Healthcare - Atlanta Can’t Live without Grady – Really?

Just about everywhere I look these days I see Grady’s tagline, “Atlanta can’t live without Grady”. I wonder just how true that statement is. Who exactly is Grady serving and how effective is the treatment being given? You decide - picture this if you can. For days you have a squeezing, heavy sensation in your chest. Breathing is difficult to achieve and at times every breath is a labor of intense effort. Your lungs feels like there is something blocking your air-way and you are forced to breathe in through your mouth but have no trouble exhaling through your nose.  As uncomfortable as this is, you opt to wait a few days until your next appointment at the free clinic because you have no income or health insurance and you know a trip to the ER will result in a bill you cannot afford to pay.  Turns out your wait was for nothing because the doctor at the free clinic informs you that he is not equipped to handle your issue and refers you to the nearest ER.   

With referral in hand you hop on the Marta train and embark on a trip that will end at Grady Hospital. It’s a little after 3 o’clock in the afternoon when you walk through the entrance of the ER at Grady. You quickly go through the security check point and once deemed “not a threat” you were allowed to proceed to the registration counter. A quick glance around the room indicates this is going to be a while as just about every seat is occupied and so is most of the wall space around the room. You observe a couple of people sitting on the desk-top of a couple of abandoned cubbies which you suspect once were used for registration or consultation in the past.  While standing in line to register, you estimate there must be close to 60 people ahead of you but you make up your mind to wait because the free clinic doctor’s words was stuck on “replay” in your mind, “you need to get that checked out because it could be serious.”

After about 6-7 minutes of standing in line it’s your turn. You quickly scribble your name and social security number on the sign-in form and hand it to the nurse/attendant standing behind the portable computer station. Attempts to make eye contact with her to ask a question prove futile as she is busy having a conversation with the security guard. So you abandon that thought and set out to find a spot long the wall that you can claim as your own.  The further into the room you walk the more the stench in the room become more noticeable. Closer observations revealed that the majority of the occupants in the room appears to be homeless or suffering from some sort of mental illness.  Doesn’t seem to you that this ER is the first choice for those who had a choice. “Oh well, I’m already here”, you think to yourself as you walk pass a woman in a wheelchair that you swear is the source of the stench in the air.

Fifteen minutes into your wait you hear a nurse repeating a name that could be yours but the first name is “Gloria”. After no takers you decide to go ask if maybe they meant you instead, maybe they got your first name and the first name of your emergency contact person mixed up – it could happen.  Sure enough it was you. The nurse apologized saying he was just speaking to his sister “Gloria” on the phone and must have transposed it in his mind over mines.  No harm done, right - but you can’t help but wonder just when did he find time to chit chat with his sister with a room full of patients waiting to be seen by the doctor? You suspect its lapses like these which adds to the wait time especially since the interview process went by so quickly. Maybe he needed to get back to his sister to finish up their conversation.

  

Anyway, a quick interview which includes what brings you to the ER ensues, as well as a few screening questions to rule out Ebola exposure and you are sent back into the waiting room. By now your little space on the wall has been confiscated by a new comer and you are forced to wonder further back in the room. People are coughing, sneezing, and even drooling. Some patients, who appear to be regulars, are sporting face mask. Made you wish you could get your hands on one but that quickly got addressed when you observe another patient approach the registration nurse requesting one and was told those were for “special cases”.

Almost three hours has past and there was little to no activity so you decide between the pain in your back, the stench in the room, which is now almost unbearable, it was time to leave. As you walk towards the front of the room you heard your name called among others. The excitement that you were about to be seen quickly turned to disappointment as you were informed they were just doing a roll call to see who was still there. At that point you tried to get a sense of what number you were, but was told it’s had to say. So you decide to leave.  The whole train trip you kept hearing that doctor’s word in your head, “you need to get that checked out because it could be serious.” So you turn around and go back.  To your dismay, it does not look like anyone left the room but it’s hard to tell. You check in with the registration nurse who informed you she removed you from the list when you left. You ask to be put back on but you were interrupted by another woman who is wearing street clothes but appeared to be an employee that was leaving for the day. Even though she was sporting a name badge, it is hard to see just who she is.  She told the registration nurse you had to go through the registration process again because they can’t have people just walking in and out.  Ten minutes into your wait time your name gets called again to go through the registration process again, however this time the nurse takes your vitals and blood pressure unlike the first nurse. Seems they had a shift change in your absence. Interesting - looks like getting re-registered comes with some perks. It’s about 6:30 pm now.

By 9 o’clock you start second guessing your decision to return to the ER. You are still having difficulty breathing and the lack of fresh air was making it even more difficult to breath. You had already made a couple of trips outside to help flush your lungs with fresh air but was mindful to let the registration nurse know of your whereabouts, as well as made it a point not to be gone for too long. Just when you think you had reached your limit and was about to leave, hopefully for the last time, you hear your name called among a list of others. You were then instructed to stand in line outside a door that lead to the examining rooms.   Once everyone was accounted for and herded together, you are led through the doors and placed in yet another waiting area. This time the room was much smaller and had just enough chairs for everyone in the group.  A few minutes later someone came and called each person’s name and took them individually to an examining room. As you enter the examining room you notice it resembles a hospital room setting except there was no bed or cot only a lonely chair that was facing the TV on the wall. Closer examination of the room reveals the floor could use a good moping. You clutch your purse and pray for this to be the beginning of the end. By now you realize the battery on your cellphone has gotten low and you don’t have a charger – damn.

A nurse assistant came in and asked you a lot of similar screening questions that you had already answered before in registration.  She shares that someone will be in shortly to examine you but in the meantime she would like to gain my consent for AIDS testing which was being offered free and confidential. At this point you don’t really care so you say “okay”. Shortly after that a “doctor-in-training” comes in and ask you the very same questions as the nurse assistant. Not wanting to appear rude you answer anyway hoping this will soon be over. You are told they will be running some test to try and identify the cause of your issues.

Okay let’s fast forward to 12:45 am. You are sitting in a larger waiting room within the examination area with 2 dozen or so other patients. Looking around, you get the feeling that this is a makeshift treatment center for the homeless/mentally ill, as everyone around you is either getting a shot, placed on oxygen, or given some sort of oral medication. Everyone except you. You are sitting directly across from the treatment supply room and you observe everyone going into that room using the same access code “1234”. “How safe is that?” you think to yourself – “no accountability for sure.” You shake your head as though trying to dismiss that thought from your head and quickly return your attention to your current situation. You've given blood, had your chest x-rayed, and had an EKG yet no word as to what could be wrong or the results of said tests. Knowing Marta will soon stop running you approach the nurses’ station looking for answers. The first nurse was fast asleep so you turn your attention to the other nurse who didn’t seem to be as busy only to be told, “You have to wait for the test results to come back.” You insist you need to go now because you have not eaten or drank anything since you first got there at 3:00 that afternoon. After much insisting that you can’t wait any more, you are told you can check yourself out but you need to sign a waiver “in case you end up dying.” However, they could not figure out how to get an electronic copy for you to sign, after a few tries by a few people they finally get it sorted out but just when you were about to sign it another nurse comes over and in a kinder, gentle manner convinces you to give it a little more time. “Besides,” she point s out, “Marta has already stopped running.”

At 2:45 am test results are back but they want to run a few more tests. No one is saying what tests are being run or what they are looking for. By now your ride has arrived and they send you into another examination room to get test results. This time there is a bed but the cleanliness of the room was no better than the first waiting area. A trip to the bathroom leaves a lot to be desired as it too could use a good cleaning. Smells like urine and the floor is sticky under your feet. Paper product (toilet paper and paper towel) is missing from the equation. Maybe you can just hold it til you get home but who knows when that will be. So you relieve yourself being careful not to touch anything. You made it back to the room with time to spare as the nurse has yet to show up.  Finally after what seems like forever the nurse comes in the room and shares that all your test results were negative – whatever that means – but they want to run two more tests. 20 minutes go by and no one comes to take the blood for those last set of tests so you go to the makeshift lab where they first took your blood to see if you can expedite the process which you did. Another 40 minutes goes by with nothing so you go to the nurses’ station again and this time you are adamant about needing to leave.

At 3:45 am – roughly twelve hours after you first walked through the ER doors you've had enough. No communication from staff, just a whole lot of waiting, so you decided it’s time to go. At checkout they print out their description of what you came in for and wrote a prescription for Robitussin DM. Oddly enough, there was no mention of a “waiver” this time, only the promise from the nurse to call you at 7:30 in the morning before she leaves to give you an update on the results of your tests – a call that never came.  Two days later you discover from searching your symptoms on the internet that you possibly have an upper respiratory infection which requires antibiotics. The next week you walk into the free clinic, share your self-diagnosis with the doctor and after his examination you leave with prescription in hand. Three weeks after that you get a bill from Grady for $4,500. You spend another few weeks trying to get the bill reduced. A trip to their financial assistance department with proof of no income gains you a Grady card which reduces the bill to $80, but it may as well be $800 cause you still don't have it.  You remind them that you have no income, no medical insurance, and no way to pay the bill.  You are told the only people who can get free health care are those who are homeless or lives with someone else. Since you are none of those things you have to pay the bill or it will go to collections. You count out $9 in change and take it to the finance office and made small payment as you can but, your name still get sent to collection as 30-days later you get a notice from the bill collection department in Florida.

I've heard that Grady is undergoing some major image reconstruction and even have made some physical upgrades in the hospital. I’m guessing you have to have some big bucks to be able to get into that part of the hospital or perhaps it just does not include the ER. Either way the scenario above is real and from what I can tell the treatment rendered does not convey a system that cares. If this is how Grady is treating their patients and they think this is “good health care” that Atlanta cannot live without, then someone needs to let them know they have missed the mark. Regardless of your economic status or whether or not you have health insurance, everyone deserves to receive good health care in a clean efficient setting, and in a timely manner. Healthcare that includes regular communications about what they think is wrong, the tests they are running and what those test results show. 12-14 hours of waiting around in a hospital ER to get treated is not acceptable - regardless of the nature of the illness. It would have been better for them to let the patient know they could not be seen and send them on their way.  Atlanta may not be able to live without Grady, but I can. I’m just saying. I got issues – what about you?)i(

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