Articles Posted in Staffing Issues

Surveillance footage from a hospital shows a woman falling from a chair, writhing on the floor, and, finally, dying, as workers fail to react for over an hour. Esmin Green, 49, waited in the emergency room for almost 24 hours until she fell face down on the floor from the chair she was sitting in. She fell at 5:32 a.m., by 6:35 a.m., when a medical staff member who was flagged down by another person in the waiting room nudged Green’s body with her foot, she was dead. Until that staffer was summoned, Green hardly drew any attention. Patients sitting nearby did not react at all, security guards and a hospital staff member seemed to have noticed her body a minimum of three times, but, from the video, it does not appear that any of them attempted to aid her. In fact, one security guard could not even be bothered to leave his chair, instead, he rolled it around the corner, stared at her body, then rolled it back. Green had been involuntarily committed the day before the incident and was still waiting for a bed when she fell; her body stopped moving approximately half an hour after she fell. Reportedly six people have been fired because of the incident, amongst those let go are security personnel and staff members.

This is not the first issue with the hospital’s mental health unit, which was sued last year by the state’s Mental Hygiene Legal Service and Civil Liberties Union, who called the unit “a chamber of filth, decay, indifference and danger.” The lawsuit further states that patients who complained too much were occasionally handcuffed, beaten, or injected with psychotropic drugs. The parties in that suit went before a judge on Tuesday where the hospital agreed to institute reforms, including checking on patients in the waiting room every 15 minutes. Additionally, the hospital will make attempts to shorten the average waiting time to 10 hours within the next four months.

Adding to the shocking situation is the fact that Green’s medical records appear to have been altered or falsely filled out in an attempt to cover up the incident. For example, there is a note for 6 a.m. that claims she was “awake, up and about” and another 20 minutes later claiming she was sitting in the waiting room and that her blood pressure was normal, in actuality, Green was either dead or writhing on the floor during those times.

One of the greatest organizational problems facing hospitals today is the battle over medical records. Many patients find that it can take months or years to get a hold of their own medical records after treatment. Even worse, some families of victims of medical malpractice or wrongful death have waited for years to obtain their loved one’s medical records from hospitals. Often, lost or missing records are simply part of hospital error and not a deliberate attempt to delay, but on some occasions hospitals may frustrate a patient’s records request purposefully. Patients and victims’ families must be aware that statutes of limitation often require that medical malpractice lawsuits be filed within a certain period of time after the injury occurs or is discovered. This means that patients and victims’ families must decide to file a medical malpractice lawsuit and contact their medical malpractice attorney as soon as possible and begin the medical records request process.

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By 2030, one of every five Americans will be over the age of 65 and nearly half of all medical care spending will go to seniors. However, the US health care market is not positioned to meet the needs of this ever expanding group. The consequences of an understaffed and under-trained geriatric health care workforce could mean a sharp increase in the number of medical malpractice lawsuits and medical injury lawsuits in the future. A recent article highlights the shortcomings of the geriatric health care system, noting that doctors who serve senior patients make less than their internist counterparts and that geriatric specialists have decreased in number by nearly 25%. To meet the new demand for geriatric health services, the US needs to add 3.5 million people to the geriatric health care workforce in the next twenty years. Without necessary staff and salary increases, seniors could face tough choices in selecting a quality health care provider and avoiding injury in the doctor’s office.

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CNN recently highlighted the danger that addicted doctors are still treating patients. One patient says she had to forgo cancer treatment because of a botched surgery by a doctor who was in treatment for alcoholism and had been convicted for driving under the influence of alcohol. She had to forgo cancer treatment while battling complications from the medical malpractice. Now she is dying of cancer. She sued the doctor in a medical malpractice lawsuit. While he did not admit fault, he settled with her for $250,000.

A study by the Federation of State Physician Health Programs found about one percent of all physicians practicing in the U.S. are in confidential treatment. That’s about 8,000 doctors whose patients may have no idea that they are addicts. This brings us back to the importance of researching your doctor!

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Illinois is one of the few states where the National Nurses Organizing Committee has sponsored a proposed bill to impose mandatory nurse to patient ratios. California has been experimenting with a hospital staffing law with revolutionary results in recent years. The improvement in patient safety has been drastic. The ratios are a minimum standard; hospitals are encouraged to go above and beyond the mandate. The ratios differ by hospital area, but none are higher than 1 RN for every five patients in general units or patients in post-surgical care, 1:4 for pediatric units and in the emergency room.

The important results of the law are plentiful, according to a member of the NNOC’s Council of Presidents. “Lives are being saved, our ability to be effective advocates for our patients is stronger, and more RNs are entering the work force and staying at the bedside longer, mitigating the nursing shortage.” A nurse explained that because they have more time to dedicate to individual patients they have time to check patients’ charts and maintain records, preventing treatment delays and medical mistakes, and that there is more time to teach patients and families about their situation so that they won’t have to return to the hospital for any complications.

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In a recent medical malpractice lawsuit, a birth injury that was allegedly caused by a nurse-doctor communication breakdown yielded a $1.2 million settlement. Nurses were concerned that the birth was taking too long, but were hesitant to consult the doctor about these fears due to his reputation of angry responses to perceived criticism. The infant developed cerebral palsy.

Physicians too commonly react harshly to instances where they feel bothered by the nursing staff, such as late-night clarification requests, difficulties with procedures, changes in patient condition and more. The negative consequences of verbal abuse or disruption in hospitals are significant; reduced communication, team collaboration, information transfer and concentration are all reported as responses to disruptive behavior. Patient safety is compromised in many ways by these reported breakdowns. Medical errors increase in disruptive or abusive situations and the quality of care decreases. Patient mortality increases with these outbursts. Medication errors have also been caused by verbally abusive hospital staff relations.

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Illinois Senators Obama and Durbin believe that that conduct of a Southern Illinois VA hospital has been “extremely distressing.” In July 2006, Jose Veizaga-Mendez had to surrender his license to practice medicine in the state of Massachusetts. A state regulatory board had investigated Veizaga-Mendez and found that he had provided unacceptable care to seven patients. Then, Veizaga-Mendez made his way to Illinois and was hired as a surgeon by a VA hospital in Southern Illinois. At that point, the VA hospital experienced a sudden increase in post-surgical deaths. Although Veizaga-Mendez has since resigned, Senators Obama and Durbin have written a letter to the VA Secretary, James Nicholson, demanding answers on how this man was hired.

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A recent survey of physicians at the Stroger Hospital in Chicago, Illinois has revealed overwhelming dissatisfaction with the hospital, leading to low morale and an exodus of doctors. Doctors cited a lack of funding for their low morale, as budget crunches have led to layoffs and have created a scarcity of resources. As a result, many of the doctors are leaving the hospital or are making plans to do so. Only one third of the physicians polled stated that they planned to stay. The survey also revealed that the conditions of Stroger Hospital prevented them from delivering a quality of care that they would consider excellent or very good. In response, the county administrators plan to do a better job of informing the physicians of the positive changes taking place at the hospital.

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A recent HealthGrades study revelaed that 248,000 patient deaths over a three-year period were preventable, and mistakes multiply during the night shift. Every type of patient is at danger during the night.

Studies have shown that babies born at night are 16% more likely to die than babies born during the day. Patients going into cardiac arrest at night were also more likely to die. Pediatric patients admitted at night are more likely to die within two days. The risks appear even more serious when birth injuries and pediatric injuries also occur preventably. Medication administration errors also multiply at night. Weekends are also dangerous for patients.

Because workers with seniority get priority shifts, night time staffers are not only fewer, but less experienced. Night staffing issues are not limited to doctors and nurses; mental health, social services, directors, and administrators are also understaffed on the night shift. Not only are night workers less experienced, they also suffer from fatigue- a major contributor to night shift errors.

A recent study showed that sleep-deprived doctors are at a high risk of making medical malpractice mistakes that harm or even kill patients. Why then are medical residents routinely scheduled to work shifts that last 24 hours or more? The study showed that people who stay awake for 18 hours straight can have trouble thinking clearly and can zone out or nod off suddenly.

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