You may have heard horror stories about mistakes that happen in hospitals. You may even have experienced them.
And you may be familiar with the statistics:
- Up to 440,000 patients who go to a U.S. hospital each year for care suffer some type of preventable harm that contributes to their death, according to a Journal of Patient Safety report in 2013.
- That makes medical errors the third-leading cause of death in this country, following heart disease and cancer.
The actual number could be much higher because the tool used to measure errors doesn't account for things like treatment that should have been provided or diagnostic errors.
As shocking as these numbers are, they also don't include less serious errors, which don't lead to death.
Anyone who has ever spent time in a hospital has probably witnessed these types or errors, as I did while staying with my sister, Marie, during her recent hospital confinement.
I won't name the Tennessee hospital where my sister underwent emergency surgery for a blocked colon, because the kinds of things that happened there are likely typical of small community hospitals everywhere. And, based on a quick scan of the scores given to hospitals by hospitalsafetyscore.org, mistakes occur in both large and small facilities alike. (For the record, the hospital where my sister stayed received a "C" from the website; one would hope for better, but in emergencies, you don't always have a choice.)
What can you do?
In cases where you or a loved one must be hospitalized, one of the most important things you can do is have someone stay as an advocate and caregiver for the patient. This is especially true for those who are too young or old or disabled to speak for themselves. But, it's helpful for everyone, even someone like my sister, who is a veteran of hospital stays and isn't afraid to ask for the care she wants or needs.
In my sister's case, her daughter arrived soon after her emergency surgery. Three weeks later, she is still by her side, helping her navigate through recovery, wound care, ostomy management, physical therapy and preparation for chemotherapy and ongoing cancer treatments. I and other relatives also were there for the first 10 days, alternating spending nights in the hospital chair by her bed.
Here are some of the problems we encountered:
Thankfully, Marie knew what medications she was supposed to be taking and on what schedule, because several times the nurses brought her meds she wasn't supposed to get.
Meal tray mix-ups
After Marie's release from ICU, her surgeon ordered a clear liquid diet for the first couple of days and then a soft foods diet. Her first five meal trays were completely wrong, filled with things she wasn't supposed to eat. Since when did Salisbury steak and grilled chicken breast become "soft foods"? Once she was on a normal diet, her meal choices, which she selected to be easy on her stomach, were often ignored. Fortunately, family and friends helped get replacements for the inedible meals.
Slow nursing response
Because of her ileostomy and her large abdominal incision, my sister needed a bedpan for several days after surgery—and she needed it frequently and urgently. When she buzzed for assistance to get on the bedpan, the nurses often didn't show up. Her daughter or I had to assist. One particularly busy night, the nursing assistant didn't appear for nearly four hours. (The harried nursing assistant on duty that night told us that the other assistant who was supposed to work with her on the 7 p.m. shift had quit at 6 p.m.—and there weren't a lot of replacements available on Super Bowl Sunday.) We became so accustomed to helping that we stopped buzzing and just tended the bedpan ourselves.
The worst event happened one morning when my sister's ileostomy bag came unsealed and started leaking. She buzzed for help. After a 10-minute wait, I went looking for a nurse. It took 20 minutes before someone came, by which time my sister and her bed were a huge mess, and she was in tears, fearing that if the fecal matter contaminated her abdominal wound, it could cause potentially fatal sepsis. This leads to the next problem …
Inadequately trained staff
The nurse who came apparently didn't know how to clean and repack my sister's wound, so she enlisted another nurse's assistance. They did the best they could, but we could see that they had not cleaned the area thoroughly or packed the wound tightly, despite the agonizing two hours that they worked on my sister. When the hospital's one wound care nurse arrived later that morning, my niece asked her to please check the wound packing. She found fecal matter still under the wound bandaging and had to re-clean and repack the wound.
Anyone who's ever been in a hospital likely recalls experiences like these: Surgeon instructions to the patient aren't clear and she's not up to asking questions. Doctors fail to enter orders into the electronic records in a timely manner. Nurses don't give meds on schedule, causing unnecessary pain. One shift doesn't tell the next shift what is going on. A doctor wants to release a patient, but no rehabilitation facility is available. The list goes on … and it happens everywhere.
The staff members at this hospital were generally friendly and helpful and likely doing the best they could, given the levels of staffing and training. But, I'm extremely grateful that my niece could be my sister's number one advocate and protector, and that I and others could help when needed. Marie's personal physician visited her in the hospital nearly every day and served as one of her biggest advocates and a go-between with the hospital staff.
My sister also is fortunate to have many, many friends. They called, sent cards, visited, brought food, ran errands and sent flowers—so many flowers that her room looked like a floral shop. Marie received the best care possible, thanks in part to her family and friends.