mistakes were made

I just finished reading a chilling essay by an ER doctor at a local B.A.T.H. relating his experiences with a hospital’s massive, life ending errors during the care of his mother.  The article is titled As She Lay Dying: How I Fought To Stop Medical Errors From Killing My Mom, published in Health Affairs.

Here’s the part that moved me to tears:

“I wish I’d done more at that point—raised hell, insisted on waking both my mom’s oncologist and the hospital’s intensive care doctor at home, demanded that they come to the hospital. Instead, by that point I felt lost and powerless. I’d already insisted that my mom be moved to the ICU. What would happen if I made additional demands? Would the ICU nurse start avoiding my mom’s room? If I criticized my mom’s oncologist, what would happen to their relationship? I knew there could be a downside to being too demanding in a hospital.”

Yes, there certainly can be.  This is a grinding, soul crushing position to be in – knowing that the standard of care that is being delivered is wrong and bad  but also knowing that your advocacy will be seen as so contentious that it could result in a lower standard of care; having said everything you can as well as you can say it and being dismissed; feeling like there is nothing else you can do.  It is a terrible, helpless feeling.  When my brother was suffering from a MRSA pneumonia in a little crap hospital that makes its money off baby birthing and out patient oncology treatment, I recall having a similar feeling.  Can’t they do a sensitivity on the specimens to find out why it isn’t responding to vancomycin?  Can’t the nurses fix the IV line since it’s clearly infiltrating? (my mother actually ended up redoing it one night after over a day of pump alarms and my brother’s arm swollen up…she got caught and an incident report was filed.  I still wonder if in the incident report anyone bothered to mention that (a) she’s been a nurse – including ER, trauma/burn, and ICU – for 40 years (b) the floor staff were avoiding my brother’s room because he was HIV positive and had a MRSA pneumonia and they didn’t want the hassle of gowning up).  My brother’s illness was slower moving that that of the mother of the author of the essay.  Because of this, we were able to successfully advocate for his removal to a B.A.T.H., where they did do real testing on what they got out of his lungs and discovered that this was not garden variety MRSA (vancomycin resistant and PVL positive).

You want to think that medical knowledge and familiarity with “the system” will help in being a good patient advocate, whether you’re advocating for a loved one or yourself.  You want to think that a plea – phrased carefully and civilly – for a better level of care, more attention to protocol, would not fall on ears deafened by ignorant adherence to all the wrong values.  This essay highlights how medical care environments can so easily be a system where dysfunctional politics and personalities are allowed to flourish, where more value is placed in not wanting to step on professional toes than in putting in place best practice protocols (read the part about the hospital administrator’s reason for why the hospital didn’t have a policy where ICU doctors took lead in caring for ICU patients).

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3 Comments

  1. Interesting article, and like your experience so many families are stuck trying to make decisions and not pissing off doctors. When my Mom was in the hospital gravely ill, I fought more with my siblings than the doctors and nurses. I didn’t approve of the care she was getting, but I was the only one fighting to change doctors. No one would let me change things, and my Mother suffered because I didn’t stand up to them. I was amazed to read that even this Son was afraid to piss off another doctor. This type of situation is sinful.
    mo

    Reply
  2. anaphylaxing

     /  December 10, 2012

    Horrific. Have also been in that situation witnessing the family negligence. Just the worst feeling isn’t it? Thanks for posting.

    Reply
  3. Wow. Stuff like that makes me so angry and then they cop attitudes like they aren’t a cog in a dysfunctional system. Makes my blood boil.

    Reply

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