Raising the Standard of Excellence in Health Care

I don't know about you, but I just HATE when this happens.

You build a spanking new facility at an Ivy League campus, say Dartmouth, as an example.

You move everybody over there.

It's beautiful. It's quiet. No overhead paging. I know, my readership has read descriptions. I truly LOVE the new Lebanon facility.

And I truly love the overwhelming majority of the folks who work there.

But the FBI agents who watch my back, who pay personal house calls, (so nice someone does these days! To MAKE SURE I am safe & very secure ) AGREE with ME.

It is just terrible when there are bad apples that give the rest of us in our honorable & noble professions a bad rap.

My two personal agents & I agree about this; we all have to go with the basic premise that, (in their estimation & they ARE the experts in high profile criminology here, I am only a nurse) that about 98% of the general population, from ALL walks of life are GOOD, HONORABLE, HONEST & hard working people.

To be classic about this let's round it up to 98.6. A normal temperature for a human body.

That certainly is MOST of us.

Here's the rub. It's that GD 1.4 percent that keeps them running day & night.

Thank GOD or universal intelligence we have this fine force to fight crime in America!

AND we all agreed about this too; it is the wolves in sheeps' clothing that really get us all mad. That is the fire that charges us up to go for it; GET the bad guys. Sick'em boys! girls! Go team go!

Of course WE all LOVE the Constitution & the Federal laws in place to catch these bad asses.

GOD BLESS AMERICA!!!!!!!!!!!!!!!!!!!!!!!!!!

Yea for the GOOD FBI agents, CIA operatives, ATF, State troopers, local cops, district court justices, superior, & supreme court justices. Good attorneys & Attorneys General. We LOVE you! We applaud you, pray for your safety & wish you all God speed & blessings. Hurrah for the A Team!!!

It is those darned imposters though. The ones who are playing dress-up year round. The ones masquerading as good all of the above, & more; the priests, the teachers & administrators, professors, nurses.... it is THOSE shadow creatures who walk among the good folk who really wreck our days & nights, & just plain wear us OUT!

Case in point.

Now all the GOOD doctors & nurses at DHMC will be I am sure, heart sick when they hear this case, but it is true.

In fact I know it needs to be addressed still. And since DHMC recently won a prestigious award for nursing excellence there, I am sure the Upper Valley community will be hopping right on this one.

I ENCOURAGE you too. PLEASE. Print this page out & send it directly to your reliable Chief Law Enforcement Officer Kelly Ayotte. She is a good chiefteness.

As we in health care provision know, when presenting a case history, we leave out personal identifying information to uphold HIPPA protections. So I will simply use nonpersonal info to outline it here.

There is a woman who has been a "frequent flyer" to DHMC over the years. She is not originally from New England but moved here from a more southern climate. She is a wonderful person. A widow actually.

Which is the source of her tragic story. As a young wife & mother, she was in a bad car accident. So bad that it killed her beloved husband & rendered one of her legs nearly inoperable & maimed & mangled.

Over time she removed herself from the State she had been raised in & eventually came to settle in the Upper Valley, where she received ongoing treatment for this damaged limb. Multiple, multiple surgeries. Numerous pain medications were prescribed to alleviate chronic & excruciating pain.

She has valiantly kept on keeping on though.

She has had a hip ball & socket replaced, reengineered, & both Fletcher Allen orthopedic surgeons & DHMC surgeons have, over the years worked on this limb & this particular joint.

I got to know this fine woman in my transition back to the Upper Valley in the summer of 2003. I came to visit her & became her friend. And in the course of knowing her, & visiting her in a local private rooming situation, she had slipped in the shower & was emergently transported to the ER of DHMC for immediate care. She had blacked out from the pain & shock of the slip in the tub had caused her. When she arrived at the ER, she was not in a calm or usual state of mind by any fair standard at all. Witnesses who listened to their ambulance calls & police traffic over open lines heard her screaming & in pain as the paramedics rescued her.

Now, remember I told you she had had a long history of care at DHMC prior to this particular visit.

So, she had what every first year nursing student & doctor knows is the most important first page of any chart. She had a "face sheet". Or Admission sheet. It is the first page we flip to when looking up "who to call in an emergency". Next of kin. It is in every record across the country, in every facility that collects such records of care; nursing homes, clinics, camps, hospitals. The ABCs of BASIC documentation.

Anyhow, her BROTHER was clearly, in typed face identified as the person to call in an emergency. I don't know about you, but a sister in writhing, agonizing pain would qualify for me. I would want to be called.

But he was not. He never knew, one town over in Enfield, not a far distance to travel to be with her, & advocate for her, hold her hand, soothe her brow, ease her fears, that she had been taken there in the first place.

So what happened next, I just can't figure out. But maybe you all can help me now. Because group thinking is better than thinking in isolation usually. I always taught my kids that. If you dont't know, FIND OUT! Ask somebody to HELP you. They do. There is never any shame in admitting you don't know something. You don't have ALL the answers.

It is far more hazardous to pretend that you do, especially when you are given the great responsibility of caring for another vulnerable human being. One you are teaching, or flying through the air, or administering medications or any invasive procedure to.

Our sophisticated medical procedures are absolutely wondrous these days, But IF they are not properly administered they also can be lethal.

Which is WHY we have ETHICS at all. Ethical standards of care, our peer review groups, our medical & nursing boards are such entities. That is why we have them. To keep illegal & dangerous practices at bay near the bedside; in the OR, the ER & especially locked psychiatric wards. WE DO NOT TAKE THESE STANDARDS LIGHTLY. They keep us all striving for further excellence, further research into ways to prevent & recover from HUMAN SUFFERING. Plain & simple.

But this particular case is one that still bothers me. Because my sister, my friend whom I am describing was not treated well in this particular visit & encounter. No, not at all.

IN FACT, I would go so far as to say, that those who handled her care during that particular visit & hospital stay are actually WHITE COLLAR CRIMINALS.

Yes I would characterize them as such. I see no difference in what they did in white coats, with licenses & identifying badges as what the Nazis did in secret chambers to the jews.

When you DO NOT have informed consent for ANYBODY to lay hands on you, & someone does, it crosses over into the realm of CRIME. It is not mere negligence. Or malpractice. NO, when highly trained surgeons are calling the shots at the head of a surgical team they are the leaders of; give orders for medications to be injectd, anesthetize a person & CUT INTO THEM WITH A SCALPEL, no that is in my mind a horse of a different color altogether.

We in New Hampshire call that Assault & Battery with a deadly weapon & it is a class A felony.

I am not sure what the statute of limitations is on this, but I am pretty sure they don't run out tooo quickly.

Since the Hanover PD can keep a frivolous warrant out for a trespass charge to a person who is sitting quietly by a pond. During this exact same time frame. I think the larger crimes are still open case investigations then. But this is obscure, because sometimes in New Hampshire it is hard to get a straight, verifiable answer to such very pertinent & public rights type of questions. So if I had any feedback for Kelly it would be, whatever you can do to clarify Statutes of Limitations on Criminal Acts this would be a public service. Perhaps another web page could be accessible to the public. Archived in the areas where the very clear Victim Advocate laws have been hung.

At any rate, back to this troublesome case.

My friend had no personal advocate from her own family with her. BECAUSE NOBODY CALLED HIM. I know this for a fact. I checked it out. AT HER REQUEST, I did a full & comprehensive review of her massive record; zeroing in on this particular admission. My daughter even came to visit her with me. And one of my friends from California this summer of 2003.

Back to the nurses now. We all know, ladies & gentlemen, you MUST document, document, document. That is a VITAL role of the nurse within any health care setting.

BASIC, basic basic. So when I looked to see whether there was a note from the nurse who admitted her in the ER stating (s)he had notified her brother, there was none. And ALTHOUGH she was in excruciating pain, her hip completely displaced, she does recall that she felt utterly alone & at the mercy of her providers. The RECORD bears this out. She was.

Regardless, she was eventually prepped & operated on. When I did hear about what had happened, through mutual friends who had introduced us in the first place, & that she was asking to see me, it was several days later when the discharge planning team was attempting to explain what they had done to her.

It was at the end of the week, so I am sure you; the consumers of this health care can UNDERSTAND why the surgeon himself was not there to explain this to her. Why it was left to the rookie resident. And why the discharge nurse was in a hurry to move her along & out of that needed bed. It was the weekend!

Anyhow I did come to her bedside. I too puzzled at the mangled looking drawing this resident had drawn on her white board to explain that they had taken a piece of her hip socket OUT altogether!!!

Quietly at first, I flipped through her notes of care, looking through her record, leaving of course a written, a handwritten permission to do so, signed by her in the place the record was kept in case any astute manager of her care should ask. I was reviewing it because she WANTED me too. To decipher what was going on now.

Well, as it turned out that was the case. She was stunned & shocked. So was I. How could this be? Unauthorized, major surgery, without a family member notified in a major medical teaching facility that had just won Magnate status for excellence in nursing care????

This was astounding to me, & not in a good way.

On top of the injuries, the unlawful assault & battery to her person that had so recently occurred was a note written by a resident which documented a team meeting about this brave widow which stated that the team felt she had developed an addictive problem with the very drugs THEY had prescribed to her for the past surgeries, legitimately needed, & that because of this, the whole "fall" scene had been an act. Attention seeking & drug seeking act.

Talk about adding insult to injury.

Because now this lady needed yet more medical attention, it was felt that "she should be taught a lesson".

So they took the ball joint of her hip OUT altogether so she would live with THAT for awhile.

Say WHAT???????????????????????????????????

I truly could not believe what my eyes were seeing. This COULD NOT be happening here.

But it was. In the full light of day. Broad daylight. Day people, senior managers & administrators had concurred on this assessment. Taking a vital part of her body OUT under surgical, general anesthesia conditions was "standard of care" for managers, professors, & both from medicine & nursing.

Let us pause here.

Doesn't that just make you MAD!

Her care was being supervised by the Chief of Orthopedics. AND the head supervisors of all of the nurses who are supposed to be minding the fort.

I know this too, because I personally visited each one of them in their offices. That is why I felt uncomfortable seeing Claudia Zayfert. Not because she is scary, she isn't. But these chief cheeses ARE. Because they STILL HAVE JOBS!

It seems you may be able to; as consumers; of medical care, nursing care, & education that an Ivy League campus provides, with Millions & I mean that MILLIONS of dollars in donations, TAX FREE dollars in donations pouring in, AND let us not forget Federal government loans & grants that students qualify for to go there, so this is where the TAX PAYER is being robbed in all of this, "get this".

YOU ARE BEING SWINDLED BY NEOCON NAZIS dressed as ordinary looking doctors, nurses, deans, a president or two of YOUR HARD EARNED MONEY!!!!!!!!!!!!!!!!!!!!!

THESE PEOPLE, THESE WOLVES are HAZARDOUS TO YOUR HEALTH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

They need to be rounded up now.

I don't know about you, but I do NOT want any surgeon trained by such a man or group of them. Not EVER. I want them brought to accountability, & this poor woman's case VINDICATED. NOW.

So here is the little mystery for MY FBI agents, MY private eyes, & MY free lance journalists.

BOOK 'EM Danno! Get the bad guys & gals. THESE ARE FEDERAL CRIMES.

Just to send you in the right direction; ask for a warrant for ALL the surgical records of care, because if it happened to one unfortunate widow, believe me it happened to more. She is a Steel Magnolia from the south. She has a mouth. She knows how to give them lip. She knows how to be assertive. But NOBODY can be verbal when they have been put out under general anesthesia.

To be politically correct I will give you a hint. Her initials are P.C.

I would also obtain a Search Warrant to investigate every record archived in the "Risk Managemnt " offices, the "Discharge Planning " Offices, of course the ortho offices, AND the Pain management clinics.

The assault & battery occurred sometime in the early summer of 2003.

By the way, I did contact attorneys in both Vermont & New Hampshire. Because she is poor nobody wanted her case.

So I thought about that too. Especially when I got my own FBI agents. Really we shouldn't be wasting local State attorneys' time. It is a Federal investigation now. It is CRIMINAL. You need the right experts on the case for the right kind of massive crime & cover-up. Don't you just HATE it when people DO bad things to people & then lie about it & OBSTRUCT JUSTICE????

Boy, I know what you mean. I do too. When I feel that way, I usually call an anonymous Crime Stopper line somewhere. It is safe, it is confidential, & the more calls the merrier. After all you are alleviating SUFFERING. Isn't that at the heart of nursing & medicine & crime stopping & prevention?

Let's go!

Let's CLEAN-UP the Taj Mahal!

It will be a great gift to those who HAVE been cut into, assaulted & battered. What better way to prepare for the upcoming holiday season.

Peace through meeting the Ethical Challenges of Social Justice.