Bedside Manner(s)

Snotty Nurse

We named her “Snotty Nurse”.  Not a very nice thing to call someone who works with critical care patients and sees what is probably the worst of the worst in the hospital.  But, her bedside manner just wasn’t there.  When the nurses change shifts or doctors did rounds she would say to anyone there quietly sitting at the patient’s bedside, “You have to leave” in a tone that was anything but pleasant.  No explanation.  When the patient, a 20 year old boy just opened his eyes and recognized me for the first time in over 24 hours and he squeezed my hand while scared from the ventilator breathing for him, I begged her to let me stay 2 more minutes.  “He just opened his eyes and is holding my hand tight” I told her.  “No, you have to leave” she said abruptly.  Reluctantly I gathered my things and left so the doctors could talk about him without any input from the people who know him best.

She doesn’t say hello as all the other nurses do.  There is no greeting or acknowledgement, but  she will grunt something if someone is in her way or if we greet her with a “good morning”.  She won’t explain things to the patient’s mother unless asked and when one guest tried to relay information, she gave a sarcastic reply.

I began to realize that this nurse can actually become a liability to a hospital.  Were something to go wrong, the family may feel she didn’t listen and want to hold her, as a representative to the hospital, accountable.  There was a time that the patient’s family didn’t want to “bother” her with information, that was important about the patient’s look which turned out to be relevant to this patient’s outcome. 

Some people feel that bedside manner is irrelevant but the fact is bedside manner is an important piece of communication which can help predict an outcome.  Most probably, the care will be fine and the outcome will be good.  But, if not, I for one will wonder about this nurses patient care.

Newsday Uncovers What We Need to Know

Following the News

“Doctor Busted” the headline reads in today’s Long Island Newsday on page 4.  A Long Island doctor was arrested on charges that he was illegally prescribing drugs to people who didn’t need them and were not even seen as his patient.  Dr. Telang has written over 40 articles and works for the National Institute for Health.  He has a very impressive resume.   The story also reads that his office is in Port Jefferson but looking at the NY State Physician Profile website, it says that he is practicing in Upton and Bethpage.  The state physician profile says nothing about Port Jefferson.

In the same article we are reminded that Telang is the third doctor in the past month who is part of this investigation.  Dr. Leonard Stambler was also accused of selling prescriptions for pain killers. He too is listed in the physician profile website as practicing with a clean record.  Besides one small payment from a medical malpractice case, he looks like a fine physician if we count on the states profile to help is choose a doctor.   

Newsday reminds us that Dr. Eric Jacobson pleaded not guilty of charges that he wrongfully prescribed pain killers from his Great Neck office when in fact the NY State website says he practices only in the Bronx – and he has a clean record too.  Dr. Jacobson is the doctor who prescribed thousands of pain killers to David Laffer who killed four people at a Medford pharmacy robbery.

Do you remember Dr. Sanji Francis who was led away in handcuffs 2 years ago this month?  NY State Physician Profiles has him as surrendering his license but Healthgrades, an independent organization rating doctors and hospitals  has him still practicing in Massapequa LI, NY.

Also in today’s Newsday a health aide is accused of stealing $3,000.00 from an elderly man.  So, besides all the inaccuracy’s in the records that are supposed to help us gather empowering information, don’t believe that no one in healthcare wakes up and plans to hurt someone.  For some, they not only plan it, it has become a lifestyle.

HIPAA, HIPAA, HIPAA!!

HIPAA What Does it All Mean??

I just received another conference notice.  This time, it’s about HIPAA, it will be held in Washington DC for the small registration fee of $1,195.00. But, if you are late paying, the cost goes up to a measly $1,795.00.   This 3-day conference will cover breakouts, keynote speakers and probably everything and even more than you ever wanted to know about patient privacy. 

Do I sound sarcastic?  Maybe just a bit?  What about us patients who walk into a doctor’s office or a hospital setting and sign that we received the HIPAA policy (and have no clue what it says).  Or, we are told “no” for any number of things like we want to find out about a patient, want to accompany a patient to a doctor’s office or are trying to help a patient / friend get information.  We get “HIPAA, HIPAA, HIPAA” (said in the whiny Jan Brady voice).

I wouldn’t pay $1,000.00 to go to Washington to learn about HIPAA nor would I pay $100.00 and now YOU don’t have to either!

Greg Radinsky, vice president and chief corporate compliance officer North Shore-LIJ Health System,

On February 1, 2011 NorthShore LIJ Health System is lending out their Vice President and Chief Compliance Officer Greg Radinsky to help us, the general public understand “HIPAA Everything You Want to Know About Patient Privacy but Are Afraid to Ask"  and it will be FREE to all who want to attend. 

We just ask that you bring your business cards and take notes. 

You may never get another chance like this again!

When:  February 1, 2012

Time: 1:00 – 3;00 PM

Where: South Nassau Unitarian Universalist Congregation,

228 South Ocean Ave. Freeport NY

Who should attend:  Anyone who advocates for patient’s, is a patient or may be a patient and wants to learn about HIPAA in terms you can understand.

RSVP to PULSE (516) 579-4711 or icorina@pulseofny.org

See a list of upcoming free educational programs here. http://www.pulseofny.org/series.html

This program is sponsored by the PULSE of NY Patient Safety Advisory Council

About PULSE:

PULSE is dedicated to raising awareness about patient safety and reducing medical errors through advocacy, education, and support. We work to empower the public to make informed decisions, increase effective communication and respect between healthcare providers and the public, and create community partnerships that will foster and ultimately lead to safer healthcare environments.

Hospital Readmissions

The Cost of Re-Hospitalizations

When it comes to preventing hospital readmission's, no one wants that more for the patient (or family) than PULSE, a grassroots patient safety organization.  Not only because of the cost to health insurance, Medicare and Medicaid but because of the cost to the economy and risks for the patient’s safety for a number of reasons .

Hospitals, as we already know are dangerous places.  There are high infection rates, possibility of patient mix-ups and risk of falls.  But what about the additional lost work time for the family because of a hospital readmission or what congress is calling a re-hospitalization?  There is additional time for replacement of staff, payment of sick time, and of course using Family Medical Leave when a family member has the right to be with the patient or take care of things at home.  Getting out of the hospital is important for patient safety reasons.  So how do we get the patient home and to stay home which we all know is the best place for the patient?

As a patient safety educator in the community for over 15 years, I am confident that the public wants their family home too.  Given the tools to help with patient compliance, understanding discharge instructions and safe medication use are all important areas patients and families can play a role in reducing re-hospitalizations.  This is not something we need to “work on” this is something we have done since 2006 with Family Centered Patient Advocacy Training”.  Our next training is February 7 at 6:00 PM.

Nice Works for Safety

Being Nice in the Hospital

As I walked through the hall of a hospital I needed to remind myself that it was, in fact a hospital.  Each employee smiled and held the door.  In this very busy hospital with crowded hallways, I had to remind myself that this was not a hotel.  The volunteers were friendly and courteous.  The cleaning crew smiled as they walked passed me and no matter where I was, someone always seemed to want to know if I needed help finding something.

I watched as an employee escorted a woman off the elevator and brought her to the cafeteria following a brief interaction on the elevator.

In most cases I would say that “nice” doesn’t make an organization competent.  But, in some cases, being nice in a hospital setting can relax the patients and their family, it can help patients be more honest about their illnesses and problems allowing for more accurate record keeping, and it of course, makes patients want to come back.

No, being nice is not a sign of competency but when it is across the board, being nice obviously is coming from the top.

Informed Consent

Informed Consent

Is it consent, if they aren’t informed?  A friend of mine who is a paramedic explained this to a colleague when treating a patient at his home while on a call.

Kyle has been a paramedic for many years and also works in an emergency room as an Emergency Room Technician.  His skill for treating people in an emergency go way beyond their physical needs.  He is gentle and kind and also willing to take the time to explain the options to a patient.

I like to ask him about his calls and they are usually uneventful but interesting non-the-less.  But on this evening, following his shift, he explained to me about a patient’s pain and discomfort and request to not be brought the hospital.  Kyle explained to this man what they can do for him at the hospital to relieve his pain.  Or, he can stay home and what can happen to him if he refuses care.  What made this conversation interesting to me, someone who is sensitive to health literacy or anyone’s capability to communicate with each other especially under stress, is that Kyle’s colleague questioned the man’s capability, as an adult to make an informed decision and give consent.   “When someone doesn’t understand or know their options” Kyle explained to his colleague, “Then they are not informed”.