A Health Care Worker's Bedside Awakening
by Hernando Diosa/ La Voz Hispana | December 19, 2005 8:22 AM | Permalink | Comments (2)
Dominick Maldonado (in photo) makes his living working to improve other people's health care. During a recent hospital stay, he learned what it feels like to be the patient -- and how bad an experience that can be. He told his story to the Spanish-language newspaper La Voz Hispana, from which the following story was translated.
* * * *
Essentially, a hospital should be a place of recuperation, attention and care for people who come in search of better health. In our own minds, a hospitalization center should be like a “second home" for all patients who pass through in search of a cure for their afflictions and pains; therefore, the treatment that is supposed to be given to those who come there has to be of the highest quality. This is even more the case when these people are paying for being well attended to, especially when they are not able to take care of themselves. Unfortunately, different kinds of abuses on the part of the person assigned to attend and care for them are found within some of these facilities, as has happened to Mr. Dominic Maldonado, an upstanding member of our community who is know for his long-time work in the Department of Health in New Haven, where he is in charge of HIV programs.
His Story
Ten years ago he was diagnosed with arthritis in his left hip, and at that time the doctors decided not to treat it, as the disease was not considered to be very advanced.
However, last summer Dominic went for his usual annual check-up, and his surgeon noticed that his left leg appeared to be more tense than normal, so he advised him to have some X-rays done by an orthopedist so that the problem could be evaluated.
Upon examining the films, the medical professionals came to the conclusion that Mr. Maldonado had to have on operation on his left hip immediately, so a date for his recuperation in the rooms of Yale New Haven Hospital was fixed.
“I got to the admission room of this hospital at 10 a.m. on Thursday, Nov. 17, accompanied by some members of my family, which included my daughter, my son-in-law and my granddaughter. This was a positive experience, as the intake staff conducted themselves very professionally."
Later, Mr. Maldonado was confined on the third floor where they began the preparations to send him to the operating room, where later the anesthesiologist and his team would meet to explain the process with the sensitivity and camaraderie that comes from their surgical experience.
“The operation was completely successful, and when I woke up and they had already moved me to the recuperation room where I stayed for an hour and a half, and from then on everything was going well. Later, they took me to the seventh floor of Yale Hospital, where they take all the patients that have had hip or knee surgery, and there was where my problems began…."
As we listen to Mr. Maldonado’s account, we realize the anger that he feels about the hardships that happened to him in the assistance center, which is why he decided to come to our editorial office with the purpose of relating his bitter experiences.
“Everything began the following Saturday very early in the morning. I remember that my brother had brought me a little chicken soup the night before which I hadn’t eaten at that time because I didn’t have an appetite; for that reason I had left it for later. This was why at 1 in the morning on Saturday I had the desire to have two spoonfuls of this soup, but unfortunately I couldn’t find a way to heat it up, so it occurred to me to call the nurses’ station so that someone could come and help me go to the bathroom."
A nurse was sent to the room where she found Mr. Maldonado, who politely asked if she would please be so kind to heat up the soup in the microwave so he could have a bit of it.
What the heck! Bothered by what she considered a trick, the nurse answered him immediately that she had not been sent to warm up food, but rather to help him go to the bathroom. She therefore didn’t wait any longer and left, disgruntled, with the soup container in her hand.
“As she was leaving, I got a telephone call in which they began to berate me in a tone of voice as if I were a child or had committed some mistake or crime!" reported Mr. Maldonado.
“The person who was on the other end at the nurse station reproached me for the fact that I had called to go to the bathroom, when I really was looking for someone to heat up the soup. This made me feel very bad, but even so I got out of bed with all the pain I had and tried to get to the hallway and talk to her. As I made my way to where she was, the lady was coming with the soup ready and wanted to give it to me. I thanked her, but said I didn’t want it because I was annoyed, since being an adult person I didn’t expect to be treated and spoken to in that tone of voice…"
The nurse apologized to Dominic Maldonado, and she told him not to worry and that she wasn’t the one who had the problem, that it was the one who answered the telephone, whom he could not identify because of the distance between his room and the desk where she was.
Things Get Complicated
After this bad occurrence, Maldonado returned to his bed as best he could, putting aside the past conflict.
“Around 2 in the morning -â€" one hour after having had the trouble -â€" I noticed that there was blood in my bed, and so I asked for help from the nursing staff. One of them came, and seeing the blood splattered around me, decided to put dressing all along the wound and put it on my leg around where they operated, telling me that the surgeon would come to see it early in the morning."
Mr. Maldonado continued to tell us his story, that at 5 a.m. of that Saturday, after getting up to go to the bathroom, he tripped on the IV tubes and fell to the ground; thatâ€"upon seeing the new bloodâ€"the doctor that was present attending to another patient called the nurse station so that they could take care of him.
“The same nurse that had attended me before came and proceeded to put more surgical tape on me again where I had been operated. This time it was a lot more. When the surgeon came the next day, he asked me what had happened and I told him. He was very surprised to see the quantity of surgical tape that I had on my left leg. And when he started to remove it, I felt like someone was burning my hip. The pain was so intense that I groaned and he asked me to excuse him for the suffering that this was causing me, since the bandage was so strongly attached to my skin. I had to say that he was not at fault, but rather the nurse who had with her hand covered me with all that stupid stuff."
Things being as they were, Dominic Maldonado felt upset about everything that had happened there, and it appeared that he already had a bad impression; therefore he asked the doctor who was attending him to put him ahead on the list and send him to a medical rehabilitation center, which transpired on the afternoon of Sunday, Nov. 20, after his transfer to Temple Recovery Care Center went through.
His Sufferings Get Worse
“There an assistant received me, a Latina who was very nice when she gave me the orientation; so I felt more relaxed and happy because I thought I was in a good place. But it wasn’t," he continued telling our interviewer, recounting his new troubles.
“In this place, the problems began after being there 10 days when the pain in my hip was very strong and when I specifically asked for something to relieve my pain. Unfortunately, the nurses who were attending me didn’t give me the medicine on time, but instead many times after the time had passed, and nobody was attending me. They allege that they were administering the drug precisely, that because of the anesthesia I didn’t remember the time that they were giving me the medicine."
After noticing these kinds of careless errors, Mr. Maldonado decided on his own to keep a diary to take notes on the time that he received his pain medication. “So it was that after I got it another time, I waited patiently for the moment I was supposed to receive the next dose, and yet again they didn’t appear on time; so I decided to talk to my nurse on duty and ask her why it’s late. When I called, she gave me the same story, so I said excuse me, but that was not the case, since I had written down the time that they had last administered the medication and it was not as she had indicated."
After all this, Mr. Maldonado asserts that “it seems that the nurses began to talk to each other, labeling me as a difficult patient, and in this way they began to make my life at the center impossible.
“On one of these occasions I had a difficult confrontation with one of the nurses who came to see me to give me instructions using a loud, sarcastic and aggressive tone."
Seeing how things were becoming, Mr. Maldonado decided to complain to the shift director named Patt.
“She told me, ‘Mr. Maldonado, this is impossible because this nurse has never shown a lack of respect to anyone.’ So I told her, ‘Ms. Patt, this is the first time that she did it and unfortunately she did it to me.’"
After making the complaint to the nurse in charge, this same nurse decided to confront her assistant, who responded that she believed she had treated him sensitively, to whom our patient contradicted by saying, “Look, if this is your idea of sensitivity, I’m very sorry because you didn’t treat me in a nice way. You spoke to me as though I were a child and you were my mother."
After everything was said, the nurse apologized to the patient repeatedly, as though wanting to forget the matter. However, the matter didn’t end there.
“Afterwards the troubles continued. When the shift changed, that information was passed on from nurse to nurse, and they gave me the label of a problematic patient."
According to Dominic Maldonado, the lack of attention and bad times he experienced were numerous--so many that we can’t list them in only one edition.
In any case, here we submit part of what happened to Mr. Maldonado during his time at this hospital, hoping that it serves as an example so that other people expose the abuses that are committed in certain health facilities; most frequently at night when there is a lack of good supervision.
“The treatment that was given to me in the hospital, you don’t even give to a dog..." So concluded our informant.
Comments
Posted by: Selma | December 19, 2005 3:47 PM
Oh No.
Posted by: nfjanette
| December 20, 2005 12:37 PM
Most of the care givers at Yale are great people that do great work. They do difficult work, often with a smile. But not all of the employees are great - far from it. The scary part is that if only a small portion of care givers are uncaring (or worse), the longer a patient is exposed to the hospital setting the more statistically likely they are to come into contact with the bad workers.
I can personally confirm observing every type of complaint reported by Mr. Maldonado on numerous occasions over the past several years at Yale, where both my father and mother (of blessed memory) spent a significant amount of time. I found myself reading Mr. Maldonado's stories and thinking, "check, check, check", as he recounted the details. The report about being declared a problem patient and the following consequences is exactly correct; once you're on the nurse's sh-t list, it can be quite difficult to get responsive care. I caught nurses and patient care workers speaking obnoxiously to my father on several occasions; they didn't know I was waiting outside the room in the hall to visit. My father isn't the best patient, but no one deserves the bad attitude those workers were gleefully expressing.
Forget about complaining to supervisors about receiving poor care. They will protect the workers without fail in my experience, and deny any report of poor care. Assuming, of course, you can even get access to a supervisor. During one of my father's visits to Yale for surgery, the staff had neglected to see an important note on a medical record regarding infection until after the operation. The result was that they kept him for seven hours in the surgery recovery room because they didn't have a single-bed room for his admission. They refused him food, even soup, despite the fact that he hadn't eaten since midnight to prepare for the surgery, and had already passed the post-operative recovery time period. When I tried to get some intervention from a supervisor, I was told - with a smile, by the staff - that the supervisor was GONE FOR THE DAY.
Patients need to know their rights to timely, quality care. They also can benefit from have someone acting as an advocate on their half. Having spent so much time in the hospital acting as an advocate for my parents, I shudder to imagine the problems a patient would have without a family member or friend to request or, when necessary, demand better care. The demanding part can be tricky, and it's important to always stay cool, calm, and collected even when dealing with care givers that are failing to perform their jobs.
It should be noted that sometimes, especially at night, the shifts in some sections were understaffed by at least one worker. That can place a tough burden on the workers for that shift, especially if there are several patients that require a significant amount of care. And, while the nurses may like the four day a week 12-12-8-8 schedule because it gives three day "weekends", most people aren't at their best at the end of a twelve hour shift.
It's also true that there really are some terrible patients - I saw some of them, too. Sometimes, they are overly demanding selfish people that think they are in a luxury hotel. Sometimes patients have a medical condition that makes them call for help all of the time or badly interact with the care givers. However, no one is a patient at the hospital because everything is going well; patients are often anxious and frightened, sometimes in pain or discomfort, and generally not at their best. The workers should know that - that's what they're paid to understand and treat.
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