Hospital incompetence.

**sacc51** · 30th July 2022, 03:43 PM

Just returned home from the amoeba asylum. I told the staff when admitted that I would be controlling my insulin insulin requirement myself and I expected no input from that. But what a visit: First one or two shots of insulin were ok, the nurse just gave me my inulin pen and asked how many units I'd like. Third was a bit different, instead of referring to the notes she asked the on-call doc how many units I should have. With that, the doc insinuated himself into my diabetes control. At the same time, I got extremely nauseous and started filling barf bags, could not eat without bring everything up, including any pills they gave me.
In short order my glycaemic level rocketed up to 22 (normal is 4-6), so I asked for some insulin. Nurse asked the doc, the doc said no, withhold the insulin until I was eating. I demanded to see him and he came up to see me, we had a wonderful discussion: He advised he wouldn't allow any insulin until I ate, I advised him I couldn't eat without throwing up, 'further, I also advised that the insulin wouldn't kick in for around 30 minutes, so by the time it did kick in my glycaemic level would climb to over 30, probably around 32 on one sandwich.

For those that don't know, at that level you risk going into a coma. I called him a blithering idiot and told him to get out of my room. He objected strongly telling me not to call him an idiot, I simply said ' if the shoe fits?' At 22 I would need around 17 units of insulin to bring my level down to normal. I'm not a doctor, so how would I known that? Simple, 23 years of experience.

The doc apparently changed his mind and the nurse came in with a syringe with 6 units, 'fat lot of good that will do me’ I said. Two hours later my level was down to 18 and rising again. Then the diabetes specialist came in and another argument ensued. I asked him how many years he had been overseeing my diabetes treatment 'none, said he', 'exactly', said I, ‘I've been overseeing it for 23 years, and that places me in a better position to know how different foods affect me, how I work out how much insulin to take (carb count), how different forms of exercise affect me and how the different medicines affect me: Anaesthetic, steroids and so on.

I also informed him I no longer consulted a specialist as he thought it pointless as my diabetes was well controlled, three-monthly test confirmed I regularly maintained a average level of 6.8 (anything over 7 can cause complications). So, again I called him an idiot and kicked him out of my room.

Miraculously, my insulin pen appeared with the hour and was left on my table. My levels dropped rapidly to a little over normal, I was being very cautious as my food intake was still zilch. Insulin should always be taken with food, but as I could not eat,, my sugar levels would simply keep rising. Incidentally, high blood glucose levels can also cause nausea and vomiting.

Next problem, the nausea and vomiting were getting worse, even water was causing me to vomit. I suspected the antibiotic drip was the cause, so asked for a different antibiotic. The nurse informed the doc and he said no, continue with the current antibiotic. The next antibiotic drip I had caused nonstop vomiting, so I refused to allow them to pump any more into my body. The specialist came the the next morning and asked how I was, I told him Id eaten nothing for three days and was now dry reaching as there was nothing left to bring up. I told him that just wasn’t sustainable
The specialist then said ‘why the hell didn’t you tell me that yesterday. My reply ‘why didn’t you read the notes, they set out the problems I was having. If you’re not checking the notes daily then what is the point of the nurses taking them’. The specialist then changed to a less aggressive one and the nausea gradually abated over the next 24 hours.

On the fifth day the specialist wanted me to stay another day as it was a big operation (3 hours) and there was a lot of damage. I’d been walking ¾ times every day gradually increasing the length until I was traversing nearly the entire first floor by this stage, the physio was more than happy with my progress and so I practically ran out of the hospital, with the aid of a wheeled walker, very, very happy to be leaving the amoeba asylum
Diabetes control in hospital has always been problematic for me in hospital, whilst the staff think nothing of levels in the order of 20, I disagree, so there is always an argument and I become extremely abusive. But I will not allow anyone, regardless of credentials, to control my diabetes treatment. Past history of what hospital staff have put me through prevents me from allowing input on diabetes control, anything else, they have free reign.

As a side note,
Every diabetic is different: Different foods have different effects on different people. Some require more or less insulin than others, the only way to find out is to experiment. Or, you can do as a very good friend of mine did: Blindly follow the specialist's advice of eating the same meals every day, have the same physical output, and take the same amount of insulin everyday. After 4 or 5 years they found him on his kitchen floor - dead from a hyper!

**Bushmiller** · 30th July 2022, 07:38 PM

Wow!

Regards
Paul

**verawood** · 1st August 2022, 02:44 PM

Yep, wow.

**Bohdan** · 1st August 2022, 04:16 PM

Which hospital?

**sacc51** · 4th August 2022, 08:57 AM

Ashford in Adelaide.
Not really any different from other hospitals in respect of diabetic care.
Unfortunately, Doctors don't have a lot of respect for their patients and seem to suffer from a superiority complex, we're just the ones who pay for their BMW and Mercedes cars.
Every diabetic is different, food, insulin, activity affect them in different ways. So the question is, who would know more more about personal diabetic treatment, the diabetic concerned , who in this case has been treating his diabetes for 22 years, or, a Doctor who has been treating my diabetes for all of - no time at all?
I think the answer to that question lies in 'common sense'!

**Mr Brush** · 4th August 2022, 11:03 AM

I think your observations about hospitals pretty much reflects standards across the board. I've had experience of a couple of private hospitals over the years for minor procedures, and in every case things would have gone seriously wrong if i hadn't pulled them up on things ("errrr - I'm not a doctor, but is the wound supposed to be bleeding from here?"). Similar experiences with potentially incorrect drug doses. The sad fact is that you really need to have your wits about you in hospital, at a time when you aren't likely to be feeling anywhere near 100%.

I have an extra layer of disdain for specialists here in Oz, most of whom seem inordinately keen to foist their particular procedure on you whether it is justified or not. I've had two procedures performed by specialists; one turned out to be completely unnecessary, the other yielded no benefit at all in terms of the supposed ailment it was supposed to address. Lost count of the number of $400 "specialist" appointments I've had for a 20 minute session with no tangible benefit. When you walk through that door you're not a patient, you're a "business opportunity".

. Don't even get me started on the ones charging massive amounts over the schedule fees (= out of pocket expense even with best private health cover).

**sacc51** · 5th August 2022, 10:27 AM

When being admitted, they ask you about your medication, name, dose when you take it and so on, and yet in every stay I've had to ask for my medication (BP meds as well as insulin. I take Novorapid three times a day with meals and Protophane at night before retiring, this time around I never got the Protophane at all.

I had the upper and middle lobes of my right lung removed five years ago due to cancer. After being cleared, the cancer came back, I underwent chemo and radio and was declared clear again. Then it came back and I underwent more aggressive radio, was declared clear then it came back again.
I'm now on my fourth merry go round with lung cancer. Given that, I seriously doubt it was necessary to remove most of my right lung, when the first two spots were much smaller than the spots that showed up second, third and fourth time around.

Then I had my hip replaced, the surgeon left the cup protruding and the psoas tendon kept rubbing on it, two surgeries later, no improvement, so back in for hip replacement revision surgery.

I then had the left, big toe joint replaced, the toe now points to the sky, it hasn't seen the ground since.

I had two fingers fused, the wire used to pin the joints in place is now poking it's way through the skin.

I went in for a hemorrhoidectomy quite a few years ago. After surgery the surgeon came to see me and told me he had released the sphincter muscle, but he noticed I had hemorrhoids and advised me to have them removed.

Any confidence I ever had in medical science is being systematically eroded. Unfortunately, there is no alternative!

**Mobyturns** · 5th August 2022, 11:04 AM

Hospital safety protocols dictate that nursing staff must follow the approved standards for in hospital medication with tracking, charting, prescribing, patient management and handover to your GP etc.

Which typically means that all patient supplied medications are received then stored in a locked medication drawer only accessible to nursing staff. There are very sound reasons why patients are not permitted to self medicate whilst in hospital. Security of prescribed drugs, some of which may be scheduled drugs, being the prime factor and ensuring that medications are not shared, misused, administered by "helpful" non-nursing visitors, or stolen. The patients dietary intake is also charted and dosages calculated from that information. Non-charted dietary intakes (snackies) can create issues.

The nursing staff undertake a medication risk assessment, upon arrival to their ward, which may include the patient's "ability to self-administer medication." Clearly in your case the doctors and nursing staff reviewed your assessment and then approved self-administration of a specific medication.

This may help (note may not be the current revision) - Safety and Quality Improvement Guide Standard 4: Medication Safety

ps - I'm not a qualified medical practitioner, only been through the hoops a few times as a patient.

**Mobyturns** · 6th August 2022, 09:51 PM

Originally Posted by sacc51

Nothing like pointing out the obvious!

I have undergone around a dozen procedures in the last five years, do you think I might be aware of hospital protocols???

Perhaps not! Maybe just a disgruntled difficult patient perhaps?

How about you also note the obvious - nursing staff are under a hell of a lot of pressure due to COVID! Many are being "required" to work in areas outside their specializations, extra shifts, "doubles" etc. They are also constrained by the medical directions they are given and most senior nurses are more than prepared to take on an intern, registrar, doctor or specialist IF they are of the opinion that they are not acting in the patients best interests.

Critical staff shortages, under resourced, over capacity wards, with staff down due to COVID or simply just had enough of a "broken system" - all staff are burned out and really questioning whether to continue in the profession. Be thankful there was a hospital bed in a staffed ward available to you and you received the procedure because many hospitals have been forced to cancel all but emergency surgery.

"amoeba asylum" - well how insulting can one get.

**jack620** · 6th August 2022, 09:54 PM

Originally Posted by sacc51

Any confidence I ever had in medical science is being systematically eroded.

Doesn’t seem to stop you going back:

Originally Posted by sacc51

I have undergone around a dozen procedures in the last five years

Sounds to me like they’ve done a pretty good job of keeping you alive.

**jack620** · 6th August 2022, 09:57 PM

Originally Posted by Mobyturns

Maybe just a disgruntled difficult patient perhaps?

An absolute PITA I’d say.

**A Duke** · 6th August 2022, 10:17 PM

Now now be nice!
All of you.

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