It seems appropriate that the first topic of my new serious issues blog titled “Write From the Hip” is about tribulations that my father-in-law has endured after “routine” hip replacement surgery.
A good man who worked hard all of his life to take care of his family is now enduring adverse medical ramifications due to a few who are arrogant enough to believe that the rules just don’t apply to them. What makes this problem worse is a hospital administration that is either unwilling, or unable, to enforce the protocol that is established to ensure the well-being of their patients. MRSA stands for Methicillin Resistant Staph Aureus. In short, it’s the hospital based infection that that is spread from patient to patient/person to person sometimes by unclean surgical rooms or items in those rooms but usually by the health care staff themselves.
My father-in-law has nearly been a continuous patient at Jefferson Regional Medical Center since he was admitted on Saturday, August 25, 2007 for post operative complications after hip replacement. According to his doctors, he was diagnosed with having MRSA at the surgical site. Although it is undetermined where and how he got the infection, I have observed and documented a deliberate disregard for my father-in-law’s health and safety at the hands of a few of his providers. Although I believe that most of those tasked with Albert Manns’ care follow the rules and proper patient protocol, the following are scenarios that put him as well as other patients at risk:
On Monday, August 27th, a nurse on the third floor was tasked with starting an IV line in the patient’s right arm. After numerous attempts, she was unsuccessful and asked another nurse to assist her. While Angela was attempting this procedure, she was not wearing gloves. On Wednesday, August 29th, a nurse or nurse’s aid came into the room on the third floor to change the patient’s dressing. She saw that the bio hazard trash can was overflowing (see photo) and while wearing gloves pushed the trash down into the can. She then began to attempt to change the patient’s dressing without changing her gloves. She was stopped by the patient’s wife. Carrie did change her gloves but not without an indignant attitude. He was transferred to the fifth floor after he tested positive for the MRSA infection. Joke number one: It was an “isolation” ward where specific protocols were “supposed” to be followed.
On Monday September 3rd at 5:00 pm, another nurse’s aid came into the room to take blood pressure and temperature. When I saw that her hands were bare, I asked her why she wasn’t wearing gloves. She replied, “I washed my hands.” I said that there was a sign outside the patient’s room (the pink “Resistant Organism Isolation” sign) and was it not true that the reason for that sign and protocol it stated was to protect the patient as well as the staff member? Her answer again was that she washes her hands before coming in the room. She then left the room. At 5:15 pm, she returned to the room to retrieve the dinner tray. I said nothing to her but she asked me, “Do you have a problem with the infection in his wound?” I said, “No, I have a problem with the fact that there is a specific protocol that should be followed according to the posted sign outside and that you have chosen to ignore it.” Her reply was, “I wash my hands all the time… that’s more than most people in this hospital can say!” I said again, “The paper posted outside clearly stated gloves and/or gowns to be worn by staff members. Are you aware of that rule?” She said that she hadn’t worked on this floor for three months. I asked, “Were you trained in that protocol?” She replied that she was. I asked if she agreed with these protocols for the benefit of the patient. She answered, “Yea, kind of.” At that point she said, “Well I just won’t come in here at all then.” To that I asked if she were then denying this patient care and I asked if she were a health care professional. She then left the room without answering either question.
On Saturday, September 8, a nurse extern came into my father-in-law’s room at about 8:25 pm to retrieve his water pitcher. She entered without wearing gloves or a gown and was told by the patient that she had not put gloves on as per the policy. Her response was, “Yea, I know,” but still made no attempt to put them on. She was asked by the patient to put gloves on because she would get into trouble. She just said, “No, I won’t.” She then took his water pitcher out of the room for, in her words, “disposal” and returned to the room again with a new pitcher without washing her hands or wearing gloves. On Monday, September 10 at about 8:00 pm, one of his doctors stopped in his room and examined his surgical site. Not only did he not wash his hands before or after examining the site, he did not wear gloves or the gown as protocol dictates. It is assumed that this doctor had returned from surgery as he was wearing scrubs.
On Tuesday night, my father-in-law was to be released and sent home. For this to be achieved he had to see one of his own doctors to give the ok. He, and the family, were told that he would be released at about 2-3 pm. After waiting for nearly nine hours, he was seen by yet another doctor in the same practice. This doctor entered his room at about 9 pm and sat down on the bed. No gloves, gown, washed hands, etc. When asked by my wife if he would please wear gloves, he curtly replied, “I’m not going to touch him.” Probably the biggest joke is that there is a sign that hangs in every patient’s room that states, “It’s ok to ask” and that proper hygiene is important. My experience is that it’s obviously not ok to ask. If you do, you get a load of crap from nurses and doctors who are just “Holier that thou.”
In conclusion, I’d like to know why are these flagrant rule violations tolerated by the hospital administration. I spoke with patient care managers and even the manager of infection control at the hospital. The conversation was filled with “How terrible and unfortunate this was” and “Oh, thank you for bringing this to our attention”, but the overall attitude was, “We do what we can and if it doesn’t work, sorry about your luck.” I was told by one of the doctors and one of the floor supervisors that they both would wish to fire the nurses and nurse’s aids for their actions. But both said that they are union and just couldn’t be touched. Jefferson’s staff is filled with many nurses, doctors, and nurse’s aids who are professional, caring and just excellent health care providers. It’s a shame that they also have on their staff a few arrogant, ignorant, thoughtless and unprofessional idiots who put their patients in danger. It’s unconscionable and downright criminal. Based on a report published by the Pennsylvania Health Care Cost Containment Council published in November of 2006, the state average for hospital infections is 12.2 per thousand. Jefferson Hospital’s average is 28.7, more than double the state average but when I asked the patient care and nursing supervisors about these figures, the answer from each was, “Well, reporting procedures can be inconsistent and numbers are often skewed.” It’s interesting to me that when Great Britain is taking steps to ban health care workers from wearing jewelry and lab coats as they carry these infections easily, the administration at Jefferson can’t even get some of their people to wear gloves or wash their hands.
I want to reiterate that 98% of the doctors, nurses, nurses’ aids and staff members at Jefferson are true professionals who obey all of the rules and do care for their patients. I’m sure that they, too, are angry as it takes only a few to give the entire staff a black eye over something so simple yet so dangerous.