Villages Hospital
 

I took my 85 yo mother to the Villages Hospital Emergency Dept. Sunday, Feb 19. She was suffering hip pain with no history of a fall. We signed in at 10:00 am. She was triaged at 11:59 am. She was brought back to the treatment area to be seen at 7:30 pm! OK-I checked with the registration desk volunteer more than once on where in line Mom was. I was told there was one patient ahead of her---but wait, 2 other folks also asked the volunteer the same question. They also got the same answer. "There is one patient ahead of you". HMMM!

When we finally got to the treatment room, the RN and the doctor were fairly quick to address Mom's needs. The exception was that neither the doctor, nor the RN, asked Mom even a basic health history (except if she had fallen) and Mom was never asked for a list of the medications that she takes. I've dealt with many ED trips in the past, and my career was medically based. I don't understand the standard of care when those kinds of things are ignored. Mom had a CAT scan and blood work done, was given a narcotic pain medication and told to see her physician within a week.

I wasn't happy about having to wait 9 1/2 hours for Mom to be seen. Neither was she! I somehow thought that the care would be better. Asking an elderly patient basic health questions and for a list of medications is not too much to ask. The standard of care at The Villages Regional Hospital needs a serious review.

I was at Munroe in Ocala for ER this past weekend. 8 hour wait. Not unusual for an emergency room.

I think you may have somehow missed the history and medication part. Perhaps you stepped away for awhile?

I'm a RN on the medical floor in TVRH. When patients are sent up from the ED I see all the paperwork (yes there is tons of it!). One of the basic and yes most important forms is the history and medication list. In fact we need to reconcile the medications with a doc ASAP when the patient is admitted. The health history area is usually very extensive and details all known conditions. Maybe it's different when someone is not considered for admission but the facts I just stated are just that - facts, for all the patients I have admitted.

Right now the ED is completely overwhelmed with patients. Two days ago we had 14 patients waiting for a bed upstairs but the hospital was booked. And quite often the ED is in 'divert' mode where we send patients (non life threatening) to other hospitals.

I'm not saying it justifies the long wait but she was triaged in decent time for a non life threatening injury and I'm sure the triage nurse (hopefully) let you know that it would be some time since the injury wasn't urgent. We have dozens of very ill patients that get seen in appropriate time in the ED and unfortunately this time of the season presents many challenges.

I hope she is well.

Russ

Villages Hospital
 

I was with my Mom the entire time she was in the treatment room. At one point I even produced the plastic bag I had brought Mom's prescription meds in and said to the ED nurse, "Look, I even brought Mom's meds with us." She said, "Oh, we love it when patients do that", but she didn't look at the meds. That was the entire discussion about current meds.

I understand the triage concept and the need for it. I get it on how busy things are here this time of year. What I don't understand is how after years of this topic, the situation doesn't seem to improve. I don't have an answer but I'm not in a position to fix it. I hope the folks who are in that position are working on it in some way.

Mom is still having pain in her hip. There really isn't a reason except for favoring that leg for a day (10 days ago) while she had a charlie horse in the opposite leg. She will get better, in time. Thank you for your concern. And thanks for reading my story.

This tells a lot of the story. But just wait. When final plans and construction of the new Brownwood-area TV hospital get under way, those who think they know how to run TV and the hospital system better will be on here screaming about how "money should not be spent on that", "the developer makes money off this", etc. etc. etc.

When your mother was in Triage she was asked for a health history, she had a very specific complaint "Hip Pain" without injury. While you had to wait a lengthy time in the ED, they did address the hip pain. What would have been the reason to see all the medications your mother had when she wasn't admitted into the hospital? Those medications were not related to her hip pain. If she was having chest pain or couldn't breath it would be important to see what her medication list was. She would be most likely be admitted and would be an important part of the admission process, in her case, since she was not going to be admitted a full list of her medications wasn't necessary. If you come in with an ear ache the doctor is going to examine your ear, treat that and send you home-the same is true with someone coming in with hip pain.

I'm sorry to hear your mother is still in pain but hope that with follow up care she will soon be feeling much better ...sometimes we just don't have an answer as to why someone has pain.

I had been to the Munroe ER twice and did not have much of a wait. I suspect it may be the time of yhe year (seasonal residents, et al )

I see the point about the med list. I only see them after admit so I have the list. And yes we do love it when people bring in the bottles from home:) Makes our job easier.

Note: everyone should keep a med list in the purse or wallet - just in case.

At this time of year in The Villages ED the wait can be very long...there are many seasonal visitors here and many more very ill patients. When there is no bed available within the hospital we must hold them in the ED which decreases the treatment areas within the ED to accommodate the increasing influx of patients coming in...it makes for very long wait times to be treated in the ED and long wait times for patients to go to their assigned rooms. It isn't a win-win situation for anyone, but change takes time and to make room for everyone will take even longer as it's not as simple as building more rooms/floors. People don't realize that it's not just about money and desire to build but a governmental problem as well. The governmental process for permitting is a long drawn out one that involves so many agencies and also includes the other surrounding hospitals. Everyone must agree or it doesn't get done...it takes years for this to happen.

Let's hope the new facility in the Brownwood area can take up some of the slack. Not sure what is going to be put there but my guess is some sort of urgent care type system to take the strain off of the ED. The new CEO just took over so let's give him some time to plan and yes, work with the government issues.

ARedheadedmermaid: You do not have to sell me when it comes to nurses. I have unfortunately been hospitalized more than I care to remember and nurses and support staff in my view deserve more pay and more respect than is accorded them. I do not know how you function so well in this fast paced and adverse environment but you do...and for that I will be eternally grateful

Wow
 

So sorry about your husband having the mini-stroke! One thing to consider when having stroke like symptoms is to get to the hospital as soon as possible....don't wait it out at home....time is very important to getting the 'clot busting' drug. That being said, I am not accusing you of doing this...just want to make sure everyone is aware. I am a nurse and deal with patients all of the time who try to 'wait it out at home' wether it be heart pain or stroke sx. The goal is to prevent irreversable damage.

I think I do see a patten in the posts though. It appears that scheduled procedures have a better outcome than those that come in through the ED. Of course, this may not at all be the case.

Also I am glad you got a copy of your records/ tests. I was going to recommend doing that. Will be better for your own records.

wow
 

I did get hubs to the hospital right away. He never received any clot busting drug tho, maybe because his symptoms started to subside?
Thanks for the support. It's been quite a journey.
I think it also makes a difference if you have an established MD so that you are not at the mercy of the hospital staff MDs.
The DR.s we had were incompetent. Plain and simple.

Ambulance to hospital
 

Insist on being taken to Munroe in Ocala!!!!

Ocala Drs.
 

Thank you, I will insist.
Now that means we need to find a good Neurologist and good Family Dr. or Internist in Ocala.
Any suggestions?

I am a little surprised that the medical situation in TV is not as well thought out as the developments. Knowing that you have 85,000 "patients" soon to be 110,000, should dictate a fairly decent medical facility, especially considering the demographic of the population.
I hope someone decides to put in the same attention to detail that TV has done with their homes to make a world class medical facility. It seems to be the one thing TV is missing.

How exactly would one attract the doctors, nurses, technicians, administrators and specialists to a city of 85,000 that does not allow the above people to live here if they have children under age 19??? (And for the record, I'm not advocating that kids be allowed to live here.)

The Charter Schools here are a brilliant concept to attract the professionals and clinicians needed.

The recent alliance made between TV and the USF Medical School, which agrees to accept TV Charter High School graduates into med school is a nice way to attract the parents who are professionals needed here, too. But the bottom line is, the students cannot live here in TV with their parents.

Then, how would one attract physicians and professionals here when 85% of patients at TV Hospital are on Medicare, and Medicare reimbursement to hospitals and doctors keeps getting cut more and more every year...which leads to constant belt tightening and staffing cuts at the hospitals....and more cuts of $500 billion are part of the new law??

I do not live in TV yet so am just learning about it. I actually will be moving there in 2 months. But in answer to your question where would the doctors and nurses live because their children couldn't live with them, there are lots of other towns surrounding the villages where they could live I would think. Where I live, there isn't a teacher at any of the public schools that can afford to live anywhere in this county. They travel 40 - 75 minutes each way to get here. It is very sad but that is how we value our teachers in this country. As for hospitals servicing only older people, I hadn't considered the financial impact. I guess my next question would be, if the hospital in TV is compromised because of the financial considerations, then what medical institution is nearby that services the general population that would be considered world class?

TVRH employees are eligible for charter school. (At least I know a nurse who works there for that reason, so I assume it's available).

Again, Ilovetv,...another articulate post with exactly the most logical bottom line assessment. You can build a dandy hospital but "THEY" have to agree to come.

Another thing too, there exists the finest large teaching facilities across the country such as Harvard Medical and Cleveland Clinic and Sloan Kettering, MD Anderson etc.etc. that are kind of the ultimate in prestige for physicians to be employed there. There are other not quite as wonderful, but still great hospitals that are located in areas where people enjoy a lot of the things that only hugely populated areas offer. The best and finest in abilities usually gravitate to those places.

The middle of Florida in not a hugely populated area is not the greatest draw for people who have spent many years of post graduate time being educated and can write their own ticket.

So we can't make the developers miracle makers.

but close.

So if you are really ill, where do you go. Not for emergency care but where is the best hospital in FL? Is there an equivalent to Mass General or Sloan Kettering or Mayo in FL? This is not judgmental; I am just trying to understand what the options are.

I have heard friends who are physicians say they go to Shands associated with the Medical School at University of Florida in Gainesville. Gainesville is about an hour away. There is a branch of the Mayo Clinic in Jacksonville, and the main site of Moffitt is in Tampa.

Does anyone have experience with or an opinion of Leesburg Regional ER? I assume that is the closest emergency room outside of TV.

I was going to mention Shands too. It was very highly recomended to us too. We were/are several hours' drive away at the present time but that was not an issue for us when we wanted the best care. From my research (including all those Gracie mentioned) I feel pretty comfortable with the level of hospital care that is available "fairly" close to TV when the need arises.

I am, however, a little bit worried about being able to find decent primary care, dental, and other care providers in or close to TV.

Thanks for the info. It makes moving in to the area easier knowing your way around in the event of medical issues.

Come on people, there are a lot of good doctors here in or near The Villages.
I have friends who have been treated for cancer right here and they are now cancer free. I'm sure others can say the same thing.
To say one has to travel to get good care is just not true.

You are right Bogie. But it takes awhile to find the best docs, and sometimes there is a waiting list for them.

Thank you, Bogie. My husband is alive today following a heart attack in 2009 when he was transported by ambulance to TVRH, had a stent placed, and was in CCU in about two hours total. The outcome would not have been so good had he gone to Leesburg or Munroe because of the time involved in transporting (not the care he would have received).

Wait times would be much less if those without life-threatening problems would use the urgent care clinics instead of the ER. If the clinic determines that you have a real emergency, they will call an ambulance. (Chest pain always warrants a trip to the ER, preferably by ambulance.) While I was in the waiting room that same evening of my husband's attack, some lady was in there complaining about the wait time. She was telling them that her back had been hurting for a couple of days and she decided to come in to see about it.

Touchy subject
 

The problem isn't with the Hospital it seems to be the ER Department. But why? People from TV aren't the only ones who use it, some people don't have a doctor to go to when they don't feel well because they haven't gotten one yet, some go to the urgent care who sends them to the ER for tests. The ER is there as an Emergency. You fell,were in an accident, had a stroke or heart attack, cut yourself or called an Ambulance and that's where you were taken.
If not an Emergency the ER Dept. gets backed up,non emergency people have to wait because Emergency cases come in. There aren't enough beds in the Hospital so your stuck in the ER. TVRH isn't the only Hospital with ER problems. Having come from Long Island and riding with the Ambulance for many years I can tell you this is the norm. You can wait hours just to be called then hours more to be cared for. As medical insurances change and doctors get bussier, the population ages this is only going to get worse. As Russ stated there's a new man in charge. The Villages can only make certain changes. The state has the final say. I guess I'm lucky my visits have all been inpatient and I have had only great sevice. Be patient and remember the ER is for emergencies. Just my opinion!

And you are right too Dillywho.

Our Helene was born with a congenital heart abnormality that is very rare and she still is seen, at the age of 46, at Children's Hospital in Cincinnati.

So it is hard to transfer her care to a new Cardiologist, because a pediatric cardiologist is the one who kind of "speaks that language".

I am sure Bogie that there are great doctors here and we are satisfied with the GP we are seeing. And the dentist, and more than admire the highly qualified, Dr. Alex Ghazal an oral surgeon.

Keep posting all of the good things here folks. We are all trying to learn this place....and the bad things too.

...

I'm happy to see that a lot of you have found local physicians that you are happy with!! I like to read that it is possible to find a good one. That helps to lessen my fears in that regard.

From reading posts over the past few years I got the impression a lot of people were having a difficult time finding docs they were happy with...and it seemed like the good ones were not taking new patients.

I hope it won't be a problem to find ones we like and trust when we get to move there.

TVRH is a stroke center (so we do have a neurologist available 24/7) and our protocol is to immediately obtain a CT of the head and make the right choice to give "clot busters" if the patient meets that criteria. There are many times that the patient does not meet that criteria and it would be life threatening to give certain medications. Just because a patient appears to have a stroke doesn't mean they are having one, there are many illness that cause the same symptoms...you do not treat a TIA as they resolve on their own. You do not treat Transient Global Amnesia as it will also resolve. Myasthenia Gravis has stroke like symptoms but isn't a stroke at all and needs entirely different care. All these types of sudden onset stroke-like symptoms are scary but not a STROKE and do not require "clot buster" meds.

The Standard of Care "might be" 3-4 hours for admission but that doesn't mean a bed is available for that patient to be admitted to...we admit within those parameters all the time and while those patients are in the hallway they are still being cared for by the ER RN using the admission orders until a hospital bed becomes available.

Which brings us to another issue and that is the bottlenecking or holding of patients in the ER while trying to manage the influx of patients who walk in and/or come by ambulance and not have an endless wait time either in the waiting room or waiting to be seen once they are brought back to a treatment area. If you can't move your patient upstairs or to the ICU you have no place to treat incoming patients. ICU nurses have 1-2 patients at any given time, ER nurses are still caring for the ICU patient and 3-4 other patients at the same time. So it's understandable when a stable patient who has been admitted has to wait in the hallway for their hospital room to become available to make space for a critical patient needing a treatment room. It doesn't make it easier for the waiting patient nor the ER RN taking care of those patients to have them in the hall-floor nursing has it's own way of doing things and the ER isn't set up for that. We much prefer to follow through and get the patient to their room within the hospital.

TVRH has 223 hospital beds and 25 ER beds and there are over 85,000 people with a projected build out of 110,00 people, serving the tri-county area, and the non-emergent issues that could easily go to an Urgent Care (and there are many UC's in the area) something has to give and what that relates to is long wait times for everything.

Thank you Stacy for that sincere and concise post. I experienced a very long wait in ER, waiting for a bed to be admited....while in ER my care was excellent, it's when I got to my room that things started to deteriorate for most of the 8 days I was there. But I am hopeful that the hospital is constantly working to improve in all areas.

Thank You Stacy
 

.....Thank You Stacy. I appreciate your concise, straightforward approach.

You have cleared up a LOT of mis-understanding on the use of clot-busters
and wait times at the ER.

The Villages Hospital is fortunate that you have chosen their facility
to share your talents.

Please...Please... KEEP POSTING.....

.....you are a breath of "fresh-air"..........................................
.....You do not tell others they are wrong....or become defensive.
.....I LIKE your style.

Did you mean the care you received went downhill or your condition? 8 days is a long time in the hospital so I'm sure your condition was serious.

Stacey
 

so glad you cleared that up about the waits etc.

Reminds Me of A situation:
 

A few years ago (5 or 6) my sister in law was on vacation in Ft.Lauderdale.
She woke up in the middle of the night with terrific pains. Her family with her
took her to the Ft Lauderdale Hospital which is very large. They put her in a bed in the ER and then she was placed in a hall. After about 4-5 hours of pain waiting for a room I stepped outside the ER, saw an Ambulance, wrote down it's phone number and called them to come for her. She signed herself
out and they transported her to Stuart Fl. Hospital which has a great reputation. A surgeon saw her immedicatley, took exrays and immediately took her to surgery. She had a major blockage scar tissue from a previous surgery when she was young and as the Dr. said she had about 24 hours left before she would have so much infection nothing could have been done.
The moral of the story is that your health is in your hands..Don't let any
medical Dr. or facility take over your health. Demand action and if they are not responding go somewhere else one way or another. Not allowing the Ft Lauderdale Hospital abuse her and instead taking action in the end saved her life. Be sure to have an alternative plan if you are not being treated properly and excerise your rights..:mad:

Scary healthcare
 

Healthcare is soooo scary these days! I do fear not getting good health care in TV. I hope, if I should need emergency medical care, that I need it in the summer when all of the snowbirds are gone. Nothing against snowbirds, but the facility may be less crowded and therefore treatment faster. You must have an advocate with you who can watch out for you while you are ill. Make sure the docs and nurses do their job in a timely manner.