about the expansion of the hospital. It is a step forward I hope.

[spk7951]

Can someone give me a brief overview of the hospital story? Still out of town for another week or so and we are curious about the announcement. Did not see it posted yet on the Daily Sun web site.

[janmcn]

Can someone give me a brief overview of the hospital story? Still out of town for another week or so and we are curious about the announcement. Did not see it posted yet on the Daily Sun web site.

The front page article is now posted on The Daily Sun's website.

[Russ_Boston]

The front page article is now posted on The Daily Sun's website.

Shouldn't be news to anyone since we detailed most of it earlier in this thread. Devil is in the details however.

Still don't know how they are going to staff it when we have issues today with only 200 beds and 25 ER rooms. Hope they have a plan.

[KatieDidNot]

Russ Boston

My Mother had to use The Villages ER after an accident and she was properly triaged by the nurses, received immediate assistance and was hospitalized for a week. The doctors and nurses took exceptional care of her, and I would like to thank you all for that.

I too got to see all the beds with the EMTs in the hallway of the ER, but I think the Nurses who are working overtime to make sure they get it right are doing the best with the resources they have.

Anyway, I hope this expansion helps...it is certainly a step in the right direction.

Katie

[zonerboy]

In addition to doubling the number of ER rooms they better double the number of ER docs, or else patients will still face 8 hour waits before being seen.
I spent over 8 hours in the waiting room in severe pain from a kidney stone before being evaluated and medicated. This was 9 months ago.

[Russ_Boston]

In addition to doubling the number of ER rooms they better double the number of ER docs, or else patients will still face 8 hour waits before being seen.
I spent over 8 hours in the waiting room in severe pain from a kidney stone before being evaluated and medicated. This was 9 months ago.
Yes, as I mentioned staffing will be the real issue going forward, not available space.

[johndamelio]

I've been there twice . Both times there was a wait of 8 + hours.
Nurses have told me that when snowbirds are here they are overwhelmed.
I'll try Leesburgh next time if I have to.

[perrjojo]

I also read in The Daily Sun that part of the problem was that 10 to 15 patients a day come to the ER with chest pain. It was stated that Medicare required that chest pain patients must be tested and observed for 24 hours before they can be admitted. Is this truly the protocol?

[The Buckeyes]

In addition to doubling the number of ER rooms they better double the number of ER docs, or else patients will still face 8 hour waits before being seen.
I spent over 8 hours in the waiting room in severe pain from a kidney stone before being evaluated and medicated. This was 9 months ago.

I'm surprised you didn't pass out from the pain!

[Vinny]

It is everywhere. I waited for 18 hours in NJ with painful kidney stones a few years ago.

[simpkinp]

I took my late husband to ER many times. Over in Brevard County and never got out of therein less than 8 hours, usually longer. It is not just TV Hospital. It's everywhere.

[queasy27]

I went to an urgent care center in March and after a bit of hullabaloo, they called an ambulance and hurried me out of there. The Villages hospital was diverting so I was sent to Leesburg, where the paramedics waited with me until I was processed and placed in an ER room. I ended up being admitted but had to wait in the ER for almost a day before a room became available.

In March/April, I had to go to The Villages ER, once on a Sunday morning and once at about 8:30pm on a Wednesday. The ER was almost empty on Sunday morning and full (like, no chairs left in the waiting room) on Wednesday night. Both times I was taken in and seen by an ER doctor within 15 minutes. I'm sure having a "cardiac episode" in progress considerably speeds up the triage!

At any rate, I didn't find my experiences at Leesburg and The Villages ER departments to be any different. Both were very crowded and both treated me on gurneys in the hallway because there were no ER stalls available, but I thought the care at The Villages was more than adequate. I was also admitted at TV and had no issues during my stay.

[salferg]

Forget Leesburg! We just had an 8 hour wait last week.

[daviskgb]

The same thing does not necessarily happen in other Emergency Departments (ED). Many hosptals have processes and practices in place to provide superior service that results in excellent clinical outcomes and higher patient satisfaction rates. Someone mentioned what powers that be allow this, we are the powers that be, we are the consumers. Take your business elsewhere. You would drive an extra mile to go to a new restaurant, do the same for your health. And complain! Letters to the CEO of hospital, the parent corporation and to your physician. Become involved, do not settle for less.

[dillywho]

Too many here do not seem to realize that Villagers are not the only ones using TVRH. It is not exclusive to us.

One reason for the long waits is that so many come to the ER instead of the Urgent Care centers. (As someone else pointed out, the UC will call an ambulance for something that is beyond their scope of care.) I am not talking the middle of the night but the daytime hours. I overheard one lady in the ER making a ruckus about her long wait who had been experiencing some back pain for several days and finally decided to come to the ER. This does not qualify as an "emergency" that needs to be seen immediately. The ER needs to be for emergencies only and conditions that can only be taken care of in a hospital.

As for being developer owned, the health care system is not. If it were, it would be like the rec centers, etc. that have been referenced in this thread and you would have to have your Villages ID to be treated there.

Restaurants and hospitals cannot be compared. You always have time to drive wherever to a restaurant regardless of the distance. This is not the case if you have a life-threatening emergency.

I would still like for someone to explain to me why the waiting room in the ER is not packed during holiday times. It was virtually empty over Easter. This I observed first-hand on my way in and out of the hospital when my husband was in ICU. Come Monday morning....different story.

I know this is a rant, but when you still have your loved one because of the excellent care received here, you'd be hard-pressed to see it any other way. Even when you get into the ER treatment rooms (everyone is triaged), any testing takes time....lots of time. Until results are known, you wait. Your tests are not sent to the front of the line unless there is a compelling reason.

[queasy27]

One reason for the long waits is that so many come to the ER instead of the Urgent Care centers. (As someone else pointed out, the UC will call an ambulance for something that is beyond their scope of care.) I am not talking the middle of the night but the daytime hours. I overheard one lady in the ER making a ruckus about her long wait who had been experiencing some back pain for several days and finally decided to come to the ER. This does not qualify as an "emergency" that needs to be seen immediately. The ER needs to be for emergencies only and conditions that can only be taken care of in a hospital.
There's no cure (ha!) for human nature -- people also call 911for the most mundane things.

But wouldn't it be nice if the process also worked in reverse and the hospital could send patients to urgent care. The walk-in facility could be located near/adjacent to the ER.

[Bizdoc]

I would still like for someone to explain to me why the waiting room in the ER is not packed during holiday times. It was virtually empty over Easter. This I observed first-hand on my way in and out of the hospital when my husband was in ICU. Come Monday morning....different story.
.

Having worked for a number of years in ERs at holiday time and been a medical administrator for a time, people are too busy to realize and/or acknowledge that they are ill. Go to almost any hospital ER on Christmas day and you will see lots of empty chairs. Ditto New Years Eve with New Years Day packed with folks who sobered up enough to realize what they did to themselves.

[Mack184]

The same thing does not necessarily happen in other Emergency Departments (ED). Many hosptals have processes and practices in place to provide superior service that results in excellent clinical outcomes and higher patient satisfaction rates. Someone mentioned what powers that be allow this, we are the powers that be, we are the consumers. Take your business elsewhere. You would drive an extra mile to go to a new restaurant, do the same for your health. And complain! Letters to the CEO of hospital, the parent corporation and to your physician. Become involved, do not settle for less.
Actually...take a trip in most major city ERs and you will find that a 36 hour wait is not the least bit uncommon. Most hospital ERs are WAY overburdened by things that are NOT the definition of a TRUE emergency. I hate to say it..but while a kidney stone hurts like fire it is NOT a TRUE emergency. Things like emergent strokes, MIs, gunshots, severe trauma and babies popping out trump a kidney stone every single time.

As far as complaining to hospital management, especially TVRHs hospital management, you would be better off to direct your complaints to the POTUS. Why? Because at his lawful direction in 2010 he required Medicare to REDUCE the amount of payment to hospitals and doctors. Those reimbursements will drop once more with the implementation of the Affordable Care Act on 1/1/2014.

There is currently an active thread here on TOTV griping about the cost of greens fees and other fees within TV..and how things cost more than they used to. Virtually EVERYTHING costs more than it used to. A gallon of milk, a gallon of gas, a can of beans..a knee replacement, a heart stent and so on. NOTHING costs less.

I have mentioned this multiple times here, and nobody wants to listen, but the problem at TVRH is that it receives fully 88% of it's revenue from Medicare. While the price of virtually everything is rising, the hospital is being forced to get paid less and less for the many different services it must perform in it's hospital. So exactly how do they expand their number of beds, expand their slate of doctors, nurses and other staff while they are forced to take less and less to do the same amount of work? Costs didn't go down. The cost of doing business didn't go down, but the patient load is going up and reimbursements are going down.

Last year it was said that there would be no COLA increase for SS. Seniors cried bloody murder! How would you like to get 30% less than you did? Well, that's what your local hospital is trying to figure out because that's what's been happening to them! But to listen here they are just a bunch of incompetent mangers and lazy staff who don't care about their patients! Get real! The problem is that they have to do more & more with less and less. Take a 30% cut on YOUR income and then see how you make up the difference.

And..it's not going to get better as long as the senior population here continues to increase and the Medicare reimbursements continue to get lowered. THAT is the problem. Not incompetent or uncaring service from the hospital.

[ilovetv]

Actually...take a trip in most major city ERs and you will find that a 36 hour wait is not the least bit uncommon. Most hospital ERs are WAY overburdened by things that are NOT the definition of a TRUE emergency. I hate to say it..but while a kidney stone hurts like fire it is NOT a TRUE emergency. Things like emergent strokes, MIs, gunshots, severe trauma and babies popping out trump a kidney stone every single time.

As far as complaining to hospital management, especially TVRHs hospital management, you would be better off to direct your complaints to the POTUS. Why? Because at his lawful direction in 2010 he required Medicare to REDUCE the amount of payment to hospitals and doctors. Those reimbursements will drop once more with the implementation of the Affordable Care Act on 1/1/2014.

There is currently an active thread here on TOTV griping about the cost of greens fees and other fees within TV..and how things cost more than they used to. Virtually EVERYTHING costs more than it used to. A gallon of milk, a gallon of gas, a can of beans..a knee replacement, a heart stent and so on. NOTHING costs less.

I have mentioned this multiple times here, and nobody wants to listen, but the problem at TVRH is that it receives fully 88% of it's revenue from Medicare. While the price of virtually everything is rising, the hospital is being forced to get paid less and less for the many different services it must perform in it's hospital. So exactly how do they expand their number of beds, expand their slate of doctors, nurses and other staff while they are forced to take less and less to do the same amount of work? Costs didn't go down. The cost of doing business didn't go down, but the patient load is going up and reimbursements are going down.

Last year it was said that there would be no COLA increase for SS. Seniors cried bloody murder! How would you like to get 30% less than you did? Well, that's what your local hospital is trying to figure out because that's what's been happening to them! But to listen here they are just a bunch of incompetent mangers and lazy staff who don't care about their patients! Get real! The problem is that they have to do more & more with less and less. Take a 30% cut on YOUR income and then see how you make up the difference.

And..it's not going to get better as long as the senior population here continues to increase and the Medicare reimbursements continue to get lowered. THAT is the problem. Not incompetent or uncaring service from the hospital.

This really is the crux of the problem (low medicare reimbursements being the bulk of revenue to TVRH, while costs keep going up and medicare reimbursements are being cut even more).

If not for the 500+ volunteers doing what would be paid work elsewhere, the hospital couldn't afford to keep the doors open with the lights on.

[StarbuckSammy]

Sitting in an ER waiting room for 3-12 hours is unacceptable. If this is occurring in The Villages Hospital then something must change.
Over the last 2 years, I have taken my elderly parents to the ER's located in a large metro city hospital....the waiting time..in the waiting area...was from 5 minutes to 15 minutes. This was on 5 separate occasions. One of the hospitals was located in city and the two others were in the suburbs.
Depending on The Villages Hospital's ER scares me.

[Mack184]

Sitting in an ER waiting room for 3-12 hours is unacceptable. If this is occurring in The Villages Hospital then something must change.
Over the last 2 years, I have taken my elderly parents to the ER's located in a large metro city hospital....the waiting time..in the waiting area...was from 5 minutes to 15 minutes. This was on 5 separate occasions. One of the hospitals was located in city and the two others were in the suburbs.
Depending on The Villages Hospital's ER scares me.
Before we came here my wife was at a major Baltimore hospital. ER waits averaged well over 16 hours and in many cases could run from 24-40 hours. Waiting 3.5 hours here is NOTHING. I don't know where you found your 5 minute wait but it's NOT the norm. And if you think 3.5 hours is bad..then you're going to be VASTLY disappointed going forward.

[Mack184]

This really is the crux of the problem (low medicare reimbursements being the bulk of revenue to TVRH, while costs keep going up and medicare reimbursements are being cut even more).

If not for the 500+ volunteers doing what would be paid work elsewhere, the hospital couldn't afford to keep the doors open with the lights on.
The volunteers do offer a great help to TVRH. And..if it wasn't for them, service would be even slower. Of course the volunteers cannot help/assist or provide medical services at any time.

[DianeM]

Maybe poor service is just a way to get us to die. This is very depressing to someone who hasn't even moved in yet.

[CFrance]

Maybe poor service is just a way to get us to die. This is very depressing to someone who hasn't even moved in yet.

Holy cow.

[queasy27]

It's not just Medicaid reimbursements, either. I have BCBS through my employer and they only paid $7,076 out of an $18,755 bill at TVRH.

At Leesburg hospital, they reimbursed a measly $1,345 on a $28,659 bill for a 4-day stay.

I have no idea why there was such a disparity in reimbursement percentages between the two hospitals, but I owed zero at TVRH and a $50 co-pay at Leesburg because I was admitted through the ER, so it's not like I'm personally making up the difference.

Who is making money? Hospitals and medical staff are getting squeezed to the breaking point. Various online articles put the profit margin for major insurance companies from around 4-8%, which is not exorbitant.

[DianeM]

Holy cow.

Sorry. I'm just in a crummy mood today and probably should not have written that.

[ilovetv]

Maybe poor service is just a way to get us to die. This is very depressing to someone who hasn't even moved in yet.

If I thought that a sinister, collective "somebody" running a hospital or treating patients wanted me to "just die", I certainly would not go there.

[maine04578]

I'm on Medicare and Blue Cross, but a hospital bill was sent to me for some reason (I don't usually see them), and I was stunned. My paper "johnny" was $65. Each pair of latex gloves in the OR was billed at $14. I could go on, but why bother? Recent coverage of outrageous hospital billing reveals that hospitals use a price list that has no relation to the actual cost of items they bill to patients/insurance companies.

[DianeM]

If I thought that a sinister, collective "somebody" running a hospital or treating patients wanted me to "just die", I certainly would not go there.

OK OK - I admitted to just being in a crummy mood.

[CFrance]

OK OK - I admitted to just being in a crummy mood.

This whole subject is enough to put anyone in a crummy mood.:cryin2:

[DianeM]

This whole subject is enough to put anyone in a crummy mood.:cryin2:

Isn't that the truth. Very depressing.

[StarbuckSammy]

The initial post for this thread is the unacceptable time one spends in The Villages ER. I have suggested in my previous post of much better experiences in other hospitals in my northern home.
The one thing that TV Hospital should do is post the ER wait time. That way, you would have some sort of expectation. As an example, as I write this Ocala Regional Er Wait Time is 13 minutes and FL Waterman ER Wait Time is 20 minutes.
According to Medicare the wait times to see a health care professional for selected ER's are as follows:
The Villages-55 minutes
Munroe -52 minutes
Leesburg-50 minutes
Waterman-35 minutes
Ocala Regional-18 minutes
FL Avg-29 minutes
National Avg- 29 minutes

See a trend? Performance? Look who posts their wait time.
No one of course would object to wait 50 minutes. But when you under perform the national average by a wide margin then I would suggest that there is a real problem and those that complain about their experience certainly have a legitimate complaint.

[Mack184]

The initial post for this thread is the unacceptable time one spends in The Villages ER. I have suggested in my previous post of much better experiences in other hospitals in my northern home.
The one thing that TV Hospital should do is post the ER wait time. That way, you would have some sort of expectation. As an example, as I write this Ocala Regional Er Wait Time is 13 minutes and FL Waterman ER Wait Time is 20 minutes.
According to Medicare the wait times to see a health care professional for selected ER's are as follows:
The Villages-55 minutes
Munroe -52 minutes
Leesburg-50 minutes
Waterman-35 minutes
Ocala Regional-18 minutes
FL Avg-29 minutes
National Avg- 29 minutes

See a trend? Performance? Look who posts their wait time.
No one of course would object to wait 50 minutes. But when you under perform the national average by a wide margin then I would suggest that there is a real problem and those that complain about their experience certainly have a legitimate complaint.
Let me explain to you what that means since you haven't a clue. What those times mean IF you read the fine print is that's how long it takes you to see a medical PROFESSIONAL. Which means....The Triage Nurse! That does NOT mean that you're in an ER bed and seeing a doctor in that time. AFTER that initial time you will be waiting as long as it takes to get an ER bed and a doctor and that means hours.

[perrjojo]

Let me explain to you what that means since you haven't a clue. What those times mean IF you read the fine print is that's how long it takes you to see a medical PROFESSIONAL. Which means....The Triage Nurse! That does NOT mean that you're in an ER bed and seeing a doctor in that time. AFTER that initial time you will be waiting as long as it takes to get an ER bed and a doctor and that means hours.

:agree:
That is just the point I was going to make. I am the OP on this thread. I think my husband was seen by the nurse within about 10 minutes but his wait time was to be 24 hours.

[StarbuckSammy]

Hey Mack184, I am not suggesting that it takes the time stated to be in bed in the ER seeing a doctor, did I? My point is that The Villages Er is not as efficient as many other hospitals. If YOU read the fine print it says if the numbers are high compared to the national or state levels than there is a problem of either under staffing or insufficient space etc. That's the point. And quite frankly, I am a little surprised of how mean-spirted your post was directed to my post...
Did you even read my post? Did you like the idea of posting the wait time?
And Perrjojo, I agree with all that you said in the original post so I do not understand your comment now. What happened to your husband is inexcusable. If you knew the stats were bad at the TV ER you may have considered going to another hospital or if TV ER posted a wait time of 2-3 times more than another hospital you may have opted to go elsewhere. The stats may have foretold what was going to happen.
Sorry for the confusion...and MACK184 sorry for being "clueless"?

[perrjojo]

Starbucks Sammy..I didn't think you were "clueless". Only that the statics could be misleading. And yes, I did understand that by comparison TV was not looking too good. I really think we could benefit from a 24 hour Urgent Care in TV. If that had been available, we would have gone there. Also I wasn't so much complaining about my husband's treatment being inexcusable, but for many others who needed attention far worse than he did. Those people had been waiting over 12 hours. They may not have been highest priority when they arrived but were becoming worse with the long wait. There is certainly MUCH room for improvement.

[mommieswamie]

...

Actually...take a trip in most major city ERs and you will find that a 36 hour wait is not the least bit uncommon. Most hospital ERs are WAY overburdened by things that are NOT the definition of a TRUE emergency. I hate to say it..but while a kidney stone hurts like fire it is NOT a TRUE emergency.

Unless you don't know it's a kidney stone


Things like emergent strokes, MIs, gunshots, severe trauma and babies popping out trump a kidney stone every single time.

As far as complaining to hospital management, especially TVRHs hospital management, you would be better off to direct your complaints to the POTUS. Why? Because at his lawful direction in 2010 he required Medicare to REDUCE the amount of payment to hospitals and doctors. Those reimbursements will drop once more with the implementation of the Affordable Care Act on 1/1/2014.

There is currently an active thread here on TOTV griping about the cost of greens fees and other fees within TV..and how things cost more than they used to. Virtually EVERYTHING costs more than it used to. A gallon of milk, a gallon of gas, a can of beans..a knee replacement, a heart stent and so on. NOTHING costs less.

I have mentioned this multiple times here, and nobody wants to listen, but the problem at TVRH is that it receives fully 88% of it's revenue from Medicare. While the price of virtually everything is rising, the hospital is being forced to get paid less and less for the many different services it must perform in it's hospital. So exactly how do they expand their number of beds, expand their slate of doctors, nurses and other staff while they are forced to take less and less to do the same amount of work? Costs didn't go down. The cost of doing business didn't go down, but the patient load is going up and reimbursements are going down.

Last year it was said that there would be no COLA increase for SS. Seniors cried bloody murder! How would you like to get 30% less than you did? Well, that's what your local hospital is trying to figure out because that's what's been happening to them! But to listen here they are just a bunch of incompetent mangers and lazy staff who don't care about their patients! Get real! The problem is that they have to do more & more with less and less. Take a 30% cut on YOUR income and then see how you make up the difference.

And..it's not going to get better as long as the senior population here continues to increase and the Medicare reimbursements continue to get lowered. THAT is the problem. Not incompetent or uncaring service from the hospital.

[mommieswamie]

:agree:
That is just the point I was going to make. I am the OP on this thread. I think my husband was seen by the nurse within about 10 minutes but his wait time was to be 24 hours.

There is a website www.inquicker.com that you can use to register for a time slot. I used it in a hospital in South Carolina. My wait time was 15 seconds to be taken to a room and maybe another minute to be seen by a doctor.

[CFrance]

There is a website www.inquicker.com that you can use to register for a time slot. I used it in a hospital in South Carolina. My wait time was 15 seconds to be taken to a room and maybe another minute to be seen by a doctor.

Inquicker doesn't appear to be available at TVHR, Closest location to our zip code is Tampa.

Hopefully someday; it sounds like a good deal.

[Russ_Boston]

Posting wait times (and making sure they look good) is a marketing gimmick, make no mistake. Yes you see a triage nurse faster but that could just be how they do their intake. i.e. quick registration with basic info, then triage nurse, then back to a secretary for more info etc. Anyone could lower their initial wait times with gimmicks. Remember the vast majority of Hospitals are about money - unfortunately.

I was in the ER yesterday (Sunday 5/26) and you could walk right in most of the day. I had 3 rooms on the second floor waiting for anyone who got admitted. Didn't get anyone until after 6PM. It's all about numbers and seasonality of residents.

Another anecdote from yesterday: I had 3 discharges. 1 of them was the angriest person I've met in a while. He was only in the hospital for less than 7 hours when he wanted out. No problem I told him - he could just sign out AMA (against medical advice). He was saying things like: "no one does anything around here", "been here for 7 hours and not one thing has been done to help me" etc. etc. Truth was that he had a CT done, an ultrasound of the carotids pending, an MRI pending, a neurologist to visit after the test results and the regular attending after that. This person left AMA even though he had a stroke and could not move his left arm very much. The carotid test showed 80% blockage of both arteries. Hopefully he'll make it back to get worked on before he dies (probably soon). We were following national standard care protocol for stroke. Some people just think enough is not being done. The other 2 discharges couldn't thank me enough for the great care they received (and they had been there for almost 4 days each!).

[BobnBev]

I'm not sure, but isn't part of a stroke being angry and uncooperative?

[Russ_Boston]

I'm not sure, but isn't part of a stroke being angry and uncooperative?

Uncooperative? To the point of refusing treatment? Um, NO.

Angry at the hand you've been dealt? Yes. Mean to the staff and others? Um, NO.

Vast majority of my stroke patients, and I have at least 2 per week, are upbeat and determined to get back to full functionality. This person was born mean and angry, the stroke just made it worse.

I was attempting to point out how a person's innate personality comes into play when telling others about their treatment while in the hospital. I guarantee you that his person will be blaming the care and not himself.

[ilovetv]

Posting wait times (and making sure they look good) is a marketing gimmick, make no mistake. Yes you see a triage nurse faster but that could just be how they do their intake. i.e. quick registration with basic info, then triage nurse, then back to a secretary for more info etc. Anyone could lower their initial wait times with gimmicks. Remember the vast majority of Hospitals are about money - unfortunately.

I was in the ER yesterday (Sunday 5/26) and you could walk right in most of the day. I had 3 rooms on the second floor waiting for anyone who got admitted. Didn't get anyone until after 6PM. It's all about numbers and seasonality of residents.

Another anecdote from yesterday: I had 3 discharges. 1 of them was the angriest person I've met in a while. He was only in the hospital for less than 7 hours when he wanted out. No problem I told him - he could just sign out AMA (against medical advice). He was saying things like: "no one does anything around here", "been here for 7 hours and not one thing has been done to help me" etc. etc. Truth was that he had a CT done, an ultrasound of the carotids pending, an MRI pending, a neurologist to visit after the test results and the regular attending after that. This person left AMA even though he had a stroke and could not move his left arm very much. The carotid test showed 80% blockage of both arteries. Hopefully he'll make it back to get worked on before he dies (probably soon). We were following national standard care protocol for stroke. Some people just think enough is not being done. The other 2 discharges couldn't thank me enough for the great care they received (and they had been there for almost 4 days each!).

I've seen older relatives and friends talk and act a little crazy, like they have a couple of loose wires, after having an unknown small stroke or series of small ones. They were not fit at that time to make a huge decision like signing oneself out against medical advice.

[barb1191]

I was in my oncologist's office and he sent me to the ER at TVRH at about 11 AM for a test.

When I walked into the ER waiting room the place was EMPTY!!!! Lucky me, I thought. Not so. The front desk gave me one of those buzzers to sit and wait. I waited in this empty room an hour and was disgusted.

Walked to the Reception desk and returned the buzzer and told them that I've been waiting an hour and this room is empty!!!! What's going on? Everyone leave for lunch at the same time?

The Receptionist responded, "don't go; there are five empty beds that we've been waiting to be washed; one is ready for you now!!!!!" I couldn't believe what I was hearing....FIVE EMPTY BEDS AND THEY COULDN'T GET ONE CLEANED IN AN HOUR? I left feeling thoroughly disgusted.

I had signed myself out of that hospital a number of times....mainly because the staff is so loud and noisy yelling to each other from one end of the room to the other. I don't believe they are understaffed, I feel they hire most, pay them peanuts and thus lousy care; not all, but most.

I guess that "HOSPITAL QUIET" signs no longer exist.

[simpkinp]

My late husband had CHF and I spent many days in ER. In triage, he usually was a priority, but there are tests to do and doctors to see and rooms to be prepped, so I knew it would always be an 8 hour time frame to get him in a room. The people in ER are angels for the most part, and he was not an easy or agreeable patient. Maybe that comes from being sick a long time, because he was a really nice man when he was well, and loved by everyone. Sick folks can be difficult. He didn't live long enough to make it here, and this was his dream place. God rest his soul.

[Russ_Boston]

I've seen older relatives and friends talk and act a little crazy, like they have a couple of loose wires, after having an unknown small stroke or series of small ones. They were not fit at that time to make a huge decision like signing oneself out against medical advice.

He was competent and it is against the law to hold anyone, who is competent, against their will. It's called false imprisonment. Nursing 101.

[Russ_Boston]

My late husband had CHF and I spent many days in ER. In triage, he usually was a priority, but there are tests to do and doctors to see and rooms to be prepped, so I knew it would always be an 8 hour time frame to get him in a room. The people in ER are angels for the most part, and he was not an easy or agreeable patient. Maybe that comes from being sick a long time, because he was a really nice man when he was well, and loved by everyone. Sick folks can be difficult. He didn't live long enough to make it here, and this was his dream place. God rest his soul.

So sorry for your loss. Yes sick patients can be difficult but any nurse knows how to deal with that and nobody is more compassionate than I am. That was not what I was referring to.

[Russ_Boston]

I was in my oncologist's office and he sent me to the ER at TVRH at about 11 AM for a test.

When I walked into the ER waiting room the place was EMPTY!!!! Lucky me, I thought. Not so. The front desk gave me one of those buzzers to sit and wait. I waited in this empty room an hour and was disgusted.

Walked to the Reception desk and returned the buzzer and told them that I've been waiting an hour and this room is empty!!!! What's going on? Everyone leave for lunch at the same time?

The Receptionist responded, "don't go; there are five empty beds that we've been waiting to be washed; one is ready for you now!!!!!" I couldn't believe what I was hearing....FIVE EMPTY BEDS AND THEY COULDN'T GET ONE CLEANED IN AN HOUR? I left feeling thoroughly disgusted.

I had signed myself out of that hospital a number of times....mainly because the staff is so loud and noisy yelling to each other from one end of the room to the other. I don't believe they are understaffed, I feel they hire most, pay them peanuts and thus lousy care; not all, but most.

I guess that "HOSPITAL QUIET" signs no longer exist.

I've worked there for a year and a half.

Cleaning: I can get a room cleaned in 5 minutes by our staff if I ask and down in ER we have many volunteers who do the cleaning if housekeeping is busy (especially at 11AM). Perhaps the 'test' room you needed had other patients in it and thus the wait.

Sounds: We don't even use the overhead speakers except for code blue or emergency measures. All rooms on the units have doors that we can and will close if requested. ER rooms are open however since they need to have eyes on patients at all times.

Pay: TVRH actually pays more than the Ocala hospitals, Florida Waterman or the Crystal River and Inverness hospitals. I know because I had offers from all 4. ( i.e. Monroe pool rate =$30, TVRH=$35). Granted it's no where near what you earn up north but still better than the others many think are better.

I've only known one patient that I agreed with when he left AMA. He got the wrong end of a communication breakdown and I would have done the same. All the others who left AMA where, well, I'd rather not say on this forum what I think about them, you might misinterpret.

[mommieswamie]

I am really disturbed by what you are saying here:


"born mean and angry"

"person's innate personality comes into play when telling others about their treatment while in the hospital"


I wonder if you could clarify this a bit, please


Uncooperative? To the point of refusing treatment? Um, NO.

Angry at the hand you've been dealt? Yes. Mean to the staff and others? Um, NO.

Vast majority of my stroke patients, and I have at least 2 per week, are upbeat and determined to get back to full functionality. This person was born mean and angry, the stroke just made it worse.

I was attempting to point out how a person's innate personality comes into play when telling others about their treatment while in the hospital. I guarantee you that his person will be blaming the care and not himself.

[Russ_Boston]

I am really disturbed by what you are saying here:


"born mean and angry"

"person's innate personality comes into play when telling others about their treatment while in the hospital"


I wonder if you could clarify this a bit, please

Not sure why you are disturbed. Are you telling me that you don't know anyone who are just jerks? A jerk in life is a jerk in the hospital. Being sick is different than being a jerk. You've never met anyone who felt that nothing was good enough for them?

If you have a negative feeling about life in general you're not likely to tell someone about a positive experience you had. I've met people who just complain all the time, about everything. Fortunately I think the that the vast majority of people and the vast majority of my patients are great people. But once in a while you get that person either in the hospital or out on the golf course that is just a real jerk. In the hospital I put my best smiling face forward and do the job to the best of my ability. On the golf course I just shut up and make sure I never play with them again.

Not sure why this is disturbing.

[ilovetv]

Not sure why you are disturbed. Are you telling me that you don't know anyone who are just jerks? A jerk in life is a jerk in the hospital. Being sick is different than being a jerk. You've never met anyone who felt that nothing was good enough for them?

If you have a negative feeling about life in general you're not likely to tell someone about a positive experience you had. I've met people who just complain all the time, about everything. Fortunately I think the that the vast majority of people and the vast majority of my patients are great people. But once in a while you get that person either in the hospital or out on the golf course that is just a real jerk. In the hospital I put my best smiling face forward and do the job to the best of my ability. On the golf course I just shut up and make sure I never play with them again.

Not sure why this is disturbing.

It's disturbing because you say "This person left AMA even though he had a stroke and could not move his left arm very much. The carotid test showed 80% blockage of both arteries".......and then you imply the real problem with him is that he is just a born jerk.

Maybe he was "jerky" because he was extremely sick with his brain being deprived of oxygen by the blockages!!

[mommieswamie]

No, I don't know anyone that I would consider to have been "born mean and angry", and I have never met or know anyone who was "just a jerk". I have certainly had some very unpleasant encounters with people along the way in my 70 years, but those people are someone's friends and family and are loved by them.

As far as the "innate personality", I would gather that anyone who complains about their treatment in the hospital is just basically a "jerk" in all aspects of their life and not to be believed if they complain about their hospital care.

This is disturbing to me because it comes from a nurse whose job is to care for people when they are at their most vulnerable.

Back on topic - TV Hospital emergency room - all of my experiences there have been bad and I have spoken outwardly to others about my experiences. Does that make me a person "born mean and angry". My husband, 6 children and 9 grandchildren and many, many friends would beg to differ.

This is not the first time that one of your posts has disturbed me. Your post about caregivers just "dumping" their sick spouse in the ER just so they could then go to rehab, was very disturbing.

[golf4me]

No, I don't know anyone that I would consider to have been "born mean and angry", and I have never met or know anyone who was "just a jerk". I have certainly had some very unpleasant encounters with people along the way in my 70 years, but those people are someone's friends and family and are loved by them.

As far as the "innate personality", I would gather that anyone who complains about their treatment in the hospital is just basically a "jerk" in all aspects of their life and not to be believed if they complain about their hospital care.

This is disturbing to me because it comes from a nurse whose job is to care for people when they are at their most vulnerable.

Back on topic - TV Hospital emergency room - all of my experiences there have been bad and I have spoken outwardly to others about my experiences. Does that make me a person "born mean and angry". My husband, 6 children and 9 grandchildren and many, many friends would beg to differ.

This is not the first time that one of your posts has disturbed me. Your post about caregivers just "dumping" their sick spouse in the ER just so they could then go to rehab, was very disturbing.

Russ Boston is a competent, excellent nurse and I have read his posts for years on this forum while he was in training before he moved here, giving up a lucrative and successful career to reeducate himself for a job that would allow him to retire here. He is right about people being born a "jerk". Behaviorists are learning that it is more nature than nurture to born with a negative personality and be irascible, surly and demanding.... people are born with brain structure to have those traits. The reverse is also true and all along the spectrum. In fact personality traits are probably genetic. Mean dogs run in mean families and the reverse.

Russ states his point without emotion sometimes on this forum but he is a responsible and caring medical man.

[Russ_Boston]

Russ Boston is a competent, excellent nurse and I have read his posts for years on this forum while he was in training before he moved here, giving up a lucrative and successful career to reeducate himself for a job that would allow him to retire here. He is right about people being born a "jerk". Behaviorists are learning that it is more nature than nurture to born with a negative personality and be irascible, surly and demanding.... people are born with brain structure to have those traits. The reverse is also true and all along the spectrum. In fact personality traits are probably genetic. Mean dogs run in mean families and the reverse.

Russ states his point without emotion sometimes on this forum but he is a responsible and caring medical man.

Thanks for the support. My follow-up survey scores (we try to call every patient after they leave) are as good or better than most. I know that my career move was good by the lives I touch every day at work.

1. Obviously we did everything we could do to have that person stay at the hospital for treatment. There are just some people that can't be talked to. But the law is the law we had to let him go.

2. On the point of people being dumped: Just a fact. Don't know why that would raise any questions about me. These people get put into the hospital mostly because the caregivers are tired of care. They don't even show up for the 3 days so whose uncaring now? The state of FL needs better mechanisms to allow for caregiver respite services.

3. I'm glad you never met a jerk before. When you deal with the general public like I do you have to deal with them. In a year and a half as a nurse I've had patients (and actually more relatives and friends) who just are not nice people. But to insinuate that I don't care is not a judgment you should be making. You've never read that I don't care and do my best to rectify every situation and make the patient's stay as pleasant and efficient as possible. I try to state facts on this forum especially when it comes to the hospital since I do work there. Being on this forum for 6 years I know the people that simply say things to 'stir the pot'. I try to call them out if I know they are wrong.

[Russ_Boston]

Back on topic - TV Hospital emergency room - all of my experiences there have been bad and I have spoken outwardly to others about my experiences. Does that make me a person "born mean and angry".

Never said a person was mean and angry because they spoke bad about the hospital. Did I? I'm talking about only a couple of patients who were just mean people, not because they didn't like their stay. It happens.

I'm sorry that ALL of your experiences at TVRH have been bad. But I would say that it's mostly a factor of bad luck. Don't think we'd be in business if everyone's experiences, all the time, were bad.

We'll try to do better.

[mommieswamie]

Well - apparently this can go on and on, which is not my intent, so I will focus my response on just two things.

"The state of FL needs better mechanisms to allow for caregiver respite services." I agree with you 100%.

"When you deal with the general public like I do you have to deal with them." My whole career of 30+ years was entirely spent in positions that involved dealing with the general public. I think I have a little bit of experience there.

I remain disturbed by your posts on the topics that I have mentioned.

[Quixote]

.... I was attempting to point out how a person's innate personality comes into play when telling others about their treatment while in the hospital. I guarantee you that his person will be blaming the care and not himself.

.... A jerk in life is a jerk in the hospital. Being sick is different than being a jerk. You've never met anyone who felt that nothing was good enough for them?

If you have a negative feeling about life in general you're not likely to tell someone about a positive experience you had. I've met people who just complain all the time, about everything. Fortunately I think the that the vast majority of people and the vast majority of my patients are great people. But once in a while you get that person either in the hospital or out on the golf course that is just a real jerk.

He is right about people being born a "jerk". Behaviorists are learning that it is more nature than nurture to born with a negative personality and be irascible, surly and demanding.... people are born with brain structure to have those traits. The reverse is also true and all along the spectrum....

.... There are just some people that can't be talked to. But the law is the law we had to let him go.

In a year and a half as a nurse I've had patients (and actually more relatives and friends) who just are not nice people.... I know the people that simply say things to 'stir the pot'....

I'm talking about only a couple of patients who were just mean people, not because they didn't like their stay. It happens.


Ironically, this is EXACTLY what is being talked about on other unrelated threads: TOTV members who appear to be constantly complaining, innately negative, hostile, antagonistic ("stir the pot")--and the annoyance and/or exasperation on the part of most other members with those who do this. In the ER, no doubt anxiety about one's reasons for being there may exaggerate these character traits, and as I've mentioned before, it IS difficult to understand the concept of triage when one is in pain (or when one sees one's loved ones in pain). I accept the statement, but I am flabbergasted at the comment by the poster who has NEVER in her entire life met a "jerk." How fortunate....

And back on topic, I reiterate that when I was brought by private car to TVRH's ER following an accident, bleeding on the floor, I was taken to an ER room almost immediately, and it took FIVE HOURS of care to put me back together. I have dealt with serious medical issues all my life and have to say that this was THE most painful experience I had ever had! Yet feedback told me that I never became negative.

And in deference to hospital operations, it was only after those five hours, when I was resting and finally able to have a bite to eat, waiting for a surgeon to confirm an office appointment before I could be discharged, that someone from the business office came to ask about my insurance coverage. Again, I don't doubt the incredibly long waits that patients in the ER have encountered; I guess I was just fortunate and triage worked for me.

[BobnBev]

Uncooperative? To the point of refusing treatment? Um, NO.

Angry at the hand you've been dealt? Yes. Mean to the staff and others? Um, NO.

Vast majority of my stroke patients, and I have at least 2 per week, are upbeat and determined to get back to full functionality. This person was born mean and angry, the stroke just made it worse.

I was attempting to point out how a person's innate personality comes into play when telling others about their treatment while in the hospital. I guarantee you that his person will be blaming the care and not himself.

I understand, Russ. Could some dementia be involved?

[Russ_Boston]

I understand, Russ. Could some dementia be involved?

Oh absolutely. The problem with ER and admitting to a floor, as I see it, is that some know how to play the game. TVRH is an acute care hospital, not a long term rehab hospital. I have at least 1 patient per day who has dementia. The problem comes when the person, who needs a break at home, brings in the patient knowing that is the best way to get them into a rehab facility. As a nurse (and I know the docs feel the same) we can't do much for this patient. We are not treating them in any meaningful manner because there's not much that can be done in an acute care medical setting. We give them their daily meds, watch out for their safety, maybe do a new CT or MRI and then after the 3 midnights (Medicare requirement) we find a rehab setting for them. In 1.5 years I've had some patients 3-4 times already. I know one patient who was there 15 times last year and is already up to 6 this year (true story). But if the family comes into ER and says something like "he's just not himself" or "we see a big change over the past week" then we admit the patient and see if we can do anything. Unfortunately many times there is nothing to be done medically. But in the mean time the bed is filled for those 3 days and others in ER need to wait until a bed opens up.

[Madelaine Amee]

Russ Boston is a competent, excellent nurse and I have read his posts for years on this forum while he was in training before he moved here, giving up a lucrative and successful career to reeducate himself for a job that would allow him to retire here. He is right about people being born a "jerk". Behaviorists are learning that it is more nature than nurture to born with a negative personality and be irascible, surly and demanding.... people are born with brain structure to have those traits. The reverse is also true and all along the spectrum. In fact personality traits are probably genetic. Mean dogs run in mean families and the reverse.

Russ states his point without emotion sometimes on this forum but he is a responsible and caring medical man.

I agree wholeheartedly with this post. Russ is a great guy, but then he's from Boston, what else could he be!

(mommieswamie) I quote you: [I]"No, I don't know anyone that I would consider to have been "born mean and angry", and I have never met or know anyone who was "just a jerk". You have indeed been very fortunate in your long life. Unfortunately I knew mean and nasty and just plain ugly up close and very personal - my Father-in-Law was the meanest, ugliest natured person I have ever met, he was mean and spiteful to his wife, jealous of, and mean, to his one and only son, and he was absolutely rotten to me .......... he heard me laughing with my Mother-in-Law one day and threw me out of the house! Unfortunately true! On his death bed he wrote my oldest son the most awful letter you could imagine because he misunderstood a "get well" card my son had sent him. His last words to my son were "go rot in hell" ........... Thankfully, his son takes after his Mother and not the old man - thank you God! So, believe me, there are people who are born just plain mean!

[BobnBev]

Oh absolutely. The problem with ER and admitting to a floor, as I see it, is that some know how to play the game. TVRH is an acute care hospital, not a long term rehab hospital. I have at least 1 patient per day who has dementia. The problem comes when the person, who needs a break at home, brings in the patient knowing that is the best way to get them into a rehab facility. As a nurse (and I know the docs feel the same) we can't do much for this patient. We are not treating them in any meaningful manner because there's not much that can be done in an acute care medical setting. We give them their daily meds, watch out for their safety, maybe do a new CT or MRI and then after the 3 midnights (Medicare requirement) we find a rehab setting for them. In 1.5 years I've had some patients 3-4 times already. I know one patient who was there 15 times last year and is already up to 6 this year (true story). But if the family comes into ER and says something like "he's just not himself" or "we see a big change over the past week" then we admit the patient and see if we can do anything. Unfortunately many times there is nothing to be done medically. But in the mean time the bed is filled for those 3 days and others in ER need to wait until a bed opens up.

Do you ever feel like you're shovelling S*** against the tide? I wouldn't want your job, no way.:crap2::crap2::ho:

[travelguy]

such horror stories. i do not know of any first-hand experiences of bad service at the villages hosp[ital. i do remember one back in penna where a friend broke her elbow when she fell down some stairs. this was on a friday evening, at the start of a holiday weekend. they gave her pain killers and told her to come back on tuesday morning. so she returned on tuesday and had the elbow set, but since a few days had elapsed some bone knitting had already occurred, and it was a bit more complicated than if it had been attended to right at the beginning.
i am looking forward to a better system of care when the affordable healthcare act finally begins and we will have universal healthcare like most progressive european nations (and canada).
btw: i had excellent care at the villages hospital.

[alonzo]

oh please tell me this is not in The Villages... is it? I hope all those people are doing well too including your husband. What can we do about this problem that's happening nationwide Sally? Alozno

[rubicon]

The terms mean angry jerk are being thrown around a lot here. the causes can be anything from genetic to learned to health related to just a bad time in someone's life.

If you deal with the public then you learn that it is your obligation to control the situation as best you can even if that jerk is in a position above yours. As a manager that is the advice I had given to my staff. some got it and some did not and for the latter we soon parted company because their inability to contain a situation damaged everyone.

I have stated repeatedly that I am in awe of nurses. It is truly a difficult occupation but yet they seem to remain in control manage a smile and stay focused on the problem. They all have my greatest respect.

[Golfingnut]

We have needed tv emergency room twice in our 3 years here. Both times were great experiences and perfect treatment both times. Sorry to here about those that did not feel they received great care.

[princess2u]

This hospital is an embarrassment to the town. I was in there a few months ago and had a similar experience. I have been there twice. The first time, I broke my foot at the square. I waited in the ER for 6 hours to be waited on. My foot began swelling the minute I fell. They determined I broke it. I had to wait 6 hours to hear that. But when I went to the foot doctor 2 days later, he said that I sprang my ankle, broke my foot and tore tendons. It was really bad. Good thing I had a vicodin in my purse to get me through the 6 hours. The second time I went to the ER I waited 5 hours. I had an infection in my foot. An ingrown toe nail. It was a Sunday so I couldn't go to my regular doctor. The ER doctor ended up removing my toe nail. It was that bad. An infection and they made me wait forever to be treated. The hospital has HORRIBLE service and no one seems to care about the patients. Something really needs to be done to change that place. It's dirty and dingy for such a young hospital. They need to bring in a company to revamp that place.

[Sage327]

I had my first experience in TV ER and hospital a couple of days ago and I have nothing but good things to say about my stay. The ER was pretty crowded when I arrived but because of my symptoms I was seen within 20 min and the appropriate testing was done (Cat scan, chest x ray etc). I arrived at the ER at 7:30 and was in a room by 12:30. The wait time is the same if not worse in the hospitals in NY. Everyone who attended to me was caring and went out of their way to make me feel comfortable including the nurse's aide who ran the water in the bathroom ahead of time to make sure it was hot enough for me to wash. My room was beautiful and clean as well as the hospital hallways. The next day, a male nurse who was just coming on duty, came in to see if he could get my husband and I anything while we were waiting to be discharged. At first I urged my husband to take me to Munroe because of the negative comments I have been reading about TV ER, but I am glad we made the right choice. Why would Munroe's ER be any different? People are seen according to the seriousness of their problem, not who walks in the door first.

[ilovetv]

I had my first experience in TV ER and hospital a couple of days ago and I have nothing but good things to say about my stay. The ER was pretty crowded when I arrived but because of my symptoms I was seen within 20 min and the appropriate testing was done (Cat scan, chest x ray etc). I arrived at the ER at 7:30 and was in a room by 12:30. The wait time is the same if not worse in the hospitals in NY. Everyone who attended to me was caring and went out of their way to make me feel comfortable including the nurse's aide who ran the water in the bathroom ahead of time to make sure it was hot enough for me to wash. My room was beautiful and clean as well as the hospital hallways. The next day, a male nurse who was just coming on duty, came in to see if he could get my husband and I anything while we were waiting to be discharged. At first I urged my husband to take me to Munroe because of the negative comments I have been reading about TV ER, but I am glad we made the right choice. Why would Munroe's ER be any different? People are seen according to the seriousness of their problem, not who walks in the door first.

So glad to hear this because one day, it could be one of us who needs the ER here, not farther away.

Having been in various hospitals many times, it means a lot when nursing and other staff make an effort to tune in and ask if you need anything. Some small, kind measures like running the water to get it hot first go a long way. It's not the measure itself, but the thoughtfulness. People don't want to have robots moving thru the room acting like there's nobody in that bed that might need something.

To be fair about the wait times, this is the slow season and this kind of wait time might not be possible in the height of winter. But the hospital is building on and hopefully some of that seasonal crunch will ease up.

[FloridaShrimp]

When we moved into TV last September, one of the first things that we were told was in an emergency, not to go to the emergency room here at TV Hospital but to go to the hospital in Leesburg. It is much closer than Ocala for us. What good does it do us to have a hospital on property if the care is so poor?