Taking The Hell Out Of Healthcare

By F Nicholas Jacobs

For those facing hospitalization -- or those with loved ones in need of hospital care, this book provides an excellent guide for a better understanding of the entire process. The reader will gain invaluable insight regarding the admission process, what to expect from the doctors, nurses and administrators and much much more. From the ER to the OR to rehab, the reader will be lead through the step by step process with candor and understanding. Mostly, the writer provides the tools to give YOU more control over your hospital experience and your health

• Language: English
• Publisher: F Nicholas Jacobs
• Release date: Feb 8, 2016

Book preview

Copyright © 2008 by Nicholas Jacobs. All rights reserved.

Published by Real House Press, San Diego, California.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the author.

Limit of Liability/Disclaimer of warranty: While the publisher and author have used their very best efforts in preparing this book, they make no representations or warranties with respect to accuracy or completeness of the contents of this book. The advice and strategies herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor the author shall be liable for any expenses or any other damages, including but not limited to special, incidental, consequential, or other damages.

Book design: Leah Cooper

ISBN: 978-0-9799394-1-9

Library of Congress Cataloging-in-Publication Data

Jacobs Nick, 1947

Taking the Hell Out of Healthcare: A Patient’s Guide to Getting the Best Care/ Nicholas Jacobs

Printed in the United States of America

First edition

2008932638

CIP

DEDICATION

This book is dedicated to everyone who believes in creating a better future, in not being a victim, and in moving heaven and earth to reach positive goals. The spirit, love, and wisdom of my family, my dear friends, and my co-workers is represented in this book. Every success that has ever been part of my life has come from them. Special thanks to Reut and Lois, the angels who helped this book finally come to life.

TABLE OF CONTENTS

Forward

Introduction

Personal Reflection

Chapter 1    Getting There – In an ambulance?

Chapter 2    The Emergency Room – Look before you leap

Chapter 3    Registration – How do I get into the place?

Chapter 4    Laboratory Services

Chapter 5    Radiology – Sorry, I can’t tell you

Chapter 6    Respiratory – Take a deep breath

Chapter 7    Anesthesia – It’s not about putting you to sleep; It’s about waking you UP!

Chapter 8    Integrative Medicine and Physical Therapy

Chapter 9    Medication Errors – That’s not the way I wanted to die

Chapter 10  Infection Control – But did they wash their hands?

Chapter 11  Obstetrics

Chapter 12  Special Care Units – The CCU and Y-O-U

Chapter 13  Housekeeping – Can you tell by the smell?

Chapter 14  Cardiac Rehab

Chapter 15  Occupational Therapy – To do or not to do

Chapter 16  Food Service

Chapter 17  Psych – Stop the world. I need to get off

Chapter 18  Credentials

Chapter 19  Social Services – Wheelchairs, nursing homes, oxygen and other fun

Chapter 20  This is a Bill – How to survive without health insurance

Chapter 21  Research – Giving it back

Chapter 22  End of Life – When dying is finally enough

Chapter 23  They Really Hate Those Kids – What’s really going on in this system?

Chapter 24  Questions and More…

Chapter 25  Epilogue – What went wrong?

Appendix Your Rights as a Patient and a Person from A-Z

FORWARD

Why Did I Write This Book?

What is the ideal healthcare environment?

A healthcare environment dedicated to the creation of a healing philosophy leading to reduced mortality rates. This ideal is not only achievable, but a necessity as the baby boomers and everyone else grow older.

This book is dedicated to every man, woman, or child who has experienced the challenge of navigating the often treacherous white water of hospital care. Each year thousands of people are almost harmed, seriously harmed, or even killed due to normal human mistakes that occur in our nation’s hospitals. Sometimes these mistakes are related to medication errors, physician or nursing misjudgments, or fatigue. Sometimes they are caused by a combination of all of these elements.

The majority of the time, however, these situations can be avoided through close observance of your own care, education, and active participation in your treatment by yourself and your selected team of care partners.

During my more than twenty plus years in healthcare senior management, hundreds of these mistakes have crossed my desk for my input and acknowledgement. Each time I pen my name to the forms describing these mishaps, it brings home the reality of those near misses or nonfatal interventions.

This book is intended to arm its reader with the proper knowledge, skills, and insider insights to, ironically, allow you to survive the world’s most incredible, most effective, and most advanced healthcare system.

Let me be perfectly clear; this is not about flying in an airplane that was put on the secondary market 20 years ago following 30 previous years of service. This is about being able to enjoy and relax in a brand spanking new Boeing 757. Referring to United States healthcare, we are not talking about a group of misguided, under-trained, or unskilled individuals. We are talking about the most highly trained, highly educated, gifted human beings on the planet who have been equipped with the finest tools available.

The key is that these people are just that, people. They are human beings and, as human beings, as they do their work each day mistakes happen. Unlike a widget factory, six-sigma perfection is more challenging when the human body and human biology are involved, both as a caregiver and a patient. This book is not about placing blame or pointing fingers. This book is about the realities of healthcare.

The laws of probability and statistics will demonstrate time after time that one in 1000 carpal tunnel surgeries will go poorly, that one in 100,000 people will be totally paralyzed for a short amount of time by certain types of anesthesia, that during one percent of heart catheterizations the catheter may puncture and perhaps penetrate the right descending coronary artery causing damage that will later lead to another blockage or that may even require an immediate trip to the open heart surgery suite.

In the spirit of the bumper sticker made famous by the movie Forrest Gump, S- - - Happens.

This book is about how to help ensure that it does not happen to you. One of my favorite lines from one of our top surgeons has always been, Major surgery is anything that happens to me! Hospitalization is major when it happens to you. We live in a society that spends more on healthcare than any other in the world. We live in a society with the finest and fastest care available. But, it’s not perfect, and this book will help you navigate your own hospital stay with insights and suggestions from some of America’s finest and best providers.

We have been fortunate to have a wonderful staff of people who have contributed to this work through their wonderful compassionate care. Their combined years of experience would take us well into the 22nd century. None of this would have been possible without them and their daily care of patients. Having spent over $14 million for liability insurance coverage for all settlements slips, falls, and malpractice at our hospital since 1997—we have had to pay out slightly over $300,000 in total payments to individuals who have suffered in any way. This is a remarkable track record…for any hospital. Let me share that success with you.

Enjoy your trip through the maze and keep in mind what you learn, as you get a peek inside the world of healthcare administration. Along the way, I will share with you what I have found relevant both as a hospital administrator and as an individual. As your guide through the world of healthcare, I will explain your rights, answer common questions, and provide my opinion on this complex system.

INTRODUCTION

What is Patient Centered Care? How do you know if you’ve had it?

Each day I prepare myself for work by asking myself the same question over and over again. What if it was your mother, your wife, your daughter or son? How would YOU personally want to be treated? What about this facility makes you uneasy? What makes you feel at home?

For the past 16 years, my mission has been to create an environment of caring that provides a loving, nurturing feeling for families and their loved ones. It is to provide a center of excellence that addresses not only the need to be competent, but also the need to be human.

It has been my goal to create a truly healing environment wherein patients have an opportunity to take part in their care and to make decisions about the type of care they receive.

Patient Centered Care is about creating a place where Care Partners can actually provide support and participate in their loved ones’ care if they so choose.

How will this book get me Patient Centered Care?

It will provide a working tool that demonstrates patient rights and patient choices when dealing with a healthcare institution so that it is not just that, an institution using the old model of care giving.

When anyone has the pleasure or challenge of dealing with a hospital, it is important that they know the facts. It is important that they can anticipate the bumps in the road and learn how to navigate those challenges without damage.

Patient Centered Care can be the new world order, and unless or until every individual is attuned to this concept, it will not reach its full potential. Patient Centered Care represents a demystification of healthcare delivery. It represents an open spirit of communication that allows individuals to make the same types of informed choices that they have been entitled and encouraged to make in every other aspect of their lives.

As you read this book, understand that you are the decision maker. You are in charge. Don’t give up your rights. It’s your body. It’s your life. It’s your future.

CASES I HAVE SEEN

The case that ultimately sent me on my journey to demystify and humanize healthcare was that of my father. It was observing his experience that made me a crusader. It was this difficult experience that became a key driver in my life. At 28, those who represented the noble profession of healthcare frightened me. Being in a hospital was something that I never wanted to experience again. Working with physicians, smelling the antiseptic, being confronted by cruel attitudes were all things that clearly, in my mind, should be avoided at all costs in the future.

I watched my father being awakened by a phlebotomist at 2 a.m. so that lab results could be back in time for the resident to make rounds at 4:30 a.m. The doctor could almost be certain that no one would be available from the family to discuss the patient’s condition. These practices were all normal and acceptable.

Making my mom, brother, and I sleep in straight-backed wooden chairs and scolding us for leaning against the bed beside him because it will wrinkle the sheets was normal too.

Making the family wait for hours and days and weeks for test results was both normal and acceptable. Placing patients on cold gurneys and leaving them exposed in the hallways while the staff went to lunch or the specialist negotiated with his tax consultant was all part of the environment.

WHAT CAN YOU DO?

Take control of your hospital stay. You have the right to request humane care. You are the customer and client. You pay the bills that keep the facility open, and you and your advocates are not only permitted to question you should be encouraged to question every aspect of the care that’s being rendered. You have access to nursing managers, nursing supervisors, and nursing administrators. This is generally the same model that exists in every area of the hospital; i.e., radiology, laboratory, physical therapy. There is mid-management and senior management at every level. Don’t be shy about asking to see whomever you need to get your questions answered. Truthfully, most senior leaders won’t have the details relating to your case, but will certainly bring attention to the situation if called into the query.

PERSONAL REFLECTION

Then There Were Three

It was September of 1974 when my 57-year-old father’s cough was diagnosed as a lung cancer. He had stopped smoking 14 years earlier, and none of us were totally cognizant of the ramifications of his environment. All we knew was that a great person and a great father had been given a death sentence.

Ironically, our 74-year-old neighbor was diagnosed with lung cancer on the same day. The healthcare paths that these two very different men, from opposite ends of the socioeconomic spectrum, pursued on their way to death are notable and ironic.

My father did everything available to mankind in 1974-75 to arrest this disease and regain his life. This meant surgical removal of the lung, radiation, chemo and lots of morphine. He spent 18 months