LAWRENCEVILLE, NJ – Phyllis Smith went into Cooper Hospital with migraines, a swollen liver, and stomach pains among other symptoms. She was there for a month from July to August 2010 and another two weeks at the end of August. During her stay, she went through many tests as the doctors tried to determine what was wrong.
Nicole Smith, her daughter, 22, arrived one morning to visit her mother and after visiting with her for two hours noticed that the urinary catheter bag and tube were full. These should be changed regularly as it is a health risk. The most common problem from an unchanged bag and a full tube is a urinary tract infection.
Smith, concerned for her mother’s health, particularly as she is studying to be a nurse, went to the nurse’s station to inform them that the bag needed changing and her mother needed more medicine. She explained that the tube was backed up completely and had been that way for some time. The nurses told her they would be there soon and she returned to her mother’s room.
Nicole returned to the desk several times reminding them that her mother needed to be seen. Someone finally arrived to change the bag and give her mother medicine nearly three hours after Nicole had brought it to their attention.
“I understand that nurses have a lot of work to do and patients to look after but something like that, which needs to be changed or it will create even more problems for someone who is sick, they need to take care of that. They still did not know what was wrong with my mom at that point. I didn’t want her to have any more problems. Especially since I told them, the nurses should have been there to change that almost immediately,” Nicole said.
A 1999 report, which was the last comprehensive study on medical negligence done in the United States done by the Institute of Medicine, found that at least 44,000 deaths and as many as 98,000 could be attributed to medical mistakes. A more recent study done by Dr. Christopher P. Landrigan focused on 10 North Carolina hospitals and it shows that there has been no improvement over six years.
“It is unlikely that other regions of the country have fared better,” Dr. Landrigan, an assistant professor at Harvard Medical School, said. The hospitals in North Carolina were selected because they have worked harder with programs to reduce mistakes and improve patient care. If these hospitals have not had any improvement, then other hospitals in the nation probably have not improved either.
The Cooper Hospital website declares they have a “commitment to Patient Family- Centered Care, we want to make sure your experience is as pleasant as possible. Your needs — medical, of course, but also emotional and spiritual — are our primary concern.”
This is a hospital that prides itself on giving care of all kinds to its patients. The doctors and staff “welcome [the family and friends] involvement” in the healing process, which brings the relatives into a role in the hospital as well. However, this situation that the Smith’s experienced contradicts everything the hospital policy states.
In non-federal short- stay hospitals there are 1,143.9 discharges per 10,000 in a population with an average hospital stay of 4.8 days, according to the Centers for Disease Control and Prevention. With this number of people being released from a hospital, many perhaps experienced similar problems in care that Phyllis did.
Phyllis was a nurse in the Cooper Hospital Emergency Room for six years before moving to the Labor and Delivery Center at Virtua Hospital in Voorhees, where she worked for five years. During her time as a nurse, Phyllis witnessed this kind of negligence from fellow nurses.
“The nurses would use the phones for personal calls and they would be sleeping during the night shift instead of helping their patients. I would go to my superiors but it never seemed to result in any change. Most often, I would check on those nurses’ patients myself,” Phyllis said.
There is a problem here with the ethics and sense of responsibility that the nurses have. “There needs to be more consequences for nurses who are caught not working. I am appalled and embarrassed as a nurse that this treatment is occurring in a hospital,” Phyllis said.
This negligence in the hospital system from nurses and other staff members, could lead to other hospital acquired infections. In Phyllis’ case she avoided any major complications. However, many others like her have picked up other infections.
Hospital acquired infections get the credit for killing 48,000 patients. They are also responsible for 2.3 million days for patients spent in hospitals in addition to the days spent for the reason they entered the hospital to begin with. This amount of time has the price tag of $8.1 billion.
Medicare recently stated, as reported by the Canadian Medical Association Journal, that they would no longer pay for eight preventable hospital mistakes. The includes infections from the use of urinary catheters, which was a potential problem Phyllis faced, or other problems like retrieving tools left in a patient after surgery. Insurance will not cover these costs.
These costs will now have to be covered by the hospital; regulations prevent the hospital from charging the patient. Many patients are going to need to have these costs covered by the hospitals.
The Department of Health and Human Services completed a study in 2008. It found that 1 in 7 of Medicare recipients experienced an “adverse event” during a hospital stay. An adverse event is the technical term used in official reports about medical care causing harm on a patient.
These adverse events are related to medication, patient care, surgery or other procedures, and infection, according to the study. These categories represent all the issues that have resulted from improper care. The most problems result from medication, which includes excessive bleeding, severe hypotension, and respiratory complications, among others.
This could serve as an even greater incentive for hospitals to enforce increased care for their patients and stricter punishments for those doctors or nurses who make the mistakes. Hospitals are not going to want to cover these bills.
This does not include the amount of court cases that result from improper care. According to the Bureau of Justice Statistics, in 2001, the most recent data available, in the 75 largest counties in the country, the total costs awarded to plaintiffs were $448,219,000. These costs were for medical malpractice.
Hospitals would face hefty bills for care to correct these adverse events or in payouts as a result of court cases. If hospitals lose money this way, that means there will be less money for paying employees and equipment, which could make it difficult for hospitals to help people.
Phyllis believes the best course of action to remove the prevalence of adverse events in hospitals is to remove the “incompetent nurses.” Nurses are expected to care for the patients all the time as doctors cannot always be with them.
However, as Nicole witnessed when her mother was sick, some nurses do not react when patients need attention. There are some excellent nurses caring for patients, but there are also nurses who sleep or talk on the phone as Phyllis saw firsthand during her time as a nurse.
The problem could be relative to the amount of people who are utilizing hospitals on a daily basis. There may not be enough nurses to deal with the patients or visit each patient often enough. In this case, hospitals need to alter the requirements for how many nurses should be staffed at a time so they may perform their tasks.
Hospitals are going to have to generate change in policy to prevent medical negligence. Many hospitals will no doubt be interested in making changes to prevent unnecessary loss of money through corrective surgeries and court cases.
After the study completed in 1999 by the Institute of Medicine, the hospitals responded with assurances of change. However, as recent studies show, hospitals have not done enough to fix this problem. Hopefully, hospitals will continue efforts to improve their staffs and prevent more adverse events from occurring.
Patients should be vigilant when in a hospital as well. In some cases, the patients will be entirely in the care of doctors and nurses and will need to trust that they do the right thing. However, in other cases, like Phyllis’, having an attentive family or being aware of your own needs and insisting nurses help could make the difference between getting an infection or not.