As a former hospital administrator, I’m a believer in the old saying that “the squeaky wheel gets the grease.”
Hospitals are big, busy places. Patients are typically seen and followed by multiple doctors and it’s easy for needed tests, consultations, and reports to get lost in the shuffle. In other words, with lots of hands on deck, it can seem that no one’s really managing patient care.
It’s hard for patients—often in pain, sleepy from nightly staff interruptions, and being poked and prodded—to keep up with what’s going on. That’s why I’ve always recommended that hospitalized patients have a family or friend with them, if possible, 24/7 from admission to discharge. Family and friends are able to watch and listen and go advocate for urgent help when needed.
With the appearance of COVID-19, the possibility of being with a family member of friend quickly went from a possibility to a prohibition at many hospitals. Even as I write this article, lots of hospitals are on a virtual lockdown. Whether these measures are needed are not aren’t the point on this article. Rather, we’ve seen a big uptick in family members calling Painter Law Firm who have virtually no idea what happened in their loved ones’ care because they were locked out of hospitals.
We’ve spoken with potential clients whose elderly parents were hospitalized for relatively minor problems, but suffered unexplained falls resulting in head trauma. In some cases, this led to brain bleeding and eventually death.
Any fall in a hospital setting is considered a sentinel or never event, which must be thoroughly investigated to identify what happened and what steps the hospital can take to reduce the risk of falls for future patients. Additionally, the standard of care requires the nursing staff to assess and reassess the fall risk of all patients, and to take preventive measures to keep them safe.
Without family and friends present in the hospital to witness what happened and the care that was provided, the available information is sometimes limited to what’s documented in the medical records. And, on that topic, some hospitals have been more resistant to release those records than they were before COVID-19. In some cases, we’ve had to push back for clients and remind hospitals that they still have to follow federal and state laws that guarantee patients the right of access to their medical records, even in a pandemic.
In other potential cases, we’ve had family members call with questions about hospital care provided to family members in severe pain who have little recollection of what occurred.
Some patients were discharged from hospitals with new symptoms of a stroke, such as difficulty moving the extremities on one side and impaired speech yet had not been diagnosed with or treated for a stroke.
Other patients who had normal skin integrity upon hospital admission were discharged with severe bedsores. Bedsores or decubitus ulcers are a type of injury caused by unrelieved pressure on the bony prominences of the body. The standard of care requires the nursing staff to assess, reassess, and document each patient’s risk for pressure injuries using a standardized tool. Further, nurses are required to advocate for physician orders for preventive measures, when appropriate, including things like pressure-relieving mattresses, a schedule for repositioning the patient, and specialized ointments and creams.
Over the years, we have handled numerous bedsore cases and have found that friends and families often fill in the gaps on the care that the nursing staff provided—and didn’t provide. We’ve learned details about nurses not answering patient call buttons, changing soiled clothing or sheets of bedridden patients, or advocating for medical attention.
When hospitals and skilled nursing facilities don’t allow visitors, though, because of coronavirus concerns, families are left to guess what happened with their family members.
Fortunately, there are still some things that you can do to prepare a squeaky wheel in advance of a hospital or nursing facility admission.
• Have a medical power of attorney in place. Provide a copy to the hospital or facility upon admission and ask that it be placed in your chart. A medical power of attorney is a legal document that allows a person to designate a health care agent to make health care decisions when the person is unable to do so.
• Have a HIPAA release in place that designates one or more trusted friends or family members as individuals who can have access to your confidential health information. If you want your trusted friends or family to be able to inquire about your health care, then you’ll need to provide them with a HIPAA release. Provide your HIPAA release to the hospital or facility upon admission and ask that it be placed in your chart.
• The patient should stay in regular communication with family and friends during the admission. Facetime or other video calls are helpful. Talk about how the care and treatment is going and identify any concerns. Patient should be sure to share the name of the unit or ward where they’re admitted.
• If there’s a problem, a trusted person named on the HIPAA release should call and ask to speak the nursing supervisor on the appropriate unit or ward. This is the time to share concerns and advocate for additional care.
If you’ve been seriously injured because of poor hospital or nursing facility care in Texas, then reach out to a top-rated experienced Houston, Texas medical malpractice lawyer about your potential case.
