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March 28, 2013

Not just the cost of health care matters ...

Cooperstown Crier

---- — After last week’s column regarding billing procedures within the health care industry, we have been asked if we have an opinion regarding the quality of health care regardless of its cost. And while we cannot speak to the overall quality of health care in the country, we can answer the question when it comes to our own experience, most particularly our inpatient experience, with the quality of the health care system locally.

To say that we found the care we received as an inpatient following hip surgery was satisfactory would be a stretch, a very big stretch. In fact, it is most difficult to justify as acceptable medicine the fact that we were not given a morphine pump for pain control following surgery or that we received discharge directives that told us to resume medication which, we later discovered, were not appropriate given we were put on Coumadin to avoid blood clots.

Beyond that we are still mystified at having been left lying on our left side for 14 hours the first night following our surgery in spite of asking at least twice to be moved, something that evidently could not be done as we were told it was too painful for us to be moved. We also, while on our side, were appalled to realize we were forced to eat our scrambled eggs with our fingers as we could not manage to reach them to eat them with a fork. And then, of course, there is the question of whether they were worth eating in the first place. For the most part we found the food to be inedible, with the possible exception of the Caesar salad with grilled chicken.

However, we really think that what bothered us the most was the fact that during our stay, we, unfortunately, wet the bed three times as we did not receive the necessary help to get to the bathroom before we had an accident. And, although this may be difficult to believe, we did not enjoy one bit lying in a pool of our own urine. In fact, the third time it happened we called the administrator in charge to complain about the care since our PCA (personal care assistant), formerly known, we think, as a nurses’ aide, explained, after apologizing profusely for her tardiness, that she was taking care of 22 patients that day.

During the conversation with the administrator in charge, we pointed out our frustration with our situation as a inpatient. Quite frankly, we expected more and were sorely disappointed with what we got. We added that we did not think it was possible to run a hospital that seemed so woefully under-staffed. The response to this is that the hospital is fully staffed but the employees just don’t show up for work. Such an answer made no sense whatsoever to us because it did not seem to us, from the patient’s point of view, that they were as “fully staffed” as they might like to think.

All in all, we are sorry to report that we would rate our inpatient experience as quite poor. However, we hasten to point out that, unlike some comments we have received from patients regarding care, our rating does not in anyway reflect poorly on the many dedicated nurses and PCAs who took care of us during our stay. With few exceptions, we found those people in charge of our care to be some of the most caring and most dedicated people we have encountered. Unfortunately, they are being asked to work under conditions that almost guarantee they will not be able to deliver the care they know their patients deserve.

In fact, we are utterly amazed that there are so many hard-working and dedicated employees who come to work each and every day knowing they will not be able to provide the care they want the patients to receive. It is unimaginable to us that employees would be expected to work under the conditions that they evidently encounter on a daily basis. So instead of faulting the employees for the quality of care, we would instead fault the administration for its seeming utter lack of staffing necessary to provide even an adequate level of care for patients in the hospital.

We would also add that the success of a health care facility is only as good as its weakest link. There are many fine doctors in the system. But the work they are doing is seriously compromised when an equally fine support staff is not available to successfully continue excellent care for the patients. And at this point, given what seems to be obvious lacking in numbers of that support staff, there is no question that patients are not being provided with the health care they not only want, but with the health care they deserve.

In fact, as we have mused over our experience we are reminded of what we said many years ago, not long after we started writing this column with our late husband. We were interviewed for article regarding Cooperstown’s designation as a great four-season retirement community. We well remember saying during that interview that one of the real pluses for Cooperstown as a retirement community was its access to good health care. Unfortunately, after our recent experience as an inpatient, we would have to think long and hard, and are not all certain, that we would be able to say that today.

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