The Patient Advocate as a Witness

A Reader Shares Her Experience in the Hospital
A reader who purchased my Smart Patients, Safe Patients book left a review with some honest feedback that I very much appreciated.  I am posting her review here without her permission, since I don't have a way to contact her.  I assume she won't mind, since her review is public. Here is what the reader, Jean, wrote:
I think the book has good ideas but it's not is Emphatic enough about how dangerous hospitals are. Personally, I was dropped in bed by a technician and a nurse came to my aid when I was in the hospital. But my nurse covered up the accident. The nurse never reported the accident in the daily notes. I told subsequent nurses and the resident on Saturday and Sunday morning but when I confronted the hospital there's just an empty spot in my medical notes – so this book guides you to say that when nurses change shifts they should discuss in front of you your care. But A patient's medical needs go further than that. A patient needs a witness to virtually everything that goes on in a hospital. Nurses and technicians lie for each other – nurses technicians and doctors cover up each other's mistakes and the only way A patient is protected is to have a witness. This information is glaringly missing from the book.


I completely agree with Jean that the patient's medical needs go further than having the nurses do report at the bedside, and I did attempt to convey that message.  I can understand the desire for a stronger message after the experience Jean shared.
By Sharing Experiences, We Can All Benefit
I think of this blog as a dynamic book, and it is one that we can all create together. If you have had an experience and have learned something as a patient that might help others, I would be most happy for you to share it here.  I only ask that you do so in a manner that is respectful and helpful to others and not as an opportunity to bash or demean anyone.
About Jean's Experience
I'm sorry Jean had a bad experience when she was a patient, and I hope no one else has that kind of experience. I would like to share what should have happened in Jean's case based on the information she gave. 
Jean was dropped by a technician.  Either the technician or the nurse was required to complete an incident report, which would go to the manager of the floor where the event occurred.  The nurse should have notified Jean's physician about the event.  If there was any question of injury, the physician should have ordered an appropriate follow up test, such as an x-ray to check for fractures. The physician notification should have been documented in Jean's chart. The nurse should have also written a nurse's note or possibly completed an event form, depending on the type of documentation used.  Jean doesn't say why she confronted the hospital, so I'm unclear if she wanted a copy of the documentation for legal purposes or simply wanted to make sure the event had been documented.  It's entirely possible that an incident report was filed, because those are separate from the chart.
What Would I Do in This Case?
If I was dropped by a technician, and I had any concern that I might have suffered an injury, I would verify with the nurse that an incident report was filed and the physician was notified.  I would request that she ask the physician to obtain an order for an x-ray of whatever part of my body I felt might have been injured.  Even if there was no injury, I would still ask if an incident report was filed.  The purpose of the incident report is to give the manager an opportunity investigate the event, find out exactly what happened, and do whatever can be done to prevent another event.  In addition, I would ask the nurse if he or she documented the event in my chart, and I would ask to be shown the documentation. I would also tell the nurse, "Please don't feel that I don't trust you. This is simply my practice and it is what makes me comfortable."
I do want to add that in all my years of working in the hospital, I personally have never known caregivers to cover up for each other when a mistake was made, although I don't doubt that it happens on rare occasions.
Questions and Stories are Always Welcome
I love questions, and I love for people to share their stories when they feel comfortable doing do!  If you have had an experience as a patient in the hospital and don't quite understand something that happened or simply want to know how to make it a better experience next time, I would love to help if I can.  Questions asked and answered can benefit everyone.