- number of people diagnosed with the virus: 2,221,079
- number of people who died from the virus: 119,112
Thank you for returning my phone calls and for providing me with your e-mail address. As I feel my observations and experiences within your ER this Tuesday are noteworthy and of great concern. I live in Washington, DC and have extensive experience working with hospital systems. I am in town now to help care for my dad, who was admitted to your hospital at the end of May and again this week.
On Tuesday, while home with my dad, I realized he had an impacted colon and needed immediate attention. So my husband and I drove him to your ER. My dad was in terrible pain and every minute sitting in a wheelchair was unbearable for him. When I arrived inside the hospital, we were greeted by a nurse who took our information and walked us through the process of registering. At that time I was told I couldn't stay with my dad. However, I explained that my father has dementia and needed a family member with him throughout the process. The greeting nurse understood and allowed me in.
We proceeded to the check in window and again that went smoothly. We were told to sit in the waiting area and that a triage nurse would call us. This is where it went down hill. We waited for 2.5 hours and throughout that time no one kept patients informed about the wait time or where any of us were in the cue. My father was bent over in pain and it was clear he was not a priority. It was only because I started complaining at 2.5 hours that we were finally called back to see the triage nurse. I want to mention that I wasn't the only person who had issues with the long wait. Other patients were very frustrated and visibly agreed with me as I was complaining. I was told the wait was so long because other critical patients were coming in by ambulance and being addressed. Though I understand and realize patients must get triaged based on critical needs, it is very clear that Providence St. Joe's is under staffed and can't effectively manage the needs of patients who walk through your doors. This is of great concern to me since this is my parent's local hospital. Given what I experienced on Tuesday, I have no confidence that your facility can handle critical cases in an emergency. Much less handle patients who have dementia.
I am troubled by the lack of regard for vulnerable patients. Patients who have dementia and other cognitive or mental health concerns need a family advocate present in a hospital system. I understand the issues surrounding COVID-19, but these vulnerable patients can't possibly receive effective treatment and care if your medical team doesn't have the full picture of the problem. This is where the family advocate is vital, as we are a crucial part of the treatment team, and my dad is lucky that I am assertive and understand how to negotiate my way through a hospital system, because if I wasn't with him, I know his visit would have been a disaster.
Case in point, after the triage nurse talked with us, she then said I wasn't allowed back into the ER. I told her, NO WAY, that I had to come. She told me she would talk to the manager. I was asked to go back to the waiting room, and she proceeded to take my dad into the ER. By the time she came back to get me (because I was given permission to come back into the ER by the manager), I found my dad in the ER hallway, alone, and holding a urine specimen container. He had NO IDEA where he was, or what he was doing. He also had NO IDEA why he was holding a container. It was a disheartening scene, one which I photographed and happy to share it with you. If your hospital expects family members to leave you with their vulnerable family members, then you need a system in place to help shepherd these patients, so the process does not add to their disorientation, confusion, and fear.
As promised, here is a list of the concerns as we experienced them:
- A 2.5 hour wait time, with no updates or interfacing with staff during that time.
- No system in place to help patients with dementia process through the ER.
- It is very clear the ER is under staffed and the staff who are there are over worked. This directly affects the quality of care provided to patients.
- In the ten hours I was in the ER with my dad, we NEVER saw a medical doctor. Only a nurse and physician's assistant. Both were competent and lovely, but patients expect to see a physician when in an ER.
- Throughout my time in the ER, many patients around my dad's bed (#12) were calling out for help and a nurse. Of course NO ONE was around! Nurses are managing too many patients and unfortunately are assigned patients in multiple areas within the ER. So one's assigned nurse isn't even physically stationed within the area of the patient to seek help or ask questions. In fact, I would say that several hours went by between nursing visits. Which was disorienting to my dad, as he needed a lot of explanations and reassurances about what was happening to him and why he was in the hospital. How would these concerns and fears be managed if I wasn't there? I know the answer.... they wouldn't be!
- My dad was in the ER for ten hours. At 10pm, I complained again and spoke with Sabrina, the night charge nurse. I demanded that my dad get an IV for fluids and some food. Why wasn't an IV inserted during these ten hours? Given that it was clear my dad was dehydrated (drawing his blood was next to impossible, as his blood was flowing like molasses), and dehydration exacerbates dementia, it leaves me wondering why he fell through the cracks.
I am happy to discuss these concerns further, and it is my hope that this email will get passed along to your upper management. I am saddened to see how Providence St. Joe's is now managed. I remember volunteering at St. Joe's when I was a teenager, and it is very clear this is NOT the fine institution it once was. I look forward to hearing from you, as I feel my email merits a response. Much thanks for your time.
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