Through blogs and comments, patients and experts explore what it takes to find good health care and make the most of it.

Contemplating Safety While Lying Down


I write about what it takes for us -- whether we are sick or well -- to find and make good use of health care today.  At the end of September I was hospitalized for surgery to remove a tumor in my stomach. Below is one in a series of five observations about my experiences since then.

You have to get out of this hospital it's a dangerous place, each of my physician friends exclaimed when they came to visit me during my recent stay after surgery for stomach cancer.

Jeez!  I know! Prior to my operation, I was more preoccupied by the possibility of medical errors than of the operation itself or the pain it might cause.  What if they take out my kidney instead of my stomach?  Or leave a sponge in there?  Or over-hydrate me so I drown? What if one of my many overnight vitals-taking-shot-givers infects me with MRSA?

The human imagination has wondrous capacities, especially when fueled by true stories of harm people have experienced due to medical errors.  I read closely the IOM report To Err is Human: Building a Safer Health System ;  I am horrified by the medical errors experienced by Sue Sheridan and impressed by her leadership of Consumers Advancing Patient Safety and  Diane Pinakiewicz's at the National Patient Safety Foundation to raise awareness about the dangers patients face due to carelessness and lack of system-level controls.

But for all my well-informed apprehension and the warnings of danger by my doctor friends, during my recent hospital stay, I was in no condition to be vigilant about my care.  I was far too ill. Not too ill to forget the danger, especially when repeatedly reminded of it, but too befuddled by the after-effects of anesthesia and the pain medication to actually track the actions of the many health professionals who poked at me day and night. My husband, a constant presence during the day, was vigilant, but often I was on my own: in the operating room, during the hours spent getting various scans and overnight.

And so I spent those seven days on tenterhooks, worried about the dangers that lurked in and on the hands of each doctor, friendly nurse and aide.

What is the real aim of efforts to inform the public about medical errors and the appalling state of patient safety in U.S. hospitals?

Is it to get us to choose the hospital we use based on hospital performance reports? That is an optimistic goal to date. The primary impact of those ratings appears to be to prompt hospitals to improve specific clinical services that are rated, not to shape patient choices among different institutions.

Are these public education efforts an attempt to spark a citizen uprising against medical errors?  Hmm.  If the pre-election public climate is any indication, competition for our outrage is pretty stiff, and most of us are more focused on putting our hospital experience even if it is negative behind us.

Is the aim to ensure that we are vigilant while we are in the hospital?' Yes, our loved ones should watch out for us while we are hospitalized, although many of us don't have the person-power in our lives to mount a 24-hour defense.  However, as a patient who was sometimes watched over by my hyper-alert husband but often was not, the messages about the possibility of harm caused by my care frightened me. They permeated my dreams and contributed to an anxious wariness about each staff person who entered my room.

Would I rather not know about the risks of medical errors?  Not for a moment.  If there is a danger, I want to protect myself as well as I can. I strongly support the work of dedicated volunteers across the country to educate us about them.

But I am also acutely aware of this shift in responsibility, this additional task that patients and families must take on to ensure that we benefit from our care. And I am concerned that this is yet another example of how, in the name of 'choice, patient-centeredness and 'autonomy, we are carefully informed about the risks of our health care while most of us actually possess little of the experience, judgment or ability to act effectively to reduce them.

More Blog Posts by Jessie Gruman

author bio

Jessie C. Gruman, PhD, was founder and president of the Center for Advancing Health from 1992 until her death in July 2014. Her experiences as a patient — having been diagnosed with five life-threatening illnesses — informed her perspective as an author, advocate and lead contributor to the Prepared Patient Blog. Her book, AfterShock, helps patients and caregivers navigate their way through the health care system following a serious or life-threatening diagnosis. The free app, AfterShock: Facing a Serious Diagnosis, offers a pocket guide based on the book. | More about Jessie Gruman

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Accidents and Safety   Inside Healthcare   Jessie Gruman   Find Good Health Care  

Comments on this post
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Star says
November 1, 2010 at 12:36 PM

I thought about you so many times--and when hospitalized, thought of what
you wrote about in your first entry so many times...

I am glad you are out!!! And didn't have to return, like many do. Those places are
so impersonal--like hotels with needles, change the sheets, who was that again, next...

Anyhow, I am so glad you are through this...


Tweets that mention Prepared Patient Forum: Contemplating Safety While Lying Down « CFAH PPF Blog -- says
November 1, 2010 at 1:59 PM

[...] This post was mentioned on Twitter by ResearchAmerica, said: RT @ResearchAmerica: Dr. Jessie Gruman begins a 5-part blog series on patient responsibilities in the hospital [...]

Lynn, age 50 says
November 3, 2010 at 12:12 AM

The prepared patient can--and should--become part of the solution to the problem of hospital-borne infections. In Great Britain, the National Health Service is conducting a social marketing campaign in all hospitals with the followingmessage: "Stop Infection in Its Tracks. Every Patient Contact Needs Clean Hands." A concurrent campaign aimed at patients tells them, "It's OK to Ask," meaning, it's ok to ask your nurse, doctor, phlebotomist, etc., "Have you washed your hands?"

In this way, patients are empowered to help change the culture among healthcare workers. Failure to wash hands before patient contact should become analogous to smoking in a patient's room.

Sarah Jorgenson says
November 3, 2010 at 12:30 PM

I agree with you Jessie. What are we, as consumers, to do with this information? Two more recently published studies leave me more worried. If I have surgery, do I need to ask the surgeon how many hours they have worked that week because I read, â??Long Hours Put Surgeons, Patients at Risk, Study Suggests?â?? Or, if a family member of mine suffers from a stroke over the weekend, should I be more concerned for that loved one because it is not a weekday, â??Weekend Admissions Worse for Stroke Victims: Study?â??

Though errors may happen less often than not, the vignettes of friends, family members, or strangers brand our minds with skepticism and add an extra layer of worry to an already stressful experience. What responsibilities should we, as potential patients, accept in regards to preventing medical errors? Are we prepared to accept these responsibilities? Do we want to?


Steve Schoenbaum says
November 4, 2010 at 6:09 AM

I extract a couple of lessons from your experience, Jessie: First, I am both happy and sad about the assessment of the physician friends who told you that hospitals are "dangerous". The good news is that physicians recognize that there are safety problems that need to be improved; the bad news is that we haven't fixed enough of them for the professionals who work in them to be able to say that hospitals are safe places.
Secondly, many professionals interested in patient safety recommend that patients have a famiily member or friend present at all times as their "protector"; but as you note there are many times and places that family/friends cannot be around to provide that "protection". Furthermore, many patients are not conscious enough to look out for their own safety, and many family/friends are not "savvy" enough (arguably none of us is) to provide sufficient protection. So, logically, the standard for safety in health care should be that the setting is safe for all patients at all times and there is no need to question that the standard is being met.