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.,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

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.