I got a new book today! I happened to stumble upon a blog online and liked what I read! I was so surprised to hear somebody else talking about what happened to all of us who objected to Versed. Anyway, this is a really good book, and it answers some of the questions I have asked on this blog about medical care... Here's an excerpt;
"When a patient reports facts that don't square with the doctor's assumptions, it's often the facts that get discarded. To account for taking this approach, doctors often discount concerns of vital importance to patients, or fail to consider their perspective, leaving them feeling diminished."
There's lots more. Chapters about being a mushroom in regards to our own health care, deliberately kept in the dark and fed bs. There are some chapters about why doctors feel that they are God, and what happens when we try to get information. It's a really good book and is absolutely on point as to what happened to all of us who were assaulted with Versed AND/OR had terrible sloppy surgery done without regard for our health and well being. Thanks Elizabeth!
Saturday, February 12, 2011
Sunday, February 6, 2011
What we are up against!
I grabbed this post from http://www.versedbusters.blogspot.com/ as an example of how the medical field refuses to listen to us and uses ridicule and a patronising tone to shut us up... this post speaks volumes in what it says and even MORE in what it doesn't say.
John said...
John said...
"Why , why, why would an anesthesiologist feel a nned to "sneak" in a medication? This blog is full of paranoid people. Take a break! I've used this drug in the Peds ICU for years without a single complaint. Get a grip."
First of all you have to realize that this person "John" posted at the end of over 500 posts, the majority of them from people who have had a severe reaction to Versed. A good proportion of them are from people who have been given Versed WITHOUT proper consent. As a subset to this, there are the unfortunate ones who have had Versed injected even after they had declined it.
So now we have "John" who states the he has "used this drug in Peds ICU for years without a single complaint." Has he heard of any complaints NOW? Do you think that "John" has heard a single complaint about Versed after he read all of our complaints about Versed on versedbusters? Has he read any of the numerous articles about the dangers of Versed use in ICU? Has he read that sedation as practiced in many hospital ICU's is CAUSING major problems? Has John continued his education about his Versed addiction in medical settings? I think not, and yet, he takes a supercilious tone with us on versedbusters... These people ARE addicted to using Versed...
I too would like to know "Why, why, why would an anesthesiologist feel the need to sneak in a medication." That's exactly what I want to know. I have attempted to find out the reason for this apparent aberration on the part of Versed pushers for YEARS now. John is the trained medical professional, who by his own statements is involved with wholesale Versed use! Why, why, why, doesn't he reveal unto us mere mortals the reason he uses it? Hmmm!
Notice the personal attack by John. Right away, we must all be suffering from a mental disorder called "paranoia." Here's the definition of the diagnosis of paranoia that I got from here. Paranoia Define Paranoia at Dictionary.com It says in part;
1)"Psychiatry . a mental disorder characterized by systematized delusions..." Delusions John, not reality. We do not have DELUSIONS about Versed use and you PROVE it by your own statements.
2)"baseless or excessive suspicion of the motives of others." Since medical people completely deny that Versed has a single side effect, their motives are suspect. It's not baseless! What is the motive behind the almost invariable use of Versed, even when the patient declines it? What is the motive behind the almost total lack of informed consent for this little item? I don't think its excessive at all to be suspect of the motives of Versed pushers. They won't respond to us except like this alleged anesthesiologist who begs us to tell him why HE HIMSELF uses Versed. Is that rational on his part? If medical people can't come up with an answer as to why we are getting Versed, who wouldn't be suspicious of them? (Not sure that John is even a Dr. let alone a specialist in mental disease IE a psychiatrist so his snap judgement is suspect on its face)
"Take a break" and "get a grip" are the usual phrases medical people use to negate any conversation about their precious drug Versed. I want to delve into that a little bit, but I'm confused. "Take a break" from what? Take a break from the Versed induced PTSD? That would be very nice wouldn't it? "Take a break" from telling others our stories about being poisoned by willful, aggressive medical people who assault us with Versed? I think its the latter. I think John really wants to tell us to SHUT THE HELL UP ABOUT VERSED! He likes it and he wants to keep on using it. "Get a grip" is exactly what we HAVE done. We have gotten a grip on the medication called Versed, we have a grip on the horrendous side effects, and we have gotten a grip on medical ways. We have gotten a grip and we are REJECTING Versed.
My personal take on John is that he is suffering from the same "Narcissistic Personality Disorder" that I see is so common among anesthesia providers. It's all about HIM isn't it! He is also in denial. I'm sure there is medical parlance to describe the mental disorder that prevents reality from intruding in a person's mind in spite of proof to the contrary... Is that being delusional? I'll have to look it up. Maybe John is having a little paranoid episode of his own about all of US! LOL
Good luck John! May your patients always be too young to "complain" about Versed and/or SUE your sorry butt for wrecking their minds with your nasty little drug. Your mental disorders seem too deeply ingrained for me to offer much help. "Take a break" and "get a grip." Get professional help with your Versed induced "paranoia." (Funny that John would rather be thought up as mentally disturbed or psychologically lacking than give up his precious Versed.)
PS I looked around on the internet a little bit and found this site!!!! Anyone's LO have Versed before a surgery? Update#29 - MotheringDotCommunity Community So "John," honey, have you seen this one? How many mothers do you see on this web page that are COMPLAINING ABOUT VERSED being used on their children? Can you hear us now? This website has been around for a while, so there really is no excuse for you not seeing it! That is if you were even slightly interested in the well being of your young patients and not just the expediency of drugging them with Versed. You still going to try to convince us that you have NEVER heard of any complaints? You are perfect, Versed is perfect, and we all live in that happy place? Excepting of course those of us who have a severe reaction to this beloved poison! ROFL!
Saturday, February 5, 2011
Medical Transcript Writer Speaks out!
I found this in my comments section from this post.
hangrt has left a new comment on your post "New Comment on "Turf Wars in Alphabet Soup Land"":
"A medical office assistant career requires the expert handling of billing codes and patient information without which, could result to errors: either the patient could be billed with the wrong, higher amount or, the doctor would be paid less than their due."
Medical transcript writers can only write what the medical people put down. My OWN transcripts are full of errors, omissions, and bald faced lies. These transcripts that I cite are from hospitals as far as I can tell. With hospital transcripts, not only are the above true, but also there is zero followup on out-patient services, followup surgery to correct bad outcomes etc... My own badly performed surgery isn't listed as a bad outcome! My surgeon will deny that I had a bad outcome to his dying breath regardless of proof. My anesthesia services weren't listed as a bad outcome. My CRNA and his supervisor consider forced drugging along with violations of "informed consent" laws to be well within range of "good outcome." My paradoxical reactions, PTSD, anxiety disorders and brain damage subsequent to their ministrations, have no bearing on what they consider a "Pt. tolerated procedure well" type statement! Want to bet on it? So how anybody can use their training in transcription as PROOF that errors aren't being swept under the rug is beyond me. Garbage in, Garbage out. Again, we are only talking about who gets paid from whom. This has NOTHING to do with patient safety.
I had to add this comment, also from hangrt; Hangrt, I am in no way denigrating the complicated job of medical transcription writers! I don't have any beef with you, nor do I think that you are in any way remiss in your job. What I AM saying is that reading a bunch of billing information IN NO WAY can be used to determine the OUTCOME of a particular surgery, nor can it be used to compare Dr's to nurses. I'm sorry, but that information just isn't there. We know who did what in order to get MONEY, we don't know how the patients feel about what happened. You don't know how many angry patients there are out there... You don't know how many were treated SUBSEQUENT to the billing event for bad treatment. You get to bill patients for services EVEN IF the patient was harmed by said "services." I suppose if the patient DIED from their anesthesia that THAT might be on the paperwork... Nobody at my hospital wrote anything down about the horrible anesthesia, the total lack of informed consent, the forced drugging with Versed, paradoxical reactions, OR the incident in the PACU! What "heading" would you put that under as a medical transcriber? It WASN'T SAFE FOR ME TO HAVE A CRNA! But I'll bet MONEY that my medical transcriber would assume that my anesthesia was just fine... How would they know it wasn't? It angers me to think that my DEBACLE with a CRNA is being counted as a plus for them because the jackass didn't kill me! You are talking about "FEES FOR SERVICES RENDERED" not how piss poor the services rendered were! I'm not sure how to get this message across...
hangrt has left a new comment on your post "New Comment on "Turf Wars in Alphabet Soup Land"":
"A medical office assistant career requires the expert handling of billing codes and patient information without which, could result to errors: either the patient could be billed with the wrong, higher amount or, the doctor would be paid less than their due."
Medical transcript writers can only write what the medical people put down. My OWN transcripts are full of errors, omissions, and bald faced lies. These transcripts that I cite are from hospitals as far as I can tell. With hospital transcripts, not only are the above true, but also there is zero followup on out-patient services, followup surgery to correct bad outcomes etc... My own badly performed surgery isn't listed as a bad outcome! My surgeon will deny that I had a bad outcome to his dying breath regardless of proof. My anesthesia services weren't listed as a bad outcome. My CRNA and his supervisor consider forced drugging along with violations of "informed consent" laws to be well within range of "good outcome." My paradoxical reactions, PTSD, anxiety disorders and brain damage subsequent to their ministrations, have no bearing on what they consider a "Pt. tolerated procedure well" type statement! Want to bet on it? So how anybody can use their training in transcription as PROOF that errors aren't being swept under the rug is beyond me. Garbage in, Garbage out. Again, we are only talking about who gets paid from whom. This has NOTHING to do with patient safety.
I had to add this comment, also from hangrt; Hangrt, I am in no way denigrating the complicated job of medical transcription writers! I don't have any beef with you, nor do I think that you are in any way remiss in your job. What I AM saying is that reading a bunch of billing information IN NO WAY can be used to determine the OUTCOME of a particular surgery, nor can it be used to compare Dr's to nurses. I'm sorry, but that information just isn't there. We know who did what in order to get MONEY, we don't know how the patients feel about what happened. You don't know how many angry patients there are out there... You don't know how many were treated SUBSEQUENT to the billing event for bad treatment. You get to bill patients for services EVEN IF the patient was harmed by said "services." I suppose if the patient DIED from their anesthesia that THAT might be on the paperwork... Nobody at my hospital wrote anything down about the horrible anesthesia, the total lack of informed consent, the forced drugging with Versed, paradoxical reactions, OR the incident in the PACU! What "heading" would you put that under as a medical transcriber? It WASN'T SAFE FOR ME TO HAVE A CRNA! But I'll bet MONEY that my medical transcriber would assume that my anesthesia was just fine... How would they know it wasn't? It angers me to think that my DEBACLE with a CRNA is being counted as a plus for them because the jackass didn't kill me! You are talking about "FEES FOR SERVICES RENDERED" not how piss poor the services rendered were! I'm not sure how to get this message across...
hangrt has left a new comment on your post "Medical Transcript Writer Speaks out!":
"Some typical tasks include the registering of patient info, insurance verification and pre-authorization for patients, maintaining patient accounts, coding, and medical assistant insurance policy claims. assistant specialists can also collect payments from patients and perform collection pursuits to end out patient accounts. They compile the records of fees for services rendered to patients in a healthcare facility."
Friday, February 4, 2011
Brain Function
Here are some excellent articles about brain function. In plain English they describe the function of the frontal lobe, you know, the same part of the brain that Versed suppresses blood flow to. These also chronicle what happens when this part of the brain is damaged. They describe the behavior and physicality of people on Versed... Compare the effects of Versed and the effects of BRAIN DAMAGE!
Medical people SHOW ME THE EMPIRICAL PROOF that starving the frontal lobes of oxygen via disruption of full blood flow with Versed doesn't cause permanent damage. This does not include demonstrations from you people using ANECDOTAL evidence! An example of this type of "evidence" would be "I have given Versed hundreds of times with no ill effects." NO, I want proof, as in EEG's performed before during and after Versed, especially after using Versed in the massive amounts that some of you prefer. Followup appointments for non biased blind studies by brain function experts and/or neurologists who perform tests on the subjects to ascertain the damage caused by Versed usage is an example! Perhaps some personality tests performed by skilled mental health EXPERTS to measure personality traits before and after Versed as well.
We patients ARE TELLING YOU, that we are experiencing symptoms of brain damage and personality disorders, PTSD etc. following Versed injections. It's hubris to suggest that our personal experiences with Versed are without merit... I thought that a lesson in brain function might be in order.
Frontal Lobe Function
Here is a companion piece about the specific areas of the brain that Versed poisons...
Midazolam decreases cerebral blood flow in the lef... [Int J Neuropsychopharmacol. 2000] - PubMed result
Here's a study about the areas of the brain which make us human. Remember that I accuse medical workers of turning us into a vegetable group by injecting us with Versed. I took great exception to having my personality decimated by this drug. Here's an scientific article about this very thing. Frontal Lobes and Human Essence
Versed is a dangerous, dehumanizing poison whose long term effects are hard to judge and harder still because medical workers are in denial that their drug of choice causes brain damage! Happy reading.
Medical people SHOW ME THE EMPIRICAL PROOF that starving the frontal lobes of oxygen via disruption of full blood flow with Versed doesn't cause permanent damage. This does not include demonstrations from you people using ANECDOTAL evidence! An example of this type of "evidence" would be "I have given Versed hundreds of times with no ill effects." NO, I want proof, as in EEG's performed before during and after Versed, especially after using Versed in the massive amounts that some of you prefer. Followup appointments for non biased blind studies by brain function experts and/or neurologists who perform tests on the subjects to ascertain the damage caused by Versed usage is an example! Perhaps some personality tests performed by skilled mental health EXPERTS to measure personality traits before and after Versed as well.
We patients ARE TELLING YOU, that we are experiencing symptoms of brain damage and personality disorders, PTSD etc. following Versed injections. It's hubris to suggest that our personal experiences with Versed are without merit... I thought that a lesson in brain function might be in order.
Frontal Lobe Function
Here is a companion piece about the specific areas of the brain that Versed poisons...
Midazolam decreases cerebral blood flow in the lef... [Int J Neuropsychopharmacol. 2000] - PubMed result
Here's a study about the areas of the brain which make us human. Remember that I accuse medical workers of turning us into a vegetable group by injecting us with Versed. I took great exception to having my personality decimated by this drug. Here's an scientific article about this very thing. Frontal Lobes and Human Essence
Versed is a dangerous, dehumanizing poison whose long term effects are hard to judge and harder still because medical workers are in denial that their drug of choice causes brain damage! Happy reading.
Tuesday, February 1, 2011
The Correct Response
I write a lot about what all the crna, my surgeon and the rest of the nursing staff and hospital risk management (OOPS, patient relations) did wrong. For all of the medical types who read this blog, here is what SHOULD HAVE HAPPENED!
Ignoring the facts of what happened to me, beginning with the Versed, and ending with a hospital acquired infection and a second surgery to correct the first. Ignoring all of that because I pretty well have it covered on here, I want to enlighten our medical workers on what would have defused the situation... I am not that different than most people.
First of all when I "awoke" in the PACU already on my feet and creating a danger for myself and everybody else, somebody in a position of authority should have been summoned at once. I should not have been sent a "patient relations" nurse. My complaints and my reaction to being forcibly restrained with a chemical to further more intervention than I had allowed etc. should have been accepted as a legitimate complaint, not glossed over as "standard of care." It isn't a "standard of care" anywhere except maybe at the veterinarians office! There is absolutely NO POINT in antagonizing an already violently aggrieved patient with this kind of nonsense.
I should have had the person in a position of authority in my cubicle chronicling what had happened. There was confusion even among the staff, MY staff, about what had happened and why. I guess they don't have that many patients who 1) tell them what they can and cannot do, and 2) wake up violently angry over their lack of regard for patient rights. Everybody was pretending like they just couldn't understand it. This is the wrong response. Patients need to know that they MATTER! Lying to patients and dismissing their anger is guaranteed to create more anger. The idea that I was so UNWORTHY of good care, honesty and respect regardless of the enormous price tag, was adding fuel to the fire.
The CRNA responsible for the debacle should have been summoned. If he was busy assaulting another patient, then he should have been brought in at the earliest possible moment, so that he could explain himself fully AND to give me the chance to question him about the incident. Preferably before he had the time to make up a story. IE Why did you go ahead with the things I told you not to do? What made you think that I would appreciate Versed? ("I give Versed to all my patients" is NOT an answer when the question is "Why did you give Versed to ME!") Did you think that I would "be happy to wake up and have it all over" when I clearly stated that I wished to remain "awake and alert" and watch the surgery, just like I watched my ORIF femur TWICE? What does the word 'NO' mean to you? I wanted an explanation. Scratch that, I WAS OWED AN EXPLANATION, one that related to me personally, not general platitudes! A tape recorder should have been used while this "interview" was in progress, in order to avoid any misunderstandings or bald faced lies, such as happened with Dr. B's "interview" with me. This should have been a TEAM effort just like the whole incident. My team conspired to treat me without regard, and there should have been a team of authority figures to grill my team. This type of immediate response would have at least made me think that things would be different!
Make no mistake, no amount of passing the buck, telling me that everybody gets Versed, telling me that my DOCTOR wanted this, telling me that it's standard of care, backpedaling, ridiculing me etc. was going to make it better. All this is designed to inflame an already angry patient. Can you see that? Telling me that I asked for it by seeking help is just like telling me that tight jeans are a reason for rape. Its just a man thing, they do that to all their women etc. Nope, wrong is wrong and they were WRONG to treat me like that. NO EXCUSES! My issues with my treatment are VALID and should have been treated as valid.
The people responsible for my debacle reflect badly on the medical center AND on health care workers everywhere. Can you see why this is? Having health care workers sneer at me, accuse me of mental incompetence etc. doesn't help. Why would you think that talk such as this would be calming for an irate patient? Don't try to minimize the event in any way! Take ownership of it and at least pretend that steps will be taken so that this will never happen again.
Chastise those responsible for the event. As far as I know NONE of the people responsible for my debacle knew one thing about it! They all felt they got away with assaulting me. They were fine with it, and there are no repercussions are there? I wanted to see and hear my team being called on the carpet. This would have mollified me somewhat. At the time I was unaware of the poorly done surgical part and the kidney infection I got from them.
I also asked for an adjustment to my bill to reflect the fact that most of the expense was incurred because of the egregious departure from my wishes and consent. This should have been available to me. I should NOT have been billed 800+ dollars for the CRNA who attacked me without a second thought. All those charges for "levels of care?" Gone. The charges for the drugs, other than the Fentanyl, Zofran, antibiotic and lidocaine, gone. The charges for "general anesthetic" gone. Oddly they charged me 280 dollars for writing "general anesthetic" on my chart. That shouldn't have been there in the first place. Do you have any IDEA how infuriating it is to be expected to bankrupt yourself to pay for things you never wanted and had declined? Another thing that patients, already angry, should not be subjected to is the cost associated with the deviation from patient authorized intervention. I didn't ask for any of this and I shouldn't be expected to pay for it. It's insulting! This, if done immediately, would have further defused the situation.
As far as the hospital acquired infection goes... This is not something that should have happened either. With the surgery performed as I wanted (which is actually the PREFERRED method) I would never have had a catheter in the first place. If the hospital staff had the slightest regard for patient safety this wouldn't have happened. The hospital should have reimbursed me for the expenses of treating this infection. What they should NOT have done, is claim that I never had a catheter at all, especially as they KNEW I was in possession of medical records which stated otherwise. Expressing dismay, that this happened to me and assuring me that they were going to have a staff meeting on the importance of hand washing would have gone a long way towards ameliorating the situation.
My surgeon was also in on this. He should have been at my side during the preop interviews instructing my team, reinforcing my wishes and explaining the surgery in detail. It's the law. Don't show such disregard for the patient as to appear 1 1/2 hours late, far too late to explain anything... And far to late to prevent me from being drugged against my will. I wanted my surgeon to be POSSESSIVE over me, as in, "this is MY patient and she will be treated with respect." However, my surgeon had even more disrespect for me than the rest of my team. On top of everything else that happened in that chamber of horror called a hospital, the last thing I needed was shoddy workmanship! I was in a state of panic, bankrupt, suffering from hospital acquired PTSD, kidney infection etc. and then I find that my hand is completely numb and unusable. Screws are sticking out into the tendons, and I can feel those tendons snapping back and forth over the screws. Shooting pains up my arm from the underside of my wrist closest to the Ulna from yet another screw improperly tightened, the incision through the tendons, and my Dr., instead of expressing alarm, or sorrow, tells me that it's just fine and fires me. Wrong answer. Can you see how this would be upsetting? He didn't bother to tell me that these were side effects of the surgery ahead of time, and then he denied them afterward. He should have APOLOGIZED! Some alarm would have been nice and an offer to correct it free of charge, or at least not charge me for the original surgery. He knew that it couldn't stay that way without serious repercussions, even if he wouldn't admit it! As an aside, there is no way I would trust this person to operate again, especially since he threatened me with Versed and g/a at this point. This is not the way to treat a patient. He should have threatened me with Versed and g/a during our "consultation." That way I wouldn't have had the surgery... Using this kind of threat on an already distraught patient doesn't help the situation at all.
To sum it up, here are the tools to alleviate a bad situation from a patients perspective, after the fact... 1) Own up to the situation. Don't make excuses or try to defend the indefensible. Don't blame the patient or minimize what happened in any way. It's unprofessional and inflammatory.
2) Get upper management involved to show the patient that this is NOT business as usual and to prevent the appearance of CYA machinations. Bring in the responsible parties ASAP for an interview in the presence of the patient. Use a tape recorder so that there is no (further) misunderstanding. Give the patient a copy.
3) Assure the patient that this behavior will not be tolerated in the establishment and that the miscreants will be dealt with severely. Tell the patient what changes in hospital policy will be implemented due to this incident. If you are really good at this, you can THANK THE PATIENT for bringing this to the attention of management.
4) Adjust the bill or forgive it completely with apologies. If the patient needs further medical attention as a direct result of the incident, offer to help pay for it. Whether it's treatment for a hospital acquired infection, additional surgery or counseling, offer to help! Just suggesting a different Dr. to consult with would be welcomed by a freaked out patient! Even if the patient decides to sue later, this will go a long ways to impress the judge or jury of your intentions...
5) Do NOT leave the angry, frustrated and upset patient alone to stew in their own juices. Believe me, ignoring the situation and/or making light of it is not the way to go. Personal calls, e-mails, just the appearance of caring can help a patient "get over it." If you can get each member of the team, from the OR nurse who failed to advocate for the patient, to the crna and his/her supervisor to apologise that will be helpful. It is not an admission of guilt per se! It's an admission that the system failed and that the patient wasn't treated in a way that they wanted and expected. Everybody has to say they are sorry, it was inexcusable, and it won't happen again at some point in their lives. Even if it is readily apparent to the patient that these people AREN'T sorry, just the fact that THEY were forced into something they didn't want is like payback! Do you get it? Patients want to feel empowered again after an incident like mine. They want to feel that there will be justice, and that this won't keep on happening.
Saying "We're sorry you are upset" isn't the same as saying "We are sorry this happened to you and we are taking steps to make sure it never happens again!" The first is an insult and the latter is an exhibition of patient care. If your goal is patient care and satisfaction these simple steps I have outlined will probably keep you out of court. They would also have prevented ME from sitting here at my computer and tar-and-feathering the whole medical community!
AND FOR GOD'S SAKE QUIT USING VERSED ON EVERYBODY! THAT'S THE FIRST RULE OF PATIENT CARE! QUIT CAUSING DAMAGE TO PATIENTS BRAINS! WITHOUT VERSED I WOULDN'T BE HERE, NONE OF THIS WOULD HAVE HAPPENED!
Ignoring the facts of what happened to me, beginning with the Versed, and ending with a hospital acquired infection and a second surgery to correct the first. Ignoring all of that because I pretty well have it covered on here, I want to enlighten our medical workers on what would have defused the situation... I am not that different than most people.
First of all when I "awoke" in the PACU already on my feet and creating a danger for myself and everybody else, somebody in a position of authority should have been summoned at once. I should not have been sent a "patient relations" nurse. My complaints and my reaction to being forcibly restrained with a chemical to further more intervention than I had allowed etc. should have been accepted as a legitimate complaint, not glossed over as "standard of care." It isn't a "standard of care" anywhere except maybe at the veterinarians office! There is absolutely NO POINT in antagonizing an already violently aggrieved patient with this kind of nonsense.
I should have had the person in a position of authority in my cubicle chronicling what had happened. There was confusion even among the staff, MY staff, about what had happened and why. I guess they don't have that many patients who 1) tell them what they can and cannot do, and 2) wake up violently angry over their lack of regard for patient rights. Everybody was pretending like they just couldn't understand it. This is the wrong response. Patients need to know that they MATTER! Lying to patients and dismissing their anger is guaranteed to create more anger. The idea that I was so UNWORTHY of good care, honesty and respect regardless of the enormous price tag, was adding fuel to the fire.
The CRNA responsible for the debacle should have been summoned. If he was busy assaulting another patient, then he should have been brought in at the earliest possible moment, so that he could explain himself fully AND to give me the chance to question him about the incident. Preferably before he had the time to make up a story. IE Why did you go ahead with the things I told you not to do? What made you think that I would appreciate Versed? ("I give Versed to all my patients" is NOT an answer when the question is "Why did you give Versed to ME!") Did you think that I would "be happy to wake up and have it all over" when I clearly stated that I wished to remain "awake and alert" and watch the surgery, just like I watched my ORIF femur TWICE? What does the word 'NO' mean to you? I wanted an explanation. Scratch that, I WAS OWED AN EXPLANATION, one that related to me personally, not general platitudes! A tape recorder should have been used while this "interview" was in progress, in order to avoid any misunderstandings or bald faced lies, such as happened with Dr. B's "interview" with me. This should have been a TEAM effort just like the whole incident. My team conspired to treat me without regard, and there should have been a team of authority figures to grill my team. This type of immediate response would have at least made me think that things would be different!
Make no mistake, no amount of passing the buck, telling me that everybody gets Versed, telling me that my DOCTOR wanted this, telling me that it's standard of care, backpedaling, ridiculing me etc. was going to make it better. All this is designed to inflame an already angry patient. Can you see that? Telling me that I asked for it by seeking help is just like telling me that tight jeans are a reason for rape. Its just a man thing, they do that to all their women etc. Nope, wrong is wrong and they were WRONG to treat me like that. NO EXCUSES! My issues with my treatment are VALID and should have been treated as valid.
The people responsible for my debacle reflect badly on the medical center AND on health care workers everywhere. Can you see why this is? Having health care workers sneer at me, accuse me of mental incompetence etc. doesn't help. Why would you think that talk such as this would be calming for an irate patient? Don't try to minimize the event in any way! Take ownership of it and at least pretend that steps will be taken so that this will never happen again.
Chastise those responsible for the event. As far as I know NONE of the people responsible for my debacle knew one thing about it! They all felt they got away with assaulting me. They were fine with it, and there are no repercussions are there? I wanted to see and hear my team being called on the carpet. This would have mollified me somewhat. At the time I was unaware of the poorly done surgical part and the kidney infection I got from them.
I also asked for an adjustment to my bill to reflect the fact that most of the expense was incurred because of the egregious departure from my wishes and consent. This should have been available to me. I should NOT have been billed 800+ dollars for the CRNA who attacked me without a second thought. All those charges for "levels of care?" Gone. The charges for the drugs, other than the Fentanyl, Zofran, antibiotic and lidocaine, gone. The charges for "general anesthetic" gone. Oddly they charged me 280 dollars for writing "general anesthetic" on my chart. That shouldn't have been there in the first place. Do you have any IDEA how infuriating it is to be expected to bankrupt yourself to pay for things you never wanted and had declined? Another thing that patients, already angry, should not be subjected to is the cost associated with the deviation from patient authorized intervention. I didn't ask for any of this and I shouldn't be expected to pay for it. It's insulting! This, if done immediately, would have further defused the situation.
As far as the hospital acquired infection goes... This is not something that should have happened either. With the surgery performed as I wanted (which is actually the PREFERRED method) I would never have had a catheter in the first place. If the hospital staff had the slightest regard for patient safety this wouldn't have happened. The hospital should have reimbursed me for the expenses of treating this infection. What they should NOT have done, is claim that I never had a catheter at all, especially as they KNEW I was in possession of medical records which stated otherwise. Expressing dismay, that this happened to me and assuring me that they were going to have a staff meeting on the importance of hand washing would have gone a long way towards ameliorating the situation.
My surgeon was also in on this. He should have been at my side during the preop interviews instructing my team, reinforcing my wishes and explaining the surgery in detail. It's the law. Don't show such disregard for the patient as to appear 1 1/2 hours late, far too late to explain anything... And far to late to prevent me from being drugged against my will. I wanted my surgeon to be POSSESSIVE over me, as in, "this is MY patient and she will be treated with respect." However, my surgeon had even more disrespect for me than the rest of my team. On top of everything else that happened in that chamber of horror called a hospital, the last thing I needed was shoddy workmanship! I was in a state of panic, bankrupt, suffering from hospital acquired PTSD, kidney infection etc. and then I find that my hand is completely numb and unusable. Screws are sticking out into the tendons, and I can feel those tendons snapping back and forth over the screws. Shooting pains up my arm from the underside of my wrist closest to the Ulna from yet another screw improperly tightened, the incision through the tendons, and my Dr., instead of expressing alarm, or sorrow, tells me that it's just fine and fires me. Wrong answer. Can you see how this would be upsetting? He didn't bother to tell me that these were side effects of the surgery ahead of time, and then he denied them afterward. He should have APOLOGIZED! Some alarm would have been nice and an offer to correct it free of charge, or at least not charge me for the original surgery. He knew that it couldn't stay that way without serious repercussions, even if he wouldn't admit it! As an aside, there is no way I would trust this person to operate again, especially since he threatened me with Versed and g/a at this point. This is not the way to treat a patient. He should have threatened me with Versed and g/a during our "consultation." That way I wouldn't have had the surgery... Using this kind of threat on an already distraught patient doesn't help the situation at all.
To sum it up, here are the tools to alleviate a bad situation from a patients perspective, after the fact... 1) Own up to the situation. Don't make excuses or try to defend the indefensible. Don't blame the patient or minimize what happened in any way. It's unprofessional and inflammatory.
2) Get upper management involved to show the patient that this is NOT business as usual and to prevent the appearance of CYA machinations. Bring in the responsible parties ASAP for an interview in the presence of the patient. Use a tape recorder so that there is no (further) misunderstanding. Give the patient a copy.
3) Assure the patient that this behavior will not be tolerated in the establishment and that the miscreants will be dealt with severely. Tell the patient what changes in hospital policy will be implemented due to this incident. If you are really good at this, you can THANK THE PATIENT for bringing this to the attention of management.
4) Adjust the bill or forgive it completely with apologies. If the patient needs further medical attention as a direct result of the incident, offer to help pay for it. Whether it's treatment for a hospital acquired infection, additional surgery or counseling, offer to help! Just suggesting a different Dr. to consult with would be welcomed by a freaked out patient! Even if the patient decides to sue later, this will go a long ways to impress the judge or jury of your intentions...
5) Do NOT leave the angry, frustrated and upset patient alone to stew in their own juices. Believe me, ignoring the situation and/or making light of it is not the way to go. Personal calls, e-mails, just the appearance of caring can help a patient "get over it." If you can get each member of the team, from the OR nurse who failed to advocate for the patient, to the crna and his/her supervisor to apologise that will be helpful. It is not an admission of guilt per se! It's an admission that the system failed and that the patient wasn't treated in a way that they wanted and expected. Everybody has to say they are sorry, it was inexcusable, and it won't happen again at some point in their lives. Even if it is readily apparent to the patient that these people AREN'T sorry, just the fact that THEY were forced into something they didn't want is like payback! Do you get it? Patients want to feel empowered again after an incident like mine. They want to feel that there will be justice, and that this won't keep on happening.
Saying "We're sorry you are upset" isn't the same as saying "We are sorry this happened to you and we are taking steps to make sure it never happens again!" The first is an insult and the latter is an exhibition of patient care. If your goal is patient care and satisfaction these simple steps I have outlined will probably keep you out of court. They would also have prevented ME from sitting here at my computer and tar-and-feathering the whole medical community!
AND FOR GOD'S SAKE QUIT USING VERSED ON EVERYBODY! THAT'S THE FIRST RULE OF PATIENT CARE! QUIT CAUSING DAMAGE TO PATIENTS BRAINS! WITHOUT VERSED I WOULDN'T BE HERE, NONE OF THIS WOULD HAVE HAPPENED!
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