Sana Cruz, CA hospital emergency care – jammed to overflowing Feb. 2018 — what to do?

Santa Cruz CA hospital emergency care — jammed  to overflowing the last week of February, 2018. What to do?  What to know?

There are two hospitals in Santa Cruz County:  Dominican Hospital — a Dignity Hospital now — located in Santa Cruz, CA  and Watsonville Hospital located in the southern area  of the County.

The population  of Santa Cruz County has grown enormously.   Infra-structure which  supports the population — such as  hospitals and roads — has not grown. Getting around the County is a major problem only getting worse.

Our politicians and policy makers have served the population poorly concerning roads. Do we need another hospital?

Ever feel  seriously ill?  Experience major symptoms?  Think you need to get to a hospital?

What to do:

1)  Go by ambulance.  Hopefully you don’t have to travel to hospital  during  early and late hours (7-9 & 3:30 to 7).

2)   Take your medications with you.  If you are admitted,   Dominican gives generic medications which can be quite  different from those prescribed by your MD.

3) If available, bring a ‘advocate’/ scribe — someone  who can verbalize what your symptoms are to hospital personnel,  who can keep track of who does what to you   and who can write down the  changing nature of your symptoms.

Once you are in a bed in Emergency,  Dominican Hospital provides  excellent care for life threatening, catastrophic issues.

What  to know:

A  M.D. referred to a ‘Hospitalist’ is the person who decides whether you will be admitted to the hospital, i.e., stay overnight in a bed for further tests, proceedures  and observation.

The number of  M.D. ‘Hospitalists’ who see you may be one or several.  This is one reason  why it’s important that your ‘advocate’/scribe can communicate with the medical personnel you come in contact with  — especially the ‘Hospitalists’ and Nurses.

Once you are admitted to a bed in the hospital, your  R.N. communicates with the Hospitalist assigned to you.   The name of the Hospitalist is typically written on a board near your bed.

Depending on how your symptoms change and how impacted the hospital is,  you may be moved multiple times to other Units in   the hospital.

While you are in the hospital, you will   come in contact with many person performing  different  medical procedures.   It may be helpful for you to keep track of time of day, date,  and who performed what procedures on you.   That way you know what’s happening and you can better communicate with your Hospitalist concerning your medical needs.

Dealing with the fragmentation due to the  multiplicity of medical contacts and procedures:

What if some of your medial  issues are addressed but from your perspective other crucial ones are not?   If you and your advocate/scribe and family think that your  immediate medical concerns are not getting met, that more is going on than it appears,  you can request  a Rapid Response Team intervention.  This is a team that will quickly come and  evaluate you  and address your concerns.   If issues arise communicating with your R.N. there is a supervisor for all the nurses in your unit, the  Charge Nurse who can address  your concerns. Other eyes, ears and perspectives from the Speech, Occupational Therapist and Physical Therapist may provide invaluable  information and evaluation.

Discharge:   Later on, the  Hospitalist  MD assigned to your case is the person who  “discharges” you,  saying  that  you are no longer experiencing catastrophic symptoms,  and certifying that you are ready to leave the hospital for a lower level of  medical care (i.e., nursing home, home health care, out patient care).

If you do not agree with the  M.D. Hospitalist be sure to speak up and say why.

 Did the M.D. Hospialist actually  meet and talk with you before deciding  to discharge you? Did  the the Hospitalist actually  review  the results of  the medical procedures before making and conveying to you his/her  Discharge decision?    The person in charge of the Hospitalists is the Medical Director for Dominican Hospital.

Dominican Hospital has medical personnel performing ‘”Leadership” functions.  These persons (who are in top management positions)  go around to the rooms and initiate conversation  with patients as to  specific needs and as to  the overall experience.  These conversations can and do  enhance overall  communication.  From the patient’s perspective the overall experience can seem quite fragmented as the patient has so many brief contacts with many medical personnel.  

Dominican Hospital posts what it calls  the experience principles.  A promise to our patients and each other:

Know me as a person.  Connect with me, not with why I am here.

Communicate with me.  Keep me informed about decisions that impact.  Listen to me and respond to my concerns.

Empower me.  Allow me to be in charge of my care.  Advocate for me and teach me to advocate for me.

Comfort me.  Notice when I am having dificulty and take action to help to relieve my suffering.

Work together as a team.  Support each other.  Do what you say you are going to do.

Champion the ministry.  Treasure the mission.  Build and strengthen capabilities of the ministry.

Dominican Hospital’s experience principles are aspirational.  Having your own advocate/scribe can help enormously.

Traveling to and from Dominican Hospital:

Workers from Salinas, CA who start work at 6 am at Dominican Hospital  can get to work in 40-45 minutes. When the Dominican Hospital  MRI machine was ‘down’ the last week of February 2018 it took 45 minutes for an engineer to drive from Aptos, Ca to the hospital  wherein he repaired  the machine in 2-3 minutes.

Dominican Hospial’s emergency facilities are impacted by various populations including 1) a large homeless population which sleeps out ‘in the rough’ and gets sick when it’s wet and cold;  2) a  large population of drug addicted individuals ;  3) 30% of Santa Cruz County has families with children whose first language in not English. And more and more people are coming to the County.

The population of Santa Cruz CA has grown enormously in the last 30-40 years.  There were and still are only two hospitals with emergency facilities for catastrophic medical conditions. The roads are impacted and increasingly it’s more and more difficult to get to and from Dominican Hospital.

You can “schedule’ your trip to the Emergency facilities at Dominican Hospital.   Sudden major health events cannot be scheduled or dealt with by appointment.

What to do?   Start by talking about your experiences ….

Santa Cruz County has two main hospital  facilities and perhaps, given all the changes of the last 30  years, we need an additional facility located in mid-county.  Or perhaps we need  some additional  smaller facilities that are open 24 hours a day and can handle catastrophic issues?

written by Cameron Jackson




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