Tuesday, February 10, 2009

Warpath! (2 posts in 1)-Med Records and Mom yelling "Help ME"!

SeaSpray's Rorschach test. :)

This is a picture of a sunset I took in December. I think it looks neat upside down like on another planet and I am putting it in this post because it ties in with how I was feeling today with my frustration with a couple of situations. I guess you could say I was seeing red. The upside down trees are symbolic of how upside down some things feel to me right now and the golden light symbolic of hope. This picture reminds me that even though I have to walk through a difficult path, don't allow myself to be swallowed up in the anger and pitfalls I have to navigate through... but rather hold on to hope, keep an eye on my goals, and believe for better days ahead.

Also when I look at this... it reminds me of being held back... a struggle forward to freedom and sunny days ahead... once I break free.

Missing Med Records

I think I am beginning to sound like a bitch... and I am not..really.. I am not.

I came home tonight feeling on the warpath. Anyone that knows me in my personal life would not associate that word with me. I wouldn't either... but I am becoming jaded.

I often say I don't understand how people sue the way they do and I never would. I still believe that I would never ever want to sue people to get rich-easy money at someone else's expense and reputation... take advantage and all that dishonest stuff. I loathe that mentality.

But I have to say... that I called that office (that lost my records) twice and have not gotten them. Maybe they are doing half days. But today...I left a long message (2 min?) until cut off on voice mail and sent it through as urgent.

I was polite... even apologetic and empathetic and conveyed I understood it was a mistake, that people make mistakes and that I could make it too ... but... that it was an EGREGIOUS mistake and now I am worried about identity theft, insurance fraud and *my* PERSONAL information is out there. I mentioned HIPAA, state and federal laws are in place to protect a patient's identity/info and that corporations are expected to protect a person's personal information and not put them at risk for identity theft. I stated that the records HAVE to be found. I requested speaking or meeting with the office manager.

I said that since they had a few things to give my other doctor..that tells me they HAD my records and probably mixed my medical records with someone else's when they were making copies for the patients and that there was a good chance that someone else or many people have parts of my records.

I also thanked them for sending what they had to my other doctor. And I told them that I appreciated that they were always good with and sweet to me as a patient.

I was trying to convey that I knew it was a mistake, appreciated how they treated me during my visits there and even identify with them that anyone could make a mistake..including me... BUT I wanted them to know how serious this was. I mentioned that my bp was high when I saw my doctor the day I found out and that I have been upset about this.

When I listened to my message... I could hear the authoritative serious tone in my voice.

That's the gist of what I said. Maybe I shouldn't have said all that but I could've said a lot more.

I did not hear from them.

I expect that I will hear from them tomorrow.

I BETTER hear from them tomorrow!

I have been talking to people in my personal life. One friend didn't seem to understand the seriousness of it... but the others said they would be mad too and one person said they'd be furious. That helped me to feel better.

I had to call the cable company today and told a woman about it that works there. I know her from when I used to go to church and she is a woman of real strong faith. She told me she would be right on their doorstep demanding they find her records. It helped to hear her say that because I don't want to hurt them in any way and I am a forgiving person and feel guilty for being angry...although I know it is justified.

So...as the day went on and I did not get a call...I admit I began to think they were avoiding me.

Then I began to think they might not be trying or even care.

I began to get angry all over again.

And then I began to identify with how a patient who was treated poorly might feel... and then I thought how some pt/DR lawsuits could be avoided if they handled the patients better... depending upon the situation of course.

If a person feels unheard, blown off and is not treated respectfully... they are going to get angry.

I have decided 2 things. I will go over there if I don't hear from them and that will be real AWKWARD for me and should not be put in that position... to go there unannounced.

The 2nd thing is I am now considering getting an agency involved. I don't know who... but someone to act on my behalf. Someone that will demand my files be found. I am sorry to do this. I really am.

A friend recommended that I look in the phone book or google recovering lost medical records. I do have someone in the law profession I was thinking of getting advice from... because my concern is if they don't find them before they close up... how will I ever have an opportunity to get them again. Some new doctor buying the practice won't want to be bothered with that.

And another thing... if I get someone else involved to help insure that someone will pursue finding my records after the practice closes for good... will that affect the sale in any way? Of course I don't want to do that either!

The only thing with doing that... is that opening up a can of worms for them... assuming someone can help that is? I do not want to cause harm in any way.

My doctor died. I don't want to cause a problem. But I now have a problem because of someone's carelessness! ALL I WANT is my medical records to be found. And if they find out where they ended up...to call the person or people that may have received them to get them back and also so they would know they were identified with possibly having the info.

This is a perfect example of why you should not leave your patients dangling, feeling hopeless, and uncared for. Their seeming hands off and ignoring me is is only fueling my distress over this.

If I were the office mgr... I would be calling to connect and reassure. And I would certainly call asap after getting my message. I think I said if they have to start over with the a's to z's.. they needed to do that.

It would be easy for them to lie and say they just found them mixed in and never have to say copies went out.

I feel so powerless about this.

It is imperative that they find them!

I did inform my insurance company today and no claims other than my own have come in.

On the one hand I feel bad to be adding to their stress... but on the other hand...I am glad I let them know how I really feel about this.

And maybe I am overreacting because they didn't call me back yet. You know what it is? I feel shut out. They are no longer taking calls at the office. They direct you to call 911 for an emergency, the covering doctor or leave a message for them.

Help Me!

Tonight, as I neared my mother's room (about 2 doors away) at the nursing home... I heard some one yelling "Help Me! Help me! Help me! Help Me!" I thought it was my mother's voice just before I got to her door.

It WAS my mother!

She was COMPLETELY slumped down in her wheelchair! She was horizontal with her head scrunched up on the back and her butt almost halfway off and she was only still on the chair because her feet were planted squarely on the floor. And her call bell was not attached to the arm of her chair but was on the other side of her bed...on the FLOOR! The foot rests were not on her wheel chair.

I ran over to her exclaiming "MOM!" and then said "I'm getting help!"

I knew the nurse was at the desk and the aides must've all been in with other patients. I bolted to the door and just shouted down the hall " MY MOTHER HAS BEEN YELLING HELP ME AND I NEED SOMEONE TO HELP HER NOW!"

I know it wasn't life and death ... but seeing my mother so HELPLESS (not knowing how long) and in that position alarmed me greatly and I KNOW how difficult it is to get help there sometimes and I wasn't about to let her stay like that. I also needed assistance to get her back up into her chair. We were just lucky the nurse was at the desk. Sometimes she is nowhere to be found either and the bells are going off non stop.

The nurse came right down and together on the count of 3, we lifted her back up by grabbing the back of her pants and and under her arms. She seemed alright ... just looked tired.

I pointed out where the call button was and I asked why she didn't have her leg rests on the chair. They help keep her from sliding. And they put a pillow under her legs so they don't drop down through the leg rests.

And I asked about a wedge ..kind of like a saddle they used to keep her from falling out but they decided against that. I don't know how comfortable that is. Also... Mom unbuckles her belt.

The nurse told me that my mother does that...slides down. Well then...shouldn't they be checking on her more?

The nurse told me her aide was attending to the patient in the next room. I like her night aide. She seems very responsible and caring.

Then while the nurse was there... I said she had an open wound Friday night that I thought needed some attention because blood was transferring to her stocking but the aide didn't think it was necessary because it seemed closed already. (It bothered me but I let it go.)

I picked her leg up and it was open, bleeding and a larger opening. It almost looked like a small crater...smaller as going down in depth. It was like her skin was split and widened compared to Friday. It seemed with pressure, blood transferred to these stockings too. Not much... but indicative of an open wound.

I said this needs to be cleaned out and needs a dressing. The nurse didn't comment. Then I said that with her poor circulation (both legs are almost black and ice cold), an open wound in a facility like this... she is at risk for a staph or super bug infection. I couldn't think of the medical terms for the infections other than staph.

I went on to say that a podiatrist had told us that she should always wear support stockings to help protect her legs from open wounds because the elderly population is more at risk for infection, particularly someone like her with the vascular issues she has. He said he has seen time and again where these infections are hard to get rid of and sometimes they never do and they can die from them. Then I asked...who cleans and dresses this? She said she would.

As she was putting the 3 in 1 antibiotic ointment in my mother complained of it hurting. More proof that it was an open wound.

Then I asked who would take care of the wound in the daytime? She said they have a wound doctor that comes in once a week. I commented that I thought this should be checked, cleaned and dressed in the morning and everyday. Not only does she have severely compromised circulation..but she is diabetic! Shouldn't this be done every day? Am I right about this? She said I was right.

In the meantime the Aide came in her room, apologized and said she put the buzzer there and had taken my mother's foot rests off because she was about to put her in bed and pointed to the fresh linens and gown on the bed. I like that she took responsibility. I respect that.

She was the one who told me my mother's leg didn't need attention because it closed. I did attempt to get her to get some care for it a second time and she said it stopped bleeding and was closed. I let it go. But when I got home it bothered me because I started thinking of the possibility of infection, was going to call the next day... but let it go. And now it looks bigger.

The nurse did not seem thrilled that I wanted this checked again or that she had to do a dressing for it. If I did not practically insist... she would have let it go too. Was I wrong about this?

They just had an inspection last week and now they are waiting for a state infection any day now. I wonder...if their now having to take care of this wound tonight...showing up in the documentation will affect their scores with the state? I have no idea how these things work. i just don't understand why it was like pulling teeth to get her to take care of this. She again stated she didn't know anything about this.

My mother had 2 other injuries via wheel chair to her legs and both times the nurse called me to tell me. It is some protocol they have to inform the family of even the tiniest injury and yet this time they were bypassing it.

I also brought up the fact that my mother had a rash and was complaining that her skin was burning on Friday night and wanted to know if she is on a bathroom schedule so she is not sitting in urine. The aide said mom didn't have a rash that it was from sitting. (Well if she is red from sitting that long in the wheel chair...shouldn't she be moved sometimes?) I said but you put the white cream that looked like Desitin all over her private areas.

She said she tries to get her patients to the bathroom twice during her shift so they aren't sitting in urine but she can't always do it when she is busy.

I told both women I know they work hard and I appreciate the care they give my mother. (I just wrote them a nice thank you note and left a big bag of chocolate candy at the desk on Friday for everyone who has been helping my mother) I feel I have developed a nice relationship with the staff.

I admit though that tonight...while I certainly wasn't yelling... I was a tigress with my barrage of questions and wanting to get things done for mom. And to think I almost didn't go tonight!

I asked them if they were short staffed and they both looked at each other and then the nurse said "We can't say that." So they are and we talked about it. I asked if I complain about this to the social worker will you hear about it because I don't want anyone to get in trouble but they need more staff. She said they probably would.

They have to do one on one with a patient now and they don't call in extra help, but instead more work is placed on the remaining aids. The nurse told me they are told the census matters but not how difficult patients are.

So they staff based on census not the demands/needs of the patients. Is that the norm for nursing homes? I know budget matters and providers cut where they can.

I will say...that everyone seems to be busy working when I am there.

The aid told me she loves her work and helping the patients but that her blood pressure is going up because of all they are expected to do with short staffing. She told me I should ask to speak with the director of nursing but that she didn't say it.

So... I don't know if I should report what happened to mom..or trust that they will be more attentive. ??? I don't want to hurt them though.

Okay...can someone please give me a cyber slap in the face to stop this nonsense of worrying about hurting other people? If I am not an advocate for my elderly mother...who will be?

Perhaps I could just ask to speak with the social worker and director of nursing and ask what their staff to patient ratio is because it seems my mother has to wait a long time for help sometimes...and I notice the call bells are ringing for long periods of time without anyone being at the desk. Or I am waiting at the desk and no one is there or when I call the phone usually rings and rings until it goes back to the operator. Some nights.. I can't get staff on the phone.

I am sure they care about PR... but I don't think they will care that staff can't do it all and they probably just think they have to work harder.

I am also wondering if I should look at other nursing homes. I didn't because I wanted mom to have the continuity of her own doctor and she was familiar with the staff, etc... but maybe I was mistaken.

Do the ratings count or anything? They actually got a good rating when I looked them up... better than a home that I thought was supposed to have a better reputation. Doctors will tell you that certain types of hospital ratings don't really mean anything... and the way they arrive at their stats are flawed.

I was talking with a friend earlier today and she was telling me about her mother's bad experiences in a new assisted living facility that she was paying $4,000.00 a month for. She was a retired college professor who had all her mental faculties. My friends mother was left to sit on a toilet for over an hour, even though she kept ringing the call bell for help. When the aide on the next shift came down, she told her mother that the previous shift had turned her light and bell off!

Both of my friend's brothers got involved and one of them is a lawyer. They took matters into their own hands and also withheld payment until things were straightened out.

So...you can have the supposedly top notch facilities... but the patient care is only going to be as good as the staff that works there. And you can't be with your relative 24/7 and can only hope and pray that they are not being neglected and are being treated well.

I will just add...that a provider's under staffing must contribute to the poorer quality of care and putting the patients at risk.


Dr. Deb said...

Another reason digital files *may* be a good idea. Sorry this happened to you.

SeaSpray said...
This comment has been removed by the author.
SeaSpray said...

Thank you doctor Deb. Yeah... I am an EMR convert now...bring em on! Thanks again. :)

passionstamper said...

beautiful sunset...even upside down! Great analogies! Glad to hear you have found some sense of peace in it amidst the turmoil.

Seaspray, forgive me if I didn't appear to empathize with the severity of the situation when first explained (I was extrememly tired having not slept well for many days-and only receiving a few hours of not-so-restful sleep). I was overdosing on emotional issues myself at the time.... (not that it excuses my seeming lack of compassion for your situation).

That being said and having read all your posts about the missing records, I can see how unsettling this is and also how serious a situation this is. It is also time-sensitive, and you are the one who has alot to lose if this situation is not taken seriously by this practice-immediately!

I think you are being way too nice-at a time when you need to get action and answers before the door is shut on the opportunity and you find yourself with no one to contact at all. A very serious mistake and infringement to your privacy has taken place and you have been more than gracious about this "mistake" that someone has made. But be realistic-to be ignored is grossly negligent as well as downright unprofessional. You have every right to pursue this, even if you have to take it all the way to court to have it addressed. (hopefully it won't come to that, but it's certainly within your rights to do so). I think it would be advisable to have someone else act in your interests if you get no satifaction in a day or two-before it's too late. As you can see, I have been getting more sleep and have come to my senses about the seriousness of this situation-and I hope you come to yours and realize you need to take control and exercise your rights as a patient whose privacy has been compromised (unintentional as the error may be). Laws are made to protect citizens and patients-and when they are broken, someone has to be brought to accountability, or justice is the consequence of their negligence.

passionstamper said...

me again-I got so carried away responding to the missing records, I forgot to comment about your mom and her care (or lack of it). Too many subjects to respond to in one post...LOL

I just want to say, that again, in your heart of hearts, you know you have every right to stand up for your mother. Your concern is not how or why there is not enough help to go around. Your mom is dependent on these people to provide her with the basic care she needs-whatever that may be, and in a timely fashion. If you see that is not happening, you are the only one who can speak on her behalf! Have you asked yourself how long she may have been left unattended while calling for help, as you found her-if you had NOT showed up at that precise moment? This is why it's so important to visit randomly when you are not expected-otherwise you wouldn't even know these things are going on. I would definitely speak with the Director of Nursing. And I would definitely do some research into other options or places for your mom in the meanwhile. It certainly can't hurt to keep your options open.

If we aren't the spokepeople for our elderly parents, who is? And remember, one day we may be the ones in that situation-ask yourself what would you want your children to do?

SeaSpray said...

Thank you Pstamper. Your support and suggestions are appreciated.

Glad you like the pic. I will put the rest up soon. :)