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The reason I hate hospitals and don't trust doctors, part I

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  • The reason I hate hospitals and don't trust doctors, part I

    I may have posted this here (well, not here, but somewhere on CS) once before, but it's been a long time if I have, and it's best suited for this new board, so here we go.

    December 23, 2009. I was working (at the time, I had an office job in a call center) when I suddenly got a horrible, horrible pain in my side/lower back. Long story short, the HR manager and I decided it would be best for me to go to the ER, so he drove me there. I told them my symptoms and they admitted me right away, suspecting kidney stones.

    I put the gown on and laid down on the bed...gurney...thing, and the nurse came in to give me an IV for the pain (which had subsided considerably since I had come in.) I told her that I'd never gotten an IV and I was really scared (of the IV, and just in general) and she looked at me like I was crazy. "You've never had an IV? Really? I can't believe it. How have you never had an IV? That's just crazy." I didn't know it was such a big deal to not have had an IV by the time you're 25.

    She stuck me, several times, with the same needle, in the top of my right hand, trying to get a vein, with me whimpering the entire time. The pain from her digging around in my hand was far worse than the side pains at this point. Finally she stopped and said she was going to try and get someone else to do it. Another nurse came in and got an IV in my arm without a problem. The first nurse told me that the vein in my hand was very, very difficult to get so if I ever needed to get an IV again, I should tell the nurse or whoever was administering it not to do it in that hand. Three weeks later when I had surgery, I said exactly that to an anesthesiologist. He took one look at the hand in question and popped an IV in before I even knew what he was doing. I didn't feel a thing.

    The doctor came in and talked to me briefly, telling me they thought it was kidney stones and that they were going to run some tests. I didn't really see him much at first, honestly.

    Next they took me for a CAT scan, I think. I was in a big tube and they were scanning my abdomen, so whatever that was. The guy who did that was nice and seemed competent, by far the best person I dealt with that afternoon. Too bad I was only with him about 20 minutes.

    Back to my little room to wait for the results. The results came in and the kidney was fine, no stones, so they were going to do an ultrasound. An ultrasound? What? At the time, I didn't know what else ultrasounds were used for besides looking at a pregnant woman's baby, so I sort of started to freak out. I asked why they wanted to do the ultrasound and no one would tell me because the doctor wasn't around, and the doctor ordered it and needed to explain it himself. He never came back to explain anything between the CAT scan and the ultrasound, though. I didn't think I could be pregnant (I was sexually active, but we use BC and I'd had my period since the last time we had intercourse, but I've heard of weirder things happening) but I was still pretty freaked out.

    They did the ultrasound. At the end of it, I asked the tech (or whatever her title was) if she saw anything. She got this little grin on her face and said, "You'll see." Once again, I was freaking out. The only thing I could think of this whole time was that I was pregnant, and I really, really didn't (and still don't) want to ever be pregnant. The very thought terrifies me.

    Back to my little room to wait. I asked the nurse for some water; she said she couldn't give me any without the doctor's permission, and said she's go find him and ask. Some time later, the doctor finally showed up. I asked him if I could have some water, and he said it was the nurse's job to get some for me. He told me that the ultra sound had revealed gall stones, which had caused the pain in my side and back. He had sent for the ER surgeon to come in and talk to me.

    The nurse finally came back with a small cup of water, then asked me to pee in a cup. She handed me the cup, said "You know what to do" and left. Okay. I'd never had to give a urine sample for anything before, but how hard could it be, right? So I peed in the cup and gave her the sample. I was still thirsty so I asked her for more water. She never brought me any before I ended up leaving an hour and a half later.

    The nurse took my urine sample and the ER surgeon came in and started discussing surgery. She said she didn't think I needed surgery that same night, but that I would need to have my gall bladder removed eventually, probably sooner rather than later. There were other treatment options, like crushing the stones, but they would probably come back eventually and the best long-term solution was to have it removed.

    At this point I started crying. I'd been in the ER for over 2 hours at this point, alone and not feeling particularly supported by anyone. The doctor had been very scarce, the nurse was nice but I had very little competence in her, and I was scared shitless. I'd never had surgery of any kind up until then, not even to have my tonsils or my wisdom teeth removed, so I was all kinds of freaked out. The surgeon was very cold and did not sympathize or try to instill any kind of confidence in me when I started crying. She continued to drone on about the risks of surgery, etc, and left.

    The nurse came back and told me it looked like I had a UTI from the urine sample. Queue me getting even more upset. But, she said the sample was "funny" and that they wanted to take another one because it looked like it had been contaminated. She asked me if I had "properly wiped" before giving the sample. Uh, no? She said I needed to wipe my urethra with an antiseptic wipe before peeing in the cup. Okay, would've been good to know that before I just emptied my bladder for you.

    I couldn't pee again. I'd asked repeatedly for more water and she never brought me any, and I really had emptied my bladder the first time, so I had nothing to give. The nurse said the doctor had ordered her to catheter me if I could've give another sample.

    I didn't really know what all that involved (I knew what a catheter was, but again, never had it done) but she said it would be very quick and easy and then they'd have a clean sample to run and we wouldn't have to worry about it. So I agreed.

    It took her FIVE TRIES to stick me with the catheter. By the end of it, it was more painful that the missed IVs, and when I got home, I had blood in my urine for 2 days.

    They got their damned urine sample, though, and it turned out I didn't have a UTI. Sometime after the catheter, the doctor came back, and asked me why I was crying. At this point, I was downright bawling, from the overall treatment I'd received, the prospect of surgery, and the pain from the catheter. I told him I was scared about having surgery and he gave me a lecture about how gall bladder surgery is very minor, people have it done every day, it's not a big deal, and I need to suck it up and stop crying because this was nothing to cry about.

    Fortunately, my mom showed up shortly after this and got me out of there (they were about ready to release me, anyway.) I never went back to that hospital for anything. I went to a different surgeon at a different hospital about 2 weeks later for a consultation, and he said I absolutely needed to have my gall bladder out ASAP. The following week he took it out, and said if he had been the ER surgeon who saw me the night I was in the ER, he would've taken it out then and there. It was swollen, infected, and full of 12 marble sized stones. It was the longest laprascopic surgery he had ever performed (and he was in his 60s.)

    The ER I went to got a very long letter, followed up by a very long phone call from me detailing why I would rather drive an hour to the neighboring town's ER than ever go to their ER again. The person I spoke to was very apologetic and said that they were going to work to rectify all the negative things that happened to me. For the sake of every other patient that ever has had the misfortune of stepping into that ER, I hope she was sincere.

  • #2
    Wow. Maggie, I am so sorry. That is an absolutely horrible experience.

    The fail here on the part of the staff is epic.

    1. The ER nurse does so many IVs she can't conceive someone might never have had one. I always ask the question, and then explain what I'm doing if the answer is no.

    2. The hand is not my favorite place to start an IV. Lots of nerve endings and tendons to get in the way, and the veins often have lots of bifurcations (splits) that make putting the catheter in difficult (the valves block the advancement of the catheter, the part that slips over the needle, into the vein). I prefer the arm, but not the crook of the arm (the antecubital space).

    3. You never, ever stick more than once with one needle. If you stick, and don't get in, you discard that needle and use a new one. We do this for several reasons. 1) the needle is contaminated, increasing the risk of infection, and 2) ever poke dulls the needle and dull needles hurt more than sharp ones.

    4. You don't stick more than twice. If you can't get it in two, you can't get it. Get someone else to try.

    5. Don't blame your inability on the patient by telling the patient to avoid a certain part of the body. You just look foolish when someone else gets it in one go.

    6. Explain to the patient why you order additional tests. Don't assume they are mind readers. Yes, I know you do this a million times a day. They experience it once in a lifetime, if they are lucky.

    7. When a patient comes in with a potential surgical issue, explain to them why you don't want them to eat or drink anything from the get go. Patients really do understand if you explain it to them from the outset.

    8. Don't pass the buck. If you're a doc, and a patient asks for water, either tell them yourself you don't want them to have anything by mouth, or say "sure, I'll make sure you get some" and ask the nurse or tech to deal with it when you're outside the room.

    9. If you want a clean catch urine from a patient, ask them if they know how to do a clean catch (use that term). If they say no, give them instructions. Don't assume they know how just because you have patients do a million of them a day. If they end up getting a cath, it's your fault.

    10. If you screw up the clean catch and have to ask the patient do it again, and the patient is not NPO (nothing per oral, or nothing by mouth), then give them some water and some time to make the urine. Don't risk introducing a UTI or causing bladder trauma with an unnecessary cath if you don't have to. And DON'T threaten the patient with the cath if you don't provide them with the means to void on their own.

    The fail here is unbelievable. I can't address the fail of the ER surgeon, not having access to your u/s results or labs . . . but that sounds pretty epic too.

    Lesson for ER staff: if you screw up a patient interaction like this, you should not be surprised when members of the community at large are distrustful of what you do.

    They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

    Comment


    • #3
      I want to know how it took 5 times to properly cath Maggie, and how that idiot nurse thought trying 5 times was ok. And did she use the same catheter? Ewwwwww. You're really lucky you didn't get a UTI from her.

      Comment


      • #4
        I can believe it took that many tries as I had two nurses try atleast that many times when I was in labor with my son.

        Comment


        • #5
          Wow. Sounds like some people had an extreme dearth of communication. That place... geeze. What the hell ER?
          "Is it the lie that keeps you sane? Is this the lie that keeps you sane?What is it?Can it be?Ought it to exist?"
          "...and may it be that I cleave to the ugly truth, rather than the beautiful lie..."

          Comment


          • #6
            Quoth trailerparkmedic View Post
            I want to know how it took 5 times to properly cath Maggie, and how that idiot nurse thought trying 5 times was ok. And did she use the same catheter? Ewwwwww. You're really lucky you didn't get a UTI from her.
            I'm difficult to catheterise in the urethra as well, it seems. I didn't count the tries, but it was probably something of that order.

            In my case, it was being done as part of continence testing, by a nurse and a doctor who presumably do this often. I have no complaints about their competence or attempted gentleness, mind you!

            And yes, after the nurse' first failure, she asked me if I minded having the doctor watch her second attempt. After her second failure, he took over. After HIS failure, they worked as a team. And I meditated and made a point of not paying attention, so I was as relaxed as possible.

            I suspect I ended up with a paediatric-diameter catheter!
            Seshat's self-help guide:
            1. Would you rather be right, or get the result you want?
            2. If you're consistently getting results you don't want, change what you do.
            3. Deal with the situation you have now, however it occurred.
            4. Accept the consequences of your decisions.

            "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

            Comment


            • #7
              Quoth trailerparkmedic View Post
              I want to know how it took 5 times to properly cath Maggie, and how that idiot nurse thought trying 5 times was ok. And did she use the same catheter? Ewwwwww. You're really lucky you didn't get a UTI from her.
              5 times IS a bit much, but not unheard of. The female urethra can be hard to see, and there are a lot of anatomical variations that can make putting one in a challenge.

              There are some tricks to it. Use a good light: a goose neck lamp, or over the table surgical lamp are good choices. In a pinch, get someone to hold a flash light over the perineum.

              The betadine solution used to clean the perineum will cause the urethra to spasm (because is is colder than body temperature). It looks like a winking eye. Watch for it.

              Make sure you're holding the labia as far apart as possible. It is slippery. Your hand will cramp. If it is cramping, you are probably doing it right.

              If the patient can tolerate it, put them in a slight Trendelenburg position (bed is flat, but tilted head downwards). Gravity will pull the urethra into view. This cannot be done on women who are pregnant (due to the risk of supine hypotension caused by pressure of the gravid uterus on the aorta and vena cava), and some other patients.

              If you miss and put the catheter into the vagina, leave it there! Get a new sterile catheter, reclean the area, and aim above the catheter.

              If you miss on the 2nd go, get someone else to do it.

              Putting in a catheter is like putting in an IV. It's a learned skill that anyone can do, but that requires patience and practice. In spite of that, even the best at it will miss. It's not the end of the world to ask for help.
              They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

              Comment


              • #8
                Quoth Panacea View Post
                If you miss and put the catheter into the vagina, leave it there! Get a new sterile catheter, reclean the area, and aim above the catheter.
                That's what happened with the first one I ever did. The patient gave me kind of a weird look when I opened the second package but didn't ask any questions.

                I'm more concerned that the nurse tried 5 times without getting assistance, and I'm squicked out at the idea that she might not have used a new cath every time she tried.

                Comment


                • #9
                  Quoth trailerparkmedic View Post
                  That's what happened with the first one I ever did. The patient gave me kind of a weird look when I opened the second package but didn't ask any questions.

                  I'm more concerned that the nurse tried 5 times without getting assistance, and I'm squicked out at the idea that she might not have used a new cath every time she tried.
                  Don't blame ya. If that's what happened, it's (pardon the pun) piss poor practice.
                  They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

                  Comment


                  • #10
                    The FIRST time they messed up with the IV is when I would have high-tailed it out of there & gone someplace else. What you went through is unacceptable. Someone's head or heads need to be on the chopping block for what you went through.

                    Comment


                    • #11
                      I think my brain just blue screened. That is some EPIC fail.

                      Although, sad to say, not all that surprising. The more time I spend working in hospitals, the less I ever want to be a patient at one. I tell all my friends locally I can recommend a good cardiologist if they ever need one. On the flip side, I can also tell you which ones I wouldn't want anywhere near me.
                      I am no longer of capable of the emotion you humans call “compassion”. Though I can feign it in exchange for an hourly wage. (Gravekeeper)

                      Comment


                      • #12
                        Quoth jedimaster91 View Post
                        I think my brain just blue screened. That is some EPIC fail.

                        Although, sad to say, not all that surprising. The more time I spend working in hospitals, the less I ever want to be a patient at one. I tell all my friends locally I can recommend a good cardiologist if they ever need one. On the flip side, I can also tell you which ones I wouldn't want anywhere near me.
                        My favorite hospital is Yale New Haven - they have an amazing staff there. I can recommend a parkinson's specialist, a cardiologist, and a gyn oncologist there.
                        Last edited by AccountingDrone; 05-03-2011, 05:38 PM. Reason: spelling...
                        EVE Online: 99% of the time you sit around waiting for something to happen, but that 1% of action is what hooks people like crack, you don't get interviewed by the BBC for a WoW raid.

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                        • #13
                          I have to say that you making it to 25 w/o ever needing an IV means that you are very lucky! I'm surprised you'd never had to give a urine sample before if you're on BC. Does your Gyno not require a sample at your exam each year?

                          Sorry you went through all the sticks and pokes. Remember that as a patient you have rights and if you are not comfortable with or confident in the skill of a nurse or doctor you can demand a new one, especially if they are unsuccesfully trying to insert something into your body (IV or cath). Also, if you don't understand what's going on, demand an explination. You can refuse for them to perform any test until they explain to you why they are doing it. If you are asked to do something that you are not clear on, speak up and ask questions. Yes, the staff at the hospital failed you, but you also failed yourself by not sticking up for yourself. Not all doctors and nurses have the best bedside manner and in the ER they're often so busy they get focused on getting tasks done and end up being very brusque. You have to advocate for yourself.

                          Anesthesiologists and Nurse Anesthetits are often able to get an IV in when others can't. If a couple of nurses have tried to stick you and weren't successful, you can request one of the above.

                          I can be a very hard stick, especially if I'm dehydrated. I've had several nurses each try and be unsuccessful (even with me giving them permission to try 3 or 4 times each, knowing how my veins are, I'm understanding about it) and them finally have to get the Anesthesiologist come down to IV me. I had over 2 dozen sticks all over both arms and up around my collar bone during one hospital stay for a partially blocked bowel. I was NPO the entire time and was extremely dehydrated, even with the saline drip. The first IV placement was really not well placed, was barely in, hurt and caused the IV machine alarm to go off unless I held my arm and hand just so and eventually clotted off. The 2nd one took over an hour to do and was when the Anesthesiologist had to come do it. They were very close to having to do a line in my groin. Soooo glad they didn't!

                          Maybe because I've dealt with being a hard stick my whole life, it doesn't really bother me. The thing that I hate the most is the automatic BP cuff. That mother fucker hurts! Unless I'm nicely drugged up post-surgery (ah, morpheine pump, how I love thee!), I won't let them use it on me. They can come in and do manual readings. The automatic cuff usually ends up always reading much higher than the manual anyway. I normally have really good BP, but put me on an automatic cuff when I'm not sedated and it will skyrocket.
                          Don't wanna; not gonna.

                          Comment


                          • #14
                            42, if I had known then what I know today, I would have left there much sooner than I did, or at least started making some demands. That was literally my first time in an ER. I was scared, I was in pain, and I had no one around to consult with. Believe me, I wish I had said something to them while I was there. But I didn't know.

                            None of my gynos have ever required a urine sample when I go in to get BC.

                            I'm pretty sure the nurse used the same catheter on me multiple times. I wasn't paying too close attention but I don't remember her opening a new package, at least.

                            Comment


                            • #15
                              I have to say... threads like this educate me. I'm not a demanding person, at all. I also have difficulty sticking up for myself or speaking up.
                              Now I know, thanks to this conversation. Thank you.
                              "Is it the lie that keeps you sane? Is this the lie that keeps you sane?What is it?Can it be?Ought it to exist?"
                              "...and may it be that I cleave to the ugly truth, rather than the beautiful lie..."

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