With these types of things happening in hospitals, it’s more important than ever before to be proactive with prevenative healthcare. Oral health tops the list with new research linking oral health to total health.

My son had gall bladder surgery in the VA hospital in Shreveport,La in
December 2007. He became very ill. Could not hold any foods or liquids on his stomach. He had 5 visits back to hospital and they told
him he either had staph infection or lung cancer, but they wanted to wait and see. They did not do any follow up. He died in VA hospital in Dallas on Feruary 16, 2008. Dallas hospital said he had staph. Lack of
nutrition caused his vital signs to be so low that his heart stopped.
This was the information we received from the hospital. He fell
and was unconcious ,and ambulance was called, and they took him to the Dallas VA.

I was a patient in a Melbourne, FL hospital. After the nurse finished wrapping all of the cords to the machines I had been hooked up to, she took out my catheter. I was upset because these cords had been all over the floor and people had walked on them. She did not change her plastic gloves until she was ready to leave the room. Amazingly enough I came out of the hospital with only a minor infection of some type. Cipro took care of that.

I also noticed when I checked in to the hospital, the woman who registered me kept licking her fingers as she filled out my paper work. Then she handed me a stack of papers that she had been sorting. Please….have consideration for the patient. You had a cold!!!!!

Dr. Manny,

Have you ever worked in infection control? It does not seem like it from your lack of insight.

Dr. Alvarez highlights the important topic of hospital acquired infections, worrying that patients have to fend for themselves in a broken system. What is left out is mention of the patient’s best ally for preventing hospital-acquired infection, one of America’s cadre of three million registered nurses.

The well-trained, educated, vocal nurse you deserve at your bedside when you are ill knows what kind of soap, how many seconds, and how much friction an adequate hand-washing requires, but that is just the beginning.

That RN is up-to-date on research studies indicating which germs cannot be killed by alcohol-based hand sanitizers. That RN is the chair of an interdisciplinary hospital committee working on improving compliance with methicillin-resistant Staphylococcus aureus (MRSA) precautions. That RN is scheduling replacement of the plastic tubes going into your body so that you do not develop skin, blood, or urinary tract infections and communicating that to the next shift. That RN is pulling aside the provider that did not use gloves when examining your wounds, then requesting an order for topical antibiotics.

Registered nurses are professionals in preventing infection. Today’s sick and wounded need no less.

Chelsea Landolin
Student Nurse, UCSF

Dr. Alvarez highlights the important topic of hospital acquired infections, worrying that patients have to fend for themselves in a broken system. What is left out is mention of the patient’s best ally for preventing hospital-acquired infection, one of America’s cadre of three million registered nurses.

The well-trained, educated, vocal nurse you deserve at your bedside when you are ill knows what kind of soap, how many seconds, and how much friction an adequate hand-washing requires, but that is just the beginning.

That RN is up-to-date on research studies indicating which germs cannot be killed by alcohol-based hand sanitizers. That RN is the chair of an interdisciplinary hospital committee working on improving compliance with methicillin-resistant Staphylococcus aureus (MRSA) precautions. That RN is scheduling replacement of the plastic tubes going into your body so that you do not develop skin, blood, or urinary tract infections and communicating that to the next shift. That RN is pulling aside the provider that did not use gloves when examining your wounds, then requesting an order for topical antibiotics.

Registered nurses are professionals in preventing infection. If you make demands, demand them: today’s sick and wounded need no less.

Chelsea Landolin
Student Nurse, UCSF

Thank you for the tips.

I had a sigmoidoscopy last year and I remember wondering how they sterilize the tubing. It seemed like a type that would be re-used and didn’t seem to be something that appeared could easily be sterilized. I guess they must do so. And I’m assuming this would be similar equipment to that used for a colonoscopy–I guess they just go up further and you have to be sedated usually for that–which seems to be the procedure that they now were warning people about at some VA hospitals since something didn’t get properly sterilized.

But reportedly there are a huge amount of hospital acquired infections and a lot of them from just lack of basic hygiene. It seems that this is not a very high priority for hospitals or more would be done to make sure that basic hand washing, glove changing etc are done, and ensuring that medical personnel have time so they don’t feel so rushed that they neglect these things.

And at VA hospitals there has been talk about poor care for years but not much seems to be done. I wrote to my congressman several years ago after reports about one problem area and he wrote back with a bunch of excuses and they are doing the best they can type of excuse.

I, and I think most Americans agree with Dr Manny that its the least we can do to provide decent, quality care for our veterans after what they have done for us, and especially combat veterans.

When my niece suffered a horrible traumatic brain injury, she was flown to Strong Memorial Hospital in Rochester, NY. She was given excellent consistant care in the trauma unit, where well trained RN’s cared for 1 or 2 patients only. But then she was transferred to a surgical unit. My sister and I watched in horror as an overworked RN, dropped the inner canula to her trach, on a dirty floor, picked it up and then tried to insert it. Luckily both me and my sister grabbed the RN’s arm before she could do this. The RN said she was so tired she didn’t even remember dropping it. She was caring for 9 patients. Then they sent my niece for a CT because she was having trouble getting air, with an UAP (unlicensed assistive personnel) who was not trained in CPR even, from housekeeping. We went with them. I grabbed a portable suction and resp bag on the way out the door. We were 10 minutes from CT when she was completely occluded and could get no air. I started suctioning and my sister hit a code alarm in the hall. It took them 30 minutes until they could get her airway clear enough to get her test done. She was occluded because of poor airway clearance management by nursing staff. I am in EMS and a nursing student. Had I not been there she would be dead and hospital would have chocked the death up to brain injury complications. I blame this all on a facility who encourages and demands too many patients per nurse and a poor RN Management call. Nonprofits better?

It is hard to be demanding in a hospital setting. In my experiences hospital staff are very intimidating. However, while being cared for in a hospital, I am the boss. I pay the bill so I have the say so but it is hard to be demanding.

Having been a “victim” of the VA care system for over 20 years now as a military retiree, I can say that this is just the tip of the iceberg. I have had:

1) non-certified drugs tested on me without my permission, finding out about it later;

2) had dry tubes hooked up to my IV while the bag of antibiotics was left to drip on the floor until I noticed it and kinked the dry tube while screaming for help (which took 15 minutes in coming);

3) been ignored while I complained about an itching and rash-y IV site until my whole body had broken out with rash from allergic reaction to the antibiotic;

4) had doctors touch my infection site with bare hands over my objections, and not sterilize their hands as they entered my room and did not do so on their way out. While I complained I was told “Americans are soft” and that maybe I should check myself out of the VA hospital AOR and pay for care at a civilian hospital;

5) have had the first three shift of nurses all try to give me the last patient in my bed’s medicine after I was newly admitted, one of the medicines to which I was deathly allergic. Each shift apparently not notifying the next of the new patient.

All this was on my last admission to a VA hospital. Complaining to hospital administration and even to my congressman did no good, so now if I have a hospital-worthy problem, I check myself into a civilian hospital and let Medicare pay for it and only take my routine care through the VA clinics.

The VA SHOULD represent the best health care? That is a joke. I did some training at the VA for Xray Technology some years ago and the health “care” that I witnessed was a joke, compared to the traditional hospitals. Also, my husband is a veteran and for something as simple as an address change, it has taken an act of God to get it changed. I would not want my dog in a VA hospital.

And bring LYSOL! After the birth of my 5th child, I used the telephone in the delivery room and was treated to a STAPH infection behind my ear. I was sick within hours so the hospital was able to determine it was from that specific area of the room. My body still has not fully recovered, and the hospital will not claim any responsibility saying (and I quote) “To say the hospital is wholly to blame for the transfer of staph is comparable to claiming one caught a cold from a sneezing idividual in a waiting room”. I should have brought LYSOL!!!

I work in a hospital as a nurse and would never be offended if asked to do any of these things. As a matter of fact, our hospital already teaches us to purposefully let the patient see us washing our hands and tell them we’re washing them at the same time. We then put on new gloves in fron tof the patient. Same thing with needles and medication. They watch us remove the needle from the package and open new bottles of medicine in front of them. We explain this to them while doing it. It just makes sense to create that level of comfort for the patient rather than having them guess. We’re not a hotel, but we try to treat our patients like guests for a great experience and recovery during their stay with us.

Yeah sure.
Obviously this doctor has never been a patient in a hospital.
The whole idea of the hospital is to make you ill.
Indifferent nurses with attitudes, especially the vampires types that work the night shift.
Dirty rooms, with a hospital staff that never clean properly.
Doctors that treat you more as an object then a human being.
Since hospitals became profit making corporations, the care factor towards helping the patient recover has dropped dramatically!
And now Obama wants to nationalize health care!
That means one thing.
People are going to die a lot sooner than they ought to.

In the fall of 1999, my elderly father was put in the VA in Little Rock, Arkansas be cause of a suspect spot on his lung found on a xray. They said it was etiher cancer or TB so he couldn’t go home the our home of 50 years and possibly infect anyone else, who had been with him daily anyway. They put in an unsheilded UV light in his room and gave he and I both a nasty sunburn. Being admitted prior to a goverment holiday, they didn’t even run the first test until he had been in the bed 4 days. By then, he had full blown pneumonia and died from it about a week later. The autopsy showed no spot on his lungs at all. Murder by neglect.

I witnessed a similar incident that occurred to my husband who was employed by the Veterans Administration Hospital in Atlanta, GA. During the time period between 1986 or 1987 while employed at the hospital as a janitor, he was stuck by a needle while emptying the trash can in a patient room. There was a needle there that was not disposed of correctly and my husband was injured. The patient had hepatitis c that infected my husband, who in turn infected me through sexual activity. We both were treated with a series of shots by the hospital, which were given to us to fight off the disease. However, now in the year of 2009 my wife has been diagnosed with stage 3 kidney failure of 30%. There is a possibility that she will need treatment with daliays treatments if not controlled by her with diet.
Is there a class action settlement suit pending from this kind of mistreatment pending? Are there any to other type of judgement that can be made against the Veteran’s Administration Hospital for the unprofessional behavior of their employees?

I hate to say this but “filthy medical staffs” have a long history. Long held family policy with rental residences: “Don’t rent to doctors or nurses, they leave houses absolutely filthy!” I think these folks think they are “too good to be wash their hands” or “too good to be careful with other people’s health.” That’s why plaintiff’s awards need to go up, sue these folks into some humility so that they take better care of patients.

As a practicing surgeon I find your comments to be quite misleading and unfair to the vast majority of medical professionals who are struggling to provide the highest quality care that they can. I find it amazing that you fail to mention how much more difficult our job has become dealing with the effects of an aging population, an explosion in the incidence of diabetes, senility and drug resistant bacteria, plus many other conditions, all of which lead to an increase in the incorrectly labled “medical error” of “infections”. Our jobs have become difficult enough without our own people selling us out.
Please tell the whole story before you make accusations that will serve no purpose other then to make our jobs harder.

Chelsea ’s comments are the best! I know ,after being in a hospital for almost 2 weeks , the RN’s were nothing but professional,they are the best. Never accept anything except an RN.Many in my family have been hospitalized and NONE accept anything less than an RN. THEY ARE THE BEST
CHELSEA ,THANK YOU AND YOUR SISTERS for their devotion to duty and your training….again, thank-you…..

Hold on now Mr. I look forward to having my upcoming book come out “MOMMA SICK BAD, LEAVE THE PEN AT HOME: HOW TO GET GOOD CARE IN AN ICU”. I have been a Critical care RN for over 11 years now and when people like this guy write things, he is doing you a disservice. If you are going to be passive aggressive and make demands that are unfounded because you read it on the internet or saw it on 20/20, you are not going to be liked much. Think about it, if you are annoying then who wants to take care of your sick Loved one? And I bet you didn’t think of this: If you are annoying, The Charge Nurse, (the one with the most experience) is not going to want to deal with you and they get to make the daily assignments. This translates into a less experienced nurse taking care of your loved one. Less experience most likely would translate into slower treatment of critical situations, and or more mistakes. So If you want good Care in an ICU, stay away from Google, and try to pretend you are a doctor. Obey Visiting hours. Feed the Staff, be their friend, not their enemy. Do this and i’m sure your experience will be better!!!

-Brad

My father was an alcoholic. A functiioning one until the last few years of his life. In 2000 he entered a VA facility for a dry out. Upon entering the hospital he was incoherent, as he was being admitted he passed out on the floor. As an aid “helped” him up, he stepped on his leg, injuring it. Within 2 days of admittance he made a disturbing call to my mother that showed he was delusional. My father’s sister went to the hospital and found him sitting in a chair, unwashed, unattended to. She raised holy hell. She was told by staff that nothing was wrong with him and that he was just going through the DT’s. She asked about a CAT scan or an MRI and was told it was just too expensive and unncecessary. She fought and fought to have some sort of tests run and finally got someone to listen. Turns out he had a SEVERE potassium deficiency that almost killed him. If it wasn’t for my aunt’s persistance he would have died of something completely treatable. He was treated with complete disdain and all his medical issues were chalked up to the alcohol, never given the benefit of the doubt. The way we treat our veteran’s is dispicable.

Regarding comments by Thomas D Guastavino MD:

Demands on professional staff are immense. You are right when you note them here. But overloading the physicians and nurses so that they are prone to make mistakes is done nevertheless. Cost-cutting? Watch politicians’ pay; get real.

The medical staff in large institutions is caught in the squeeze between the urge to cut costs and the need to maintain quality. We should not disparage the hard-working staff–if they are competent and don’t make scoldable mistakes. But we and they should insist on withstandable workloads and a work environment in which good health care is realistic. Do not trust a physician or nurse who is in an unrealistically demanding setting, says so, and does not make some effort to improve the setting: judge intent from actions.

I am a professional nurse working in hospital Infection Control. The issues raised are not unique to any hospital and they are, unfortunately, common. Despite the best efforts of Infection Preventionists, hospital staff continue to be forced to work under conditions that are often barbaric. RNs and LPNs may have to care for 8 to 10 patients for 12 long grueling hours. They are tasked with caring for patients who are much more ill than a decade ago with an emphasis on “get them in, get them out”. Add to that the ever increasing documentation for “compliance” purposes and the emphasis today is more on dotting your “i’s” and crossing your “t’s”. All the while, the nurses are struggling to provide the very best care they can under the circumstances. It is unacceptable that nurses fail to wash their hands but in my practice I find that physicians are the primary problem. How can we expect nursing staff to comply if they witness physicians going into room after room without washing, using the same stethoscope on multiple patients without cleaning it and, in general, thumbing their nose at sound infection control principles. My advice, get the physicians and administrators to lead by example!

My mother has dementia. What about the care she receives before I get to the hospital to demand all these things? She wouldn’t know to ask.

It is a sad day when the greatest country in the world has to claim some of the wore conditions in health care safety in the world. We think of our selves as the ones who show the rest of the world how to live and yet we are not responsible people. is tht not like the pot calling the kettle black? we need to stop being so arrogant and step back and take a look at our selves.

Just think how the healthcare system will be when it’s all federally funded – you can bet your life (pray you don’t have to) on there being over-worked nurses and understaffed facilities.

To all: The VA system demonstrates what will happen if the President is successful in nationalizing the healthcare system. Believe me that it will get much, much worse along with the denial of basic procedures due to an individual’s age, job, status, etc. You will then only go into a hospital to die, even if you only need to have an ingrown toenail fixed. What service has government touched without screwing it up?

HAVING CARED FOR MY FATHER AND BROTHER WHO BOTH DIED FROM CANCER AFTER MANY, MANY HOSPITAL STAYS I HAVE COME TO THE CONCLUSION THAT THE BEST PROTECTION AGAINST BAD HOSPITAL CARE IS FAMILY PRESENCE. WHENEVER HOSPITAL STAFF BECOME AWARE THAT THERE ARE CONCERNED FAMILY MEMBERS IN ATTENDANCE THEY BECOME MUCH MORE CONCERNED ABOUT THE PATIENTS WANTS AND NEEDS.

I am totally offended by many of the posts. Do not judge until you have done the work that I do. Do not judge until you work with the kinds of people and patients that I work with. I am a RN and also a paramedic. I have worked on an ambulance as well as in the hosp. I can say that most people I ran calls on lived in filth. Most patients that I take care of need a bath. To blame everything on nursing is ridiculous. We work with blood, urine, feces, all types of secretions on a daily basis. We are in the same facility exposed to the same things. Every profession has good people and bad. And just to let you know, the box of gloves that are so clean…really aren’t. My freshly washed hands are much cleaner than that box of gloves that someone has stuck dirty gloved hands into. I have pulled out gloves that are soiled and disgusting.

As a retired RN/MSN, the level of sanitation at hospitals is deplorable. The hospitals hire immigrant labor (cheap Phillipine RNs) and people who were digging in garbage for food before sneaking into the USA aren’t the best at sanitation practices–this is why people keep getting sick on cruises too–the Haitians don’t wash their hands and don’t move the dishes before they pee in the sink. Take someone with you at all times in the hospital and make the staff INCLUDING YOUR DOCTOR wash their hands when they come into the room. Make your visitors wash their hands when they come into the room. Clean, unbroken skin is your first line of defense against infection!!

Great article. Thanks for the insights. This is one of my biggest complaints about the medical system – I am always seeing lax & non-hygienical practices in hospitals with the same examples you’ve stated. If I was a healthcare worker, I don’t care how busy my schedule was, I would be certain to wash my hands in front of each patient and put on a fresh pair of gloves in front of them and open only new bottles, needles, medicines when administering. It is only far too often that nursing staff is careless about these matters. Looks like we all have to more aggressively assert ourselves.

Regardless of these healthcare workers’ protestations about this article, they know these bad practices are common occurrence. Too bad they get offended, they should accept constructive criticism like any industry or field.

Important point is that when one is ill in the hospital, it is very hard to assert oneself to demand these proper health practices. That makes it all the more important for hospital staff to be made aware on a daily basis of exhibiting proper hygiene and sanitization practices in front of patients.

I am a nurse and have worked in infection prevention for many years. First, to Nia M.: Lysol contains phenol, which causes brain injury in newborns and infants. Hand washing is the number one method of preventing infection spread. Second, not all hospitals fall into the scenario that Dr. Manny describes. It is up to the hospital administration to decision how much to allocate in resources to infection prevention, and includes supporting that person with ability to attend conferences and update their knowledge. With the budget cuts going on now in both for profit and non-profits, it will be a challenge to keep a quality person with experience, knowledge, and give that person what is needed. If there is one infection preventionist for 250 or more beds, that says volumes in terms of what the hospital’s administration feels is important for quality patient care. because one infection preventionist is not nearly enough for the demands of the job.
An good infection preventionist does assessment of practice and education on each floor. The preventionist is responsible for preventing hospital acquired infections. The preventionist can see opportunities for improvement such as staff not washing their hands, poor housekeeping practices, and other important infection prevention instances, correct poor practice and make recommendations. There are organizations that are pushing for better hospital practices including the Association for Professionals in Infection Control and Prevention.

This whole topic is one were most of the information out there is based on fear and false or misinformation.

Health care providers all take this personally,even though best practice tels them they should be doign the things that are mentioned in this post.

1. Infection or not, you supposed to open meds at the bedside were possible. Most everything is unit dose now. And patients have always been told to ask if they dont’ know or recognize a medication.

2. washing hands? In general, I’ve found the people who freak out the most, about being asked about handwashing, are pople who aren’t as carefull as they should be. I can remember the uproar a few years ago about the “aske me if I’ve washed my hands campain”

3. Bringing your own lysol. Probably the quickest way to get asked to leave. Most people don’t know that in order to get that 99% of germs you have to get your target wet and let it air dry. Plus there is a reason hospitals don’t use lysol. Not only does it kill germs. it’s got bad stuff that can make people sick.

4. Incubation times. It takes a while for most infections to cook enough to make you sick. It’s really bad stuff and extremly rare for anything like staff to make you sick in an hour unless ou inject it.

5. Upset staff. yes your going to upset some of the staff. But I remember a movement a couple of years ago were nurses all brought another nurse with them to watch out, if they went into the hospital. Just be polite and firm. It’s your right.

The ICU nurse who stated that you can’t offend those who care for you are correct. People are human and if you insult them by telling them they are “doing” it wrong, or request that they do everything in front of you, then you are just inviting trouble for yourself. These nurses will take it out on you – it’s human to not care so much about someone once they have insulted you and that’s what you are doing when you ask to SEE a nurse was his or her hands in front of you (you are in essence telling them you don’t think they can handle their job competently).

What you should do instead is tell them you are a hypochondriac. Bring a new box of latex (or non-latex) hospital grade gloves with you, etc… Then you can go on and on about being a hypochondriac and the nurses will not take what you ask for so personally. Be really nice about it.

The other thing you can do to encourage your nurses to take a true interest in your care is to be outgoing and friendly as well. Joke around with them.

Finally, as a patient you should NEVER treat your nurse like a waiter or waitress. EVER. Don’t be that “annoying” patient. The one who is always pressing the “call” button for useless reasons, the one who criticizes the hospital staff, nurses and doctors or even the hospital itself. The one who is always too cold or too hot and then too cold again. The one who wants to literally be spoon fed when he/she is capable. Also, make sure you keep all annoying family members at home.

Healthcare is always a hot topic and once the discussion starts, the flames really let loose. That being said, I believe our healthcare system is seriously broken. Can I offer a solution? Not totally, but I do believe that our system is being entirely run by a FOR PROFIT industry (the health insurance companies) and legalized drugs (Pharma). I literally had a doctor tell my step-father that he shouldn’t worry about changing his diet even though his blood pressure is through the roof and he’s getting blind spots in his vision so badly, that they can’t put him on medication (he followed this advice by downing three bowls of soup at the Olive Garden for dinner). This less than a year after my 9-month-old was taken from me in the most unbelievably tragic and preventable circumstances (www.wyattsleamonadestand.com/story.html).

Until our system is reformed, all I can say is, making a commitment to health (not the latest diet craze) via diet, moderate exercise, reducing drugs (legal and illegal) and preventative care is the #1 thing we can do to protect ourselves and our children from an imperfect hospital system.

Good luck to us all, I hope the winds of change can continue to blow strong and hard.

Thanks!

–Leamonade

Yesterday, Fox News age a tease about heart failure being a thing of th past. I could not listen to the full story, I had to go to work. This is personal for me. How can I find out more about this story. Also, You have on the website a story about breathing easier. I cannot see this as it is in video form only. How can I get the text of this?
Thank you,
Kevin Matz

About the VA..
1. I only use themfor getting my Meds/Drugs & Medical supplies..But You won’t get anything but Generic Drugs most of the time..That are cheaper at Wal mart than getting them from the VA.

2. Their Dr.’s are Mostly either Part Time- from the private sector that have No Interest in you Or they are Immigrant Dr.’s doing their Intership from India or Asia and you can’t reach them when they are not At the VA, Ave only 1 day per week .. Your just told to Come to the ER instead..

3. And the Type of Nurses an Support staff? You have to be kidding, they could’nt get Jobs on the Outside/Private Sector and thus get them here…So what does that tell you?

I don’t blame the Better Private Care Dr.’s not wanting the Job, only getting paid $75k yr vs making Twice that or more outside the VA..in Private Practice..

The VA has become a Home for Minority and other Rejects.. that can’t get a job elsewhere..
Maybe it’s also due to where The VA’s are Located..?

I’ve had 5 Different GP Dr’s in the 5 yrs having to use them.. only 1 was interested in trying to help, but told me they have 1 hand Tied Behind their Back when Recommending treatment…

It’s the Old HMO game at the VA..

BEWARE!

If you get the spray vacine, I heard you can then give the flu to others. If this is true how long after you get it can you give it?

Although these tips do not come with an ironclad guarantee of safety, they will help you to feel more confident and in control in medical situations. By taking charge of your health, you will almost certainly reduce your risk of becoming a malpractice victim. Much medical malpractice occurs totally outside the control of the patient. In most cases, patients are stunned to discover they are victims of medical negligence. However, not all malpractice comes as a complete surprise. Some of my injured clients recall “warning signs” or “gut feelings” that, if heeded, would have steered them away from the doctor who injured them. However, there are times when your actions – or lack of action – may determine whether you get the care you need and deserve.