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  • Nursing care during hospital stay

    Just starting to think about after visiting hours are over at the hospital. Did anyone use a private nurse or have a private room where someone was allowed to stay with you while you were in the hospital? Also, for those of you who had surgery at the Hospital of Special Surgery in NY, how did you find the nursing staff?
    Debra
    Age 45
    Pre - surgery Thoracic 69, Lumbar 48
    Post-surgery Thoracic 37, Lumbar 39 (unfused)
    Fused T4-T12
    Milwaukee braced, 11 years old to 15 yo
    Surgery Sept. 1st, 2010 Dr. Boachie

  • #2
    I had a private room and my husband stayed the whole time. Luckily because the nursing staff left much to be desired, but this was in Florida.
    36 year young cardiac RN
    old curve C 29, T 70, L 50
    new curve C 7, T 23, L 20
    Surgery June 11, UCH, Dr. Cronen T2-L5, posterior
    Revision December 20 L5-S1 with pelvic fixation
    and Osteotomy to L3 at Tampa General Hospital

    Comment


    • #3
      This is a really good question and as such things go, it's one others have been concerned about in the past. I recently encountered a great thread replying to precisely this issue - ran a year or two ago. Can't put my finger on it instantly except to say the search engine found it for me before.

      Note that the Best Hospitals issue of Us News and World Report also has rankings in various areas of nursing care (pain management, hygiene, attentiveness etc - not necessarily under those exact names). Sometimes you have to jump around a bit and experiment to find just what info is available. In nursing care, they're ranked according to patient opinion.

      Here's the rating in Orthopedics.
      http://health.usnews.com/best-hospit...gs/orthopedics

      And here are some other interesting links there, related to this question:

      http://health.usnews.com/health-news...at-nurses.html

      Check out links on the left hand side to see related ratings (topics below)!

      * Hospital Patients Speak Their Mind in Satisfaction Surveys
      * These Best Hospitals are Best at Satisfying Patients
      * They May Excel, But They're the Worst Hospitals for Patient Satisfaction
      * Which Best Hospitals Are Best (and Worst) at Pain Management
      * America's Best Hospitals
      Not all diagnosed (still having tests and consults) but so far:
      Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
      main curve L Cobb 60, compensating T curve ~ 30
      Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

      Comment


      • #4
        I had someone with me 24/7. My husband, son and daughter-in-law rotated staying with me. Had they not been with me, the stopping of my urine flow shortly after my second surgery may not have been noticed until it was too late. I was in pre-renal failure and had to be rehydrated when someone finally took notice. As a result I was put in intensive care for three days. My family noticed it early on but had to bring it to the nurses' attention several times before anything was done.
        Glenda
        Age 66 Georgia (63 at time of surgery)
        Bi-lateral laminectomy 2006
        Kyphoscoliosis, approx 38* lumbar scoliosis, stenosis, disk herniations, lower back and hip pain, w/radiating pain, stinging and numbness in legs.
        A/P fusion (T10-S2) 5/17/10 and 5/20/10
        Dr Yoon, Emory Orthopaedic and Spine Hospital, Atlanta, GA
        Pleased with outcome

        Comment


        • #5
          I was at HSS for 10 days. I had either my husband or a friend with me all day during the first week, and I had a private night nurse every night until I left for rehab. The first few days and nights can be rough and the nursing staff at HSS is extremely busy -- everyone there has had complicated orthopedic surgery and everyone is in a lot of pain. My private nurse (the hospital made the arrangments using a private agency) was WONDERFUL -- she made sure I got my meds on time at night (extremely important) and she was extremely kind and concerned.

          I had one spectacularly bad nurse (she left me in the bathroom alone -- knowing I couldn't get out by myself -- until I finally had to scream and bang against the door with my walker, at which point some other nurse finally came running) and a couple of really good ones. The rest were generally competent but took a long time to show up when I called and they could be pretty crabby. I can't stress enough how busy they were -- on my floor, it seemed that all the patients did was lie in bed and press their call buttons.

          Maybe things are better now; my surgery was three years ago (and it was during the summer, a notoriously bad time for nursing care). Regardless, I urge everyone using HSS to contract a private night nurse -- it's worth every penny.
          Chris
          A/P fusion on June 19, 2007 at age 52; T10-L5
          Pre-op thoracolumbar curve: 70 degrees
          Post-op curve: 12 degrees
          Dr. Boachie-adjei, HSS, New York

          Comment


          • #6
            I really appreciate your feedback. My only considerations when picking my hospital/doctor were surgical outcomes and complication rates, which is still most important to me. But it's so good to know I have options about my care while in the hospital. I'm going to check into a private room or a nurse at least for a night or two. My surgery is scheduled for 2pm so I'm a little concerned that by the time I come around, visiting hours will be over and that sounds a little scary to be there without my husband or anyone I know. It sounds like having someone there can make a big difference, GMW-thank goodness your family was there watching over you & Singer what a scary experience to be stuck in the bathroom.
            Debra
            Age 45
            Pre - surgery Thoracic 69, Lumbar 48
            Post-surgery Thoracic 37, Lumbar 39 (unfused)
            Fused T4-T12
            Milwaukee braced, 11 years old to 15 yo
            Surgery Sept. 1st, 2010 Dr. Boachie

            Comment


            • #7
              Chris,
              Just curious: was your private night nurse contracted with your insurance?

              Brenda

              age: 60
              diagnosed age 13: no treatment
              47 degree thoracic
              85 degree thoracolumbar
              surgery scheduled for Aug. 30 and Sept. 2
              A/P T-1 to pelvis with osteotomies & cages: proposed

              Comment


              • #8
                I was at uc davis medical center for 7 days all my nurses where great to me. my mom stayed with me the whole time. My spine surgeon came to see my last day in the hospital that really made me happy to see him he always smiling to brighton your day
                Last edited by kennedy; 11-26-2010, 03:10 AM.
                Kara
                25
                Brace 4-15-05-5-25-06
                Posterior Spinal Fusion 3-10-10
                T4-L2
                Before 50T
                After 20T

                Comment


                • #9
                  Originally posted by Singer View Post
                  I was at HSS for 10 days. I had either my husband or a friend with me all day during the first week, and I had a private night nurse every night until I left for rehab. ...

                  Maybe things are better now; my surgery was three years ago (and it was during the summer, a notoriously bad time for nursing care). Regardless, I urge everyone using HSS to contract a private night nurse -- it's worth every penny.
                  This is VERY frightening, as using the above hospital rankings links I posted I see HSS comes out on top almost without fail in all measures of nursing attentiveness.

                  You say "it's worth every penny" but I have a feeling that private duty nurse must cost at least 500$/night in NYC. Don't know what insurance would cover it...Of course, maybe a policy that would please Dr. Boachie would be generous about that too.

                  For someone w/o friends and family there in the day too, one would be out abt $10K for a ten day nursing stay - if not more. And rehab facilities aren't a bed of roses either. I think one would be well advised to have someone looking in there to insure one has adequate care. (At which point one had probably just as well be home with a private duty nurse. Only thing missing would be the medical equipment in case one requires special feeding or other monitoring).

                  I've been told that the choice of rehab facility is made at discharge too - based on where they have beds (and accept your insurance).

                  Seeming like there's just gonna be no place to be comfortable! Or (more to the point) - safe. Without good nursing care (including pain management ) one is that much more likely to get an infection too. Immuno-suppression has been shown to be pronounced after major surgery like this. For someone having a staged procedure, when is one more apt to be open to a serious infection than waiting between stages?

                  And let's face it, an angry over-worked nurse who acts out her frustrations on defenseless patients (eg, leaving you in the bathroom unattended) - can you picture her washing her hands as often as she ought to?

                  Au contraire, you don't have to be a psychologist who believes in the power of the unconscious mind, to figure it's JUST such a person who is going to take chances (your life chances) with say, her personal hygiene. What a great way to get "even" with the world! Angry people are NOT safe in patient care, ESPECIALLY in the "little ways" (little, HA!) they can get away with. Who's watching THEM in the lavatory?

                  I'm scared.
                  Not all diagnosed (still having tests and consults) but so far:
                  Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
                  main curve L Cobb 60, compensating T curve ~ 30
                  Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

                  Comment


                  • #10
                    Debra-

                    I was at the Hospital for Special Surgery for my surgery from June 8 to June 16. I have to stay the one this I wish I did that I didn't do is get a private nurse. The main reason I didn't is because they were $990 for each 12 hour shift (a regular RN) and the next was $330 for a 12 hour nurse (but that wasn't for a RN, it was for somekind of a caretaker who is like a nurse (forget the exact name) who could not do alot of the things the nurse could. I didn't find the nursing staff at HSS to be too great. I had about 2 great nurses. But the other nurses were not so great. I would call my bell and no one would come sometimes to bring my meds. Two of them that I had were horrible. It was like they could care less about you and your pain. The two good ones I had were SUsan and Jesse and they were on the spinal floor (the 6th) floor. One day I got soooo frustrated because I had asked for ice chips on my 4th day there, which I was allowed to have, and all the nurses or aids kept forgetting to bring it to me. Sometimes I think they just ignored my request. I do have to say my PACU nurse was really good. I'll write more tommorrow.

                    JenM
                    Surgery date: June 8, 2010 with Dr. Boachie
                    Thoracic curve: 55 degrees, corrected to 25 degrees
                    Lumbar curve: 58 degrees, corrected to 27 degrees
                    Posterior-only surgery, Levels T3-L3
                    31 year old mother of 2 young kids

                    Comment


                    • #11
                      Brenda -- my insurance (New York-based) paid for a portion of the nursing care, but I have to go look in the records to see what percentage it actually covered.

                      And Amanda, just to add some perspective to my experience: bear in mind that I had ZERO problems with infection, and in fact, HSS is considered one of the cleanest hospitals in the country. Remember, everyone there is having surgery, not being treated for infectious disease. I wouldn't read too much into the nurses' motives: they were simply busy, overworked, and tired -- I don't think they were out to get me!

                      I would go there again if I ever need more surgery -- as long as I had someone to advocate for me at all times.
                      Chris
                      A/P fusion on June 19, 2007 at age 52; T10-L5
                      Pre-op thoracolumbar curve: 70 degrees
                      Post-op curve: 12 degrees
                      Dr. Boachie-adjei, HSS, New York

                      Comment


                      • #12
                        Originally posted by Debra JGL View Post
                        My surgery is scheduled for 2pm so I'm a little concerned that by the time I come around, visiting hours will be over and that sounds a little scary to be there without my husband or anyone I know.
                        As far as ANY hospital stay I have ever had, they always let family members stay with you past visiting hours if that is your wish. I would check the hospital policy just to ease your mind.

                        Amanda, I really feel for you not having anyone. Honestly, if you lived close to me, I would stay with you and help you out. It seems aweful not to have ANYONE. Are you sure no one will stay with you? I can't imagine the fear you have, but honestly you'll be okay. I would let the hospital staff know that you don't have anyone to stay with you. I would also let the rehab facility know the same. Usually if people know you are "alone" in the world, they afford more effort to be more attentive. At least that was how I was when I worked in health care. Maybe even a social worker could help get you a companion to be with you. Where I live there is a Department of Aging and Disability within the Human Services Department for situations like this.
                        ((((HUGS))))
                        Be happy!
                        We don't know what tomorrow brings,
                        but we are alive today!

                        Comment


                        • #13
                          Hi all. I checked in with HSS about private nursing. As you said Jen, the nurse is $900 and a nursing assistant is $300 for the 12 hours overnight. I'm leaning toward the assistant who could help me if need be (drink of water, bathroom, getting up and down) and keep an eye on me. It's such a relief to know this is an option... breathing, breathing. Singer - that's a perfect way to put it, having an someone to "advocate" for me overnight. I figure you just never know how busy things will get for the nurses, how many emergencies that come up or how demanding the patients will be (or if the coffee machine breaks and the nurses are tired). Dr. Boachie's office did say I would be in intensive care for the 1st night since I have an afternoon surgery. Thanks Debbie too for getting me to think about this.
                          Debra
                          Age 45
                          Pre - surgery Thoracic 69, Lumbar 48
                          Post-surgery Thoracic 37, Lumbar 39 (unfused)
                          Fused T4-T12
                          Milwaukee braced, 11 years old to 15 yo
                          Surgery Sept. 1st, 2010 Dr. Boachie

                          Comment


                          • #14
                            Debra -- I had family with me in intensive care as well. The need for them there was as great as when I was in my regular room. The night shift of nurses in intensive care left a bit to be desired. It wasn't like they were all that busy, I was the only one in intensive care at least one of the nights and the other nights there was only one other patient. They were on 12 hour shifts so if you did get one of the not so good, you had them for a long time.

                            That's not to imply that all of the nurses were not so good. I had some excellent nursing care as well during my 10-day stay. There were certainly more good than bad.
                            Glenda
                            Age 66 Georgia (63 at time of surgery)
                            Bi-lateral laminectomy 2006
                            Kyphoscoliosis, approx 38* lumbar scoliosis, stenosis, disk herniations, lower back and hip pain, w/radiating pain, stinging and numbness in legs.
                            A/P fusion (T10-S2) 5/17/10 and 5/20/10
                            Dr Yoon, Emory Orthopaedic and Spine Hospital, Atlanta, GA
                            Pleased with outcome

                            Comment


                            • #15
                              Originally posted by rohrer01 View Post
                              Amanda, I really feel for you not having anyone. Honestly, if you lived close to me, I would stay with you and help you out.
                              ((((HUGS))))
                              You are a real sweetheart, rohrer. Actually, I wasn't referring to myself in my comments about social isolation and the need for help. I want to remind everyone blessed with quality insurance coverage and social support, how lucky they are!

                              Also, I'm reflecting on the costs of nursing care said to be "essential " ("worth every penny") when so many of us don't have the disposable cash to pay for it, however advisable it may be (and indeed it sounds like it is).

                              I remain horrified too at the nursing care at this facility which ranks so high in the US News and World Reports survey, especially since
                              a) like most, I worry greatly about the risk of infection. If it's like that at HSS what can we expect elsewhere? Likewise, at rehab?
                              b) I have a special concern about maintenance of hygiene on the part of staff who are (as described) angry and "acting out". My psychological training tells me they endanger patients, especially ones having P/A procedures (thus even more immuno-compromised, hence vulnerable to infection). This is not a matter of being "out to get us"! It's just how the mind works, unconsciously.

                              My specific outlook, though, doesn't look so bleak right now (KNOCK MUCH WOOD). In fact, my SIL has said she WILL help after surgery for a good while - contingent on work arrangements. SIL is very experienced in this role, wants Wolpert book to read and authorized involvement. Also, my dear younger son will be able to be there for the surgical period to spell her and as needed afterward (he's taking a year off school). He's great but we're glad he doesn't have to be primary care-giver (male and 21?). His willingness and concern has been a great comfort to me right along, though.

                              Even BOTH my present insurance plans ought to provide (or help with) some hours/daily of at home care/assistance indefinitely - depending much on what the surgeon "prescribes" and the built in time limits of the policies (too anxious to spell out, exactly). Compared to many, I feel fortunate - neither uncared about nor unsafe - overall. Again, this is as things stand now.

                              I only wish I didn't feel so much pressure to commit to the surgery - way before I'm ready. Most seem to incubate the decision for years; I've only had since March. This in entirely a function of social, geographic and financial factors imposing a time limit. Meanwhile, medical reasons changed as more information was forthcoming. This is confusing me about the absolute need for the surgery. (Repeat Xrays show that, in fact, my COBB angle remained stable in the last years - NOT deteriorated by 18 Degrees in the last year alone, as I'd thought. Looks like that was an artifact of measurement in different facilities).

                              Now, I'm REALLY losing it. So, GOOD = care and finances appear quite doable, if I "get with the program". BAD = I'm going mad because of conflicting opinions.
                              Last edited by Back-out; 07-21-2010, 02:57 PM.
                              Not all diagnosed (still having tests and consults) but so far:
                              Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
                              main curve L Cobb 60, compensating T curve ~ 30
                              Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

                              Comment

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