Colleagues rarely point out errors on patients

[maxrandb]

http://www.dispatch.com/national-story.php?story=dispatch/2005/01/27/20050127-A4-01.html

Not sure if the link will work for you unless you are a subscriber. I'll try to find a link from from the Scripps story.

I think this is interesting, because all this time it's been pounded into peoples heads that the problem with health care is those "wascally" Trial Lawyers. This story kind of blows that all to hell. I'm not doctor bashing, but it appears if this story is accurate,...well then "physician heal thyself".

Lee Bowman
SCRIPPS HOWARD NEWS SERVICE


WASHINGTON — Doctors, nurses and other health-care workers seldom challenge a colleague when they see mistakes being made in patient care, a new study found.

Researchers spent more than 10,000 hours observing and interviewing more than 2,000 health workers at 19 hospitals across the country.

Among the stories they heard: a nurse who gave up reminding a colleague to put up safety rails on a child’s bed; a pharmacist who dispensed an inadequate prescription for pain medicine to a patient whose doctor is a "jerk" and gives the pharmacy a hard time; and a nurse who watched a surgical patient die after failing to convince a doctor who intimidated her that the man was in trouble.

Among the other findings were that 84 percent of physicians and 62 percent of nurses and other care providers have seen co-workers repeatedly taking shortcuts that could endanger patients.

[oneold1-4u]

1. Drs. medical, guns

Guns (not military) kill far less than Drs. and medical care.
Remember when contemplating "gun control". Ban guns or Drs.?
There is little or no control on the medical "business" and it is a protected business that kills every day.(recent report of 600 in one hospital in less than 2 years).

[maxrandb]

2. I think you missed the point

My point is that we've been told, ad nauseum, that the problem with health care and it's associated costs is that those evil ambulance chasing trial lawyers are picking on all those upstanding heroic Marcus Welby, Dr Gannon type DR's. Wonder how many lawsuits could be avoided if more than 16% of doctors and nurses would have the professionalism to say; "hey Joe, wait a minute, I think you fucked this up and this guy is gonna die if you don't fix it"

I'm no expert, but I would expect this type of professionalism from my auto mechanic; "hey Pete, you forgot to put the oil back in, let's fix that". Is it too much for me to ask the same from my doctor?

[librechik]

5. One more example of how government regulation is necessary

when powerful industries fail to police themselves.

[Straight Shooter]

3. It's the hierarchal system of retribution and reward which stops them

Just try pointing out that a superior is screwing up, and see what happens to you next time on the operating floor. I'm not speaking from experience, I'm speaking from hearsay, so take it with a grain of salt.

There are also other factors in play, such as the general state of the patient's health. If people really want to bring down the cost of health care, they'll stop popping a pill every time something is wrong and begin to address the origin of the problem instead of looking for a quickie solution. My pet peeve is morbid obesity. I frankly couldn't care less from an aesthetic viewpoint if people are immensely overweight, because that's their right. However, people who are morbidly obese are an anesthesiologist's nightmare, needless to mention all the attendant problems with carrying around such excess weight. Please note I'm not bashing overweight people, I'm expressing concern in the medical realm about those who weigh 70, 100, 150 pounds more than they should. (edit to add, a very good friend of mine is morbidly obese and it scares the willies out of me to think what's happening to her vertebrae, her blood pressure, her knees, her increased chance of diabetes, etc., etc.)

As for doctors, a friend who works in the medical field has this joke,
"What's the difference between God and a doctor?"
.
.
.
"God doesn't think he's a doctor."

[infusionman]

12. Medicine is not an exact science...

And there is ample proof of that when you consider all the variables in taking care of any one particular person. A whole host of things could go wrong. That doesn't necessarily mean it's the Doctor or Nurses fault.

Most surgical consent forms I have seen explain that medicine is not an exact science and that no guarantee as to the outcome of the surgery is implied.

[burn the bush]

4. it's an unspoken rule

I've heard of babies being dropped and severly hurt but it is kept quiet. But wait there is more. I've also heard of doctors purposely infecting a baby that has spinal bifida (leaves them paralyzed) so that the baby would die. But here is one for the anti abortion people-the hospitals do abortions when abortions are illegal. Yes they do. Catholic hospitals do it too. They do a d & c (can't remember if thats the right term.) This dialates and basical scrapes the walls which in effect aborts anything attached to those walls. They do it under the pretense of menstrual problems.
You will want proof, I have none. I used to work at hospitals and trained to be a nurse though it was soooo long ago. The info above was told to me by nursing instructors who did say they witnessed this.
Oh one more, they will snow patients who are dying. Basically they give them more drugs then their dying kidneys can handle and it kills them. They used to call it snowing.

[Horse with no Name]

9. Not saying it isnt true but

I have never seen nor heard anything like this in my 20 years as a nurse. I have seen negligence, I have seen incompetence, but I have never witnessed the deliberate killing or injuring of infants or adults. There are few instances where "Angels of Death" exist--but that is sociopathic behavior--not a normal behavior in the hospital setting.
Catholic hospitals do NOT do any form of D&C for abortion purposes--most don't even do tubal ligations to prevent pregnancy. This is very strict.
Your term of "snowing" patients that are dying--is called "comfort care". Any medication given to a dying person who is usually suffering greatly cannot be metabolized by unhealthy organs thus the medication hastens death, not causes it. If you have ever watched someone die a painful death from cancer or the like, you would understand that the medication is given strictly for the comfort of the patient and the family that is usually watching. Most people don't want to remember Mom or Grandma screaming and writhing in pain before they pass.

[infusionman]

14. Snowing a patient can be intentional or unintentional.

A patient receives a mild sedative to relax him/her before a procedure but the patient is sensitive to it and the effects are stronger.

There is such a thing I have heard of as a "Nursing dose." That which is given above a physician's order to sedate a patient who will not become sedated on the ordered dose. This is usually done I am told in Nursing homes on Geriatric patients who are combative.

[HuckleB]

6. Is there a real link to this?

I'd really like to see more than the anecdotal stuff reported in the few paragraphs here.

[w4rma]

7. Doctors should be paid more for what they do. But they need to realize

that it's the INSURANCE companies who are price gouging them, not their patients.

[infusionman]

11. ABSOLUTELY NOT!!!

Nurses need the pay more than the doctors. We are the ones who do all the work.

For example, after a grueling night of work, a nurse will stay overtime so a doctor can have the privilege of having a nurse to make rounds with. The doc sees the patient, asks a couple of questions and leaves. The doc can charge large amounts of money for this because the patient was in the hospital and it's billed differently.

Meanwhile, the nurse continues to do our job day in, day out with little raises each year, while the docs reap the benefits.

But Nursing IS more than a job, it's a way of life that we are called into. Thats why I will always be a nurse no matter the circumstance.

Nursing is an honorable profession.

[w4rma]

13. Nurses need more pay also. Why do you want to turn this into a fight

between doctors and nurses when the real problem is that the administrators and HMOs are sucking up that money.

[HuckleB]

18. 'Xactly!

:hi:

[Horse with no Name]

8. Gonna speak as a nurse on this one

I have seen nurses make life-threatening mistakes.
Yet when you report these mistakes to the higher ups--they don't want to hear about it and label you a troublemaker.

I had a nurse that I was working with one night try to fight a patient because the patient was belligerent. I had the patient previously and he was a nice guy--very calm mannered. I went in to see what the ruckus was about and the man didn't have his oxygen on--(oxygen deprivation can cause belligerence). Put his oxygen back on, his saturations were still very low. I sent the other nurse to call the doctor and he never came back--found him sleeping in the hallway. I didn't wake him up--I proceeded to take care of the situation myself.
Called the Doctor and the charge nurse--patients lung had collapsed and had to ship him to ICU. This didn't happen in a small hospital--it was a major university medical center in a large city.
Did the nurse get written up for sleeping and abandoning patient?
No. I got written up for intervening in the care of another nurses patient.

Most situations are reported up the chain of command and then they are buried--or after many times of this happening--apathy can occur.

[infusionman]

10. Me too...

I have been a nurse for twenty five years. I have seen many mistakes made by doctors and nurses.

One in particular happened in the early eighty's. Patient with an enlarged prostate was scheduled for and had a radical prostatectomy and removal of his urinary bladder, and formation of a urostomy. When the pathology report came back negative, the doctor looked at it, threw it away and told us not to tell anyone.

It has haunted me ever since.

[PinkPantherChick]

16. me too, #2

Been a nurse since 1984 and we call these losers "paycheck nurses" or paycheck docs". Every one hates them but they are warm bodies and they don't get fired because there are no other warm bodies to replace them with.

My nightmare happened when I was assigned a patient on her 5th day of hospitalization. The nurses before me had all charted that the skin was pink, dry and intact with no dressings of any kind or wounds. I did my usual head to toe assessment and found a really sickening surgical site that was over 12" long, an ENORMOUS dressing that was stinking out into the hallway and a huge infection. How 3 shifts of nurses over 5 days missed that I will never know. We ended up calling in infection control specialists and the patient died from a horrible infection. Go figure. All of the nurses involved were reported and disciplined but none were fired. I was furious with administration and ended up quitting. The case went to trial and I
didn't think twice about frying all of them.

[NashVegas]

15. It's Like This All Over the Place Now, In Just About Every Field

Not just medicine. It just seems that incompetence, that never would have been tolerated 20 years ago, doesn't matter anymore. Has it gotten that difficult to fire someone?

[HuckleB]

17. It's always been this way.

I just think we fall for the "good old days" mantra far too easy. In truth, more things might actually get dealt with today than ever did in the past.