[simpkinp]

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

[Russ_Boston]

Originally Posted by ilovetv

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

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

[Russ_Boston]

Originally Posted by simpkinp

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

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

[Russ_Boston]

Originally Posted by barb1191

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

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

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

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

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

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

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

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

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

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

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

[mommieswamie]

I am really disturbed by what you are saying here:


"born mean and angry"

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


I wonder if you could clarify this a bit, please

Originally Posted by Russ_Boston

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

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

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

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

[Russ_Boston]

Originally Posted by mommieswamie

I am really disturbed by what you are saying here:


"born mean and angry"

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


I wonder if you could clarify this a bit, please

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

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

Not sure why this is disturbing.

[ilovetv]

Originally Posted by Russ_Boston

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

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

Not sure why this is disturbing.

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

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

[mommieswamie]

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

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

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

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

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

[golf4me]

Originally Posted by mommieswamie

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

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

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

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

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

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

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

[Russ_Boston]

Originally Posted by golf4me

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

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

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

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

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

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

[Russ_Boston]

Originally Posted by mommieswamie

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

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

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

We'll try to do better.

[mommieswamie]

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

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

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

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

[Quixote]

Originally Posted by Russ_Boston

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

Originally Posted by Russ_Boston

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

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

Originally Posted by golf4me

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

Originally Posted by Russ_Boston

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

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

Originally Posted by Russ_Boston

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

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

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

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

[BobnBev]

Originally Posted by Russ_Boston

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

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

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

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

I understand, Russ. Could some dementia be involved?

[Russ_Boston]

Originally Posted by BobnBev

I understand, Russ. Could some dementia be involved?

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