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Stay out of hospitals if you can
and if you can't, have someone with you at all times.
I was listening to Terry Gross on Fresh Air today, and she had a terrifying show. She had investigative reporter Michael J. Berens, who recently did a series on how infections in hospitals are rising rapidly, and needlessly killing tens of thousands of patients each year. Excerpts from his reporting on infections:
"in 2000, nearly three-quarters of the deadly infections — or about 75,000 — were preventable, the result of unsanitary facilities, germ-laden instruments, unwashed hands and other lapses. ...
Within the average U.S. hospital today, about half of doctors and nurses do not wash hands between patients, a dozen recent health-care studies show...In thousands of cases observed by federal or state inspectors, surgeons performed without washing hands or wearing masks. Investigators discovered fly-infested operating rooms where dust floated in the air during open-heart surgeries in Connecticut.
Because of cost-cutting measures, U.S. hospitals have collectively pared cleaning staffs by 25 percent since 1995. During the same period, half of the nation's hospitals have been cited for failing to properly sanitize portions of their facilities ...
Today, about 2.1 million patients each year, or 6 percent, will contract a hospital-acquired infection among 35 million admissions annually, CDC records show."
How bad does this have to get before we as a society do something about it? Laurie Garret wrote an excellent book about 5 years ago, The Coming Plague: Newly Emerging Diseases in a World Out of Balance, where she laid out this problem. There are lots of causes for the problem, but the biggest obstacle to fixing it is that the government permits hospitals to keep their infection rates secret. I don't care how laissez-faire you are, a market requires information to function. How many people do you think would go have open heart surgery in a hospital where they knew 22 percent of the people who did so came down with infections? Especially when the hospital across town had a 1% rate? But lobbying from hospitals and the medical establishment has made sure that information is kept proprietary, and public health officials have been rendered increasingly powerless vis-a-vis hospitals, as documented in Garret's recent work,
Betrayal of Trust: The Collapse of Global Public Health. (Both Garrett books are very well written and well documented, although very depressing. Highly recommended.)
For the second part of the show, Terry Gross had Berens talk about research he has done on what the lack of nurses and their replacement with untrained $9/hr nurses aides is doing to health care in hospitals. Even more terrifying. This one chilled me to the bone, probably because I experienced something like it:
"[Since 1995] At least 418 patients have been killed and 1,356 others injured by registered nurses operating infusion pumps, which regulate medicine flow. In each of these cases, the nurse either lacked the training to operate infusion pumps or claimed to be burdened with too many patients. The pumps can be misused in several ways, and sometimes nurses punched in the wrong amount of medicine on the built-in touch pad. Calculation errors are so prevalent that some nurses called them "death by decimal."
Terry then had two experienced nurses on the show share some of their horror stories of what it was like working in hospitals today, and how hard it was to do a good job, even with the best of intentions, and how that was driving nurses out of hospitals. Both nurses said that when they had to go into the hospital, they had shifts of friends with them so that they had around the clock coverage by somebody looking out for them, and said that would be their number one piece of advice to patients - always have someone with you, 24 hours a day, and have them double check everything that is going on.
The radio show really struck me, and I have blogged on longer that I usually do, probably because I had a personal experience with this kind of problem, where I was not given the right medication by a nurse after surgery. The nurse spoke very limited English and refused my requests to have the doctor summoned. Then she managed to knock over the monitor on the table next to my bed, so she disconnected it. I spent a night in agony and fear. It brings chills to my spine just remembering it.
I wonder, how bad will we let our heath care systems get before we really start addressing some of the root causes, such as how it is financed? If our public schools are any indication, we will let it get pretty bad. Not a cheery thought.
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