Did a Pittsburgh Hospital Try to Kill my Mother-in-Law?

On Tuesday, October 25, my mother-in-law entered a prominent Pittsburgh hospital to undergo a routine surgical procedure. She was at the hospital to have cataract surgery performed. Before getting into her situation, the following factual information should be disclosed.

This year, great medical newspapers, like the Pittsburgh Post-Gazette have reported that nearly 2,000,000 U.S. citizens acquire an infection as a consequence of treatment in a U.S. hospital and that 90,000 people die as a consequence. The average hospital infection rate is five percent of all hospital admissions. The death rate is higher than the death rate of breast cancer. A copy of the official report can be found in an online newspaper: www.governing.com.

So, back to my mother-in—law. I must say that each person who treated her and prepared her for surgery was very nice to her. Each staff member was courteous and respectful of this 84 year old mother, grandmother and great-grandmother.

In the interest of time, let me focus on the pre-operative observations. One nurse, to be delicate, was ministering to the needs of her nose with her fingers and hand. She immediately went to a man and administered eye drops to his eyes and then to my mother-in-law to put in her eye drops. All three procedures were ungloved, done in rapid succession; no hand washing was performed. As a matter of fact, not one nurse nor employee in the pre-operative setting wore gloves as they prepared a group of patients for surgery. Another nurse had an interesting pre-surgical technique. She reviewed the medical record of each patient by putting two of her fingers in her mouth every time she turned a page in the medical record and then, without washing her hands, pulled back the eye lids of an elderly gentleman to examine his eye and surrounding tissues. Another nurse had something; ironically, bothering her eyes and rubbed her eyes with two fists and then, without washing her hand or wearing gloves, continued to touch the tissues surrounding the eyes of the patients being prepared for surgery.

Why did I not say something to someone in charge? Here are several lame excuses:

1. I knew my mother-in-law would have been uncomfortable with me complaining about her treatment, just before going to surgery.

2. Even though this is a form of “Russian Roulette”, I knew the odds were in her favor. Nineteen of twenty patients escape the American hospital without an infection.

3. Somewhere in my base fears was the anxiety that someone would retaliate or insult my mother-in-law because of my complaining.

4. Last, and the most honest answer, despite all of my bluster in writing, when the chips were down, I was gutless to say something in my mother-in-law’s defense.

I am truly ashamed. I love my mother-in-law. She has been feeding me for nearly forty years.

So, why are healthcare personnel so sloppy when it comes to the most basic and, perhaps, the most important infection control technique - hand washing.

That answer is deeply rooted in a very simple explanation. Hospital organizations are generally not organized or managed to change the culture with respect to infection control. How can I be so sure? Well, you do not have to go very far in Pittsburgh to dismiss two myths about infection control:

Myth # 1: Infections are an inevitable consequence of interacting with the American Hospital.
Allegheny General Hospital has provided national leadership in demonstrating that the impossible can be attained in eliminating hospital acquired infections through a commitment to patient safety and process improvement. Their achievements are well documented, and the leadership of Allegheny General Hospital does not need me to tell their story. They are among a growing number of hospitals that are fighting back against cultural norms that permit sloppy infection control practices.

Myth # 2: Nurses and physicians are too busy to wash their hands.
In many hospital settings, this is not a myth. Nurses are frequently sent out to do the impossible without appropriate support, tools or training to be effective in their advocacy for the patient. A recent feature article in Newsweek singled out the nursing leadership of UPMC Shadyside Hospital for fundamentally reorganizing nursing to eliminate the sense of chaos so often experienced by practicing nurses. And, the nurses and nursing leadership at UPMC Shadyside Hospital have not stopped in their efforts to continue improving the working conditions for nurses at the hospital. Guess what? The nurses not only have time to wash their hands, they have time to wash their hands properly.

No, the unnamed Pittsburgh hospital was not trying to kill my mother-in-law. The nurses involved in her pre-operative care would be shocked to read this. They were nice people working in a hospital that has established low expectations for them.

My mother-in-law had a favorable surgical outcome as expected and did not acquire an infection. One in twenty mothers-in-law is not so lucky.

Republished with permission from the Hospital News Group

High Technology Leads a Double Life

Who does not own a cell phone? You hear them ringing when you watch a movie. Sitting in a typical restaurant is like a scene from Saturday Night Live; every third person is talking to someone about something that is annoying to the other patrons. As a frequent flyer, my favorite experience is sitting in wait to board my plane. Men and women talk into their cell phones disclosing confidential and sensitive information about their companies and clients that would have them terminated if known to their employers.

No, these descriptions of the ubiquitous cell phones are not what is on my mind today. What I am interested in today is buying a cell phone or getting service for a cell phone. I am not going to mention my "cellular technology service provider" (notice we don't say "company" any longer) because I fear they will call me on my cell phone!

Recently I went to buy a new cell phone. I wanted to move up the food chain of new and improved cellular technology. As I entered the store, I was greeted by a woman with a pleasant countenance who directed me to a sign-in kiosk. I obediently complied. I gave up my name, cell phone number and other information irrelevant to my visit. It turns out that the kiosk was used to determine what place in line I would be assigned.

Then, while standing in a showroom that gave testimony to breathtaking time-saving technology, I waited and waited and waited. Finally, I heard my name called out. I was greeted by a young fellow who was deeply in need of a personality transplant. He seemed remarkably less human than the kiosk. We went to his standing desk and were separated by his desk and a computer. He stared into the computer screen and began asking me a series of questions, most of which I had provided to the kiosk. Okay, the poor fellow has a job to do. Without his ever making eye contact with me, the divine liturgy of buying cellular technology was in full swing. He worked over his keyboard with such determination. Most of the typing was done without asking any questions. It had a life of its own. He could have been writing the great American novel for all I knew.

Finally, I told him why I was there. Never looking up, he told me I have seventeen options. What do I know? I inquired what he thought might be best for my circumstance? He replied, “. . . How would I know anything about your circumstance?” I guess that is a fair question, but it was not so friendly. I was on the defensive with all of my ignorance in full view. I sucked down my emotions and continued to participate. I made a selection on a par with selecting cantaloupe in the summer. Sometimes it is hard to know if you have made the right selection. One thing is certain, sniffing cell phones does not help one bit.

The purchase was complete . . . sort of. Then the paperwork started. It was printed out of view beneath the computer in the stand up desk. I signed more paperwork than at the closing on my last home. The receipt was three feet long. Then came another three-foot receipt to mail in with a bar code from the package containing my cell phone so I might receive a $50.00 rebate. I get the impression they do not expect people as busy as me to mail too many of these cut-out bar codes and three-foot long receipts very often, or they would simply reduce the price of the cell phone. This is all very much unappreciated.

This experience lasted one hour and fifteen minutes. Remember, I am standing in a cathedral of advanced technology designed to make life more convenient and save time.

So, high technology lives a double life. The engineers of cellular technology have not spent much time engineering their retail stores. I exited the store with a magnificent PDA cell phone combination. Why did I not feel good about my new found technology? The answer is simple. For one hour and fifteen minutes, I was treated like I was an inanimate object . . . not a human being. This second life of the technology industry should change. In fact, the company that learns how to treat customers like human beings is likely to grow like a weed, even if they do not have the absolute best cell phone. Maybe I am just too sensitive. Maybe I am right.

Jan Jennings

Republished with permission from the Hospital News Group