Friday, June 02, 2006

From the Patient Side...7/21

I get the average number of emails, trash with the treasures, but this one was so eloquent that I couldn’t avoid using it...besides, she starts out with a complement...

Someone who has the "Granite Fixtures" to drag all the cockroaches in the PRMC program out into the glaring light of day. May you be commended. Having been a patient in that ER and a Parent with a sick child there, it is undoubtedly gone down hill past the point of rock bottom and has begun to dig with a clam-shell steam shovel. Both of my kids were delivered at the woefully gone McCuistion, at the hands of the late and sorely missed Dr. A. Frank White, MD (glad this isn't paper there would be tear stains.) God rest his soul, he would be turning like a whirling dervish in his grave to see the medical care fall apart the way it has. L.P. McCuistion would be calling for the heads of the POWERS THAT BE to roll like bowling balls.

Medicine is supposed to be a service TO the people, NOT a SERVICING OF the PEOPLE!

If the people of Paris are smart they will use a little extra gas and go to Dallas or a lot extra and head south to Houston. With the choice no longer MRMC and St. Jo the people in Paris would do better going to one of the Vet Hospitals on the loop, they would get quicker care in the case of an emergency.

Some of the nurses are ok, others should be sent back to their rolls as Dominatrix and there they should stay. Yeah, you know who you are! The procedures and policy book at that hospital should be read a little more and not be used to even up a table leg! The Employee horror stories are many and diverse and if a book were written about all of the screw-ups and idiotic actions it would make War and Peace look like a pocket book!

For what it is worth the people of Paris should demand the closure of the PRMC campuses and find a bank to loan the city the money to make it a city owned medical care facility. If they don't, the lord high masters will close down and move out in a snit!

Thanks for letting me get this off my chest
And I did ask if I could publish it. Here was the response:


You can use the whole bloody letter I wrote if you so choose! Tired of seeing the employees have to bend over and try not to smile. In the classic words of Frat boys in initiation, "Thank you Sir, May I have another".

If they don't have the hospital closed in the next 12-18 months it will be a God sent miriacle.


Anonymous said...

Funny you should mention Policy and procedures. They are on the computer now, and almost impossible to get to in the ER with all of the computers in use--not to mention it takes an act of congress to access.

A hard copy should be available and not so vague as to change to suit the needs of administration.

Another reason it should be on hard copy in every unit would be to keep administration honest. Policy changes to suit their legal needs.

fac_p said...

Okay, the "granite fixtures" I had to take a pass on, but was sorely tempted....

Anyway, Southwestern--you know, the newest E$$ent acquisition in southwestern Pennsylvania apparently has been going through a bit of what we have.

One of the web sites (and a pretty decent one, for a non-commenting type) posted a link and a former employee dropped me a line. He's passing the word for comments, so we'll be be getting possibly a different flavor to the posts--Pace Picante vs Hard Pretzels???

Just a random thought, what if the jokers that made the 'other' picante realized what capital they could make out of Pace being made in 'Gay Paris'..... That could give the superbowl commercials a whole new twist!

Anonymous said...

You know, I can see things from a pt. perspective. I've been a pt. and my children have been patients.

Sometimes it is hard for a patient, and patients family to see things from a health care providers perspective---especially in the ER.

I've had kids and teenagers, and young people to die--and then I'm expected to perform my duties after that as if nothing happened. I can keep going, but it does suck the life out of you. Not for just a day, but a couple of weeks.

Another problem I have seen in the ER (and not just here) is that there is more and more violence directed toward nurses and doctors.

There have been articles in Good Housekeeping on how to get thru the ER faster--and it actually suggests lying to get through the triage and back to a pt. room.

Jumping to the front by lying could in some cases jeopardize someone elses life. I have seen that happen more than once, when there was one bed available, someone told me one thing and got that bed--and told the doctor a different story--and someone in the waiting room fell out in the floor with a brain bleed.

Another issue facing ER's today is security. When we have a pt. in the ER who has been the victim of violence--we have to secure the ER. We don't know who the attaker, is or was, and we have to be very careful not to inadvertantly let them in the ER.

Family members of the pt who is a victim--not to mention other family members of other patients do not understand when we don't let them just come on back.

We can't invade that pts privacy by saying we have a girl in here who has been raped and the attaker said if she reported it she would be killed--and we don't know what he looks like.

And last but not least the understaffing is so stressful in busy situations sometimes we just don't have the time to do what we would like to do to give the best patient care. It's degrading to us, it makes us feel bad about ourselves on many occasions.

I'm not taking up for anyone, just showing another side. I don't work at PRMC but I have been there and done that.

I hope they choose the ER director at PRMC by what kind of pt advocate they are instead of by the Peter Principle. I hope they give this person some leadway into the staffing.

I am praying about it. I have family that might need it someday. When you have a true emergency, you can't make it to Dallas. You have to use PRMC to at least stabalize and transfer.

Anonymous said...

Yep fac_p---they could come up with a whole new cuisine. French-Mex.

Paris-site Pace doesn't sound to appetizing.

Using the Gay Paris' thing plus Pace--It could be a good promotion for Brokeback Mountain.

OOOH--we are just so wrong. GET A ROPE!!!!!

Anonymous said...

"Medicine is supposed to be a service TO the people, Not a SERVICING OF the PEOPLE!"

Your right. It feels like a cattle drive for pts. and health care workers alike.

There is no Pt. satisfaction or employee satisfaction of a job well done.

If you make time to take care of one pt. well, you may well be letting another die, or get worse. So you do what you can for the most amount of people, with the least amount of nurses. The most time going to the ones that could die.

It's time to take a stand. Employees are helpless. If they speak out they are gone only adding to the problem. What's the stand going to be?

I honestly don't know.

The National reports say that short staffing- Flooded ERs hospital aquired infections, med errors are huge problems everywhere.

Dateline reported on the hospital aquired infections last night saying 1 in 20 patients get them from hospitals--I know its worse when there is short staffing.

Anonymous said...
This comment has been removed by a blog administrator.
RJMac said...

What got me during my tenure there was the so-called rececorating of ER in the old St. Joseph building. I was foolishly believing that there would be more room. What did the good folks of Paris get? A redecorated broom closet! Not even enough room to get a cat in,much less swing one. How are folks sppsoed to treat patients in such cramped conditions?

And all this time, a completely good, large, roomy ER facility was lying fallow, across town.......because uncle Huddy wanted to combine the minor and major ER cases in one facility.

Similar to 10 pounds of candy in a 5-pound bag.........

Perhaps converting the north side ER to handle OP surgery is a good thing........but don't bet on the fairy tale of the whole kit & kaboodle moving into a new, large facility abutting the north campus any time least under the current regime.

For all you folks working in the ER broom closet (except for the soon-to-be-gone head shrew), more power to you!!

fac_p said...

Actually heard that they were going to open the North ER...some trick with the out pt surgery ctr now in the middle--aahh E$$ent, confusion is your middle name....

Anonymous said...


Ok I went to the site. I don't understand who these people are. There is no purpose for what they are doing that I can find on the site.

Anonymous said...

A Houston hospital seemed to have good results with Six Sigma in their ER, but most of what they did can be done by anyone.

Hey, fac_p, how 'bout killing the old comment? Just remembered how to post a link. duh...

Anonymous said...

What I got out of reading this site was a bunch of people who have more clue on profit, than they have on the ER.

I could be wrong--that's just the way I get it.

Anonymous said...

Okay, if you have satisfied patients, how do they treat the staff? Do you feel better when someone recognizes your efforts, or they're threatening to call the administrator on call?

One of the biggest factors is wait time in the ER: Waiting to get in, waiting to be seen, waiting to get results from the tests, waiting to be discharged.

As for profit, people are willing to pay for what they like...and not resent the bill--as much.

A win-win-win situation. Realize that administration/staff/patients can exist in a in a working relationship--the one we have is dysfunctional. Change can be good, but it has to be reasonable, and have reason.

That's why everyone has to 'buy into' change, and the impetus has to be on the local level, rather than a Nashville initiative.

Anonymous said...

I don't know if you remember, but we had a bunch of consultants in from Schumaker, that made some of these suggestions. Some of them were good, but with the amount of staff--it is diffacult if not impossible to work.

If your not going to pay out on staff--you can't have satisfation in the ER.

If you have a 1-3 ratio, it works better. The way that our ER works, the triage and the charge nurse counted into the matrix--but the end result was a 1-4 patient ratio, and if someone called in either the charge nurse had to take 4 patients, and control the flow of the ER or the nurses had to take 5-6 patients a piece. Either way the ER bogged down.

If you have one bad trauma pt, or pt going to Cath lab etc, or code etc, it takes two nurses--that is 8 patients nurse taking care of one pt.

Another problem, is that some nurses were holding their patients---dragging their feet getting them out, because they knew they were going to get a new pt. as soon as the room turned over, so they paced themselves down to a crawl.

Rational--I get paid the same if I see 4 patients or 13 patients. Yes it bogged down the ER. Not getting a raise anyway-what difference does my evaluation make.

Slower times etc...

This is just the tip of the iceburg--

Anonymous said...


Ok, I've been reading some more on the Six Sigma site. I am interested but I still don't understand what they do. Are they a consulting firm, or what?

There are a couple of things I like such as putting the pt. first--and the customer part of it, and error reduction, but there are a few things that are big turn offs too.

One of the things they are talking about is different doctors doing things in different ways instead of everything being done the same way, and although it would make my life easier if every doc did everything the same way, I don't think it is necessarily best all of the time.

Another thing they were talking about was the efficency of the nurse and how they were going to accomplish that. It kind of sounds like the cattle drive we are doing now instead of pt. care.

Somehow I get the feeling that these people actually don't do the labor, and what they are saying actually is going to do better on paper, than it is in real life.

That is what I hate about statistics. The numbers can be changed to the advantage of the company.

I'm not saying its a turn off all the way around.. just that we have been told that something was going to fix us before, and it resulted in massive dysfunction, but who knows how much of that was related to their ideas, or our staff reduction, or Essent itself.

I mean if the company is not going to invest in staff--nothing is going to work anyway.

Anonymous said...

Six Sigma is a logical extension from TQM. The "Black Belts" were coaches, and the philosophies are utilized in all forms of business, industry, and healthcare.

The programs, like TQM and Six Sigma, make both the staff and the administration partners in change. And if any place I have ever worked at needed change, this is the one.

Essent understands that healthcare is a business, but what they fail to understand is that it is a people business. Until they do that, any sucess will be unsustainable.

cs19884 said...

how do i get on cantact with the person reliable for making this site? i would like to talk to him/her about something that happened to my mother at prmc. thanks cs19884

fac_p said...

As per the statement of purpose on the left side of the main page, just email

This is a blog for the employees and the public, with the public good through awareness my foremost concern, when it comes right down to it.

Sure, there is clowning around, and I probably should limit what gets posted, but when it comes to the patient, that's what the blog is here for...making it better through awareness.