Wednesday, April 15, 2009

KNOW YOUR RIGHTS...


Pardon me while I vent a bit in hopes of helping someone else.

Some of you who read my blog already know my family story. I'll make the story short for those who don't. My sister walked into the hospital back in 1984 when she was just 18 years old. Went to the hospital after being hit in the throat playing basketball. No injury, nothing wrong, but her coach wanted her checked out. She didn't walk out. Instead we took her home almost 6 months later having profound brain damage. She could no longer walk, talk, eat on her own, or move any part of her body voluntarily. We were told the doctors had no clue what happened. The last thing we were told in the ER that night before they wheeled her away she needed to have surgery and if they didn't do it immediately my sister would stop breathing and die. That was the last time we saw my sister "healthy" and "functioning."

As time went along and evidence revealed itself, we learned that my sister wasn't given any oxygen during her "minor" surgical procedure. We also learned that this "minor" procedure wasn't even necessary. There wasn't anything wrong with her. I was young at the time, only 13, but I remember wondering WHY

Why did the doctors lie to my mom about how serious my sisters condition was?
Why did the doctors lie about not knowing what happened during surgery?
Why wasn't someone making it all better?

Over the past 25 years I've met many families who have been left to deal with the "incompetence" of doctors and nurses. I say incompetence because dropping someone on their head or amputating the wrong leg is not a mistake. A mistake is when a doctor gives his/her opinion on what they think is wrong with you and they are wrong on the diagnosis.

Don't get me wrong. I know there are excellent doctors, residents and nurses out there but they are few and far between. My sister has an excellent neurologist who cares deeply for her and does his best when treating her, but he is rare. And before you jump to conclusions, I have had my fair share of contact with doctors and nurses over the past years. My opinion about the medical field isn't based on a couple bad experiences it is based on hundreds of bad experiences.

Having these experiences and wanting to make sure others don't is why I write this post. I compiled a list of things that I believe can help put you in charge of your care if you ever need to go to the hospital.

Going to the ER or the Hospital:

1. Never forget that you are in complete control over what happens to you. You can refuse any test that you aren't comfortable with, you can refuse any treatment. Same for those you have guardianship over (or your children).

2. Don't forget to ask questions. Never assume a doctor is going to tell you everything. Doc's usually don't volunteer information, especially the negative side effects of a treatment (would you want to volunteer that the blood pressure meds that your giving could potentially kill the patient???? No, not if you don't have to). If your doctor wants to give you medication, ask what the side affects are and how to spot problems if they arise. It is one thing if a doc tells you that a life threatening rash could happen from the meds he's given you but where does the rash appear, what does it look like. If the doctor wants to run tests, make sure you understand the procedure start to finish. Many times doctors order scans and with most scans they may use a contrast dye. If contrast dye is used you can have a life threatening allergic reaction. By law they are required to tell you that but I've been in situations where they didn't volunteer the information.

3. Don't let doctors act superior to you because they aren't. In hospitals there are patient advocacy groups. If you are questioning a doctor and he becomes hostile in response to your questions or concerns, immediately stop the conversation and demand to speak with the patient advocate group at the hospital... he'll change his tune then. I would do the same if they talk circles around you and refuse to give you information in layman terms.

4. You have the right to refuse treatment by a resident and insist to be seen only by a staff doctor. Many hospitals have resident physicians. I always refer to them as "students" because that's exactly what they are. They might be a first year resident, 2nd year resident, 3rd year, etc... but a student nonetheless. These people are overseen by a staff doctor. They screw up a lot! Now, I know that a resident needs experience but their is a limit to what experience I will allow them to get on me.

Example: my sister had to have an appendectomy in 1983. Every time a team of residents entered her room they'd ask my mother to step out. It happened 7 times in 24 hours. Finally my mother asked my sister what they were doing every time they came in to her room. My sisters response "pelvic exams." My mother hit the ceiling and ended up screaming at the next person who walked in the door reminding them it wasn't free feels day but being naive at the time she didn't realize she could refuse treatment by residents.

You can demand a staff doctor. Doesn't mean he/she will come to you immediately. I've demanded to see a staff doctor and waited 4 hours to see him, but it was worth it. BTW/he wasn't too happy that his services were demanded but ask me if I cared.

5. Some nurses aren't too swift either. Your lucky if you get the angel that actually cares about you. I've had good ones and I've had bad. They are easier to replace at a hospital than a doctor so feel free to bitch about them if they bug ya. Watch out for the lazy ones. You'll know a lazy bugger when you see one. They are the ones that you push the nurse call light, they come and ask what you need, you tell them and they promise to be back and you never see them again. Get rid of that one right away or you'll be dealing with a headache the rest of your stay in the hospital. (and before people say "but sometimes they are really busy", I take that into account before getting annoyed. If I've asked nurse "I don't have time for anything but blabbing to co-workers" to bring me seizure meds at 8 am and I still haven't received them at 11 am, it is time for her to go.

6. Remember, you need a doctor to order EVERYTHING. You can ask a nurse for medication but unless the doctor orders it, you aren't going to get it. Make sure when you request tests, medical supplies or medication from your nurse that you also ask her how long it will take to contact the doctor and then how long after he gives the order it will take to get what you want. Note: Dr.'s who see patients in the ER cannot place orders for things you want when transferred to floor 7. If you move from ER to a room, your dealing with a whole new doctor. Don't rely on hospital staff to remember your requests or even care about you once you are transferred.

7. Please do not treat a doctor like he's God. He/she is not infallible. They are humans just like the rest of us. They lie. I've had doctors lie to me about tests they've done, even lied to say they've seen the results of a test when they didn't (those pesky residents again). You'll get a doctor that thinks he's God but then it is your job to remind him that he isn't. Doctors don't respect people who don't take responsibility for their healthcare. The more you know and show your doctor you know, the more likely he/she is going to remain on their toes when treating you.

8. Staff physicians don't supervise staff residents. We all would like to believe they do but in the real world it isn't possible. If a staff doctor had to supervise a resident he/she would never get anything done. I learned this one the hard way. My sister had a rotation of 12 residents at one hospital. Depending on the day, I would get a different resident giving me a new diagnosis. It took me more than a minute to realize not a single diagnosis or plan of treatment was being run through the staff doctor. All of the residents had an idea of what tests needed to be done, what treatment was needed, and none could agree. They don't ask you if it is ok, they just come in with their ideas and expect you to go along with it all. Thats when I ended my relationship with the residents.

9. Don't become a guinee pig for student doctors. If you doubt that is what you are when they are poking and prodding you, guess again. These residents have to learn somewhere and you are IT. If they can get away with it they will have you upside down drinking some toxic white liquid running you through an MRI machine when all you had was a sore finger.

A recent study by the Institute of Medicine of the National Academy of Sciences estimated that as many as 98,000 patients may be killed each year in hospitals alone as a result of medical errors. Don't become a statistic!!

Remember, medical students are now being told that medicine is big business. In my opinion if healthcare is big business than we, the consumers, deserve a refund if we are unhappy with the service we received. I also propose that incompetent doctors be sent to prison but I'll save that for another post.

NEWSWEEK HAS A GREAT LIST OF THE MOST COMMON MEDICAL MISTAKES AND HOW PATIENTS CAN AVOID THEM, HERE IS THE LINK: CLICK HERE