[blueash]

I am a fan of teaching hospitals. One small, very small, consideration with Shands, which they will not be telling you is that under a recent law passed in Florida there is a very low malpractice cap on any error made there. One certainly hopes no errors would ever be made but they do happen.

[blueash]

Here is some information, one respected well balanced source, on when is a stress test needed, and nuclear vs exercise.
Choosing Wisely | Stress tests for chest pain

To the OP, as you have suggested that your being fit should have gone into the decision making process, I would respectfully disagree. You presented with acute chest pain. Your past ability to exercise did not preclude your having a significant cardiac event at the time of this hospitalization. Had they said, "Well, she is Beachbody Coach so we don't have to evaluate her heart, she must be fine." that would have been terrible care.

As to who ordered what test, I can't tell from your posting. You said you were seen by a PA, and then said a doctor ordered your test. A PA is not a doctor and despite your telling the PA you wanted a treadmill, if the MD the previous evening had ordered a nuclear test, that order would still apply. I don't know what your blood work showed or whether there might have been some concerns on your baseline EKG that they may not have even mentioned to you as they can be non-specific.

You can be 100% certain that some technologist in the cardiac lab did not make the decision of what stress test you would receive. They were following an order from someone. And as someone else posted, if you objected to having the test it is completely within your rights to decline it. At worst this will result in someone coming to explain to you the pros and cons and that if you die from an MI on the ride home they told you to have the test (CYA informed consent).

[angiefox10]

Originally Posted by blueash

Here is some information, one respected well balanced source, on when is a stress test needed, and nuclear vs exercise.
Choosing Wisely | Stress tests for chest pain

To the OP, as you have suggested that your being fit should have gone into the decision making process, I would respectfully disagree. You presented with acute chest pain. Your past ability to exercise did not preclude your having a significant cardiac event at the time of this hospitalization. Had they said, "Well, she is Beachbody Coach so we don't have to evaluate her heart, she must be fine." that would have been terrible care.

As to who ordered what test, I can't tell from your posting. You said you were seen by a PA, and then said a doctor ordered your test. A PA is not a doctor and despite your telling the PA you wanted a treadmill, if the MD the previous evening had ordered a nuclear test, that order would still apply. I don't know what your blood work showed or whether there might have been some concerns on your baseline EKG that they may not have even mentioned to you as they can be non-specific.

You can be 100% certain that some technologist in the cardiac lab did not make the decision of what stress test you would receive. They were following an order from someone. And as someone else posted, if you objected to having the test it is completely within your rights to decline it. At worst this will result in someone coming to explain to you the pros and cons and that if you die from an MI on the ride home they told you to have the test (CYA informed consent).

Both the PA and the Doctor were clear they wanted a walking stress test. I explained that to the techs and was ignored. I asked them to contact the doctor before they did the test... They went ahead and did the test. When the doctor came in after the test he was clearly displeased.

Now... lets go on the premiss that someone wrote the wrong order and they were simply following orders. That brings us to the fact that the wrong orders had been written. Compound that with the fact that no one would check with the doctor when I told them it was not right... second mistake!!!!!

As to all other testing... All were perfect! NO heart problems of any kind. Blood test were excellent as well as the EKG..

[dbussone]

Originally Posted by blueash

I am a fan of teaching hospitals. One small, very small, consideration with Shands, which they will not be telling you is that under a recent law passed in Florida there is a very low malpractice cap on any error made there. One certainly hopes no errors would ever be made but they do happen.

The same is true of many hospitals, especially public hospitals, that receive legislative relief or very limited malpractice caps.

[blueash]

Originally Posted by dbussone

The same is true of many hospitals, especially public hospitals, that receive legislative relief or very limited malpractice caps.

It is not at all common and the situation with Shands in Gainesville and Jacksonville as well at Jackson Memorial in Miami, as far as I know, is unique to our state. The cap of 200,000 amazingly is not for public hospitals but rather for private hospitals that also are teaching hospitals. However the protections do not cover all the teaching hospitals in Florida. Additionally this seems to be the only law anywhere that includes a cap on your economic loss, not just non-economic loss. This is important. Non economic things are pain, suffering, scars, disfigurement, loss of companionship. Economic are.. they took out your good kidney not your bad one. Now you can't work, lifetime of dialysis, lots of $$ meds and doctor visits 200K is gone in no time. No other state has caps on economic losses.
State Limits on Medical Malpractice Awards | LegalMatch Law Library

[villagerjack]

A muscle pull? Bad food?

[MoeVonB61]

Everything everybody has typed to you is great and you should follow through on all the suggestions......I also, however, have no idea what you mean by "Beachbody Coach" and I can ASSURE you a health care worker having to spend an extra 3 minutes to look it up would detract from another patient's care..............In addition, IF YOU HAD TO HAVE SURGERY/ANESTHESIA, giving you food would be even more harmful. HOWEVER, nobody should be comparing treatment in the past to todays' health care moving towards socialized medicine. With the deficit reduction act and SO MANY CUTS to reimbursements, health care workers have to do a lot more with less resources/help....HERE'S the fact that you never hear on the Sales Bus Tour. ACHA, The Agency for Health Care Administration turned down the application to build another hospital on Route 44 in Wildwood......The Villages Hospital WILL HAVE only a total of 323 beds and there are approximately 110,000 Seniors 50+ living in the Villages..........that means, there will not even be enough beds to house 1% of the population here....... a population that uses healthcare 3X more than younger generation.......We are also in high season (Jan, Feb, March, April) and all the seasonal renters choose to go to this hospital (they don't know any better).
GIST: Ask to be released (even if it's an AMA) and follow through on your instincts.........I am sure your Caretakers were trying to do 5x more than what they normally do out of season......

[rn1tv]

Just FYI to those that might need it but contacting risk management did me no good Peggy Grey is the manager and Penny Bennet is the rep. I believe the phone number is 751-8008.

[kissmelatr]

I spent 3 days in the TVRH and I had no problem....I had A-fib and took me in right way. I too spend 30 hours in the emergeny room on a bed as hard as a rock. That is my only complaint . Other then that I had a very good experience.....Was very please....

[57ChevyFI]

Originally Posted by angiefox10

I went to The Villages ER on Saturday February 7th, 2015 with chest pains. (FYI my heart and total health is GREAT!) They immediately took me to a room and hooked me up to monitors and placed a nitro patch on my chest.

My husband made it clear several times he wanted me to see his cardiologist at the Citrus Group. I’m throwing that in now, all will become clear.

I laid on a gurney for hours in the ER waiting for a room. I hadn’t had much to eat or drink before that so my husband asked if they could get me some food or water. I don’t know what the response was… but I didn’t receive food or water. He finally found a vending machine and purchased some water for me. The only thing in the vending machines to eat was junk, and I don’t eat junk. (I am a Beachbody Coach and have gotten to enjoy healthy food.) My husband asked again and again for something for me to eat. Finally they brought me a dry tasteless turkey and cheese sandwich and grapes. I was hungry… I ate! I entered the ER at 3:00 PM and made it to a room at 10:30. At one point I had asked if they could move me closer to the machines, I was hooked up to, as I was tangled up in the cords. They said that wasn’t possible and walked out. I told the nurse I had a horrible headache. She said it was from the Nitro and walked away… When she came back in, I asked if I could get something for the pain, she said she would get me something and walked out. 30 minutes later, she came back in, I asked about the meds for pain and she said she told another nurse to bring them… Didn’t I get them yet??? She went back out and got the meds and when she came back, she moved the Nitro from my chest to my ankle. She said that would move it away from my head and stop the headache.

They told me they would take blood three times to see if I was, or had had a heart attack. The lady taking the blood told me there are people who have been in the ER for up to 3 days and didn’t get a room! OH wow….. I wasn’t on a bed, but a gurney! Not comfortable!

I sent my husband home to take care of our pets who needed meds and to be fed and told him I would let him know when I was in a room.

At 9:20 someone came in and told me he was taking me to my room. This gentleman left….. at 9:40 a nurse came in and told me I had a room… hmmmm I was told I had a room 20 minutes ago…. At 10:03… I was finally in a room. The nurse there took my patch off so the headache went away.

The nurse said I was scheduled for a stress test for the next day, did I want to eat something. I said yes. He brought me the dry turkey cheese sandwich again and Ginger Ale. I tried eating it. I just couldn’t! I took the bread off and tried eating the cheese and turkey. I could only eat one bite of that. I don’t drink carbonated drinks and I don’t drink sugar so I drank some of the water. By that time I was so exhausted, I fell asleep.

The next day the PA came in and told me they were going to do a Stress Test on me. Asked if I could walk the treadmill. I told him I could…. I explained I was a Beachbody Coach and did extensive workouts. He didn’t know what I was talking about and didn’t seem to want to look it up. It might had given them an indicator of my health… but… Whatever…. So, it was decided that I would walk the treadmill. When I was taken down for the Stress Test they laid me on a gurney and said they were doing a chemical test instead of walking the treadmill. I was very agitated about this. I didn’t want anything else put in my system and told them this. I also told them the Dr. and specifically said I would be walking the treadmill. They ignored my request and never called the Dr. to find out what he wanted. They just went ahead and did the chemical test. BTW, the Dr. was in the hospital and they were aware of it.

When I got back up to my room, the Doctor came in and he asked if there was a reason I couldn’t walk the test. When I told him what happened, he was surprised and clearly didn’t order that. I would like to add that this was not the doctor we had requested, but in fact a hospital doctor.
The nurse asked me if I was hungry. I of course was. She brought me that dry turkey and cheese sandwich and ginger ale. *sigh* I just couldn’t! It was that bad! I handed it back to her. This was 5:00PM the next day and I wasn’t THAT hungry! And, I’m still not drinking sugar!

They brought me my first meal. Meatloaf. Well, I guess low sodium is no taste. Seriously??? They don’t know how to put some flavor in food without salt? It wasn’t like ground beef. It was like a thick pate’. The massed potatoes were fake. The green beans were canned and overcooked. White bread and fake butter with 1% milk. Trust me when I say hospital food is not healthy! I didn’t eat the white bread, fake butter or colored water!

That evening I was hungry and asked if they had anything to snack on. The nurse brought me saltines and ginger ale. Saltines???? I can’t have salt on my food but salt and sugar for a snack is ok??? I of course refused. She asked if I was diabetic and told me she could bring me ice cream. I guess fruit in the hospital is out of the question.

Now… I notice they are still taking blood. I questioned the blood letting and the lady said they were checking to see if some levels were elevated. I asked if they didn’t find that out in 3 tests.. She said yes. I told her to check on it as they had gone WAY past the three tests! She went ahead and took my blood and said she would ask the nurse when she was through. Huh??? Wouldn’t you ask the nurse first???

Next an internist came in and asked me the same questions everyone else had asked me. Clearly NO ONE had even looked at my chart! After answering all the questions, she informed me the problem was that I didn’t know how to breathe deeply! She wanted me to do some sort of therapy. A therapy that would include taking steroids. I told her breathing deeply wasn’t the problem… I knew how to breathe deep. I was a Beachbody coach… It’s part of the job! She didn’t know what that meant nor did she care.

The internist sent in a Pulmonary Doctor. He made it to my room later that evening. He had read my chart! I think he was the only one. He asked questions according to my chart. He looked up Beachbody. He checked my body and listened to me. He told me I had pulled a muscle in my chest. It was causing me pain as I wasn’t letting it relax. He gave me sound instructions and he LISTENED to me. He sat down and talked to me. He said I certainly didn’t need to learn how to breathe deeply.

The food in the hospital is probably the most unhealthy I’ve seen. A diet of that food for very long will kill you. So much so… One of the nurses told us she won’t eat it.

I never saw anyone from Citrus group. I’m not even sure is they wrote it down even though my husband made it clear several times I should see them.

Most of the staff didn’t listen to me. Scary when you are telling them not to do a treatment that you know you aren’t supposed to have and they do it anyway. Once I was checked into the hospital, I no longer had a say of what happened to my body. I found the experience scary. I would do everything in my power to never go back there!!!!


Lest you think I have never been in a Hospital. Not true. At 63, I have been in hospitals, my husband and my children have been in hospitals. This was the scary bad!!!

Sadly, I apologize for your experience. However, I would like to tell you that with the experience I have with several hospitals-maybe I can assist you from things on the other end of the spectrum.

They immediately took you somewhere to hook you up to a monitor--GREAT, you GOT IMMEDIATE care for CHEST PAIN. Nitro on your chest wall, one of the first lines of defense for potential heart damage. Great-side effect is headache.

Gurney- yes, that is what is in ALL Emergency Rooms. Sorry, with holding ER patients for days because the SNOW BIRD season is here and the beds are full with patients. The new addition should open this month- however, ER will not be expanded until Fall 2016. You will stay on a gurney while in the ER.

Hungry? Hmm, you are having CHEST PAIN--you should be NPO (nothing to eat or drink) until ALL results are in-in case you are having a heart attack. Sorry, EKG is not the only indicator of heart attack. Lab work and yes, they do three sets of cardiac enzymes and then routine lab work as well- to see if maybe your WBCs changed as well from the baseline.

Waiting for pain medication? Might had to get a MD to write the order, then pull the medication. Along with take care of 4 other patients- maybe a critical patient? Approx 30 minutes is appropriate.

9:20 you were informed you have a room- GREAT!! You are a lucky one that didn't have to spend the night a busy ER. The nurse then has to call the floor nurse and give report. In hopes that the nurse on the floor is available that first call to take report. Then, need to find someone to take you upstairs that can monitor your heart as you travel-usually a nurse or paramedic. Remember the same thing going on with you may be happening with the other 4 patients the nurse is just settling in or giving discharge instructions too at the same time. Or, just maybe they had another loved one come in without a heart beat or breathing on their own--CODE BLUE--usually 3 nurses, Respiratory Therapy and MD with paramedic. There is no CODE BLUE team in any ER--it is the staff already there helping others just like you.

Dietary concerns- Valid, maybe education to the nurse that offered saltines! Along with sandwich (yuck)! Grapes, sounded good....

Stress Test- I would research that further request copy of your records and orders, etc. You were awake right? Not under anesthesia- you can certainly question anything and tell them no without doctor clarification. That should not have happened to you and I am sorry that it did.

I am sorry you feel you would do everything not to go there again. Seems you have concerns- but certainly not life threatening and you received PROMPT treatment in the ER regarding your chief complaint of CHEST PAIN. Which is ruled out CARDIAC first- just thought you should know what usually goes on in any given ER and reading your post--you might have not been able to see what was going on behind the scenes.

TVRH will never be able to handle the stress of the continued growth of THE VILLAGES. Look at all the people in The Villages- do you know that ER is only 24 rooms with hallway beds? Yes, 24 rooms. So- 100,000 people, I think approx 260 beds--when the hospital is full, there is no rooms for the patients being admitted to go upstairs (or off a gurney). You sit and wait, receive the same care as if in a room--without the private room and with all the chaos of the ER on any given night during snowbird season. I am sure you are aware of 1/3 of the patients who use the hospital as an urgent care and child care clinic.

The Villages need a 24 hour Urgent Care near Brownwood/Wildwood Area. That would assist in the overflow of patients with the ER. I also think that another hospital would benefit this aging population.

You can certainly choose another facility for your continued emergency care- however, it might be more than the food that you complain about next time. Each visit, nurse, MD are different. Good luck and best wishes for quick recovery.

[dbussone]

Well said 57Chevy. A knowledgeable individual making a response that should be understandable to most. We are fortunate to have a number of posters who have a medical background.

[Challenger]

See post #55 -57ChevyFI-

Best response that I have seen on TOTV for issues at "Our Hospital".
Thankfully from one who has a clear working knowledge of ERs and can write with skill and clarity.

[TNLAKEPANDA]

One would think that the medical and hospital services in a place like the Villages would be top notch and second to none! I have heard nothing but bad things about this hospital. We will go to Leesburg or Ocala should we need a hospital.

[graciegirl]

Originally Posted by 57ChevyFI

Sadly, I apologize for your experience. However, I would like to tell you that with the experience I have with several hospitals-maybe I can assist you from things on the other end of the spectrum.

They immediately took you somewhere to hook you up to a monitor--GREAT, you GOT IMMEDIATE care for CHEST PAIN. Nitro on your chest wall, one of the first lines of defense for potential heart damage. Great-side effect is headache.

Gurney- yes, that is what is in ALL Emergency Rooms. Sorry, with holding ER patients for days because the SNOW BIRD season is here and the beds are full with patients. The new addition should open this month- however, ER will not be expanded until Fall 2016. You will stay on a gurney while in the ER.

Hungry? Hmm, you are having CHEST PAIN--you should be NPO (nothing to eat or drink) until ALL results are in-in case you are having a heart attack. Sorry, EKG is not the only indicator of heart attack. Lab work and yes, they do three sets of cardiac enzymes and then routine lab work as well- to see if maybe your WBCs changed as well from the baseline.

Waiting for pain medication? Might had to get a MD to write the order, then pull the medication. Along with take care of 4 other patients- maybe a critical patient? Approx 30 minutes is appropriate.

9:20 you were informed you have a room- GREAT!! You are a lucky one that didn't have to spend the night a busy ER. The nurse then has to call the floor nurse and give report. In hopes that the nurse on the floor is available that first call to take report. Then, need to find someone to take you upstairs that can monitor your heart as you travel-usually a nurse or paramedic. Remember the same thing going on with you may be happening with the other 4 patients the nurse is just settling in or giving discharge instructions too at the same time. Or, just maybe they had another loved one come in without a heart beat or breathing on their own--CODE BLUE--usually 3 nurses, Respiratory Therapy and MD with paramedic. There is no CODE BLUE team in any ER--it is the staff already there helping others just like you.

Dietary concerns- Valid, maybe education to the nurse that offered saltines! Along with sandwich (yuck)! Grapes, sounded good....

Stress Test- I would research that further request copy of your records and orders, etc. You were awake right? Not under anesthesia- you can certainly question anything and tell them no without doctor clarification. That should not have happened to you and I am sorry that it did.

I am sorry you feel you would do everything not to go there again. Seems you have concerns- but certainly not life threatening and you received PROMPT treatment in the ER regarding your chief complaint of CHEST PAIN. Which is ruled out CARDIAC first- just thought you should know what usually goes on in any given ER and reading your post--you might have not been able to see what was going on behind the scenes.

TVRH will never be able to handle the stress of the continued growth of THE VILLAGES. Look at all the people in The Villages- do you know that ER is only 24 rooms with hallway beds? Yes, 24 rooms. So- 100,000 people, I think approx 260 beds--when the hospital is full, there is no rooms for the patients being admitted to go upstairs (or off a gurney). You sit and wait, receive the same care as if in a room--without the private room and with all the chaos of the ER on any given night during snowbird season. I am sure you are aware of 1/3 of the patients who use the hospital as an urgent care and child care clinic.

The Villages need a 24 hour Urgent Care near Brownwood/Wildwood Area. That would assist in the overflow of patients with the ER. I also think that another hospital would benefit this aging population.

You can certainly choose another facility for your continued emergency care- however, it might be more than the food that you complain about next time. Each visit, nurse, MD are different. Good luck and best wishes for quick recovery.

Excellent post. Thank you.

[dbussone]

Originally Posted by TNLAKEPANDA

One would think that the medical and hospital services in a place like the Villages would be top notch and second to none! I have heard nothing but bad things about this hospital. We will go to Leesburg or Ocala should we need a hospital.

Leesburg has a really good hospital, particularly for Orthopaedics and Cardiology/Cardiac Surgery. The cardiac surgery program is ranked 3rd in a state with a number of really good programs. You should also know that TV Hospital and Leesburg are part of a system called Central FL Health Alliance, so they have the same management...and same physicians for the most part. I have watched the healthcare industry grow here in central FL for the past 25 years. It has come a long way, both in facilities and physicians, as well as the quality of care. Sure, it has room to go, but for most everything I would stay here for my care. I am very pleased with the physicians I personally have here, and am really picky having worked with physicians for more than 40 years.

I would also note that it is uncommonly difficult to manage the swings in patient volume that occur when Season brings another 25-30K people to our community. I've not been happy on one or two occasions with TVRH myself. But I've contacted administration to let them know. They can't fix a problem unless they know it exists. And I believe they are genuinely interested in fixing things. It is in their best interest to do so, as well as in our interests.