Bonny, you are right, I should have explained more thoroughly. After six hours my heart rate suddenly went back into a normal rhythm. It came on suddenly and left suddenly. I went to the doctor the next day and they are putting me on a holter monitor. Sorry about that.

We had similar experience. Waited 4 hours only to be told they could not do anything for my wife except give a referral. Then billed the insurance for $1500. I would never voluntarily use this ER again.

I mean I simply can't believe what is being said here. Why I have read practically everyday since moving here 10 years ago in the Daily Sun's two-three page coverage of the high quality health care facilities and continuing improvement in the Hospital and you people are still complaining.

Are you saying the Daily Sun's news articles about health care in TV isn't what they purport it to be?
Blasphemy !:D:D:D:D

If everyone who has a complaint about TV Hospital would take that complaint to the state, something might be done.

Check out this webpage and maybe get some kind of action.

AHCA: Complaint Administration Unit

See if they will do an article on the ER.
No way that will ever be sanctioned/allowed.

LOL....Praise The Lord!!

these comments regarding the local ER do not instill me with confidence! I am a retired R.N. with many years worked in various Emergency Departments so I understand that non-urgent things have to wait for the more critical patients but when my son and his wife were visiting they ended up in the ER at T.V. one night for a non-emergent but extremely painful ear infection...arrived at 2 a.m. and were told "it will be a while" and eventually did get seen but not until well after 8 a.m. They were as patient as can be expected but very frustrated when they later learned that there was a physician on board but they didn't wake him up unless it was a bonafide emergency and nobody was seen until 8 a.m. when the morning staff arrived. Again, not being seen immediately for ear pain (which was eventually diagnosed as a rip roaring infection) is understandable as it really wasn't emergent but when they initially arrived they should have been told what to expect (e.g. wait for the day crew to begin in 5 or 6 hours)

After hearing other unsettling stories from neighbors who experienced the ER care first hand, I have decided that we will be going to Leesburg for any emergency problems. When my neighbor was experiencing chest pain, the paramedics told them that it would take the same amount of time to get from our neighborhood to Leesburg as it would to TV so if the distance/travel time is the same and the quality of care at Leesburg is that much better that makes Leesburg a "no brainer" decision for our family.

Isn't leesburg under same management as TV?

I was released yesterday from Leesburg after a 3 day stay in the hospital and I have nothing but good things to say about them. I was transported by Lake EMS after a fall at home. My ankle was clearly broken and needed surgical repair. When we arrived at the hospital, there were many people on beds in the hallways because the ER was extremely busy. However, within minutes of my arrival I was taken into a room, seen by a doctor, had xrays, and sedation while they temporarily set my broken ankle. A few hours later I was taken to my room. I had surgery on Sunday and was released the following day. The entire experience was positive. I can't say enough good things about the wonderful doctors and nurses who took care of me. My room was very clean and comfortable, and the food was, believe it or not, very good!
With all the negative reviews here, I felt it imperative that I speak out in favor of the wonderful care I receive there.

We live in Lake Deaton and it quicker for us to get to the hospital in Leesburg than to The Villages Hospital.

As per Mapquest, you are indubitably correct !

Someone posted about King's County and the harrowing cases and pace. To assume that what WE experience in TV ER is really NOT happening is pathetic. I, for one, have been a nurse for 43 years. I worked at Columbia Presbyterian-Babies Hospital, North Shore University Hospital and Long Island Jewish; all 3 NY hospitals. I can assess the doings of most places I experience FIRSTHAND. While we may be aging here in TV, however, don't let the hair kid you. I can still run circles around many new grads. If something does not make medical sense; is that the point being made? Confounded might be the word to reach for.
I simply feel that diminishing our firsthand experiences is making me wonder if we should genuflect and do the 'we are not worthy' wave.

I wasn't going to respond to your post, but I changed my mind. It was I who made the reference to Kings County.

First, thank you for 43 years of service to the community as a nurse; I can tell from your wording that you are a good nurse as well. As you know, many younger nurses, especially the good ones, find alternative career paths in the pharmaceutical or insurance industries, or go on to become a NP, or earn administrative positions. It takes special dedication to hang in there for 43 years. I too spent time at Columbia-New York Hospital. I was at LIJ for a time and my brother was a patient there as well. I spent time at North Shore, and in fact I was born at that hospital, so we share many firsthand experiences. We may have even run into each other 35 years ago or so. I've also had the "joy" of running Staten Island University Hospital ER on occasion.

Perhaps I failed to make my point clearly in my post. Certainly you don't think I believe everyone who goes to TVRH ER has a great experience, and then some lie about it. I was not diminishing anyone's experience. Likewise, I doubt you believe every word that people post about the ER on TOTV. This ER has problems, but they are very fixable. However, there are SOME posts that are so bizarre that they appear to lack credibility.
How many times have you tried to explain something to a patient and family and can literally see the exact moment they shut down and stop listening? I'm sure you learned early on to avoid the words "cancer" and "Alzheimer's", since at that point all communication, all memory, and all judgement goes out the window and emotion takes over. Likewise, there is extreme frustration from waiting in an ER, and stress and fear of the unknown, so not all recollections are entirely accurate. Just ask any detective what they get when interviewing "eyewitnesses"; I'm sure you know what I'm talking about.

There are only about a dozen posts over the last 2 years that seem incredible, so let's play a game with the one I found most egregious. I'll be the ER director and you'll be the ER charge nurse, a position you may have held in your career, About a year ago a OP stated that her 90 year old mother was brought to TVRH ER with a fractured hip and waited 22 hours to be seen by a doctor and get pain medication. What do you think? Do you really believe that is 100% accurate? Given your 43 years of experience. I know you don't believe it either.

So here we are, running the ER when EMS brings this 90 year old in. What happens first--they want to give report to a nurse, who starts a chart (paper or electronic), and points to a room to put the patient in (or the hallway if they are all full). So EMS tells the nurse they have a 90 year old woman unable to ambulate, pain in her left hip, and an externally rotated left leg (not too hard to diagnose). As charge nurse, how long do you tolerate no one from the nursing staff seeing the patient and at least getting vitals and doing a pain assessment? 5 min, 10 min, 15? At some point you would probably go in and do it yourself, as I'm sure you have. I have. How long would you tolerate the physician not seeing the patient and getting x ray/lab ordered and pain meds administered? Same? I wouldn't tolerate it and likewise, I'd go do it myself if no one else did. I've seen similar patients being wheeled in with pain and administered fentanyl right on the stretcher. You've probably seen that as well. How long would I wait before an orthopedist sees the patient? An hour, maybe.
Did that OP have a wait that she considered unacceptable? Probably. But do you honestly believe it was 22 hours??? I'd guess that nationwide about 1/2 of the patients who come in with the same hip fx are in the OR before 22 hours.
I'm not sure why you chose to use the words "pathetic" and "not worthy", since it is pretty certain we are on the same page on this.

I have not been following this thread, but have to say that I followed my husband to the ER with what turned out to be an inflamed gall bladder. As they were going out the door with him on the stretcher, the EMTS indicated his heart was fine. Since many of his symptoms mimicked heart issues, I was relieved. Ultimately, he was put through "the system" and was operated on within 10 hours of arriving in the ER. It was not a critical situation. He's almost 80 and there were a few minor complications necessitating his admission for a couple of days, but altogether, we feel that the Drs and entire staff were extremely thorough and very attentive during his stay. Did I breathe down their necks? Of course, but this is an incredibly busy time of year, and everyone remained helpful and pleasant, despite my incessant questions.

There is a big difference between how the rest of the hospital operates and the ER.

As noted in several post incuding mine the ER is a complete out of control disaster. Continuing that way seems like for years. How does that happen? Allowed?

skip: this same topic (TVERH) has been repeated so many times since I first came on TOTV. I said back then that one look around and I signed onto Munroe.

You suggest that people ought to try their urgent Care. I suggested in one thread that the ER ought to have a nurse pre-screen patients and those needing only urgent care be offered the opportunity to go to urgent care.

and in every thread some poster suggest tell management. If after all these years and all the advertising in the Daily Sun, POA, VHA management is unaware then they are more incompetent then the people running the ER.

What I am saying is the ER is a failure because of management. Indeed there can be more hair raising nights then others but planning is the key.
I worked in insurance we had plans in place for catastrophes. We knew we had to get in and get out fast to meet people's needs.

The problems associated with The Villages Hospital fall on the Board of Directors and management . I feel badly for the employees

Yes.


Sent from my iPad using Tapatalk Pro

I respect those who have spent their lives in the medical profession who post on this forum. I know they have medical knowledge and years of experience that none of us could come close to. I thank them for their service and for their helpful explanations.

Very few places must deal with the huge increase in population that stay here long enough to get really sick before they go to emergency.

STILL Triage is for the VERY ill, those who are not breathing well, or bleeding or having a cardiac emergency. You may be in terrible, AWFUL pain, but they will take someone who is in danger of death before you.

Perhaps people who stay three months every year should establish themselves with a physician here, so that small things don't become big things. We did just that when we came down for just the season. Just a thought. An ounce of prevention...

It was not too long ago that TVRH opened an Urgent Care Office in the building on the east side of Hwy 27/441. They have since moved it to the first floor of the hospital. Maybe it is time for management to consider turning it into a 24/7 facility to help relieve the burden on the hospital's emergency department, especially during peak season.

As things stand now not everyone who arrives at the hospital is transported by ambulance or requires the services of the ED.

I agree with you to a point, the failure of management is in not CORRECTING the problem. The board is not down in the ER doing the work, but they are responsible for oversight
Each ER seems to have it's own "culture", and as someone put it, I have had "firsthand" experience with 20 or 30 of them. If the people in charge are laid back and have low expectations, it carries through all the staff. Sometimes there are people there for 20 or 30 years that defacto run the show THEIR way, and are reticent to change. This problem came up when I ran the QA committee, was chief of staff and sat on the board, so here is what we did:

1) We designated 5 rooms as fast track/urgent care with a good NP in charge and triaged appropriate cases in that direction.

2) We looked at ambulance arrivals. There are people who call an ambulance for no good reason at all. About 85% of this was because car service cost $5 but the ambulance was free (to THEM, $800 for the taxpayer to fork up). The other 15% was due to the belief they could bypass the waiting room. So we started a policy that non-emergent ambulance arrivals would be triaged to the WAITING ROOM, and usually to urgent care from there, thus removing some incentive.

3) Often there are patients who are getting admitted, but were waiting to be seen by the hospitalist or attending. We made a policy that the attending had 30 minutes to see the patient in the ER, otherwise they would be sent to their floor with just a few holding orders. The floor nurses would bug them from there. This freed up many ER rooms to move patients along.

4) We overrode a nursing policy that stated no patient would be accepted to a floor for 45 min before and after a shift change. This was 4 1/2 hours each day during which no patient could be moved out of the ER. This was accomplished by staggering shifts and mixing in 12 hour shifts for those who wanted them

5) We started much more extensive tracking of ER times, from triage to nursing assessment, physician contact, lab and x-ray being performed and admitting physician writing orders. We put a big LED TV over the ER desk with the initials of each patient in each room, their preliminary diagnosis, and the arrival time. Any time more than 25 minutes passed between steps that room was highlighted

6) we put in loud and annoying call bells in each ER room that could only be turned off from within the room

7) we gave out patient satisfaction forms to every patient and family asking them to be explicit about their experience

8) We identified the slowest and laziest worker on each shift and found them a more appropriate position elsewhere. The message was clearly sent.

Bottom line, within 4 months waiting time was cut in half and was less than the national average, and patient satisfaction went from 4.6 to 8.9 (out of 10).

So it can be done. TVRH ER may have some slightly different problems, but wait time everywhere is related to volume, staffing, and patient flow. So why hasn't this problem been addressed long ago, that's the real question.

There is a NEW 24 hour ER on right hand side of 441 as your heading north just before Marion Market. Might want to give them a try.

Many well run ERs do exactly what you are suggesting - having an urgent care operation in, or close to, the ER. They typically operate 24/7 and function to fast track non-urgent patients.


Sent from my iPad using Tapatalk Pro

GolfingEagles has just noted many suggestions that really can make a difference in improving ER performance.

I'll add another. In 4 or 5 poorly performing ERs, I've changed out the group of physicians providing care in an ER. Physicians who are lazy or have a poor attitude bleed these traits to the entire department. A change in a physician, or the entire group of physicians, is sometimes necessary and can generate a huge performance boost.

My observations tell me TVRH has several problems in this area, including not properly matching patient influx and physician staffing. Physician attitudes are another. The ER physicians do not seem to be patient oriented, preferring to spend most of their time at a nurses station rather than with patients. Just my observations.


Sent from my iPad using Tapatalk Pro

I agree with you, and saw the same thing when my wife was there. I just don't know if a complete housecleaning is needed. What type of physician ER staffing currently exists? Are they hospital employees or a subcontracted group?
We didn't have this problem back in 2001 since we had a stable ER physician staff that was there 20 years. But 10 years later, most of them were gone, and we looked into a national staffing group and eventually contracted with one. The problem is that the presentation is usually given by a Harvard graduate, trained at Mass General, with a supposed staff of all American University trained ER docs. It starts off that way, but 3-6 months later, one by one, those docs are replaced with FMGs, many who have yet to master English as a second language. I suspect there is a physician recruitment/retention problem in Central Florida.

We also had a horrible experience at the ER. In March of last year I took my husband who was in great pain from a kidneystone to the ER around 6PM. He was triaged and then we sat with a plastic bucket for his vomiting for 4 hours in the waiting room. We left and went home with him never being seen and after others there told us they had been waiting 8 hours. He passed the kidney stone at home later that night. We received a bill for $392.40. Same explanation given to us as you. When we complained about the extensive wait the response was "well we are pretty busy during snowbird season". So unless we have an emergency during off season we will head to Leesburg ER. It really galls me to read the accolades in the newspaper on how great the ER is.

And there is just no excuse for that. Just get him in a room, start an IV, get a urine and abdominal flat plate, and shoot him up with IV Zofran and morphine. Shouldn't take more than 20 minutes.
I do appreciate the staffing issues that arise when the service population goes from 80,000 to 130,000 virtually overnight, but that is administration's problem, it shouldn't be the patient's. If the ER rooms are backed up because of patients waiting to go to a floor, implement the suggestions I made above.
I agree with Db, there may be a laziness factor in play. An ER room filled with a patient just waiting to go upstairs is almost no work; putting a new patient in there is a lot of work. Also, ER staff tend to have a shift mentality, if they can make it to next shift it's not their problem any more. That needs to change.
Also this is the 3rd or 4th post about patients sitting in the waiting room and given a bucket to vomit into. Horrible. Administration needs to realize that right or wrong, the ER is the "face" of the hospital to most of the community. I would never tolerate that in any ER I was running, the nice nurse who posted above wouldn't tolerate it, and I don't think the patient population should either. No one in pain EVER wants to hear "we're busy".

I wonder "IF" everyone whose had a bad experience or less than good, who have posted here all e-mail the hospital (or snailmail) and call the administration along with that with their complaints "IF" they'd begin making changes. I know that "some" of the medical staff at the ER are "traveling" contracted employees and don't even live in this area. This I know from personal contact/experience of being both in the ER and later admitted to a room on the floor.

I also know that in the past 6 to 8 mo. TVRH has changed out their procedure of patients. Unless it's an extreme emergency...even if brought in via ambulance...they will send their patients out to the waiting room. I agree this probably isn't the best way of doing things. The waiting room is right next to the front door with windows and it's not a great 1st impression (someone else stated this already). How about having the waiting-room on the other side, separate from the front entry??

Actually, it would be better to fix the problems and put their well run ER on display in the window than simply hide the problems in a back room. The "traveling" doctors are what is called locum tenens, usually a 3 month contract in a given location. Not the best in general, no roots in the community, and very costly since they are hired through a third party which bills them out at double or triple to going rate. Also, sending everything but dire emergencies to the waiting room is too much of a good thing. They need to send sore throats, earaches, rashes, toothaches and the like there, or to urgent care, but not people in significant pain, vomiting into a bucket and certainly not chest pain as someone posted about 6 months ago. Again, it makes me believe the ER exam rooms are blocked by patients awaiting admission or extremely slow assessments in the ER. As far as administration goes, I can't believe they are unaware of the problems, but likewise I can't believe they don't know how to fix them. I'm afraid that sooner or later they are going to have a medical disaster (which usually involves an illegal immigrant pregnant woman, just as it did in Texas prior to the COBRA act of 1997) that gains media attention and then they'll have real problems

Over a couple of years, for visits involving my wife, I have made suggestions to administration about the ER and my perceptions on areas needing improvement. Our personal physician has commented to administration, and my wife's orthopaedist personally talked with the highest level of administration. He was a Chief of Staff at the time.


Sent from my iPad using Tapatalk Pro

Remember when the new ER was going to be the solution to all the the problems of the then current ER? I stated then that architecture seldom resolves all those issues. The physicians, IMHO, were the bottleneck at that time and probably remain so.

So, why are patients being dumped into the ER with all the grand new space available? And is the holding area for those waiting for inpatient rooms being used? (Usually this just results in patients being held in the ER longer, as GE has pointed out.)

Current practice in hospital design eliminates the large nursing stations and creates smaller distributed staff work stations for 2-3 people. This keeps docs and staff moving around to keep them closer to patients.

The ER physician group, unless it has changed recently, is based out of the Ft. Lauderdale area. It relies heavily on Locum Tenens physicians. I terminated their contract at one hospital in the late '90s.




Sent from my iPad using Tapatalk Pro

[emoji106][emoji106]


Sent from my iPad using Tapatalk Pro

My husband was taken by ambulance to the ER on Sunday for chest pain and he was assessed and treated quickly. From what I could observe the biggest problem there is volume. They had more patients than they had rooms for and some were waiting in the hallway for a room. When he was finally admitted the hospital itself was full and he had to wait 6 hours for a bed. His treatment however was excellent. The nurses were straight out but still gave us wonderful care. Today they told us that they had 4 heart attacks in one day and heart attacks always get moved to the front of the line. I am sure if we had gone in for kidney stones it would have been a different story but that is how it works. Life threatening conditions always go first and in The Villages there is always an abundance.

Wife was recently brought to TVRH by ambulance. Waiting room was not too crowded. Brought to room in new part of Emergency Dept Had a great nurse for initial shift. Then she spent over 24 hours in bed in ED before bed became available in Cardiac Section of 4th floor. Meanwhile the crowds built up in ED waiting area to be seen and brought in for tests and treatment. Some are parked on gurneys in hallways as there are no ER beds/Rooms available

So it starts with bottleneck in ED and that spreads. Because there is no staff till next shift or later for rooms.. One thing seems certain, it's bad now and it will be worse in the following years as population increases. Recent additions to hospital have not fixed the problem of inadequate staffing, long waits in waiting room and longer waits to be admitted and brought to room.

I recently went to the Leesburg ER and was very impressed with their service and care. They followed up with a survey in the mail to see how I ranked their care. I gave them very high marks and would definitely go back there.

In most cases of "waiting an eternity", I recognize that 'eternity' can be as short as 20 minutes. That said, when one is in pain; agonizing PAIN', 5 minutes can be an eternity.
Sadly, I honestly can see someone waiting upwards of 15 hours to be evaluated; forget about treated. My dear friend got to TVH-ED after experiencing what he thought were heart attack symptoms. He complained of chest pains upon his arrival there at 10:45PM. He sat in chairs till 11:25PM and was taken back to a room. Clutching at his chest continued and he yelled out for help. He said a Dr????" stuck his head in and said he was sending help.
At 1:45AM, he was visited by a CNA and vitals were done. Pain level at that point was a 7-8. Improved but he was tachy (tachycardia- fast heart rate) and sweating. No IV line. CHEST PAINS, DIAPHORESIS (excessive sweating).
NO O2 was placed. No LABS!!!
At 3:30AM, he got to his feet and headed for the exit. He collapsed in the lobby; passed out.
He was brought back to the room, had a CXR and WAITED till 4:15AM for labs and a room. His temp at that point was 103.8 and climbing. He was taken to the OR at 1PM and had his abscessed gallbladder (never had a symptom before) removed. Shocker here, infection followed. So, to wonder if someone really waited that long' it pains me to say yes, I can believe it. It is terrifying.
I, typically, give time estimates a pass. My time is different from your time in urgent situations sometimes. Horrific care is just that.
I use Santa Barbara United Healthcare and I have been thrilled. Yes, I am very observant and I ask questions. Some folks, especially elders, are trusting of the people who hold their life in their hands. Respect. Tough to change an entire lifes behavior that readily.
I just hope that the care there improves. It will never be a Level 1. It NEEDS improvement. NOMESAYIN??

What is Going on?
 

It is outrages that yesterday I saw the Dr. for a follow up visit scheduled by the office and I waited 1 1/2 hours to see the Dr. and the visit with the Dr. was at best 10 minutes. There were no emergencies during this period and it was "business as usual".:mornincoffee:

Another is that your friend should immediately been treated with a cardiac protocol to ascertain whether a heart attack was underway. Any patient presenting with chest pain should become an immediate priority. As an aside, your friend should have called an ambulance to get to the ER. If he was having a cardiac event, he could easily have died on his way to the hospital.

I'm hoping GE sees this and weighs in on your post.


Sent from my iPad using Tapatalk Pro

Yes, I see it and it is totally unacceptable. 5 1/2 hours to be seen with chest pain? 5 1/2 minutes is more the norm. No lab/EKG for 5 1/2 hours---a disaster waiting to happen. Admittedly, it's not 22 hours, but this could be a lot more serious than a hip fx. Apparently they have never heard the term "myocardial salvage". I've had patients in a cath lab 30 miles away in less than 1 1/2 hours. I had one come in for a routine office visit and then said, "by the way, I started having chest pains about an hour ago. He had classic EKG changes and I sent him directly to Syracuse where he was in the cath lab 52 minutes after stating he had chest pain. This is nothing to mess around with. You may be right, DB, it may be time for a change in ER groups with more oversight as well.

ER Time estimates Friday night about 9 pm
 

Needed to go to an ER for side pain on a Friday night after Urgent care centers closed about 8:30 PM. Called 3 ERs for time wait estimates to be seen.

The Villages 4 1/2 hr
Leesburg 2 1/2 hr
Monroe Ocala none

Of course, the wait time can change by the time you get there. Drove to Monroe ER and they took me right in. Excellent service. BTW I've been to the Villages ER before and it was a long long wait to get in then a bed in the Hallway.

I was taken by ambulance to Leesburg at 4:00 am Tuesday (breathing difficulties due to bronchitis)and was treated not only on route, but within minutes at the ER. Incidentally, almost all the bays were occupied with many of the patients hacking and coughing as I was. I too received a follow up survey connected to my care. First rate