Archive for the ‘Medicine’ category

When Your John Doe is Homeless

December 30th, 2012

The patient, known only as John Doe, was difficult to see under the hodgepodge of tubing and the quiet clicking of the ventilator, the room’s only sound.

From all appearances he was homeless, but in the opinion of his nurse, who has had vast experience in dealing with patients just like him, everyone has a mother or a father, a son or a daughter, and homeless or not, it’s a nurse’s responsibility to do what he can to help find them. Usually it’s just a matter of taking that extra few minutes to connect the dots.

“Homeless people are very savvy and self-sufficient when it comes to survival skills,” the nurse explains. “They write important phone numbers on the insides of a hat, put them in their shoes, or sew numbers inside the seams of their coats. I go through every stitch of clothing.”

If that doesn’t turn up any emergency contact numbers or personal information, he examines the patient’s body for needle tracks, scars or tattoos and if necessary, sends fingerprints to the police for a background check.

Sometimes the police’s theory is that the homeless person had a desire to be a loner, and they see no need to reconnect them with their family after they are injured or dead. But the nurse is quick to disagree.

“Things change, [and] these people are still human beings. I believe that every homeless person is still a father or mother, [or a] son or daughter to somebody out there. These people may have done things they are not proud of, they may have mental illness, but their family has a right to know what happened to them.”

From a hospital’s perspective, a patient without an identity is a patient without funding. But once a nurse or a social worker positively IDs a patient as a US citizen, the hospital can help the patient apply for Medicaid and then get reimbursement for the bill. » Read more: When Your John Doe is Homeless

Increasing Patient Care and Reducing Liability in Seven Simple Steps

December 30th, 2012

Nearly one million unconscious patients will arrive in the emergency department this year. Although most hospitals notify patient’s next of kin immediately, that call can often be delayed or forgotten. Without it, there’s no family member present to comfort the patient, make informed decisions for his care or provide the medical history that can make the difference between life and death.

That’s exactly what happened to Elaine Sullivan, a very active seventy-one-year-old woman, who slipped and fell, while getting into the bathtub. When paramedics arrived, they realized that injuries to her mouth and head had made her unable to communicate, or as the hospital later discovered, to give informed consent for her own care.

Although stable for the first few days, she began to slip into critical condition. On the seventh day, Elaine died. But that tragedy was soon overshadowed by another. Despite having her daughter’s phone number and contact information clearly indicated on the front of her chart, the hospital failed to notify her family that she’d been hospitalized until six and a half days after her admission, only hours before she died, unnecessarily and alone.

Elaine Sullivan was my grandmother.

In her case, placing that phone call right away, would have saved her life. Not only would my mother Jan and I have had the time to fly back to Chicago to be at her bedside, but we would have made sure she received the care she needed. We also would have been able to give the physicians treating her, the medical history they needed to prevent the complications and drug interactions, responsible for her death.

After researching our own case and others like it, we realized that failing to notify a patient’s next of kin wasn’t an isolated problem – it’s something that’s been experienced by countless families nationwide. » Read more: Increasing Patient Care and Reducing Liability in Seven Simple Steps