Hospitals: Hazardous to Your Health?
By Anne-Marie Vidal

(The names of all personnel have been changed to protect both the innocent and the guilty.)

We have all read horror stories about patients receiving the wrong operation or someone receiving the wrong blood in the emergency room.  But when emergency and surgical care are removed from the equation, and hospital care is just is threatening it is not hard to figure out why.  The nursing shortage, that leaves a patient-to-nurse ratio so ridiculously high it could only have originated in a business school graduate’s brain is the likely culprit. That and cumbersome procedures combine to make post surgical care hazardous to your health. This recipe for ill health is intensified when the patient has Chronic Fatigue and Immune Dysfunction (CFIDS) and or Fibromyalgia Syndrome (FMS).

I had to have both a laminectomy and a spinal fusion and spend a few days recovering at one of New York City’s community care centers of a prestigious New York City of a chain. The care should have been excellent and might have been, if double the nurses had been available, and if someone who knew something about medicine worked in the administrative offices.

I was surprisingly awake in the recovery room after surgery and in the company of my husband.  As an epileptic, I had been warned that I was likely to have a total simple seizure (grand mal) after general anesthesia.  In the recovery one nurse ran between 10 beds noting our vitals, listening to alarms signaling problems, while several doctors strolled nonchalantly and in a relaxed manner around the room.  They appeared to have no immediate responsibilities. When I had the expected seizure and my systolic blood pressure rang off alarms, not one of them responded, although I was in their view. The overworked nurse arrived a few moments later, direct from another crisis, the seizure had passed, and she seemed shaken. “What is wrong?  Are you OK? Can I get you anything?” I assured her I was fine, because, by then I was, and she was so clearly overworked, I hated to add to it.   Unfortunately, my body repeated the scenario within a few minutes, my husband and I assured her I was fine, she remained unconvinced and noted my systolic pressure.  Once again, my seizure had take place in full view of a physician who had shown not the slightest interest.

Sometime around midnight I was sent to my room and I sent my husband home.  Then a long and frightening night began. There were four beds in the room and one patient was never in her bed, she wandered up and down the hall unrestrained most of the night, I awoke and she was standing over me, mumbling.  I decided to read for a while.  She turned off my light and left the room. No one made an effort to return her.  Another patient cried out repeatedly for pain meds, no one came; I was scared, in pain, and wondering why the other patient was not restricted to her bed in some way.

In the morning after little sleep, I began to worry about taking my epilepsy medications which I take every morning between 7:00 and 8:00. My first attempt to ask nursing assistant Smith was answered with “Don’t ask me anything, I am not assigned to take care of you.”  I had not even gotten the words out of my mouth.  When I asked a nurse when I would get my meds, I was told “If you want information, you will have to be a lot nicer and ask in much sweeter tone of voice before we help you.” I said, “I am epileptic who had a lumbar fusion 17 hours ago, I am in pain and am worried about my epilepsy meds.”  Then I was told medication was not kept on the floor and the pharmacy was late delivering it.  This is a procedure that does not make a lot of sense from the perspective of efficiency or for the ability to prevent some critical illness events.

Of my 3 roommates, one was still in pain, but was getting help at last.  I discovered that the wandering one had Alzheimer’s. My concern regarding her traveling reached a new height when I had a blood drawn and saw the tube with my name on the floor a few moments later.  She had pilfered it from a lab technician’s cart. Would the sample still be good?   Within a half hour, I saw a used syringe on the floor. That was the limit for me. When a well-meaning visitor went to pick it up, I shrieked, “don’t touch it.”  A nurse noted my alarm, gloved herself, and picked it up the offending syringe for disposal.

It was 9:00 am.  I had a catheter, two IV hookups, and drainage tubes from my back incision.  I still had no meds of any kind, and I take 14 different medications a day, several more than once, something I had made the hospital painstakingly aware of during my preadmission physical and again in admitting. I had sat patiently while nurses transcribed this information no less than 5 times, now I could not get one dose of medicine on time.  I wanted to go home.  I considered signing myself out against medical advice.  The hospital was terrifying me. Rumor had it that Ida, the patient with Alzheimer’s, made it to the lobby in an attempt to leave.  I wished I had been with her.

She was finally restrained.  She was also sedated. I could understand the restraints; there was no possible way that the staff could keep track of her. When the sedative took affect and her head was nearly in her tray, I asked if she would like to get to bed.  She said, “Yes’” and I called someone. Nursing Assistant Jones came in and said “Whassup” I explained Ida was ready to go to bed.  She untied Ida, danced her around the room, tied her again and told me that Ida lied. All of this was said as in front of her as if Ida was a piece of furniture; meanwhile it was so apparent the woman was sleepy that Stevie Wonder could have seen it.  The Patient next to me was dressing to go home, she raised her eyebrows, and said, “No visit from any of your doctors yet kid, Get the hell out of here when you can.”  She was not far off.  My phone did not work, or I would have called my husband to spring me from this madhouse.

Now it was 10:00 I was given a morphine pump, and some antibiotics for the IV, the resident showed up, and explained I was supposed to be wearing massage socks so that my legs would be massaged.  He left orders for them twice.  The nursing staff never hooked them up.  Meds arrived. They looked unfamiliar.  My hypertension and hyperliperdemia medicines were replaced with the type the hospital used, my epilepsy medicine was correct, but I was given and made to take a dose of pramexipole, which is for just before bed only.  Instead of once a day, the hospital tripled my dose, and I was and gave it too me 3 times a day, I was also given double the amount of trileptal I needed but simply broke it and half.  When I tried saving the other half for later to save the hospital money, I was made to take it. I began to throw the extra medicine away. 

Sometime during my sleeping I received two new roommates, one who had a brain tumor named Barbara, herself, a former nursing assistant possessed of a good sense of humor and wry disposition.  Another who was an elderly woman who spoke no English but had special duty nurses.  One special duty nurse slept most of the day. Another was afraid to bathe the patient, so the overworked nursing assistant’s had to do it.  But she did have a friend visit her while she was on duty. A third special duty nurse spoke no Spanish and my own weak language skills were called on frequently to assist.  In return, the private duty nurse helped Barbara on and off the bedpan as our calls for help went unanswered when we used the call button. Once I checked by getting as close to the doorway as my IV’s would allow. Two nurses and one nursing assistant were sitting at the desk talking.

I had asked every time my morphine counter was checked if I was using it too much and told, “No, you are doing just fine.” After making the mistake of gobbling down a dinner of mystery meat, I greeted the next day with nausea; I pushed the call button but received no answer.  Barbara and the private duty nurse pressed theirs, no answer; I threw up in a bedpan.  When that was full, I vomited in a used washbasin, and later, a waste paper basket.  I got an earful for not making to the toilet but no points for missing the floor. I had been pushing the bells for help so that someone would assist me in managing my two IV tubes and my drainage apparatus.  The morphine was taken away.  I was given Percocet and told I had used my morphine pump too often.

Meanwhile I began to worry about Barbara. She was good company. On Monday and Tuesday she was sharp and oriented.  On Wednesday she was becoming confused, and I recognized the malignancy that had killed my own mother 12 years earlier.  I realized that I felt overly solicitous of her well being, but I also felt that we desperately needed one another in this snake pit. I was supposed to leave Thursday but was running a high fever (indeed, a nurse woke me at 2:00 am to inform me my temperature was over 102.)

Before I left, I wanted to give her a gift, and asked that my husband take two clown dolls from my doll collection to add to her own collection of clowns. She was thrilled.  She kept them in bed beside her for a moment. Meanwhile she needed assistance using a bedpan, she rang for help, no one came, and the private duty nurse assisted her and helped her on to the pan. When help was needed to reverse the process, the by now dreaded Nursing Assistant Smith arrived.  Her first words were: “You didn’t need me to get on to the bedpan, why do you need me to get off of it?” With in a minute, I heard a crash and one of the clown dolls fell the floor smashed. Ms Smith in her characteristic lack of empathy said. “Guess you should have put that away.” Barbara began to cry, I heard the words “crybaby” and “aggravating” muttered and did not wait for more.  I knew Ms. Smith was ill suited to her job, and decided to tell her in clear but impolite terms.  Within a minute a nurse, who also enjoyed a reputation as a poor worker, was in the room letting us know we had acquired reputations as “problem patients.”

In the midst of all this, the hospital community affairs office came in to see what was the problem, Barbara asked me not to complain, so I did not.

Meanwhile, my immune system was reacting to the hospital, I checked the inside of my mouth and could see the beginning of oral thrush, my fever was climbing and I knew I needed out.  I spoke with Barbara’s daughters regarding the situation; I left nothing out including my own lapse of temper with Nursing Assistant Smith.

Friday was my moment of truth, I was burning up, the thrush was progressing and I knew I had to get out of the hospital.  If they kept me through the weekend I would only get sicker on that floor.  Whenever a nurse approached to take my temperature, I drank water. I did not lower my body temperature, but I lowered what the thermometer would register.  My husband lobbied the doctors on why I needed to go home, mostly sticking to the reason that I was too active to be in the hospital. I was scared that someone would look in my mouth or catch on to my drinking water. They took my temperature 6 times; I drank water before each time, keeping the temp inside my mouth at approximately 99.  Finally I was released from the hospital at 3:00 PM, with a prescription for 5 days of painkillers after a spinal fusion from L4 to S1. My temperature was over 103.  I immediately obtained a prescription of antibiotics and took them. I also began an antiviral to treat the thrush. By the following Monday, my temperature was 99.4 and my oral thrush was under control. I knew I could not stay in an understaffed hospital. By the time the orders were written to take care of my immune system, it would be too seriously weakened. 

From 1995-1999, millions of dollars were poured into plant and equipment in the hospital I am writing about, yet none went into an information system that allows intake information to be shared with nursing stations.  Nor was any real attention paid to staffing issues on post surgical wards. The nurses’ jobs were and remain yeoman. Very often nurses have fallen into two categories, those who wear themselves out trying to do everything, and those who have given up and do as little as possible.  

While bureaucracy kills health care, it is annihilating nurses and all but destroying the good ones.  Meanwhile, enter a hospital at your own risk. And never enter without your family or friends to advocate for you.