Family calls 911 from ER

[bstone]

This is entirely shocking and disturbing. A woman lying on the floor of an ER waiting room after being discharged, vomiting blood. The ER staff doesn't help because "she has already been discharged". Two people call 911 from the ER begging for help, only to be rebuffed by the 911 dispatchers.

Cause of death: perforated bowel. Treatable.

http://www.yahoo.com/s/603604

 

[Summit]

Someone is going to be VERY poor and/or in jail after the law talking guys are done...

 

[Chimpie]

I understand that hospitals have their rules, but the rules need to change.

 

[Guardian]

Wow, that's all I can say with the limited information given in that one sided report. I would have loved to have been there and seen both sides and how the situation developed. In defense of the dispatcher, they probably get crazy calls like this all the time. For example, someone having to wait more than 20 mins and calling 911 to take them to another hospital. This case was just the 1 in 900,000 that was legitimate. No, that doesn't make it right, just don't lynch the poor guy prematurely.

 

[Gbro]

No, that doesn't make it right, just don't lynch the poor guy prematurely.

I sure wouldn't lynch the dispatch, the ER is to blame here.
(although pre-hospital EMS arriving on scene might have opened some eyes and "might" have saved a life).

This is just another example of too many rules. When ones every move has to be governed by rules this is the results.

What a crying shame.

 

[TKO]

I would hold the ER primarily responsible but the dispatchers aren't off the hook either; they have a responsibility to respond to EVERY call. It isn't for the dispatchers to decide which calls to send a response to or not, whether it was the dispatcher or their supervisor that made the decisions, someone failed to do their job.

It's like frequent flyers: we expect that they are wasting our time and money, but we should always respond and be aware that this might be the one time that they really do need help. Yet, there are stories where the end is that they just cried wolf one too many times.

But mostly it was the ER that dropped the ball. Mind you, I see waiting times of 3-4 hours in our ERs (larger centers). Triage treats those persons as walking wounded and figure that if they couldn't bother to call 911, then it isn't that serious. The visibly traumatic pts are triaged appropriately, but those medical pts that aren't elderly usually get pointed to the waiting area.

There isn't money enough in the system to run all the tests possible to rule everything out, but standardizing practices only degrade proper pt care.

 

[Flight-LP]

While I do also believe the dispatcher could have been less demeaning and more responsive, I too would not have sent an ambulance. They are in a friggin' ER, EMS has no business going and getting involved. They can't transport her to another facility. This is a hospital issue, plain and simple. The complication was "the boy who cried wolf" syndrome. This lady was a frequent flyer adicted to pain meds. Her cries went unheard. The triage nurse should have been more attentive. An ER physician should have re-evaluated her. Lots of should haves. Unfortunately a typical night at an urban medical center. Overworked, overwhelmed, understaffed, underpaid, you get the picture. She fell through the cracks....................

But EMS did not need to be involved at all.................................

 

[BossyCow]

The complication was "the boy who cried wolf" syndrome. This lady was a frequent flyer adicted to pain meds. .........................

Hmmm I didn't get that from the story. I heard she had been in several times with the same complaint and been given pain meds and sent home rather than evaluated and treated. Also, the hospital has a history of decertifications, complaints about care and not living up to its accredidation requirements.

 

[Stevo]

She fell through the cracks....................

don't you mean canyon Flight-LP?

seems our capatalist market based self mitigating medical system is assuming the same wait time of countries that have NHC

clicky

but that notion, one in which a governance actually cares about the populance it serves is just so icky, isn't it? it's...it's...socialism...way to synonomous with communism, the red peril

the kids! hide the kids!

~S~

 

[mfrjason]

That is shocking,it shouldnt matter if the patient was already discharged or not,if something happens to them while they are still on hospital grounds or in the hospital they have a duty to act on a situation. It was obvious the woman was having a major medical emergency, a life threatening one at that,and they failed to act. I mean they should of known at first site that the woman needed emergency care.
What the hell is going on in hospitals these days?

 

[mfrjason]

While I do also believe the dispatcher could have been less demeaning and more responsive, I too would not have sent an ambulance. They are in a friggin' ER, EMS has no business going and getting involved. They can't transport her to another facility. This is a hospital issue, plain and simple. The complication was "the boy who cried wolf" syndrome. This lady was a frequent flyer adicted to pain meds. Her cries went unheard. The triage nurse should have been more attentive. An ER physician should have re-evaluated her. Lots of should haves. Unfortunately a typical night at an urban medical center. Overworked, overwhelmed, understaffed, underpaid, you get the picture. She fell through the cracks....................

But EMS did not need to be involved at all.................................

It sounds like the dispatcher didnt want to help at all,I mean they could of called the hospital and let them know that someone was calling 911 from the ER so that way it could of been handled better.

 

[VentMedic]

http://www.emsresponder.com/article/article.jsp?siteSection=1&id=5935

Updated: August 14th, 2007 01:08 PM PDT

Troubled Los Angeles ER Closes after Failed Inspection

Story by knbc.com

LOS ANGELES --

County supervisors want Martin Luther King Jr.-Harbor Hospital reopened within one year, and they directed health officials Monday to find a private operator within three months to ensure medical care is available to the mostly low-income residents near the facility.

The medical center failed its latest inspection by the U.S. Centers for Medicare and Medicaid Services, meaning it will lose $200 million in federal funding -- more than half of its annual budget. The hospital's emergency room closed on Friday, and inpatient services will be phased out over the next two weeks, with the facility being reduced to an urgent care center.


http://www.emsresponder.com/article/article.jsp?siteSection=1&id=5935

The long-troubled hospital repeatedly has been the subject of news stories chronicling breakdowns in care. It recently came under fire over the death of Edith Isabel Rodriguez, who was ignored by emergency room staff as she writhed in pain, ultimately succumbing to a perforated bowel.

Another MLK-Harbor patient, Juan Ponce, languished for four days in the emergency room with a brain tumor without getting help. Eventually, family members took him elsewhere.

 

[Airwaygoddess]

Very BAD judgement on all the parties involved......<_<

 

[GayEMTNJ]

Similar situation happened to me

I was waiting to transfer a patient (so essentially out of service for 25 minutes given the lightning speed of the care transfer process in our area) in an ER and something similar happened to me. A lady came running into the ER up to the triage window and said that her husband was in the car having a heart attack.

No one moved a muscle or flinched. The triage nurse kept talking to us like the screaming interruption never happened. The security guard that was sitting outside the window got up and walked away. The women screamed for help again and started to cry. No one even blinked. I told my partner to wait with our patient and told the lady I'd go out with her. A registrar offered me a wheelchair.

I got the guy in a wheelchair and he had the classics signs of MI, chest pain, diaphoresis, n/v, etc. I wheeled him inside and said the triage nurse that I think this guy needs to be eval'd. She continued talking to my partner. Another nurse came by and said that would come back to a room and start assessing him as long as I got him into bed.

My partner told me later that after I went outside the triage nurse said "well, if he is so sick, why didn't she call 9-1-1 then?"

 

[bstone]

There is certainly a problem with apathy of this sorts. I wonder what the basis of it is. Burn out? Just being numb?

 

[GayEMTNJ]

There is certainly a problem with apathy of this sorts. I wonder what the basis of it is. Burn out? Just being numb?

I wish I knew because it seems to be plaguing more and more hospitals in my area. I think some of it is overwork and I think a lot has to do with reduction in staff as well as ancilliary staff. This pushes more work back onto the nursing staff.

In the past few months, I've even seen nurses openly defying doctors or ignoring their orders/requests. In one case we brought in patients that were really sick and in a great deal of pain. The nursing staff was ignoring us and finally a doctor came up and talked to us and took report and commented out load "this guy is in real pain." He said to the nurse can we get a room for a him and she stood up, turned and walked away. I was dumbfounded.

I know EMS people and doctors aren't perfect. I know everyone has seen their share of burned out providers. However, it seems that burnt-out nursing staff is becoming the rule and not the exception and it is alarming.

 

[Ridryder911]

The reason being is majority of the ER visits are B.S. People automatically assume that they are at a Five Star Hotel. I left ER nursing because while I took care of an AMI, I had to answer call lights and fluff the pillow for the tooth ache patient X 6 months. Meanwhile, I had the irritated family whom had been there for 12 hours because there were no hospital beds.

It is easy for Doc's to enter and leave and give orders without really assessing or watching the patient. Some patients are great actors, and I have seen dramatization to fool the best. While agonizing in some form of pain in front of the physician, one will catch them up and around at the vending machine or prowling through the drawers/cabinets loading up on bandages. Then there are times quite the opposite in attempting to get a physician to address the pain.

I agree apathy is high, and there is a reason. It used to be one ER nurse per 3-4 patients, now it is not unusual to see 5-7 patient load. Majority of the patients that go to the ER, should had be seen in the clinic, or an urgent care setting. Even physicians have now utilized the ED as an outpatient setting. When one really has a real emergency patient, there is not enough staff or even a room to treat them. Remember, as an EMT you only usually have one patient, and are only with them for <30 minutes to an hour, not 4-? hours. I know of many ER nurses that get a UTI, because of never having the time to even go to the bathroom.

I realize many are not aware that actually most newer nurses and even seasoned ones, do NOT want to work in a ER. It is known as chaotic, hectic, get treated like feces, and full of complaints from patients & family, etc. Why not go and work areas like out patient surgery? No hassles, no complaints, and one can sit don every so often, and have week ends off. Emergency Nurses Association (ENA) predicts the average length of ER nurses has been reduced from 5 years, to about 2 years and lowering, again with very few choosing to enter the ED.

Unfortunately, it is going to get worse, before it gets better. Aging population, no medical coverage or uninsured, and abusers know ER's cannot refuse, and use as the sole provider for health care. We have not seen the tip of the crisis yet.

R/r 911

 

[Airwaygoddess]

While that type of actions happen in Emergency Departments, one must remember that this kind of behavior happens on the floors also. People are getting sicker and living longer, insurence companies are paying for less for treatments and in-hospital stays. People are mad at the whole system, period. Unfortually, it is the folks on the front lines of medicine from EMS to the allied health care professionals in the clinical setting that get the brunt of all of that frustation. Gee I sure wish I could go on vaction right now....

 

[GayEMTNJ]

The reason being is majority of the ER visits are B.S. People automatically assume that they are at a Five Star Hotel. I left ER nursing because while I took care of an AMI, I had to answer call lights and fluff the pillow for the tooth ache patient X 6 months. Meanwhile, I had the irritated family whom had been there for 12 hours because there were no hospital beds.

It is easy for Doc's to enter and leave and give orders without really assessing or watching the patient. Some patients are great actors, and I have seen dramatization to fool the best. While agonizing in some form of pain in front of the physician, one will catch them up and around at the vending machine or prowling through the drawers/cabinets loading up on bandages. Then there are times quite the opposite in attempting to get a physician to address the pain.

I agree apathy is high, and there is a reason. It used to be one ER nurse per 3-4 patients, now it is not unusual to see 5-7 patient load. Majority of the patients that go to the ER, should had be seen in the clinic, or an urgent care setting. Even physicians have now utilized the ED as an outpatient setting. When one really has a real emergency patient, there is not enough staff or even a room to treat them. Remember, as an EMT you only usually have one patient, and are only with them for <30 minutes to an hour, not 4-? hours. I know of many ER nurses that get a UTI, because of never having the time to even go to the bathroom.

I realize many are not aware that actually most newer nurses and even seasoned ones, do NOT want to work in a ER. It is known as chaotic, hectic, get treated like feces, and full of complaints from patients & family, etc. Why not go and work areas like out patient surgery? No hassles, no complaints, and one can sit don every so often, and have week ends off. Emergency Nurses Association (ENA) predicts the average length of ER nurses has been reduced from 5 years, to about 2 years and lowering, again with very few choosing to enter the ED.

Unfortunately, it is going to get worse, before it gets better. Aging population, no medical coverage or uninsured, and abusers know ER's cannot refuse, and use as the sole provider for health care. We have not seen the tip of the crisis yet.

R/r 911

R/r 911

I certainly agree with what you posted. ERs in many places are getting busier and they are being used like clinics. But there also seems to be something else driving it.

The reason that I say that is the ERs to which I'm transporting are typically not that busy. I grew up in an urban area and spent a lot of times in the ER with my brother who had a chronic illness. I'm going primarily to community hospitals in my area. Some have larger ERs (26 beds) and some are small (3 beds). There are times when they are exceptionally busy and patients are put in hallways but I've never encountered an ER that was as busy as the city ERs. This ER didn't have hall beds but hall chairs. You went from the waiting room to a chair in the ER. When it was your turn, you got moved to a bed, examined by the doc and then moved back to your chair to wait for X-Rays, follow-up or discharge.

The hospitals to which I'm going typically don't have busy ERs. When they are busy, we understand and cut the staff a lot of slack. But on a recent transport with a patient in pain from a broken leg (the patient ended up going to the ER for pins, plates and rods), the ER was empty. I don't mean that it was slow. I mean *empty*. In the 20 bed ER, there was only one other patient and the waiting room was empty. The triage nurse was on a personal call (we could hear the conversation), the doc ended up taking report, moving the patient to a room and doing the work up. A nurse came in, looked at the leg and said "I can't look at that" and walked out. Myself and another EMT ended up helping the physician resplint the leg.

That's not an isolated case. In fact, we have two city ERs to which we occasionally transport. Those ERs are truly busy but without fail our crews (and the patients) get treated better than at some of the local ERs.

I don't doubt anything you've said and I know all of that is true from nurse friends that work in busy city ERs. But in "quiet" suburban ERs where the patient load is manageable I think there is another issue to be addressed.

 

[Airwaygoddess]

I hear the ghost of Florance Nightingale just shaking her head.........:sad:

It sure makes me scared when I get old, what kind of folks going to care for me? :unsure: