Budget cuts in the E.R.

Look, I know we’re in a recession.

I know that times are tight, money is a problem, and hospital emergency rooms are overcrowded and underfunded.  I sympathize.  Really, I do.  But I had a very difficult experience on Thursday night as a direct result of a budget cut that eliminated the phlebotomists in the emergency room at our local hospital — one that may have put me in danger — and I’m writing to tell you about it.

I arrived at the E.R. at 8:30 p.m. with a high fever and a history of Stage IIIC inflammatory breast cancer.  When the E.R. nurse came to draw my blood 3 hours later, I told her that I had had a lot of chemo and my veins were pretty bad.  My right arm is strictly off-limits because of the lymphedema, so the veins in my left always have to be used for blood draws, and they’re not fully over the chemo yet.  The nurse scoffed and told me, “There’s no such thing as chemo veins. I’ve never had a problem.”  She put a small IV in my hand, and, 20 minutes later, picked my best vein (the only one people can usually get) for the second blood draw, a small one.

By the time the preliminary tests came back and the doctor determined that I would need a CT scan, that nurse had gone to lunch.  The doctor reached for my arm to be sure that the IV was in place, and was surprised to find that the IV stub was the wrong size.  It couldn’t be used for the CT because the contrast (iodine) couldn’t be flushed in fast enough.  She began to look for another usable vein, and was frustrated not to find one.  She called in another nurse.  No luck.  So the doctor began to try to prick new veins, but failed repeatedly to draw blood.  She decided to reuse the one that had been stuck earlier, sticking it closer to my heart in an attempt to tap it for new blood.  But it had been used already, and the blood clotted in the needle.  She jabbed a nearby vein, but it blew.  While I recoiled in pain, she tried — and blew — another vein, leaving me with two cm-sized purple scars and soreness on my arm today.

All this time, she ranted loudly about the incompetence of the first nurse, who took my good vein for a simple draw, leaving her nothing for the CT, when a CT was likely from the beginning.  Over and over she blasted her, alternating her incompetence with pronouncements on my need for, “an immediate CT, one which you should have had days ago!”  Finally, she said, “We can’t wait any longer,” and told the 6 ft tall male nurse to invert the bed, putting my head as low as it would go.  When I asked her what she was doing, she told me, “I’m going to put this needle into your neck.”

Needless, to say, I began to panic and shake, and had a very difficult time of it.  She did get the needle in, and the CT technician arrived soon after (apparently the IV only became an issue the minute my turn had arrived for the machine) to take me for my test.  He, on the other hand, was nothing but kind, with encouraging words.  The pillow on the CT table was so soft, and he talked to me like an equal, not a science experiment.  By the time my test was over, I was calm again.  He offered me the pillow and a blanket, two amenities not easy to come by in the E.R., and I was finally able to be comfortable while I waited for the test results.   Well, as comfortable as you can be with an IV in one hand, two blown veins in the elbow, and an IV sticking out from the side of my neck like Herman Munster.

Test results that would show whether or not I had cancer again and my lifestopwatch would have to be reset.  Because, you see, it wasn’t enough that the E.R. doc scared me with her jabbing and her frustration with the nurse-who-wasn’t-a-phlebotomist, but the E.R. doc also went on and on about whether or not it was cancer recurring — an occurence which my oncologist (at another hospital) has since assured me is almost never marked by a sustained high fever.

Days later, I’m still shaken by this, and when the phlebotomist came in today for a blood draw, I braced myself for a difficult time, warning her that my veins were shot in the same way that I had the original E.R. nurse.  She saw the purple clots and very carefully chose a vein nearby that I couldn’t even see.  The blood draw was quick and almost painless.  It was incredible.  I asked, “Is it because we’re on the oncology ward that you’re so good with chemo veins?”

“No,” she answered, “I’m a phlebotomist.”

I’ve since found out that the hospital fired or reassigned the phlebotomists working in the E.R. as a cost-cutting measure.  There’s not a single one down there.  And that includes the nurse who scoffed at me when I told her from an E.R. bed, “I have chemo veins.”

20 Responses to Budget cuts in the E.R.

  1. sprucehillfarm says:

    Susan I am so sorry you had to go through this. This story really pisses me off! You have been through enough already, and this was not necessary!

  2. Stimey says:

    Oh dear God, that is horrible. It is appalling what goes on with health care. Your experience sounds terrible and traumatic. I’m so very sorry.

  3. Heather says:

    Our local ER is similarly taxed by this issue. Though unfortunately it’s been my kids who have had to be stuck multiple times before they called someone down from a floor. I’m so sorry that this kind of pain and incompetence had to come on top of the worries.

  4. niksmom says:

    OMFG! How unutterably awful. You should consider also complaining about the ER doc to the state board. Seriously.

    Been following your tweets and keeping you in my prayers.

  5. Suebob says:

    I’m so sorry, sweetie. You deserved better.

  6. Kristen says:

    You are a nice person, but you definitely should have named the hospital. Hospitals are big business these days and that reassignment stuff is crap. A doctor was crap to us on an ER visit and we now go to another hospital if the extra 10 minute drive isn’t a problem. No one should EVER be disrespectful to anyone else but how anyone could disregard what you are saying is beyond me. So very sorry you were unnecessarily frightened. Hope you are feeling better and you can always call me to bring you a blanket and a pillow.🙂

  7. mrs. chicken says:

    Chilling.

    You should (when you are better) be sure to write a letter to the ER director, with a cc to the hospital administrator, the oncology head … and The Washington Post.

    Glad to hear that you are on the mend, and so sorry for this experience. My father spent so many nights in the ER b/c there were no beds, and he was always treated like a piece of cattle.

  8. magpie says:

    Damn it. That sucks in so many ways.

  9. Kat says:

    Unbelievable!! Unacceptable!!

    I hope you’re feeling better though.

    Hugs!
    Kat

  10. thordora says:

    I am so sorry-I remember watching my mother go through that, gritting her teeth and waiting for them to find one. I can’t imagine actually doing it. I had my doctor blow a vein on me once, and it hurt like the blazes. Since then I don’t let anyone go near it, but I’ve had nurses scoff that you can’t blow a vein. So how a simple draw caused a 10 cm in diameter bruise and an elbow I couldn’t use for two days, I dunno.

    Sigh. It’s just not cool, ever, especially when you’re already this worried. I hope it gets better.

  11. *m* says:

    Unbefreakinlievable. Heads must roll!

  12. marty says:

    My favorite part is how professional the doc was to blast other hospital employees right in front of you. That’s so reassuring.

    Jackholes.

  13. Kyla says:

    That is TERRIBLE. I’m so sorry.

    We’ve had plenty of bad experiences with people trying to get an IV or blood from KayTar, though none to this extent. It makes me crazy when they don’t listen to my instructions up front. I’ve been holding her down for these things for years, listen to me people!

    If they can’t afford to staff a phlebotomist in the ER, they should at least page one from another department to step in on cases they can’t adequately manage with nurses.

  14. Amelie says:

    I’m so sorry, Susan. This sounds terrible. I think your story should find its way to someone in charge of butget cuts and hospital management.

  15. Heather says:

    I’m sorry you have had to go through this. I am a 9 year survivor of IBC and agree with you totally about chemo veins. I have lymphedema too. I have one good vein in my hand and when I go for blood draws I tell them what size and kind of needle they may use. If they don’t, then I refuse to let them and tell them to get someone who will. I’ve learned from experience as I also have had nightmare sessions.

    Wishing you well, hoping that you too will beat this disease.

  16. jodifur says:

    that’s terrible. I’ve had my own terrible ER experiences, not at the hospital your in but another on. I hope you get an answer from patient advocacy.

  17. Queenie says:

    I’m so sorry that you had to go through that! I hate it when health care professionals don’t listen. Hoping that they soon diagnose you with some yucky old flu virus, and wishing you a speedy recovery!

  18. Lisse says:

    I’m glad you are telling this story. I’ve had a few nightmare situations of my own with a local hospital trying to do things on the cheap.

    For what we pay for health care or in insurance premiums, we should be ablet o get competant treatment.

  19. Krista says:

    Wow, what a horrible story. I know now to always ask for the “good” nurse when getting an IV because even without any history of illness they have a horrible time getting a good IV in me. When I gave birth I had one IV through a valve (very painful) and another that took 3 tries to get in. Then in the ER for my gallbladder I had a wonderful nurse who got it on the first try. That was amazing. Finally for the gallbladder surgery they let an intern try. 2 tries with blown veins, the regular nurse tried, and when they were down to one spot on my arm left they finally called the “good” nurse. Ugh, more pain and bruises from that than the actual surgery!
    I’m glad you are feeling better now though!

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