[NYGUY]

Originally Posted by rubicon

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

LOL....Praise The Lord!!

[navair4me]

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.

[starflyte1]

Isn't leesburg under same management as TV?

[Jazzcat]

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.

[Radioman41]

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

[RickeyD]

Originally Posted by Radioman41

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 !

[ronsroni]

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.

[golfing eagles]

Originally Posted by ronsroni

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.

[Opmoochler]

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.

[billethkid]

Originally Posted by Opmoochler

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?

[rubicon]

Originally Posted by skip0358

If TVH ER is really that terrible why do SO many people still use it? Guess because there are people with no insurance that go there because they have to be treated. So if you have insurance why not try the Urgent Cares or a Hospital outside of this group. See how that works out for you. Remember also IF you call an Ambulance you will be going to either TV or Leesburg unless it's a Trauma Alert. Myself I use Urgent Cares if at all possible. If I go to the ER I know it's going to be a long wait. As I said in earlier posts having ridden with EMS I know it's the same up North where I was.

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

[dbussone]

Originally Posted by starflyte1

Isn't leesburg under same management as TV?

Yes.


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[graciegirl]

Originally Posted by dbussone

Yes.


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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...

[Hancle704]

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.

[golfing eagles]

Originally Posted by rubicon

skip:

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

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.