Wednesday, August 18, 2010

Massachusetts Nurse Peg O'Connor is a hero for patient safety

Patients are not safe if the nurses cannot speak out against hospital violations, especially cases of patient abandonment. Hospitals and medical care providers cannot dump patients. That includes established patients (like Dr. Alison Toth from Duke with me) and also situations where emergency departments transfer ill patients without first making sure they are stabilized.

And this is only the beginning as doctors and medical facilities become increasingly mercenary in the wake of ObamaCare.

A dramatic case is playing out in Massachusetts where a veteran nurse is terminated after "whistle-blowing" (or, as I consider it, looking out after patients) that her hospital transferred an pregnant ED admit to another hospital without first ensuring her health stability.

Margaret “Peg’’ O’Connor, a nurse who worked at Jordan Hospital in Plymouth for more than 38 years, said she was fired in May for doing the right thing. She reported a violation by the hospital that allegedly put a pregnant patient and her unborn twins at risk.

Peg O'Connor is a hero. God bless her and her attorney. I pray that justice is done in this case and that Ms. O'Connor wins her lawsuit.

This case is about right and wrong. It is about the direction our country is taking. Nurses (and other medical care professionals) must always feel safe to protect patients by exposing unsafe conditions.

Read the Healthcare Bill yet?

Have you taken the time to read the Healthcare Reform Bill yet? Do you understand the ramifications?

A big ramification is a loss of privacy. North Carolina announced today that it is starting the electronic medical records. How long will it be before the database is hacked? Good grief - what government agency hasn't been hacked?

And what happens when privacy is breached because of a hack? The victims get at least a free year of credit monitoring. Sure that will help when your mental health or serious illness details are plastered on the Internet!

Watch also for rationing of care .... it is already happening in Medicare. The patient is the only variable cost in a hospital or medical practice.

Shame on Alison Toth, MD (Duke)

I was treated by Alison Toth, MD (Duke Medical) in 2008. At the time, my knee was in extreme pain. Dr. Toth assured me that she could help.

But then . . . a Duke anesthesiologist (pain management) fervently disagreed with Dr. Toth's suggestion that the saphenous nerve be cut in my leg. The anesthesiologist would not talk directly with Dr. Toth and vice versa about the discrepancy.

Two months, multiple falls and an injured ankle later, Dr. Toth's office manager telephoned me on a Friday afternoon and said "Dr Toth won't treat you." I am not a medical ethicist but I am a thinker. Dr. Toth abandoned me as a patient in the most traditional sense of the word.

The result was that I continued to suffer pain, instability that effected my life and the life of my dad (for whom I was caring during his fight with cancer).

Shame on Dr. Alison Toth. Shame on Duke Orthopedics.

In December 2009 and July 2010, I underwent the surgeries to my knee. I was not treated at Duke. I traveled to Chicago to have the surgeries. The surgeons did a great job.  

Lesson: you may have to travel a distance to find good medical care. Don't accept abandonment. You deserve to be well --- advocate for yourself.

Tuesday, August 10, 2010

Croatian physicians/hospitalists in the United States

How much do you know about the "stranger doctor" (hospitalist) that is treating you in the hospital?

At a minimum, you should know the country from which your hospitalist comes. If the hospitalist was not born and raised in the United States (a country that emphasizes respect, care and charity) then you should learn a bit about the hospitalist's home country and its human rights record.

During my dad's September 2007, Duke University Hospital assigned Dr. Gordana Vlahovic as his hospitalist. Dr. Vlahovic earned her medical degree from the University of Zagreb (Croatia). My dad was 74 years old at the time. His course and quality of care during that hospitalization was necessarily a function of the hospitalist's perceptions of geriatric patients. That perception is developed throughout one's life. For that reason, the hospitalist's home country and background is significant.

How do Croatians and specifically the medical community in Croatia treat the elderly?

My dad was in Duke University Hospital in September 2007 with a urinary tract infection and associated weakness. A couple weeks earlier, my dad was in the Emergency Department with an inability to void. That condition followed a procedure to reduce the size of his prostate.

Dad fell while in his Duke University Hospital room. No medical care professional seemed concerned. Why then did hospitalist Dr. Gordana Vlahovic try feverishly to have me admit dad to a nursing home? Vlahovic: "you (me) have a life too." Me: "the priority right now is my dad-he is my life."

DUH told me that they contacted dad's urologist to examine dad. DUH lied. I contacted the urologist and he came to dad's hospital room. I heard the urologist outside the room as he was checking dad's chart. I heard a DUH nurse question the urologist's authority to read the medical record. The urologist was a Duke physician/surgeon. I was learning quickly that the treating clinic doctors were not welcomed at DUH. The Hospital is the purview of hospitalists (stranger doctors).

The urologist urged me to take dad home that day. He told me that if my dad entered a nursing home, he would be subjected to a urinary catheter. It would be a matter of convenience for the staff. The problem is that the catheter is likely to cause a UTI. And very often the only presenting symptom of a UTI is an altered mental status and confusion. Ah ha. Then the nursing home staff will presume the patient has dementia and the catheter will remain. The UTI will worsen until the kidneys are affected and the patient will die.

What then is it about Croatians and their attitudes about family and aging that would cause a Croatian hospitalist working in a US hospital to recommend that I put my dad in a nursing home so that I can cavalierly go about my life?

Every culture has their own set of values and guiding moral and ethical principles. As a hospital patient or the loved one of a hospital patient, you have the responsibility to know where the hospitalist was born, nurtured and educated. Moving to the United States does not erase those fundamental principles and values from the hospitalist ("stranger doctor").