As a patient, I had high expectations. You may not care, as long as my surgeon was successful and I didn't pick up an infection or other complication along the way. But I would have preferred the care to be up to what I expected. Instead you made me fearful of being held longer in the hospital, where I would be at higher risk than at home.
Each and every minor "error" reduced my confidence in being well-cared for. On their own, each inconsistency or unintended misguided action might seem minor. Yet when experienced by a patient on a daily basis, it resulted in energy used to monitor/correct staff, energy that could better be spent healing.
Some examples of what I perceived as errors, each eroding my confidence in the staff and hospital processes:
* Staff consistently mis-assuming (and making recommendations based upon) a sternum-cut surgery when port-access was used
* Being told that medications were being stopped only to have them reappear the next day (happened twice in three days; on top of an attempt to double-dose when an RN didn’t note provision of a med)
* For abandoning me in a wheelchair outside of Radiology (after chest x-rays)…though it did enable to better learn my way back to the cardiology floor on my own
* Being tested for diabetes at 4am each day, instead of 2 hours after meals
* Providing an incentive spirometer but never checking whether I knew how to use it properly or used it regularly (I did, but not because anyone participated with me)
* Proving a heart cushion – for use with post-surgery coughing – only after four persistent requests (and also not suggesting how best to use it)
* Being unable to provide a diabetic-friendly menu or to modify existing choices to be diabetic-friendly
* Incorrectly directing me to making an appointment with my primary care physician – instead of cardiologist – in my discharge orders
* Wanting to discharge me from major heart surgery without any medication or prescription for pain meds (and RNs obviously scared of contacting the surgeon’s office about it, preferring to use an in-house NP instead)
I could go on, but the above is enough to give the gist of what I experienced in a short 3-day stay. If you had surveyed me at discharge as to my likelihood to recommend the hospital to a friend…
There is something humorous about how poorly institutions can run, especially when trying to "help" the clientele. I was diagnosed with Type 2 diabetes almost 2 years ago, and have used regular exercise and a greatly improved diet (thanks Linda!) so that I no longer use any medications to control the diabetes. This effective, self-driven approach turns out to be at odds with how this hospital “helps” diabetic heart patients.
Some thoughtful hospital person marked my post-surgical stay for special dietary needs due to my diabetes (low carbs) and the heart surgery (low fat). As a result, every requested meal was an unexpected arm-wrestling match where the order was constrained by some dietary computer program, restricting ingredient totals to hidden (hospital-eyes only) levels. If the total exceeded some pre-set level, the order was automatically halved, or denied (“no, you can’t have that).
Yet, the system was totally inflexible. I couldn’t order a burger without the bun or the French fries, the meat without the sodium-heavy sauce, etc. The computer program did not anticipate that diabetics may actually order or eat differently than other meal recipients. Plus the computer only knew how to add up ingredients for the pre-determined menu item…not for what the patient would actually eat. So if you ordered the burger, you couldn’t order it without the bun, couldn’t avoid the bun from being counted against the total carbs in your meal, and without your meal carb allowance being reduced by the bun you didn’t want/weren’t eating (but showed up anyway).
To make matters worse (or more amusing, depending upon one’s level of pain meds), it was obvious that the hospital dietician held little sway with the bookkeeper-driven kitchen. Food purchase decisions were obviously optimized on a “one-size fits all” basis - like an elementary school cafeteria – where minimizing waste wins out over healthy diabetic-friendly fare. Even the salads were not diabetic friendly.
The irony: after surgery every patient is pumped full of excess fluids. So much so that the staff uses diuretics to help the body drain. Yet the kitchen – even with the above diet restrictions – seems totally undaunted in shipping sodium-rich foods/sauces/salt packets to room. It just reminds the patient that the intent is good but the execution totally off the mark. I imagine that this hospital is not too different than most in this regard. Which is a sorry dietary situation.
PS – Similar in its execution, the diabetic monitoring was lacking. The day of surgery my blood glucose level was taken hourly, and after ICU, at periodic intervals. How this information was used I have no idea, especially as the testing was not done at proper diabetic intervals (e.g., one or two hours after eating) and no one had the least bit of concern over how the readings compared to my pre-hospitalization levels. The staff was merely executing on the a logical instruction (monitor blood glucose) but seemingly without any direction about what to do with this information. This is sad, and just another block a hospital builds in establishing the patient’s lack of confidence in staff and process. Sad.
Stabilized enough I guess, it's out of the ICU and off to the cardiovascular floor where I will spend at least two more hospitalized nights. A room with a great view of the Rockies. All the cardio rooms are singles too, so no one has to be disturbed by snoring. Well, except me of source, who will be regularly disturbed by hospital staff obviously assigned to visit only after I have fallen off to sleep.
Surgery starts 3.5 hours late as surgeon apparently waits on an instrument being shuttled from another area hospital. While most things go smoothly, I am reminded that this is the first "port access" mitral valve surgery done at SkyRidge Hospital. Things could be smoother but I don't notice as I'm off dreaming in anesthesia-land. It is hours later that I wake up (post-ventilater tube removal) where I am mostly aware of right should area (rhomboid muscle) pain. Linda helps the nursing team in ICU settle me in for the night (I'm glad she's there though I won't remember much about it later.)