Wednesday, January 9, 2008

Got good insurance?


I was actually going to post a more graphic photo and then decided this would be more appropriate...
I walked into work the other day at 11am, my scheduled time. It is when our department opens although an LVN (licensed vocational nurse) comes in a half hour before to do all the opening bullsh*t. As I walk in, the charge nurse from the main ER strides in with a syringe in one hand and a man following her who has his left hand elevated above his head and wrapped in bloody gauze. Right away I know this is not an ordinary patient. Rarely does the charge nurse from the ER get upset or excited about anything. "Bring him into room 4", I tell her, not even knowing what to expect. The story is this: a spanish speaking only construction worker (I'll call him Jose) was working with a skillsaw and "got" his fingers on his left hand. I knew right away, without even looking at his hand, that he was going to be prepared for surgery just by the presence and attentiveness of the charge nurse. I called the physician's assistant in as I started an IV and drew blood. The poor guy was pale and scared. Luckily he had his brother with him who spoke fluent english (I think!) and translated for us. The hand surgeon was called and showed up in 5 minutes. He took one look and told the patient his options. This is where it gets tricky.. Insurance. Wow, you would think that someone who's middle finger is hanging on by a piece of skin would get the best treatment available. But no. There are two hospitals in LA that specialize in "replantation". Our hand surgeon called them and they both denied him. I don't know the details on why but the bottom line is that they refused to accept him as a replantation candidate. Our hand surgeon, (who wonderfully had been making all the phone calls himself), had to break the news to the patient that no experts in finger replantation would accept him as a patient. By this time, his amputated finger was no longer viable and his only option was to go to surgery at our facility, for an amputation. Very sad. This man is a construction worker. He needs all his fingers. We all need all our fingers. Any normal person would think that if they cut off their finger and went to a hospital, that they would get all possible help. Nope. A finger that could have been saved was lost because of insurance. I find no fault with the hand surgeon that came in because he did everything he could to save the finger. The patient insisted to be transferred to a transplantation hospital (like we all would). The poor patient just didn't know that he would be rejected based on insurance. What can we do about this? This is not right! What next? We can't save your eye or your ear or your leg because you don't have the right insurance??? I'm very upset...

2 comments:

mama_nomad said...

i know--why can't the $$ be worked out later....? most people would gratefully go on payment plan if it meant keeping their livelihood--but the hospital can't afford to take the chance of someone stiffing them? that is soooooo sad...... :-(

Mrs. G. said...

This story makes me sick. I wonder when, as a country, we are going to hit the streets and raise holy hell for affordable healthcare. Unbelievable.