So is a moron with zero medical training telling post surgical patients to suck it up and go home.
Patients should be discharged based on a physician’s decision after examination of that patient. Should there be any difficulty (such as reaction to anesthesia), those should be taken into consideration. I’m not sure why that, to you, means a doctor has decided to bilk the system for another quick $1200.
No, it sounds like trained medical professionals are telling post surgical patients to suck it up and go home.
And, to you, this is a good thing? It isn’t a CNA’s place to decide if a patient is ok. By the same token, it isn’t a patient’s place either. I don’t know if you’re aware of it, but most people don’t really have good decision making capabilities right after they come out of anesthesia. But, hey, I’m sure you know way better than doctors, because after all, it’s your body. Right?
You’re right, that is what they’re doing. And that is a BAD thing, if you ask me.
The nursing care the OP received was pretty poor. However, it’s tough to evaluate this case without knowing:
a) What the procedure was.
b) What the intraoperative course was.
c) What the general medical condition of the patient was preop.
Just to clear up some misconceptions:
> But, neither of the 2 nurses was qualified to put anything in my I.V
Even if they were, they shouldn’t have. Morphine IV is a fairly powerful painkiller, but it has its drawbacks. Like any opiate, including the pills the nurses gave the OP, it commonly causes nausea. More seriously, it can drop your pressure and inhibit your breathing. If you give someone morphine, you should have both Narcan and a means to ventilate an unconscious patient within shouting distance. You can’t give someone IV morphine and then send them home. They might stop breathing in the car.
> Being given medication on an empty stomach that should not be taken on an empty stomach is not decent care.
It is preferable to give Tylenol 3 with food because otherwise it can cause nausea. It is not particularly dangerous, and I don’t think it was an unreasonable thing to do in this case. Now, they might have considered giving the OP an anti-nausea medication, but that has its plusses and minuses as well, and beyond the scope of this discussion.
> Know what they did? Apparently the doctor didn’t specify exactly where to shave, so the dumb-ass nurses shaved my leg from crotch to ankle.
The ports are inserted in small incisions around your knee. However, as you want to manipulate the joint and the limb during the procedure, you prep the whole leg. Similarly, you will often prep areas distant from the intended operative site in case you need to extend your incision, convert a laparoscopic case to open, have access to certain vessels, etc.
> Some health care practitioners will overshave because they enjoy doing it to people and they can get away with it. Not saying that this is what happened here, but it does happen.
I’ve never heard of this. You will generally overshave, however, as there’s little harm and having to reprep because you didn’t shave quite enough is a pain.
> They shaved your pubic area, without informing you of their intention to do so beforehand, while you were under anaesthesia? I would be much more upset about that than you seem to be.
Eh? Why? But I’ve come across this a couple times. I’m amazed that people are squeamish about the shaving of groins when faced with, say, death from massive MI. Trust me, they’ve seen it all before.
>I was in for knee surgery a few years ago. When they wheeled me out, I was doped out of mind, my leg killed, I was white as a ghost, the wound was still bleeding and oozing pus
No it wasn’t. Fluid, sure, but pus? Pus oozing from a wound after knee surgery is a surgical catastrophe and requires an emergent trip to the OR if you are to salvage the joint. Serous fluid is not unusual, and is not a reason to keep someone in the hospital.
> He/she should have transfered you to the hospital for overnight, rather than risk a complication from not being properly recovered.
> And I echo what picunurse said. You should have been transferred to an overnight facility for observation.
What complications are you worried about? Seriously. As I said, we don’t know what procedure the OP had, so it’s difficult to say, but what, precisely, are you concerned about? When you write your admisison orders, what do you put under admitting diagnosis? Nausea and/or pain are the norm post-op and really aren’t indications for an admission, not by themselves.
In general, I would much prefer to recover from surgery in my own home than a hospital bed. Especially given the expence. None of which excuses poor manners, but I’m not sure I can fault the medical decisions the OP described.
Not all trained medical professionals are created equal, you know. In fact, not only do they have different specialties, responsibilities, and types of training, but some are more competent than others! Blindly trusting anyone associated with medicine is just about as dumb as blindly distrusting them.
Personally, I’ll reserve judgement until a physician I trust lets us know what the acceptable standard of care is in this sort of situation. And Qadgop is busy today.
(Incidentally, I wonder how many Doper patients he’d have by now if you could get him WITHOUT going to prison)
I’m thinking at least a couple of more hours of observation were in order here, what with her problems with the anesthesia. The last time I was under, waking up and all was fairly brutal, without the added fun of being out for two extra hours for whatever reason.
What voice is that?
Regards,
Shodan
The schedule at the hospital should never become a problem for the patient. It’s obvious that in this case it did.
Trunk, being forced to walk up and down stairs after knee surgery is painful as hell but it’s still part of the recovery plan and you are still under the hospital’s supervision. Being released from direct supervision because the shift is up is a different matter. In that case, the tail is wagging the dog. The patient must always come first – especially before the nurse’s convenience and before insurance rates. First, do no harm.
I have never received treatment like that for any of my surgeries (and New Brunswick is hardly known for it’s heathcare). Anyway…
If you do need surgery in the future, absolutely tell the surgeon (and the nurses) that you anaesthic causes you to vomit. They will give you pre-emptive medication that will make the recovery process far less unpleasant. I know the agony that is puking your guts up while trying not to injure your incision. Nastiness.
I would just like to add that (unfortunately) nursing is becoming more and more about profit and the almighty dollar. There are numerous instances where nursing
personnel are threatened about working overtime. If the nurses ran the surgical center, I truly believe that nothing like the OP would occur. But doctors and insurance companies are dictating the rules now, and no matter how much we nurses complain and document about unsafe practice (are you reading this, Gov. Ah-nold?), in the end the policies are set by someone else, usually an individual with little or no medical acumen.
The breathing treatment was perfectly called for. And each doctor has a certain way that he likes his patients to be prepped/shaved. Maybe asking a few questions first could safe the patient some misery in the long run.
And what are your fucking medical credentials?
aux203 seems to know what they’re talking about and I’d assume either that this person was a nursing student, LPN, or RN.
I was a CNA, phelebotomist, and was training at one time to be an EMT.
I’d mostly agree with aux’s assessment.
On the other hand, you Trunk, are being a massive ass who is throwing around generalities and wailing with an imperiousness that borders on Monty Python levels of ludicrousness.
You yell louder and louder each time you’re contradicted. Are you secretly the love child of Rush Limbaugh and Rick Stantorum?
You man not have one.
No, this was in Alberta, where good healthcare is as common as rats. But hey, how about that balanced budget and debt re-payment?
(Great Freudian slip, Waverly.)
The time it took for her to A. breathe adequately with out assistance is the first criteria to go from surgical recovery to day surgery. In most day surgery units the criteria for being discharged is: 1. Can the stay awake enough to walk or at least sit in a wheel chair and transfer? 2. Can they take fluids without choking or throwing up? 3. can they sit up well enough to be left alone for short periods of time? (like going to the bathroom)
4. Have they peed?
She could not pass the first, the second wasn’t tested, the third was tested in a careless manner and she got a low score( in my world, a failure). the forth barely.
I would still blame the surgeon. He, by law, can’t leave the hospital until she was out of recovery. So he knew she was late, and probably wouldn’t be ready by closing.
The nurses assistants probably didn’t have the athority to just stay over, but I’m sure there was someone, a supervisor who could make that sort of decision. The fact remains, the doc knew, and left it to be someone else’s problem.
If you went to the hospital here in town, hq, drop me a note, I’ve got a friend who knows a couple of the administrators who’d probably be interested in hearing about what happened to you.
And Trunk, while I haven’t seen any studies, I’d be willing to bet that doctors who didn’t treat their patients like cattle have fewer malpractice suits against them than doctors who do, simply because if you’re well treated by your doc, if something goes wrong, you’re going to be less likely to think about suing the doc.
I know I had a broken tooth once, and had to go see a dentist about it. That dentist didn’t bother to numb me up before he started poking around to examine the tooth. When I complained about being in pain, he snapped at me and told me that it couldn’t hurt me. Needless to say, I never went back to that dentist again and had their been any complications, I would have sued his ass off.
I don’t expect any doctor to treat me like I’m their only patient, but I do expect them to treat me with respect. A doctor who fails to do that when I’m in pain, or groggy from medication, certainly won’t be getting my business in the future, and if they’re obstinate while I’m groggy or hurting, they might wind up needing a doctor themselves.
picunurse, in her last post, nails it pretty well.
By the description of the OP, it was substandard medical care. It may be common medical care these mercenary days, but it is still substandard. Just because lots of places are doing it and think they’re getting away with it doesn’t make it appropriate.
The places that do this are skating on thin ice, and eventually they’ll have a significant problem because of it, lots of nasty publicity and lawsuits will follow, and then change will come. For a bit, until everyone gets complacent.
Being 99% sure that things will work out all right with lower standards just doesn’t cut it in medicine. Because with that degree of certainty, One in a hundred cases will have significant problems, which were due not to the surgery, but to the lack of care! And in a busy center, one in a hundred is a lot!
Proper medical care takes time, it takes appropriately qualified personnel, and as a result, it takes money.
Everything you say is absolutely right and true, Qadgop, but the quality of healthcare that I’m familiar with here in Alberta is bad and rapidly getting worse, and it sounds like that is true all over. I don’t know what the solution to this is - healthcare as a business just doesn’t seem to work, because patient care and saving money seem to be antithetic.
This is so true.
Market forces just do not function in a way that I find acceptable when it comes to healthcare. The idea of letting the consumer decide based on price and outcome presupposes consumers who are savvy enough to understand the key factors involved, and have access to accurate information.
Besides, generating substandard outcomes in enough volume to drive the market away from a particular medical product damages a lot of people in the process.
And in any for-profit system, someone finds a way to generate a revenue stream by doing lots of unnecessary procedures, or at least poorly justifiable procedures.
But that’s a topic for a whole 'nuther thread.
To add a little perspective, albiet cynical, One hears “…and things won’t get better until somebody dies.” That, however isn’t cynical enough.
Things won’t get better until somebody dies and news of it leaks enough for the facility to get bad press, lose patients and therefore money.