Hospital nightmare

Published December 6, 2022, 12:05 AM

by Raymundo W. Lo, MD, FPSP

UNDER THE MICROSCOPE

Dr. Raymundo Lo

From their former image as places of disease and death, hospitals are now viewed as centers of wellness and healing. We have no shortage of first-class hospitals. St. Luke’s Medical Center, Makati Medical Center, and Medical City exemplify the highest quality and standards of health care by being accredited by Joint Commission International (JCI), a partner organization of Joint Commission, which accredits USA hospitals. JCI accredits hospitals worldwide and is now recognized as the gold standard for patient care and safety in the international health care community.

It is no mean feat to qualify for JCI accreditation, requiring adherence to the highest standards of medical care, ranging from the physical plant all to the way to patient safety, which should be the focus of medical practice, because the first dictum of doctors is, “Primum non nocere,” Latin for “First, do no harm.”

Having been in practice in St. Luke’s Medical Center for 35 years now, I’ve seen how St. Luke’s has grown from strength to strength, and I have proudly participated from the first time St. Luke’s applied for JCI accreditation. Thus, I expect the same high standards of care for patients in hospitals everywhere.

But alas, this is not the case in all. A very recent experience left me with nothing but frustration and anger. At work yesterday, my son Richard had several bouts of vomiting and diarrhea that left him dehydrated, and the company nurse told me my son needed to be admitted to the hospital for intravenous therapy. Since their company had a tie-up with another hospital, they had him admitted there the same day.

Right away, I packed my overnight bag and proceeded to that hospital. There, I found Richard in bed looking weak and dry-mouthed. He had been admitted 30 minutes ago, but to my dismay, the nursing staff had not taken his vital signs nor had they inserted an intravenous line to start the process of rehydration. Only after I inquired did they attempt to insert an IV line which they failed at. Another nurse came in with the first and inspected his arm veins which, of course, were collapsed because of the dehydration. They then left. After an hour, nothing was happening, and I was getting nervous about my son’s situation, since he was having difficulty breathing and his fingernail beds were dusky blue, which indicates lack of oxygen.

At the nurses station, I asked politely if they had contacted the resident. The nurse claimed she had. Yet, considering the patient’s situation, which I doubt they knew about as no vital signs had been taken, I told them I was a doctor and needed to talk to the resident-in-charge. Still, nothing happened for the next half hour, at which point I started calling on my med school classmates still practicing in that hospital to get some action on my son. Only then did the resident arrive and get an IV line in my son’s arm going.

Noticing the slow IV drip, I asked the nurse what the rate of infusion was. Her answer was “to consume one liter of IV fluid in eight hours.” Well, I blew my top. Told her that the patient, if she had taken his vital signs, was moderately dehydrated and needed to have lost fluids replaced at a faster rate. Again, I had to turn to my classmates for help. Can you imagine a non-medical person in that situation? There definitely would be a high risk of harm or even death for the patient if no action was taken, which required medical acumen and connections to correct!

My classmates had notified the chief of clinics and the chief quality officer of the situation, and things were better from that point on. Finally, a bolus of 150 ml. of IV fluid was given and the IV drip was hastened. Fortunately, Richard was also able to drink and keep in several bottles of water and a liter of Gatorade, which is good for replenishing lost electrolytes. He looked better then and his nailbeds were now pink.

Then I turned on the TV to get some news, and all I got from the tiny 19-inch screen was a blurry picture and bad sound from only local channels. Next, to add injury to insult, I was trapped in the toilet due to a malfunctioning lock. The nurse had to open the door from the outside. Last point, the diet ordered was low-fat, but the breakfast was beef tapa and fried egg with rice. How was that low-fat? I had Richard discharged first thing in the morning. I could take care of him better at home. End of nightmare.

So much room for improvement in that hospital, which used to be one of the best in the 1970s.

 
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