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Forum: Observations from the ER

16 August 2006

laura in pa – at 10:55

I know that there are many health care professionals here like Eccles, flamedic, grace, nesthesia, etc, etc. Yesterday my 15 yo daughter fainted during a very busy lunch shift while working at a fast food restaurant. She’s fine, but she was ambulanced to the ER just to make sure.

The staff was professional and courteous. Like at many hospitals, she was given a disc with lights that lets you know it’s your turn to be seen. While the intent of this is as a thoughtful convenience, all I could think of was……GERMS! I didn’t have the heart to say anything to an employee, but I had my daughter wash her hands and then I wrapped it in paper towels. Is there an employee that I could contact that would act as a human “suggestion box”. My next door neighbor is on the board of the hospital, but I’m sure he’d be too embarrased to bring it up!

Jewel – at 11:21

Observations of germ sources from any healthcare facility or public place: -magazines in the waiting room (ever notice how many people lick their fingers before turning the pages?) -toys in the waiting room -nurses/PA’s with long fake painted fingernails (a no-no when I went to school, what happened?) -hygienists at the dentist office using pens, going back to your mouth, using the same pen to write, do they sterilize that pen between dental patients? -fast food employees handling money then handling your food -restaurant salt shakers/ketchup containers/menus -who is cooking your food and what are their hygiene habits? Do they wash their hands after they use the restroom? -any door handle -money: do you wash your hands after handling money? Ever notice how many people put money in their mouth to hold it? Or lick their fingers before counting it? Ever wonder what those mysterious stains are? I have handled money with blood on it.

The list goes on…. It is a good thing most germs do not live long on inanimate objects. But some do. Sorry, just observations from a nurse.

nsthesia – at 11:22

Laura:

G, what an asute observation!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I had the same reaction when I took my stepson to the pediatrician. The office was divided into well and sick kid areas. He was just going in for a summer camp physical.

He proceeded to play with some of the toys…which I promptly discouraged. We then went into the exam room and there was a bin of toys there also. And you know THEY are played with by both the well and sick kids!

I mentioned it to the staff and I was assured they were cleaned regularly. GAG! I see where many pediatricians have removed the toys from their offices just for that reason. I’ll bet the E. coli levels are astronomical on those things. GAG again!

There are many areas in HC where we have just continued “business as usual.” And as healthcare is SLOW to change, it will probably take some persistence to turn the tide.

For YOUR situation, there is usually a patient representative in hospitals called an Ombudsman. They investigate complaints and interface between patients and hospital personnel.

If not, ask the hospital operator where you can register a problem. The Head Nurse in charge of the ED might be helpful. I might even contact the Infection Control person. And if you REALLY want to get some attention, ask to speak to the Risk Manager.

This is one of those situations where it is so commonplace, it is invisible. Reminds me of the stethoscope and neck tie debacles where it took forever for HCWs to realize they were instruments of pathology!

Thanks for being an informed consumer. They are my favorite patients!

Jewel – at 11:32

One more observation: when I was pregnant and going for my regular monthly check, a nurse taking my blood used gloves that had blood on them from another person. I was in shock. She obviously was using the gloves for her protection only and not for the protection of the patients. I wrote a scathing letter to the healthcare facility needless to say. ALL users of healthcare facilities must be their own advocates. Observe, speak up and tell someone right away when you see something wrong, there is a reason for high rates of nosocomial infections in hospitals (or any healthcare facility for that matter). When you are in the hospital, insist that anyone that comes near you wash their hands first, including the doctor! That is not an unreasonable request.

laura in pa – at 12:20

Jewel and nesthesia, Thanks for responding. It sounds like the Patient Ombudsman is the best person to start with in providing feedback. About the toys and pediatrician waiting rooms: I always feel like a killjoy when I tell my children not to play with the toys in the waiting rooms. The funny thing is, that some of the things that are germ-laden are actually things that are provided to make patients and families more comfortable!

My mother was the type that ran us to the pediatrician constantly. After seeing the waiting rooms in the pediatricians offices, I decided to be more careful about running there. As I tell my mother, “if they aren’t sick when we get there, they’ll be sick when we get back!” Even if they divide between well and sick rooms, that’s not fail-safe for several reasons. I’m not blaming the HCW’s, because there is only so much they can do.

Green Mom – at 12:30

On my personal pet peave list-schools that require a doctors note for an excused absence. So many illnesses-including minor regular seasonal flu, simply require lots of rest and home care but not a trip to the doctors office. We lucked out finally by being on really good terms with local walk-in clinic nurses who knew my son was susciptable to bronchial illnesses, most of which were viral and can’t be treated with antibiotics. I could just call them and they would fax a note to the school. I would always get little snide comments from the school secretary-“He’s home sick AGAIN?” and little kids going past coughing and with runny noses.

Leo7 – at 12:35

Maybe it’s just me—but I conjured up a vision of human slaves in Laura in pa’s ED staring at the plastic gizmo waiting for a vibration or light. The seething massess soothed by a wait beeper. The meth addicts in my ED would stomp them to pieces, the mothers with sick kids would start pitching them at the triage nurses head cause after all hospital security isn’t armed, and the people who were bleeding would stauch blood flow with them.

Lily – at 12:40

Once getting my flu shot I noticed the nurse not changing her gloves between those waiting. A long line… I just said, “You are going to put on fresh gloves” and waited as she did so. I couldn’t believe it considering HIV etc. There are always careless people no matter what their profession. Its up to us to protect ourselves. We have discussed how important hand washing is. It is stressed in all the literature. Now with schooltime and the change in seasons we have to teach the kids, before the flu season.

2beans – at 12:49

Green mom at 12:30:

Please, please write a formal complaint to your school board. Something along the lines of, e.g., if your rules didn’t require the expense of a doctor visit, maybe more people could sensibly keep sick, contagious kids at home and avoid exposing all the others. follow it up with live attendance at a board meeting and voice it at the mic. This problem exists in the workplace as well. I’ve said for years (in jest but it makes the point) if business really wants to reduce absenteeism, don’t hire anyone with school age kids. We need to start demanding of our public and private institutions that sick people, people with sick kids, stay at home. This should be mandatory instead of regarding minor illness with suspicion.

anon – at 13:53

Jewel at 11:21, you are right about money. I once worked as a cashier in a convenience store, and you cannot BELIEVE some of the places I’ve seen people pull their money from… inside bras, socks, shoes (no socks), underwear, you name it. There’s nothing quite like being handed a limp, soggy bill that someone just fished out of their underpants. You’d also see lots of folks licking their fingers to moisten them so they could count out bills; pick their or their kids nose, stick their hands in their kids mouth to fish something out, sneeze into their hand, stick their hand down their pants to scratch their ass or privates, etc before handing you money. I was sick with something or another the entire time I worked there. BTW, I always made sure I set aside those limp bills, and either deposited them into the safe or gave them as change to the next scuzzball who came along.

anonymous – at 17:54

Fishing money out of underpants? I’m still laughting.

Klatu – at 18:21

laura in pa – at 10:55 wrote:

“While the intent of this is as a thoughtful convenience, all I could think of was……GERMS! “


Laura in pa, has a valid concern. Pardon me if the following info the following is redundant, I’m doing this on the fly. The following URL may be of interest.

Clostridium difficile (C. difficile): ( The spores are immortal.)

http://tinyurl.com/pzrxt

Melanie – at 18:24

What’s scary is that it is occuring outside of hospitals.

Klatu – at 18:30

Melanie – at 18:24 wrote” What’s scary is that it is occuring outside of hospitals.


Correct. They recently detected C. Difficile in a dog. Hospitals are filthy with it, especially I.C.U.’s. My 2-cents.

Melanie – at 18:33

I’ve seen at least two human cases outside of hospitals reported in the last year.

Green Mom – at 18:34

2beans- Ive complained-formally and otherwise for years until I had enough and just pulled my kids out of school-we’re homeschooling this year.

Love Texas – at 20:22

anon an Jewel----I had to laugh about the money—:) Years ago I worked part time in a jewelry store. Now remember how kids like to pierce parts of their bodies---and girls have them shall we say in their private parts. Well they would come into the store and ask to have their jewelry cleaned and open their hand and have some studs with gold balls and little chains attached to another stud ball lots of them. I found a plastic basket and I would have them deposit their jewelry in it, I would dump it in the cleaner and when they left we would change the cleaner liquid. It makes me sick just thinking about it.

janetn – at 20:28

risk manager - thats the one to go to. They can put the fear of God in any unit real quick. good call nsthesia

Melanie – at 20:33

In an oilfield, it is called “hellcatting.”

17 August 2006

Ange D – at 00:03

Laura in PA-You “need to have the heart” to say something to the employee then and there. Don’t accept the device if you are concerned about germs. A complaint afterwards to the “powers that be” is going to be more heavy handed and possible resulting in a letter in the employees file that a simple reminder.

In any medical situation it is wise to insist that everyone who treats you or a family member to wash their hands, wear gloves and wear a mask if necessary. That should be everytime someone comes in the room, does a procedure or some function that involves touching the patient. Carry alcohol gel with you to use after touching doorknobs, seats, toys, etc.

You never know that your neighbor in the ER doesn’t have an antibiotic resistant wound infection that is getting inadvertently shared with anyone who has anything to do with him or that room.

Bump – at 00:17

19 August 2006

EnoughAlreadyat 01:38

The ER’s in my neck of the woods, Texas, are an absolute mess!! They are extremely overcrowded, and during any sickness outbreak they are beyond overcrowded. I sat with my daughter and grandaughter from 7 pm until 830 am about a year ago… while my gdaughter was vomitting and running a temp. The place was packed like sardines… sick people on the floors, tables, anywhere they could figure out to squeeze in. It hasn’t always been this way. There is an influx that is totally creating havoc & breakdown of ER services.

There is also a big problem in this region with MRSA.

19 October 2006

Closed - Bronco Bill – at 20:32

Closed to maintain Forum speed.

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