1 post tagged “healthcare”

Why I am frustrated with healthcare:
Among the many reasons I believe the healthcare system needs a radical overhaul, one of the primary reasons is the inefficient use of resources which results in many dollars being spent that could have been used for something else and decreased productivity.

Scenario:
Wed: My friend leaves work early because she has an intense headache (note: it is rare that she ever gets headaches)

Thurs: She again leaves early due to the headache and dizziness; takes Advil, rests, fluids, etc.

Fri: Walks into work and immediately leaves because the pain in her head is excruciating.  She contacts her primary care doctor and explains all her symptoms (knife like pain in the back lower quadrant of her head, dizziness, nausea, numbness).  Her doctor believes it is a migraine and prescribes Imitrex and tells her to call back on Monday.

Sat: My friend is awake all night, vomiting, searing pain, dizziness, periodic numbness, and she doubles the dose of imitrex (which the pharmacist instructed her to do and told her if she does not get some relief by Sunday to get medical attention)

Sun: My friend sends a text telling me she needs help asap.  She lives one block from the ER but because she was of the pain, dizziness, and nausea she thought she would pass out on the street and not make it there.  I pick up another friend on the way and the three of us spend the next 10 hours in the ER after which our friend gets admitted onto a medical unit with meningitis.

Inefficient uses of healthcare:
1. Her primary doctor did not tell her to come in for a face-to-face visit.  Instead, she prescribed over the phone medication for a migraine to a client who has NO HISTORY of migraines nor headaches and who does have a family history of brain aneurysms.

2. Had the pharmacist not told my friend to go to an ER if she had no relief by Sunday morning, my friend would have continued taking the imitrex and trying to manage the pain, nausea, and dizziness

3. Triage RN in the ER:  did a very poor assessment (which I can say unequivocally as an RN) which resulted in the persistent belief that the client was experiencing a migraine which caused the attending MD and RN to question if the client was med seeking and only resulted in a lumbar puncture 4 hours after arrival.

4.  At the ER the following resources were used:  tying up a room for 10 hours, a cat scan, 10mg dilaudid,  3 doses of compazine, a lumbar puncture, three series of labs and cultures, 3 IVs, 10 hours of nursing care, and neurology consult  (all this translates into expensive care to determine that the client has meningitis not a migraine)

5.  Additional resources that were wasted: my friend's entire weekend, two of us hanging in the ER all day peppering the staff with questions, loss of days at work for the patient (today and tomorrow) as well as reduced productivity on he part of the two friends given we are friggin' tired today (and I am blogging versus working, so clearly, I am not productive today)

What should have happened:
The primary care physician who has treated my friend for several years should have recognized that she has no history of migraines nor headaches and, thus, needed to be seen face to face especially given the recent family history of brain aneurysms.  Upon seeing her, the MD would have realized that my friend was experiencing an incredibly high level of pain and running a temperature with no precipitating factors and, thus, ordered lab work which could have yielded the correct diagnosis far sooner.  Had there been a correct diagnosis or at least appropriate lab work on Friday, my friend could have been appropriately treated on a medical unit and not spent the weekend in agony nor tying up an ER bed and the subsequent ER resources.

What needs to change:
1. The system needs to emphasize on preventative care versus emergency care
2. The reliance on giving patients pills has gone overboard and clients need to be assessed for what is happening
3. Clients need to be educated on healthcare resources and what is appropriate versus excessive use of medical tests and resources
4. It is useful to speak with the people who are with the client versus only listening to the client
5. Speaking in a common language.  If your client does not know medical jargon, don’t speak in medical jargon.  If your client says their pain is at an 8 make sure you understand what an 8 means to them versus how you interpret an 8/10.

So, I could write another entire post on the lack of privacy of medical records and patient information but I should probably get to work to rescue some productivity today.  All in all, I’m thrilled my friend will be ok but so frustrated by the waste I saw in the healthcare system this weekend.