Nursing Notes

September 7, 2011

Disruptive behavior, negligence, endangered patients, and millions of dollars

Centers for Medicare and Medicaid Services (Me...

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Here’s an article from the Patient Safety Monitor that makes my skin crawl.  Patient safety and well-being are tantamount to nurses.  Have we, as nurses, given up the role of patient advocate?  This article cites several recent court decisions against medical facilities for failed patient safety observances.  Where were the nurses in this?

Staffing is always the core problem in these types of problems.  Hospitals expect nurses to do more and more and more without giving the proper staff to accomplish this goal.  As long as hospitals continue to get away with short-staffing, they will because they are a business.  The bottom line is profit, even in non-profit facilities.

Think about it like this:  is it less expensive to pay a fine every so often that does not amount to the cost of maintaining proper staff to patient ratios?  Why pay every day for more staff, at a cost that is very high, when you can pay much less in fines and then only if you get caught.

I know that I do not speak for the majority of the nursing profession.  I can only speak for myself, based on my own experiences in hospitals.  I love nursing.  I love being a nurse.  I don’t love the way hospitals staff.

Please read this article and leave me a comment, won’t you?  When you visit the site, look around because you will find many interesting articles about nursing and hospitals there.  Be sure to leave them a comment on this post while you are there.

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August had been filled with a number of different patient safety rulings and findings that show poor patient safety can be costly in many different ways.

Let’s start with Boston, where two old cases have been settled.

First, parents of a newborn who died at Beth Israel Deaconess Medical Center in Boston seven years ago were awarded $7 million by the Suffolk County Superior Court after a physician and nurse practitioner were found negligent in their care. The parents claimed they did not react quickly enough to the infant’s deteriorating condition. The premature infant developed necrotizing entercolitis, something caregivers should have been watching for as it is common in infants delivered prematurely.

The parents alleged they came to visit their daughter and found her discolored and unresponsive, and said staff took more than an hour to respond.

In another recent decision, the U.S. Court of Appeals upheld a lower court verdict against Brigham and Women’s Hospital involving alleged disruptive behavior exhibited by Arthur Day, MD, the former head of neurosurgery. Sagun Tuli, MD, claims the hospital retaliated against her for complaining about her work environment.

The court ruled that Tuli was defamed and that her career was affected.

Now, on to Dallas.

It was recently reported that in March, 2010, Parkland Medical Memorial Hospital in Dallas, TX, informed 73 female patients that instruments that were not properly sterilized had been used on them, putting them and any sexual partners at risk of infections.

Following that incident, the Centers for Medicare & Medicaid Services (CMS) investigated the hospital in July, 2011. The investigation led to the finding that the hospital created an “immediate and serious threat to patient health and safety.” The report found that ED patients in severe pain were given maps of the hospital to find the appropriate place for treatment and children sent home without screenings.

Meanwhile, in a separate investigation, Parkland Memorial Hospital, along with the University of Texas Southwestern Medical Center, agreed to pay $1.4 million after a four-year Medicare billing fraud investigation revealed that resident surgeons were not properly supervised and also failed to comply with informed consent requirements.

Another Dallas hospital, Methodist Dallas Medical Center, was also recently cited for 10 violations by CMS, some which include failing to screen and stabilize emergency department (ED) patients and understaffing the ED.

Do these more recent findings indicate that CMS is getting tougher? Would similar findings be found elsewhere, if investigated? Is this the sign of the times of healthcare reform? What do you think? Share thoughts below.

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3 Comments »

  1. Great website…

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    Trackback by textile reports — September 7, 2011 @ 3:35 pm | Reply

  2. How scary!

    I agree with you. I am a med aide and nurse aide in a long term care facility. Too many falls happen simply because there aren’t enough staff members.

    I love doing what I do, but I want to do everything well. If there is not enough staff, I am limited on what I can do. I am only one person.

    Comment by Sara — September 10, 2011 @ 1:17 pm | Reply

    • Sara–Thank you for taking the time to comment here. It is scary when you are all alone and your patients all need help. How do you prioritize what to do first when all of the patients could fall or be injured by your inabililty to help them? We all are only able to do one thing at a time to do it well. I think hospital administrators have forgotten that human limitation. Please feel free to comment again. I enjoy hearing others ideas and thoughts.
      Shirley

      Comment by Shirley — September 10, 2011 @ 3:58 pm | Reply


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