Danger in the Hospital

[Coss]

Danger in the Hospital (my title)

https://thepattayanews.com/2024/06/13/medical-bytes-thailand-number-109-a-walk-in-the-park/

1.      On Friday 22nd March 2024, in Soi Buakhao,  Pattaya, Ron was pushed off his bike by an English tourist, see video. Ron sustained a fracture of his right hip. The Englishman involved sat with Ron for a while, apologised for running into him and he promised to assist his recovery. They exchanged phone numbers. Four hours later, once in the hospital, Ron tried to call the English tourist. His number had been disconnected.

2.      Ron was admitted to the a local hospital. An X-ray confirmed a fractured hip, see photo 1. Because of the Clopidogrel he was taking, a blood thinner, the operation was deferred for 5 days. On Wednesday, March 27th, his operation was elegantly performed, see photo 2. The surgeon promised Ron that he would walk the following day. This never happened.

3.      Ron’s management at the Hospital was dysfunctional and directly related to the poor standards of nursing care:

-The nurses did not provide the 3 meals a day included in his account.
-For the five days prior to the operation, the nurses failed to protect his broken hip.
-Following the operation the physiotherapist did not arrive the following day to assist him to walk. The nurses did not arrange for the therapist to attend the following day, or any other day.
-The nurses failed to provide Ron with adequate post-operative care, see photo 3.

4.      On Tuesday, April 2nd, I spoke with Ron’s surgeon, Dr Taweesilp, about Ron’s comorbid problems. I also informed him that Ron had remained bed-bound since the operation, which was counterproductive to optimum healing. The surgeon assured me that he would notify the nurses immediately. The following day Ron remained bedbound. I called the surgeon. Within 15 minutes of that call, a flurry of nursing activity resulted in Ron sitting in a wheelchair for 10 minutes, see photo 4. They did not walk him.

5.      Ron was already frustrated about the lack of adequate nursing care. He had suffered significant pain as he lay in bed for the days prior to his operation. He was now frustrated by his confinement to bed and the refusal of the nurses to support his rehabilitation. Further, the food privation continued post-operation. He lost 12kg, 10% of his body weight.                                                                                   

The problem I observed with the nurses was their lack of care and respect for this patient. I visited Ron 5 times during his stay in the hospital. On 4 of those occasions, I observed the nurses on duty in their station behind a closed glass door. The majority were dressed in their pristine uniforms, not a crease nor bloodstain to be seen anywhere, fixed to their mobile phones, as Ron’s protestations fell on deaf ears.
He signed himself out of the Hospital on Saturday, April 6th.

6.      Ron was readmitted on April 10th with an obstructive uropathy caused by his prostatomegaly. The back pressure on his kidneys had caused acute renal failure and a urinary tract infection. He was also hyperglycaemic; Type 2 diabetes. He was extremely ill. I was concerned that he may not survive.
With the assistance of professional medical care at the Hospital, Ron recovered from this ordeal. His catheter was removed and he was discharged home, only for his outflow obstruction to return. Re-catheterization released 1,500ml urine, see photo 5. In a male, the normal capacity of the bladder is 300ml before causing the urge to urinate!
In addition, his UTI had reoccurred.

7.      I returned from my Songkran vacation and visited Ron on Tuesday 23rd April. He was weak and dehydrated. His blood sugar was 133mg/dl (70-99mg/dl). His urine was infected. His diet was poor; fried dried-out chicken from a street vendor. He was drinking 3L of pure water daily only, with no electrolytes.

I attended to these problems.

On Wednesday 24th, I attempted to walk him, but standing caused dizziness.

On Thursday 25th, after increasing his food intake, he tried again. He shuffled slowly; he was delighted. He had been bed-bound for over 1 month. As he sat down, he became emotional as he thanked me for my assistance.

8.      Ron’s ordeal was difficult and his suffering was increased by poor nursing vigilance. Ron’s misfortune was hardly a ’Walk in the park’, but, shortly, he will be able to!

 

 

https://thepattayanews.com/2024/06/13/medical-bytes-thailand-number-109-a-walk-in-the-park/