Neurosurgeon speaks out about anesthesia errors in OR at hospital in Florida

[sice4]

Doctors at Florida hospital say patient care has suffered since HCA's cost cuts

Doctors allege unsanitary surgical instruments, an overflowing ER, roaches in the OR and anesthesiology errors that resulted in patients waking up during surgery.

www.nbcnews.com

Anyone work here or know about this? What is the staffing model at this hospital under the HCA (looking at a job on gasworks looks like it is a 99% supervision 1 anesthesiologist:4 CRNA model.

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[coffeebythelake]

Who knows how true this is. A surgeon thinks a patient is "waking up" if they move during surgery.

One such “near miss” occurred, he said, when the wrong side of a patient was prepped for surgery — anesthetizing a left hip that should have been the right.

Honestly this reads like the surgival patient was marked on the wrong hip rather than an anesthetic error.

 

[nimbus]

Honestly this reads like the surgival patient was marked on the wrong hip rather than an anesthetic error.

Could have been wrong site block e.g. PENG or fascia iliaca.

 

[TheLoneWolf]

Who knows how true this is. A surgeon thinks a patient is "waking up" if they move during surgery.







Honestly this reads like the surgival patient was marked on the wrong hip rather than an anesthetic error.



You do know surgeons are taught that ABA stands for "always blame anesthesia"

 

[coffeebythelake]

Could have been wrong site block e.g. PENG or fascia iliaca.

even if it was a wronge sided anesthetic block it reads like the patient was marked incorrectly in the first place.

 

[Shimmy8]

Is this a place HCA took over staffing anesthesia?

 

[aneftp]

It’s pays $350-hr and up. Lol. 12 week commitment may net u more. Good place to park for the winter for snowbirds for 1099 work.

Lots of things are overblown in the news. Big facilities have major complications and quality issues as well all the time. By sheer volume.

Just sayin….

So take advantage of chaos to make the money. Peeps.

 

[Blockit]

HCA is garbage, especially HCA Florida. This is one of the 11 or so facilities on the gulf coast that HCA brought “anesthesiology in-house” for the purposes of making more money.
I would believe absolutely everything in this article.

 

[anbuitachi]

It’s pays $350-hr and up. Lol. 12 week commitment may net u more. Good place to park for the winter for snowbirds for 1099 work.

Lots of things are overblown in the news. Big facilities have major complications and quality issues as well all the time. By sheer volume.

Just sayin….

So take advantage of chaos to make the money. Peeps.

350 a hr covering 4 rooms sucks.

 

[dannyboy1]

350 a hr covering 4 rooms sucks.

You must be joking. 350 x 40 hours a week is 14000/ week. Assuming you take 8 weeks off that is 616000 year working 40 hours a week. That doesn’t “suck” by any definition.

 

[coffeebythelake]

350 a hr covering 4 rooms sucks.

It depends on who you are working with? Decent capable and trustworthy CRNAs/AAs? Great. Militant and malignant nurses? Wouldn't do it for any price. The Patient's safety and my sanity is worth a lot more than that.

 

[chessknt]

You must be joking. 350 x 40 hours a week is 14000/ week. Assuming you take 8 weeks off that is 616000 year working 40 hours a week. That doesn’t “suck” by any definition.

This is sdn, the median pay is 1.5 million/yr with no weekends and 14 weeks off a year.

 

[Gasworks]

He is a very good surgeon and an incredibly crappy human being. He was ousted as president of the medical staff and wants to scorch the earth on his way out the door. I listened to him openly brag about all of the careers he ruined over the years for personal vendettas. This is another one of his personal grudges aimed squarely at corporate level hca administration.

 

[aneftp]

350 a hr covering 4 rooms sucks.

I said it’s starts at $350 and up. You can make more. Everything is negotiable. The more desperate The higher the rate.

It’s not bad. Just sayin. You can pull 80-100k easy each month.

One of the peeps there say it’s easier work than their other trauma 2 place in Florida. The advent systems have healthier patients but will run u around for $325/hr. Money is money.

It’s all relative man. If you know what u are doing.

Don’t turn down money when it’s available.

 

[Status Sciaticus]

350 a hr covering 4 rooms sucks.

You must be joking. 350 x 40 hours a week is 14000/ week. Assuming you take 8 weeks off that is 616000 year working 40 hours a week. That doesn’t “suck” by any definition.

Not when you can get 350/hr doing your own cases and limiting your liability.

 

[gunnershow]

I said it’s starts at $350 and up. You can make more. Everything is negotiable. The more desperate The higher the rate.

It’s not bad. Just sayin. You can pull 80-100k easy each month.

One of the peeps there say it’s easier work than their other trauma 2 place in Florida. The advent systems have healthier patients but will run u around for $325/hr. Money is money.

It’s all relative man. If you know what u are doing.

Don’t turn down money when it’s available.

If they're that desperate, you can start making demands and ask for solo work. No currently offered price is worth working 4:1 and the insult to your dignity for normalizing and participating in 4:1.

 

[anbuitachi]

Not when you can get 350/hr doing your own cases and limiting your liability.

Agree. Locums here getting 325 to 350 a hr doing cases solo. Mostly gu and gi cases

 

[Twiggidy]

Who knows how true this is. A surgeon thinks a patient is "waking up" if they move during surgery.



Honestly this reads like the surgival patient was marked on the wrong hip rather than an anesthetic error.

True. Devils advocate….why isn’t the anesthesiologist in the room saying “hey stupid. You’re prepping the wrong side”

 

[Twiggidy]

This is sdn, the median pay is 1.5 million/yr with no weekends and 14 weeks off a year.

Exactly the sheer amount of 800k no call home by noon jobs that must be out there baffles me but I seemed to can’t find one. Guess I don’t know the right people

 

[GassYous]

Exactly the sheer amount of 800k no call home by noon jobs that must be out there baffles me but I seemed to can’t find one. Guess I don’t know the right people

"We don't need to advertise, we find you"

 

[vector2]

I said it’s starts at $350 and up. You can make more. Everything is negotiable. The more desperate The higher the rate.

It’s not bad. Just sayin. You can pull 80-100k easy each month.

One of the peeps there say it’s easier work than their other trauma 2 place in Florida. The advent systems have healthier patients but will run u around for $325/hr. Money is money.

It’s all relative man. If you know what u are doing.

Don’t turn down money when it’s available.

Will Bayonet let you sit your own cases?

 

[coffeebythelake]

True. Devils advocate….why isn’t the anesthesiologist in the room saying “hey stupid. You’re prepping the wrong side”

This sounds like a systemic issue with poor internal controls to prevent mistakes. Swiss cheese model with huge holes. If it takes an anesthesiologist to notice that someone marked the patient wrong..

 

[kidthor]

If they're that desperate, you can start making demands and ask for solo work. No currently offered price is worth working 4:1 and the insult to your dignity for normalizing and participating in 4:1.

Agreed. For whatever rate they're offering these days to be routinely 1:4, I wouldn't personally do it. It's not safe or ethical and I want no part of it.

 

[Euripides]

True. Devils advocate….why isn’t the anesthesiologist in the room saying “hey stupid. You’re prepping the wrong side”

I’ve often wondered this myself… all we need is one person in the room to pay attention to ensure that the correct patient is having the correct procedure. I’ve reviewed a number of these cases over the years and the “team“ approach sure seems to break down into the team members believing someone else is paying attention so I don’t have to do it myself. As anesthesiologists we are the ones rendering the patient unable to protect themselves so why not us? I know the overwhelming majority of my colleagues don’t want to own this however.

 

[kidthor]

I’ve often wondered this myself… all we need is one person in the room to pay attention to ensure that the correct patient is having the correct procedure. I’ve reviewed a number of these cases over the years and the “team“ approach sure seems to break down into the team members believing someone else is paying attention so I don’t have to do it myself. As anesthesiologists we are the ones rendering the patient unable to protect themselves so why not us? I know the overwhelming majority of my colleagues don’t want to own this however.

I once caught a wrong sided carotid and the surgeon's response was "it wouldn't have mattered, the other one is bad too".

 

[Twiggidy]

I’ve often wondered this myself… all we need is one person in the room to pay attention to ensure that the correct patient is having the correct procedure. I’ve reviewed a number of these cases over the years and the “team“ approach sure seems to break down into the team members believing someone else is paying attention so I don’t have to do it myself. As anesthesiologists we are the ones rendering the patient unable to protect themselves so why not us? I know the overwhelming majority of my colleagues don’t want to own this however.

There are certainly many levels where it can break down. Is the correct side marked in preop? Is the consent written correct? Is there a pause when the patient entered the room? In this day, there are way too many checks involved for there to still having wrong side surgery to occur and if it happens I think everyone is at fault because as I said, it really doesn't take more than to stop and say "hey, that's the wrong side"

I remember at my place they tried to get us more involved with policing gyn surgeons for laparascopy surgery because someone removed ovaries when they weren't supposed to. I sort of put my foot down because while I should be paying some attention during a case, I'm not the OR police. At some point, surgeons need to be accountable for their own mistakes much like we as anesthesiologist tend to get dumped on an island when we mess up.

 

[MirrorTodd]

I once caught a wrong sided carotid and the surgeon's response was "it wouldn't have mattered, the other one is bad too".

I'm sure the lawyers would salivate upon hearing that.

 

[epidural man]

That is nuts. HCA made 5.6 billion in profits last year (according to the posted article).

Seriously, healthcare is on a crash and burn course for the sewer and it started when for-profit entities became the norm.

 

[TheLoneWolf]

That is nuts. HCA made 5.6 billion in profits last year (according to the posted article).

Seriously, healthcare is on a crash and burn course for the sewer and it started when for-profit entities became the norm.

Squeeze a strained medical system and the sick to pay shareholders....what could possibly go wrong

 

[Urzuz]

I know the overwhelming majority of my colleagues don’t want to own this however.

who the hell would want to “own” getting blamed when things go wrong and getting absolutely nothing when things go smoothly, especially when said ‘thing’ critically hinges on other team members (who may or may not have the IQ higher than a tadpole) doing their jobs competently.

You should remain engaged and speak up if you realize things are amiss (eg: wrong limb is getting prepped), but anesthesiologists absolutely should not “own” this

 

[DonFL]

HCA is garbage, especially HCA Florida. This is one of the 11 or so facilities on the gulf coast that HCA brought “anesthesiology in-house” for the purposes of making more money.
I would believe absolutely everything in this article.

Cmon now, you think anyone is actually making money on anesthesia in any acute care facility??

 

[DonFL]

I said it’s starts at $350 and up. You can make more. Everything is negotiable. The more desperate The higher the rate.

It’s not bad. Just sayin. You can pull 80-100k easy each month.

One of the peeps there say it’s easier work than their other trauma 2 place in Florida. The advent systems have healthier patients but will run u around for $325/hr. Money is money.

It’s all relative man. If you know what u are doing.

Don’t turn down money when it’s available.

I heard they really got a good group of extenders in there now - sounds like easy money

 

[Blockit]

Cmon now, you think anyone is actually making money on anesthesia in any acute care facility??

It’s not just about making money “on anesthesia”. It’s about control of the providers.

 

[Gasworks]

I heard they really got a good group of extenders in there now - sounds like easy money

Best CRNAs I’ve ever worked with. The OR is well run and they provide a valuable service to a disaster of a community. The city of Hudson is literally 3rd world and I’m talking slums of Nairobi 3rd world. If you read deeper into the story you’ll see that dr “G”, the guy that is on the news was ousted as chief and is looking to burn the place down on his way out the door. That’s about as much info as I’m gonna share publicly.

Moral of the story - don’t piss off a sociopath.

 

[sice4]

If those are the best CRNAs you've ever worked with then what does that say about CRNAs? The article literally talks about terrible anesthesia care...

 

[Aether2000]

Doctors at Florida hospital say patient care has suffered since HCA's cost cuts

Doctors allege unsanitary surgical instruments, an overflowing ER, roaches in the OR and anesthesiology errors that resulted in patients waking up during surgery.

www.nbcnews.com

Anyone work here or know about this? What is the staffing model at this hospital under the HCA (looking at a job on gasworks looks like it is a 99% supervision 1 anesthesiologist:4 CRNA model.

This hospital is in an impoverished area of Florida. I visited there to consider a job a few years ago and the lobby had paint flaking off the walls and several aspects of the hospital seemed to me to be quite retro. I did not take the position. But internal politics are clearly at play here in addition to the probable funding issues, and the anesthesia there is not at all inferior.

 

[camkiss]

Ah- the good ole "physician engagement survey". HCA places such a high emphasis on this that physicians routinely lie about how they feel because if the scores are low there are mandatory meetings and creating "action plans" to improve your score. And only "top box" (9-10/10) scores are counted. Anything else is a fail.