Sunday, May 20, 2007

They sue doctors, they send nurses to jail


I just saw this in the LA times. Even though its like 2:30 AM and I'm study the umbilical placement of the fundus, this got my goat.

http://www.latimes.com/news/local/la-me-king20may20,0,6057993.story?coll=la-home-center

Attached is my letter. Dig it!

Subject: you idiot tool
Date: May 20, 2007 2:38:09 AM PDT
To: charles.ornstein@latimes.com

This is off the record...
Good job moron. By focusing your blame on a callous nurse and by publishing her name, you have now not only endangered her personally but you have done the bidding of various county supervisors who make unaccountability an art form. Your story is so full of holes and misinformation, all the details you forgot to include while you made a case against the nurse and police.

Incidents like this happen from time to time in the ER world. Somebody cries wolf and when it really is their turn nobody believes them. ER nurses know this better (and should know better) than anybody. So what can a nurse do in a situation like this, repeated discharges and the patient is still returning? Had they performed a full workup, or did they just send her off with Vicoden? All the triage nurse can do is check the patient in, monitor vital signs every 4 hours, as is county protocol, and let the patient do whatever the hell the want in the lobby (scream, cry, threaten, use drugs, fight). Which she did, followed county protocol. Doctor's decide when to intake the patient.

So there were no doctors involved in this situation at all? What about the too busy to be bothered doctor who couldn't figure out that she had choleolithiasis or a bowel obstruction. How is it that YOU PUT THE BLAME ON A NURSE WHO IS ONLY ALLOWED BY STATE LAW TO CHECK IN, MONITOR VITAL SIGNS, AND TRIAGE ACCORDING TO SEVERITY OF ILLNESS.
A nurse cannot order ultrasounds or pull lipase blood panels . A nurse cannot order laproscopic surgery. All she can do is check the patient in and inform a doctor of the situation. Do you think her getting a workup for the third time that day was on the top of the physicians list? Should it have been?
Obese lady is yelling that her gall stones have exploded and is carrying on. Number 30 for the day. Abdominal pain is the number one complaint in the ER. It is also the most difficult to treat and diagnose. It takes time, because all those people ahead of you with heart attacks, gunshot wounds, and diabetic ketoacidosis are in more danger than your vague (but vocal) complaint.
Junior Blogger: there was nothing the nurse or any medical professional could do for her. You know why? Because LA County DHS is run by a crew of egomaniac rich politicians. As an emergency professional, I can tell you, County Emergency medical care is fucking scary. Its called a lack of reasonable resources. That's not the nurse's fault. But guess whose it is?

You are a tool because the nurse is the most expendable member of the health care team, and as you may now be noticing, DHS is going into general quarters, taking their doctors with them into a protective PR wagon circle. You chump. And just so you know, other than increased pulse, decreased blood pressure (if the perforation was bleeding), and a temperature greater than 101, a complaint of severe abdominal pain means nothing. Ms. Rodgriguez was nothing special in the ER because half the people in the ER were waiting with the same exact complaint. Unless you are involved in a trauma or have an identifiable life threatening situation,you have to wait in the waiting room, just like everybody else at county, you wait your turn. HEY CHUMP! PAIN IS NOT AN INDICATOR OF LIFE THREATENING EMERGENCY. SCREAMING DOES NOT GET YOU BACK ANY FASTER, BECAUSE THEN EVERYONE WOULD SCREAM TO GET BACK. HEY YELLOW JOURNALIST, EVEN HER OWN BOYFRIEND LEFT TWICE TO GO "RUN ERRANDS." AFTER MIDNIGHT NO LESS! She must have been really bad then right?

She was seen by two doctors for full consultations and yet you blame the nurse who evaluated her at triage. Now some media horny DA is ruminating over filing criminal charges, we're not sure who yet, but we do already know that because of your brilliant piece of heart felt investigative journalism it'll probably be the nurse. But that's good for you, right? This ridiculous story goes on and on. Hey, maybe you'll win a Pulitzer.

Mr Ornstein, let me tell you what you are now the cathartic enema for. Nurses will be afraid to properly assess people, patients who like to scream will get moved ahead of people who are really dying (idiot, Ms. Rodriguez was the exception, most people are dying quietly in the waiting room because they are too sick to scream and carry on). When nurses become the flavor of the month for stalled out DA's, any shot of recovering the American healthcare system will be permanently destroyed. You think doctors are afraid of getting sued? Imagine a nurses fear of being sent to jail, for having the strength to do her job, to not crumble under the mountain of LA's worst stories. If a nurse is afraid to do his or her job you won't even get in the door.
That's right chump, people are dying in the waiting room everyday because there aren't enough beds, hallways, tables, to put the bodies on. If someone has the energy to scream at me, I tend to think they aren't dying. Ethical Journalism Reject, you have enabled LA county DHS supervisors to shirk off some glaring reminders of their managerial incompetence, yet again. A morbidly obese Latino woman (Hypertension + Diabetes endemic) sadly crashes after a life time of giving her shoes to people and basically being kindest, sweetest greatest person on earth, well aside from those warrants, and you want to hang the nurse whose job is to categorize and put the patient in line and attend to any life threatening situations that might arise.
I wonder why the whole night shift ignored her, lying there, screaming in pain, and no doubt in real agony. Why would they do that, I wonder...

"I am completely dumbfounded," said county Supervisor Zev Yaroslavsky. Ya think?

Good job.

3 comments:

Anonymous said...

You need to get out of nursing..now. I can not believe you are defending the nurse who let a patient die before her eyes. Unbelivable. You should truly ALL be ashamed of what your profession has become...a bunch of whiny, nasty people. You are no better than the doctors who complain and complain..yet you all DO NOTHING. Leave or change the entire eroding system.

I doubt you wil print this..but re-read what you wrote. A WOMAN DIED!

Have you no shame?

angry male nurse said...

I would encourage YOU to re-read what I wrote. What do you call someone who writes a letter to the author of an LA Times article that FOCUSES THE ENTIRE BLAME FOR A NEEDLESS DEATH ON THE TRIAGE NURSE? DID YOU READ THE LA TIMES ARTICLE?
Is that just whining and whining? What the fuck do you want me to do, what should I do? Are you a nurse? Have you ever worked at MLK? I have.
The patient has no responsibility, the docs have accountability, the board of directors is stupified, a nurse fucked up and I should condemn her?
Anonymous, I will always post any comment you want to make. But be reasonable and stop expecting nurses to don wings.

Anonymous said...

I was a nurse..who left even though I made good $ because the ever changing job restrictions became a detriment to the standards I hold nursing to..and still do. I also contracted Hep C from a patient in 81 and am now one of those chronically ill dual-eligibles who were sacrificed to a heavily gatekept MAHMO for SNP that restricts care so badly that no one in my area wants to treat anyone on my plan.

Do you know that dual-eligibles under 65 got dumped into restrictive Medicare Advantage Special Needs plan with such strict gate keepership (and outsourcing of MH/DA to the cheapest bidder, often states on the other side of the country who have no idea about the area or the clients they serve) that pysicians have stopped seeing those clients? Meanwhile..the HMO's that won the rights to own those dual-eligibles got paid millions of dollars just because? Studies are now finally beginning to prove that these SNP plans are causing more harm than good . You think?

Washington knows this clientele has no voice, nor are they cared about. States bailed due to political infighting when their efforts to force Bush into NOT going ahead with the massive Medicare mess he insisted begin on Jan 1st,1996 failed. "You want seniors? Well here ~ take our dual-eligbles as well." DC responded by paying off these unprepared and cold blooded HMO's with the only language that seems to matter these days..money.

People are dying not just because of their choices..but primarily because they have NO choice in their own care in MANY instances.

I have to laugh when I see a "10 things to ask a doctor before you choose him or her for xyz" when my MAHMO has perhaps 2 providers in my large urban area to serve a population of over 100,000. Acording to some I should feel blessed. Perhaps I should, as some counties in my state have no providers in certain specialty's.

Can you honestly see me beginning to ask those 10 important questions (such as board certification, experience,etc.) to the lone two providers who might see me on thier first available appointment...10 months from now? I'd be called indignent, unappreciative, and on and on. Think about that.

If I was Paris Hilton however..I am sure I could go anywhere and get a doctor to hold the kleenex for me so I could blow my nose.



I am very bitter and very ill. Also very distressed and appalled at the ever-increasing degradation in all arenas occuring over the past ten-twenty years in medicine.

I believe in the golden rule and will die believing in it.

I would not want anyone who does not have compassion and is angry all the time taking care of me. I say "leave the profession" if you find yourself burnt out.

Or do as I did.leave before I could no longer look in the mirror and like who I saw due to the changes forced by the various org's that began to severely impact my abilty to give the quality of care I was trained and acustomed to giving to my patients.

This hospital has had major issues for years..a lot of it due to incompetence of the nursing staff.

Doctors are angry, nurses are angry and who do you think is the end recipient of all that anger? The patient..who IS a fellow human being.

I always treated my patients as if they were a relative of mine..how I would want them treated. To think that this woman died in this way is so disheartening to me.....people actually walking over or around her.

I feel ashamed because I was a nurse and I KNOW there were nurses present or nearby.


Why did no nurse come to her aid? So what is she used drugs. She had feelings. She was in pain. She was ill. She died.

I wish her death on no one and am horrified at the lack of blogging in the medical blogs on how bad it is for the patients!!! It is almost as if "transference" is taking place and patients are now somehow the ones to blame or vent about!

ALL of us will be patients one day. The current situation HAS to change.

I also admire your allowance of freedom of speech. I am sure you know some nurses are better than others. I knew of "bad apples" in my years on the floors. I have seen many nurses long overstay their employment for the money and the patient suffers due to it. It has gotten so I can spot them the minute they walk on a floor or a unit.

Here is another link with way more info on MLK-Harbour's problems.

[url]http://www.latimes.com/news/local/la-kingdrew-gallery,0,5651209.storygallery [/url]

I assure you this is not just a California problem. Trust me..I see the major disaprity of care issues in my urban area on the East Coast constantly.

It is breaking my heart.

I hope it is breaking yours and other in the medical profession as well because things TRULY NEED TO CHANGE!