Posted on 05/20/2007 10:52:28 AM PDT by John Jorsett
In the emergency room at Martin Luther King Jr.-Harbor Hospital, Edith Isabel Rodriguez was seen as a complainer.
"Thanks a lot, officers," an emergency room nurse told Los Angeles County police who brought in Rodriguez early May 9 after finding her in front of the Willowbrook hospital yelling for help. "This is her third time here."
The 43-year-old mother of three had been released from the emergency room hours earlier, her third visit in three days for abdominal pain. She'd been given prescription medication and a doctor's appointment.
Turning to Rodriguez, the nurse said, "You have already been seen, and there is nothing we can do," according to a report by the county office of public safety, which provides security at the hospital.
Parked in the emergency room lobby in a wheelchair after police left, she fell to the floor. She lay on the linoleum, writhing in pain, for 45 minutes, as staffers worked at their desks and numerous patients looked on.
Aside from one patient who briefly checked on her condition, no one helped her. A janitor cleaned the floor around her as if she were a piece of furniture. A closed-circuit camera captured everyone's apparent indifference.
Arriving to find Rodriguez on the floor, her boyfriend unsuccessfully tried to enlist help from the medical staff and county police — even a 911 dispatcher, who balked at sending rescuers to a hospital.
Alerted to the "disturbance" in the lobby, police stepped in — by running Rodriguez's record. They found an outstanding warrant and prepared to take her to jail. She died before she could be put into a squad car.
(Excerpt) Read more at latimes.com ...
All excellent points.
sometimes what can be seen as “crying wolf” is actually a case of doctors not finding the problem to begin with.
If they don’t treat the right problem - the patient is going to continue to return, and she is going to be more obnoxious each time she returns because she is in more pain and she’s pi**ed off.
It sounds like the nurse thought she’d gotten rid of this woman and simply wanted her to go away no matter what her problem was.
“I’ve gritted my teeth through it many times, but also blessed that rule a time or two - kept me from dismissing someone with a serious problem that took some digging to find.”
God Bless you.
Having GI problems myself, I’ve discussed on medical forums people with worse GI problems failing to get good diagnoses when they had to go to the ER (some sudden-hit 1st-timers, some after suffering problems for years).
GI problems are VERY hard to pinpoint, even through normal procedures with a GE specialist, and apparently, many people are dismissed as some simple problem or told it’s all in their heads. I partly don’t blame the doctors/nurses, exactly because it IS hard to deal with, but OTOH, they should KNOW it’s very hard to pinpoint GI problems. Many, many people are misdiagnosed by specialists, much less it happening in an ER.
The hospital was created by the public sector after the Watts riots in 1965 and opened in 1968. Because the private sector wasn't interested in the gang- and welfare-ridden neighborhood, the hospital has been operated ... mismanaged ... by the Los Angeles County Department of Health Services since its outset.
It is such a disaster the LATimes won a Pulitzer at the expense of the poor people who had to go there for health care. Over the years, it has digressed from a 233-bed facility with a tip-top trauma center and a conjoined medical school to a 48-bed hospital with no trauma center or medical school. In just the last two and a half years, 260 hospital staffers, including 41 doctors, had been fired or had resigned as a result of disciplinary proceedings. The trauma facility lost its certification and was closed.
Financially, it's just as much a mess. One consulting firm was paid $1 million to straighten out problems with the nursing staff. From the story above, you can see it wasn't $1 million well spent. Another consulting firm was paid $17 million to operate the facility for $18 months.
And the whole thing has sunk into a swamp of litigation ... with Ms. Rodriguez's family to join that club soon.
http://en.wikipedia.org/wiki/Martin_Luther_King_Jr.-Harbor_Hospital
County investigates a death at King-Harbor (part 2)
Los Angeles Times ^ | May 15, 2007 | By Charles Ornstein, Times Staff Writer
http://www.freerepublic.com/focus/f-news/1837134/posts
My brother does autobody work on custom cars. He dresses shabby for work (it's messy work!) and usually looks like heck when he's done. His appendix bust and within 24 hours, he was sick as a dog. His wife worked an hour away, so my parents picked him up from work and took him to the hospital.
After triage, they brought him back. Sometime later, my father inquired how J. was doing. Mom had an awful feeling something was wrong, and wanted to wait with J. The nurse didn't have an update, so she let my parents go back.
J. had been laying on a gurney in the hallway and threw up on himself. He got up to clean himself off and passed out in his vomit. A cop was kicking him, calling him a drunk, and telling him to get up.
My father exploded. He tore up one side of this guy and down the other, hauled J. off the floor and carried him out of the hospital (no mean feat, both J. and my father are big men). Took him to another hospital and got him treated immediately - Mom was on a rampage now and wasn't going to let anybody neglect her baby (her married, gainfully employed, 22 year old baby!).
Years later, my husband brought me to the same hospital - I thought I had a ruptured cycst. Turns out, I had Shingles with a whopping 104 temp. They didn't even feed me for two days, gave me no medication for the rash (thanks for nothing!) and tried to charge me $600 for a test they never performed. My Mom brought me food and gave me medication she got from our family practitioner.
Based on my personal experience, Nassau County Medical Center on Long Island SUCKS!
Conversely, Baylor Medical Center was OUTSTANDING! Went there several times, particularly for the birth of my babies, and was treated like a Queen every time. They did a fantastic job with my daughter, and her stay in the NICU. Very compassionate, very professional, wonderful staff! Can't say enough about how good they are :)
One thing I have learned over the years is to be your own advocate; don't let the triage nurse or doctor ignore your medical history. Our family has a history of low blood pressure. Throughout most of my life, my BP was 60/40, HR steady 55 PM. I can't tell you how many times I've been met with disbelief, or accused of lying, when I stress this. I lash back that I have lived in my body all my life, I know my medical history a hell of a lot better than they do, and they had better write that down because they could be ignoring something or kill me if they misdiagnose me. I had preclampsia and a 30% abruption in my 32nd week, my BP was only 120/77.
Second, avoid going to the hospital alone. Take someone with you who knows your medical history, your wishes, and can advocate for you. Bring a group of folks, if you have to. They are less likely to ignore you if you have a contingent of folks hanging around, watching out for your care.
I took someone to an emergency room several years ago. There was a woman there moaning and groaning. Later a young woman came screaming about stomach pain. After a while I asked why they weren’t being treated. The nurses told me that they came in all of the time with fake pains hoping to get free drugs/dope. If one of these people came in with a real pain I’m sure they would have to wait because of their previous behavior.
I think just about all emergency rooms of any size have these actors. It’s sometimes a very hard call—and, of course, mistakes are made. However, if you are processing and seeing upwards of 100 patients per hr as many large ER’s are, these “actors” can be very trying.
Very true. I had a similar story with appedicitis when I was in college.
I was ignored by the triage nurse even though there were no other patients in the waiting room and even though I was lying on the floor in pain. Finally, my housemate barged through the curtains, found the one doctor on duty and assertively told him "This girl has appedicitis" and demanded he see me.
The surgeon who performed the emergency appedectomy told me my appendix had ruptured. My friend may have asved my life that night. I think the triage nurse may have thought I was pretending to be sick, although I had never been there before, I did have insurance, and I was a student at the university the hospital was affiliated with. She didn't even take my temperature (which would have indicated an infection) or any other vital sign.
Actually my gallstones got stuck in the common duct, causing huge pressure to back up in both my gall bladder and liver, and nearly rupturing my liver. On two occasions prior to this, with the same sort of pain, I was sent home from emergency rooms with no particular diagnosis and told to take Tylenol. On one of these occasions, when I was 13 years old, the doctors sprung me from the ER bed and deposited me in the waiting room, even though my mother had gone down the hall to get a snack. She came back to find me passed out on the floor (from low blood sugar — hadn’t eaten since the night before, had been vomiting and under extreme stress from the pain, and they had given me IV fluids but not IV dextrose when they were “treating” me). Yep, nubile adolescent girl stuck out in a crowded waiting room unaccompanied, to pass out suurounded by all sorts of strangers, one of whom could easily have pretended to be my parent and carted me out of there.
My point is not that this woman should have been left lying on the floor writhing in pain without so much as a painkiller, but that we have allowed our emergency rooms and hospitals to be strained to the breaking point by people who are clearly abusing the facilities and who aren’t making the slightest effort to avoid getting themselves in serious health trouble (if in fact they are — many are simply there faking symptoms to try to get free narcotics). The result is that many people who really do need help (like this woman) get lost in the crowd of fakers and self-destructors. The janitor casually mopping the floor around her as she writhed is a sign of the tremendous extent to which fakers and habitual self-destructors are routinely clogging this emergency room. He no doubt mops around people on the floor every day, and they rarely turn out to be people who really should have been rushed into the back, interrupting the treatment of other patients.
As I said in a subsequent post, there’s no excuse for people who are in severe pain not to get an effective painkiller, and morphine or Demerol will do the trick even in the most extreme cases. The reason this is not happening in all cases, is because the fakers and other undeserving patients are being allowed to crowd up the facilities and get staff accustomed to the fact that a lot of the people in their facility who appear to be writhing in pain and screaming for help are really not in pain and the only help they need is a swift kick in the behind (which the staff are prohibited from delivering, either literally or figuratively). THOSE people should be arrested, charged, tried, and if found to have been definitely faking, or to have refused to comply with prior treatment instructions for substance abuse, denied care in the future other than a morphine drip for a condition that’s terminal and not going to be treated. Repeat drug overdose cases and drunk driving injuries should be designated to go to the back of the line for treatment, so that people with real and non-self-inflicted ailments get proper care. A policy like that would free up hospital staff and resources to enable accurate identification and proper treatment of patients who really do need help.
The fakers and self-destructors are what killed this woman, and they shouldn’t be allowed to continue doing that. She was clearly no angel herself (had a warrant out for her arrest on a parole violation), but she was really critically ill and as far as we know had no history of abusing emergency room services or of having self-inflicted her immediate condition. She should not have been at the back of the line for treatment, but until we’re willing to crack down hard on emergency room and hospital abuse, things like this will keep happening, despite huge amounts of public money being poured into the hospitals.
Too bad there aren’t more physicians who see it this way. The insane state of affairs in our medical system could never have reached this point without the active and tacit support of a solid majority of practicing physicians.
This should have no barring on her situation because she was not an angel or warrants on her.
She was there for medical attention and this thing that the officer did was pure prejudice I hope her family sues the hell out the hospital and the officer!
You see this officer could have check on her after she was attended too, how hateful to block this emergency!
You don't know that. This woman may well have had a history of abusing the ER, especially given that we know she had a criminal conviction for something (quite likely drugs, since she doesn't really look like a gangbanger), and a parole violation on top of that. Local ER staff and police are often very familiar with many of the people who make a habit of doing this, and taking such background in account when assessing the likelihood that this time it's real, is not "pure prejudice", it's using the available information about that specific individual and his/her past actions. Maybe you should go volunteer in that hospital's emergency room for a while. They could sure use the help, and I think it would open your eyes a lot.
Do you understand?
I just went through the same illness. My blood enzyme level was over 8000. I had to wait in the hospital for 3 days before the level was low enough for the operation.
I had seen my doctor about 2 hours before I went to the emergency room. I saw my doctor a week after the surgery and he asked he why I didn’t tell him I was in so much pain when he pressed on my stomach. I told him, “I wasn’t in that much pain when I saw him. I had a lot of pain when I scheduled the appointment that morning and when I went to the emergency room about 2 hours later.
My son’s numbers were about the same, and he did tell them that he was in terrible pain and that he had been in terrible pain every time they told him it was just food poisoning. My son thought that Phoenix had the filthiest Mexican restaurants in the country because every time he went to one, he ended up in the emergency ward with “food poisoning”.
The patient went to the ER three times for the same complaints, even HAD A RX for pain meds. So a doctor at some point did see her....
The news report doesn’t state that the Triage nurse didn’t tell the docs that the patient had returned so that is a question I would like to see raised. I would like to know what sort of pain meds were ordered for ABDOMENAL PAIN. What tests were run previously we don’t know.
I’m sick and tired of hospitals ready to dump on the poor nurses in these situations when obviously something is wrong with the whole diagnostic and treatment apparati in a lot of these institutions. Nurses can only take their cues from their superiors, ie the doc, supervisors and hospital administrators. While nurses are afforded a lot of autonomy, that autonomy of action is colored by the socio/bureau-cratic enviroments they have to practise in. The tendency of nurses to become a bit “tin-eared” is proportionately due to difficult to deal with hospital enviroment and ancillary services.
On call MD specialties such as surgeons can be extremely rude and hard to get a hold of, to the point that I have seen 30 year veteran nurses hesitate to call, thinking that patient X just is a drug seeker or is looking to get off the streets for a few days. So where are you docs? And why be nasty to us over the phones?...Hospitals are not 9-5 operations! What was going on that the triage nurse did not immediatley get the docs involved...was she cruel and burned out? Were the docs involved with trauma cases and couldn’t get to the patient?
When a fish first rots, it first stinks from the head.(an old yiddish saying)
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