Tuesday, April 12, 2011

Quality of Care

Where is the Quality of Care Going?

I thought I have seen it all, but I can be wrong. I was called to this Long Island hospital by the adult son of an elderly woman. His mom, he told me was in her bed all day at the hospital, had bedsores and he was pretty confident she wasn’t eating because no one helped her eat. He had no other family and since he lived with his mom, he feels obligated to help her stay independent. He worked during the day, went there every night at dinner time to help her eat. He felt it was just short of abuse but he didn’t know what to do.

I showed up at 11:30 AM. She was clean and resting and it turns out the son hired someone to clean her in the morning. A young man came in with a lunch tray and put it on the table at least 2 feet out of her reach. I watched as a young woman went to the patient in the next bed, also an elderly woman, and moved the bedpan from the chair to the windowsill so she can sit down.

I sat for another hour and watched the nurse come in and change her IV bag, never looking at her wrist band (but I assume she would say she knows who she is) so I asked who that medication was for. At that point she looked at the name on the medication.

I came back at 4:30 and the tray of food was never touched. Her bedsores “large enough to put a fist in” were examined by a nurse who unwrapped and then rewrapped the wounds putting the same tape and bandages back on. I asked why she did that since she was struggling with the tape sticking to everything and she said she just measures the wounds – she doesn’t treat them.

 I was there to try to find out who would speak to the son and help coordinate his mother’s care. The case manager said “you have to speak to the doctor”. The doctor is not available in the evening when the son can be there. It became a huge run around in a complete circle. This woman was not getting “care” she was existing - and the hospital was getting paid for this lack of care.

This morning, my first call was from a young woman. She was going to meet with her mother’s doctors at a hospital. The care she said is awful. She is in a dangerous place and she didn’t know what to do.
Yup, same thing.

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