Last week, while on vacation, I had the opportunity to experience an example of healthcare up close and personal, as they say. Let me qualify what I am about to address by saying that this may have been an isolated incident. My fear is that it is not, and that is why I chose to write about it.
I should like to describe what happened, and then highlight where I think the system broke down.
While in Florida visiting a 90-year old family member, she managed to slip and fall the first night of our visit. She has difficulty walking and was using a walker at the time. The walker caught on something, and down she went! She complained of soreness but was able to get back up with assistance.
The next morning, she was no better, and she opted to be taken to the emergency department of a nearby hospital – by ambulance, as we were unable to move her. Upon arrival, she was placed in an emergency room bay and attached to vital sign monitors. At some point a nurse came in to take her history, draw blood, and insert additional lines. She was given a pain pill, after initially being told she could not have anything to eat or drink, as she might require surgery.
Eventually, she was taken to Radiology for an X-Ray of her hip, which came back negative, except for a possible fracture of her pelvis. The staff indicated that she would need an MRI, and they were waiting on the physician to order one. Eventually, they came to pick her up for a CT! OK, so they changed their mind and ordered a CT instead of an MRI. About one hour later, she returned. The technologist indicated she refused the CT exam! So much for informed patients who listen to the press regarding dosage issues with CT!
After another two hours, she was finally taken to MR for an exam, and then taken up to a patient ward, where she was kept overnight. All told, over seven hours in the ER!
We were met the next day by a case worker who was to assist us with her disposition. We quickly learned that in Florida (and as I have come to find out, is also true in many other states), as long as the patient is in control of their faculties, they make the final call on their course of action. We had felt the best thing for her would have been a continuous care facility, but when confronted, she indicated she wanted to go home – no surprise there! The case worker indicated that she would take care of making all the arrangements with the proper agencies, and she would be released later in the day. At some point we learned that she could not be released without these arrangements for in-home care.
Needles to say, when she arrived by ambulance back at her home at 5 PM, we were met by the care giver. When the care giver was asked if she was OK with getting up with her several times during the night, she replied “no, I need six to eight hours of sleep at night, and no one said I would have to get up.” She was summarily dismissed, and after another two hours of negotiation with the agency, we were able to secure someone who was willing and able to care for her 24/7. I am happy to report that she is doing better, but still confined to a wheel chair and unable to walk.
Now, for the issues with the process: