#patientsafety

[littleblood]

[loreleiloon]

It's the evening before the surgery. The doctor's in the prepping room, finishing up some necessary details before clocking out. The nurses are already running the closing reports. Some have left. Whumpee lies naked on the guerney, strapped down, a simple cloth wound tight over their mouth. Whumper can't help but smile when he notices. The nurses must have done that. Not to keep whumpee from screaming, though. But whumpee does so like to ask questions.

Whumper pulls out a sharpie. Quietly, methodically, he marks out the parts on Whumpee's body that need to be operated on. That flab on their stomach, elasticity in their neck, plumpness in their cheeks. Whumpee whimpers through their gag, trying to pull away. One of Whumper's lines gets smeared.

"Now, now, you don't want me to make the wrong incision, do you?" Whumper's tongue clicks as he swabs away the line with an alcoholic concoction.

Shaking their head, Whumpee tries to say something but the gag stops them.

"What?" Whumper asks, "You want to know what I'm changing?"

Whumpee nods, huffs smothered but fervent.

Whumper smiles, "Well, I guess we have time..."

[alyfoxxxen]

APA concerned about far-reaching consequences from Supreme Court decision regarding therapy as ‘free speech’

[internationalhealthnotes]

Turkish Doctors in Dubai

Dubai has become a leading international healthcare destination, bringing together medical professionals from many countries. Among them, Turkish doctors are increasingly preferred for their strong medical education, structured clinical approach, and adherence to European medical standards.

Turkish physicians are trained with a strong focus on diagnosis, patient safety, and personalized treatment planning. This background allows them to work effectively in multidisciplinary and hospital-grade environments.

In Dubai, healthcare centers such as DRFK Turkish International Day Surgery Center reflect this approach by combining Turkish medical expertise with international clinical standards and modern medical infrastructure.

As demand for high-quality and reliable healthcare continues to grow in Dubai, Turkish doctors remain a trusted choice for many patients seeking professional, ethical, and well-structured medical care.

[shuriiiii9]

[mariansmusings]

Is Possible to Trust Doctors Again After Medical Harm?

Shattered trust. It’s a term people use to describe a betrayal in a romantic or professional relationship. A cheating partner. A back stabbing co-worker or boss. Most of the time it’s deal breaker, resulting in a break-up or someone leaving a job.

 But what happens when that shattered trust involves medical harm?  Would you ever trust a doctor again if he/she had operated on the wrong knee or kidney? What if you had been misdiagnosed or were sexually assaulted by a doctor? Even worse, what if that harm was deliberate?

 That’s what I had to confront after my father was deliberately harmed, which resulted in his death. This was not just one rogue doctor, mind you, but a concerted effort by a number of doctors and nurses at two hospitals and a nursing home to keep me unaware of what they were doing to him. 

 By going through medical records after my father’s death, I learned that his primary care doctor had drugged him with Risperdal, Haldol, Ativan, Tylenol with Codeine and Morphine after admitting him to the hospital to determine the cause of back pain. (Risperdal and Haldol are antipsychotic drugs, which carry FDA black box warnings that they are not recommended for seniors because they can cause serious side effects and death.) All these drugs had been given without my knowledge or consent as power of attorney. My dad’s doctor and all the nurses denied he had been given anything to make him suddenly lose his mind. That, I was told, was due to hospital delirium, common in the elderly; it was recommended that he go a nursing home for rehabilitation for his back and his mind for a few weeks.

 At the nursing home, however, the medical director prescribed more Risperdal and Haldol, along with double doses of Ambien and Vicodin – again, without consent or apparent need. That doctor never spoke with me about his care, refusing to return my desperate calls as my father went into a death spiral due to the deadly side effects of the antipsychotics.  When he was rushed to the hospital after his 7th fall in 12 days, the doctor slipped in and falsified a “Do Not Resuscitate” consent form.  The physician who was called in to consult denied any drugs had caused his mental decline; he turned out to be on the board of the medical malpractice company that insured the nursing home doctor.

 My father was dead less than two months after going into the hospital.  Ironically, the cause of his back pain was spinal stenosis, which could have been treated with outpatient physical therapy and over the counter medication.

 This betrayal of care had a profound affect on my entire extended family. No one trusted doctors or nurses anymore. My children were afraid to go to the doctor, and looked up anything they were prescribed for side effects before any pills were taken. My sister-in-law kept her father at home in his final years, not trusting any hospital or nursing home to care for him. Because I became a patient safety advocate after my father’s death, friends would call me in a panic if a physician recommended a nursing home for a parent.

 So it was terrifying when we suddenly had to deal with doctors again when my husband was diagnosed with GIST cancer and sepsis last year.  Because it was a hemorrhagic tumor, the doctors wanted to act quickly, wanting to do perform surgery the next day. It was hard not to panic at the thought of trusting my husband’s life to a surgeon we had not personally chosen.

 What helped is that in the three months leading up to that diagnosis, my husband’s doctors actually talked to us.  This was so different than the invisible doctors who deliberately harmed my father.  This time around, Ed’s cardiologist listened to our concerns, and tried to answer our (my) unending questions as we were referred to a pulmonologist, hematologist, and gastroenterologist.

 Several factors helped this particular doctor/patient relationship.  First, I was not afraid to tell my father’s story, basically as a warning that I knew patient rights; more importantly, these new doctors were outraged that one of their own would treat a patient that way. Second, this new set of doctors was a good 15 years younger than those who treated my father. It made me wonder whether younger doctors are more in touch with treating the whole patient, and are not as willing to force the traditional “the doctor is always right” attitude. I felt that we were tracking down the cause of Ed’s symptoms together, because each step was explained along the way. Finally, by this time, I knew how to look up doctors on the Medical Board of California website to see if they had any disciplines, malpractice lawsuits, or criminal convictions – and to see where they went to medical school. I had downloaded the new doctor app on my phone so I could look up any new physician we met along the way within seconds. (I am also aware that complaints against doctors are not listed, and some documents have been taken down and not replaced.)

 When we were told which surgeon would operate on Ed, this new group of doctors seemed genuinely pleased, almost relieved, that a reputable person would be taking care of their patient. Having that endorsement by other physicians we knew helped allay our fears.

 Later, when Ed developed a sudden fever a few days after being released, I rushed him back to the hospital, concerned about sepsis – and worried that I would have to fight to convince doctors he needed treatment immediately. I knew that there was a small window to treat sepsis, and that medical professionals often misdiagnose or ignore symptoms until it is too late. I dropped Ed and my adult son off at the emergency room door, quickly parked the car, and literally ran into the hospital, fully expecting a fight to get Ed prompt treatment.  I was stunned and relieved to find that Ed had already been given an IV and a dose of antibiotics.  He was septic, and spent another five days in the hospital – but he received treatment within that critical window.

 This experience with Ed’s surgery has helped to ease my fear of doctors and medical harm somewhat. It was not perfect though. I did report a hospitalist who refused to wash her hands and use gloves during multiple visits, declaring it “silly.” (She felt hand sanitizer was enough to kill superbugs.) However, I have gained confidence in dealing with doctors.

 As an advocate, I now read all the accusations and disciplines that the Medical Board of California releases, so I am acutely aware that preventable errors and bad doctors happen more often than we would like. By being vigilant and questioning every step of treatment, I believe patients and their families can make a difference in the outcome of any procedure. I also believe that it is critical for a doctor to communicate with the patient to discuss and agree on the best course of treatment.

 So has my shattered trust in doctors been repaired? No. Not even close.

I will always look up every doctor and verify everything I have been told. I just know better how to deal with the trust issue  – and the doctors that will cross our path in the future.

[nicoleportiz-blog]

This picture is an example of a “WOW” also known as a workstation on wheels. These computers are new to my department and came with our electronic health record system change that we experienced almost two years ago. Prior to this change we did not have medication or patient scanning in our department. We simply printed out our medication order, went to the pyxis, obtained medications and used our paper order as our way of verifying the patient and medication safely. Changing over to the new electronic health record system EPIC was a big change for our department and staff members and these Wow’s didn’t help due to one main reason, the scanner was attached to the computer.  

I would have to go back to the identification stage of the design process as I was able to identify the problem within my first couple of hours of my shift when we were using this new system of scanning the patient and medication. The scanner is attached to the computer with a short straight cord. You must be close to the patient to be able to scan them and then the medication. The problem is that emergency department rooms are small, and patients are usually bed bound and may not be able to move their extremities to assist you in scanning their bracelet. There were and still are many times that my computer either comes rolling into my patients’ feet at the end of the stretcher, or into a visitor by accident due to me pulling the scanner closer to the patient. When we identified this problem to our management team, we asked why we didn’t have wireless scanners like the rest of the WOW’s in other units do. We were then given longer, spiraled cords due to the amount of cost it would be to change out all the scanners in our department. If our nurses were involved in the identification stage of the design process this could have been something that was foreseen, and we could have acted on this design prior to it being instituted into our department, saving the hospital time, and money. 

With the SCAMPERING method in mind I would use SUBSTITUTE toward a solution to this problem. I would substitute the scanners in our department to wireless scanners. We have an overabundance of computers and we can take the eight computers that are used by nurses daily for scanning and slowly start to change them over to wireless scanning. This would improve our employee satisfaction and may also improve our scanning percentage that at times suffers due to the amount of limited space and fast paced environment we work in. Some nurses chose to “click off” the medication versus scanning, or even scan the patient’s bedside labels due to the straight and spiral cords that do not allow the nurse to reach the patient. This poses a threat to our patient’s and patient safety that could be corrected by simply changing over to eight wireless scanners. The cost of the wireless scanners should never outweigh the cost of patient safety.

Currently the attached scanner is on the usability portion of the hierarchy of design. There is a major issue with the scanners function and usability due to the attached component. The attached scanners greatly affect day to day operations of the department as many nurses look for the computers that have a spiral cord as it may give them a bit more space. But we still have computers that have the straight cord. After scampering and substitution to wireless scanners, they would not only be functional, they would improve usability, proficiency and reliability from staff.

[ramblingsofanot]

Patient Endangering, AKA The Day I Lost My Sh**

As therapists, part of our role is to make safety recommendations based on our patients’ physical and cognitive abilities. Much of our documentation explains how much help a person needs to do various activities.

Thus when I make a recommendation like “patient requires one on one supervision at all times”, I expect that to be taken seriously. And when the rehab supervisor and the entire nursing staff also recommend this I simply expect it to be done. However I was severely disappointed.

I previously introduced Nancy to you, the patient I worked with who was in a catatonic excited state. This recommendation was made for her as she was a danger to herself and others around her.

And yet I would find her wandering aimlessly down the hall alone, or screaming in another patient’s room. Frustrated, I would return her to her room where a staff member was supposed to be watching over her and several other “one on one” patients. The staff member was often unaware that she had been missing as he thought she was with one or another therapy discipline and in his defense, he was extremely preoccupied supervising at least 3 other patients who needed just as mention attention as Nancy.

We managed as best as we could until one day I again found Nancy ambling down the hall. I was assisting another patient to walk back to her room when I saw with horror that Nancy was about to walk straight into another patient who sat helplessly in his wheelchair. Nancy, completely unaware of her surroundings, continued to plow forward even though her leg was caught about the wheel. She keeled forward.

Forced to abandon my other patient, I reached out for Nancy and caught hold of her before she fell and before she could latch her hands onto the patient in his chair.

Furious that no one was with her again, I instructed one of the nurses to assist my other patient back to her room while I returned Nancy to safety.

Scratching and pulling at me the entire way, I slowly led Nancy back to her room.

“Why was no one watching her?!” I cried to the nurse at the station.

The nurse was clearly just as fed up as me. “We were told that we couldn’t spare any staff to watch her! No one is going to be sitting with her anymore!”

“Are you serious? This is not ok! She’s not safe by herself!”

“I know that’s exactly what I said too but apparently that doesn’t matter!” the nurse lamented.

“Who decided this?” I fumed.

“The director of nursing.”

“Come on Nancy,” I said, “we’re going to go talk to her.”

I took Nancy all the way to the office with me, afraid to leave her alone again. With every step I took I grew more and more enraged.

By the time I reached the DON’s office, I had morphed into the hulk. Without a warning I barged straight in and began to shout questions at the DON. After the surprise passed, I could see on her face she knew I was right but was going to give me her rehearsed answer anyway.

“We cannot afford to have staff here only to be supervising patients.”

“But she is not safe without it!”

“We are not legally required to provide patients with one on one supervision at this facility.”

“Then she should never have been accepted here if we can’t provide the care she needs!”

Another visiting manager frowned at me. “Who the hell is this?”

The DON continued however. “Well we had open beds that need to be filled and she is here now so we can’t change that.”

At this point I was so far gone that tears had accompanied my rage and my hands shook. “Right! She is here! So while she is here she has to be safe!”

The other manager jumped in. “She has no record of any falls.”

“That’s because we keep preventing them! I just stopped her from falling in the hall!”

“We have no evidence to show us she isn’t safe,” the ignoramus persisted.

I could see I was getting no where. “Well come on Nancy! I guess I’ll leave you to start that fall record!”

The next day, someone was watching Nancy again.

I know I didn’t handle myself well in this situation. Shouting at people generally solves very little. However as I neared the end of my 3 month contract I had already used up every last shred of my patience. I was tired of the unacceptable excuses like this. I was fed up with the mistreatment and neglect that I saw every day. So while I behaved poorly, I ultimately do not regret it because I knew was right and the DON did too.