On the flip side, an incredibly tiny percentage of Doctor decisions are going to kill you or save you in a life or death situation.

If you come in alive with a gunshot to the heart, it is probably important the heart surgeon is both well rested, and hasn't come from a New Year's Eve party.

Much of the rest of the crew should be able to do their job on computer aided auto pilot.

Of course people make mistakes, but the highest death rate in hospitals in from infections.
Maybe they should spend more time worrying about their infection prevention protocols.

Having dealt w/this situation many times years ago with my special-needs daughter, I agree w/Isab, although reluctantly.

After a year or so my daughter's Mother and I decided that she would deal w/our daughter and I would deal w/the hospital staff.

This was necessary due to our daughter unique health needs, the obvious fatigue in the typical emergency room doctor, the 'WTF is going on' in dealing w/a small infant having life-threatening issues on top of many other issues, and so on. It was not a fair situation for anyone but ...

As time went on it was easier to tell the tired doctor "this is what we had to do last time" which was either invaluable or insulting to the doctor depending upon his ego.

(Had one doctor change the meds that had been developed over the past year by local specialists/experience simply because he did not want to write them up. She was comatose for a week and he is only alive today because her Mother said she would handle that (I was not being rational.))

Overall though once stable the nursing staff was key and very open to 'suggestions'. So relax, go with the flow, and pray. It usually works out because of the nurses.

You're absolutely right about the nurses.

I have a lot of respect and gratitude for them, and that made a difference when my friend Cathy Seipp was in the hospital, and once, when Gregg was, too.

Also, be mindful of "iatrogenesis," how any medical care can have harmful side-effects.

A good nurse is a wonderful thing. NOT good nurses are an issue.

I had one insist the baby was NOT coming, it wasn't possible, it was too soon (baby born 10 minutes later after we called the doctor on the "I think I'm in labor" emergency number.

I had many others neglect to bring/give/offer me pain medications according to doctors instructions (had to search out nurses to get them after 12 hours when I was supposed to be given them every 6).

I have had nurses try to push opiate painkillers on me when I wasn't having any pain ("Really, I think you should take them for all the pain you're in...").

I have had nurses ignore my requests to ask the neonatologist to talk to me about my infants' care (round times were variable and would sometimes be when I was sleeping). They were honest, they didn't even mention it to the doctor.

I love the concept of nurses. I've just had a bunch of really bad ones at really critical times. :(

I understand Shannon and have experienced same.

Good nurses were retired military and they "nursed" constantly (checking around IV insertions, asking if I knew who/where I was (at times did not), and so on).

All other nurses were busy on the computer 'working' and showed up only as needed and did "nurse" (walked around for 20 minutes one night in a diabetic comma - knew I was okay just not who/where - asked for a coke and WHAM! I was "back").

Not the worst experience (had nightmares after 2 surgeries in 2000) but realized that we as a Nation are not what we used to be. Technically vastly improved but not really here at a human level.

If you know what you need and can communicate using 'their' language you will be fine. If you are not easily cataloged you are in for a rough time.

The 'common sense' stuff is not being taught and a lot of people just can not/do not really understand the very basics. They can hum the tune but can not play the music.

I hate that they expect residents to work 30 hours straight. I hate that doctors and nurses are expected to do so much paperwork that it interferes with the actual care that they can give. I hate that they have to work the insurance system.

That said, the only time I was given any care by a resident was when the choice was care from a resident or no one at all. My doctor was on his way from out of town. For better or worse, I just "waited" to push. I think that is the purpose they normally serve - on the front lines with a non-resident as backup or as a safety net in case other doctors are not available.

I blame the unions/AMA keeping numbers of des low to keep price and job security up you have to put them through artificial idiotic hell treatment. Same happens with teachers air traffic controllers where there isn't a corp pushing back on the unions crazy ideas

I had to look up "iatrogenesis" - thank you.

I skimmed this article on the subject and found the bullet points familiar/ consistent with experiences that were maddening while my wife was dying:

http://consultgerirn.org/topics/iatrogenesis/want_to_know_more

It's worth reading before you need it, to help make sense of what's going on and push for problem solving conversations if blocked by the arrogance or fear of a medical professional.

Many of the people we encountered were great. It's just that the one (or more) who are not can block access to the one thing that will make the difference, or continue to do the thing that creates pain or other damage.

Bob - regarding medical care providers not being present on a human level - the Sun literary magazine, January 2016 - Issue 481, has an interview that discusses this - The Miracle In Front of You, Raymond Barfield, On Practicing Medicine With Compassion, by Janice Lynch Schuster.

I recommend this issue, especially if you're spending any time in hospitals.

Bob In Texas: this is something to be critically aware of as the Affordable Care Act takes hold. The medical profession is not immune to the PC environment, which makes it difficult to fire some people with no work ethic at all. The medical profession will lose its luster in the paperwork nightmare of "insurance", leaving lower-skilled people eager to do nothing other than what they are told.

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"The Navy, studying submariners, found that a 10 hour shift was the most efficient."

This makes me wonder where he got this idea. Actually, from the '60s into the '90s, we did 6-hour shifts. On watch 6 hours, on call / maintenance for 6 hours, sleep 6 hours, a "day" lasting 18 hours. That's for ballistic missile boats and fast-attack subs. I found it tolerable, except for those days when your 6-hours sleep was from 1200-1800, which was when drills were scheduled.

This has been called out many times before, and yet nothing seems to change. My father was an obstetrician and gynecologist, during his specialisation in the early 70's he was working 100 hour weeks. We lived across the car park from the hospital but he would catch naps in a cot upstairs rather than come home - quicker to respond when he was on call. The driver mostly seems to be stupid macho culture. "We all did it, quit whining".

My industry (engineering/construction) has gone through a paradigm shift in my working life. Twenty years ago, 15 hour days were considered normal, 18 hours a bit of a stretch, anything longer was something to boast about. I've twice done 30 hours straight, or at least the much younger version of myself did! Then of course you had the occasional incident, like the guy who decided to drive two hours home to his wife at 2am rather than stay in his apartment five minutes away, then rolled his truck less than 10 miles from home. Several broken ribs aside, he was fine. His first call, having just crawled out of wreck, was to the boss standing next to me to apologise for fucking up the vehicle. Obviously in shock, but it gives you an idea of how fucked up your decision making can become when you're sleep deprived.

These days, a ten hour shift is standard. 12 is ok if planned. Sometimes longer just has to be done (road/rail line can't reopen unless its finished) and that is fine. But - you are not allowed to drive home. Company will pay for a taxi or hotel room. It's not even something you have to ask for. The supervisors will stop people from driving after a 14 hour shift, even if they beg and claim they are fine.

It's a shame the medical practice hasn't got with the program.

"As time went on it was easier to tell the tired doctor 'this is what we had to do last time'..."

The continuity thing is important. When I was working mission ops for NASA, a standard shift was 9-1/2 hours. It worked like this: You showed up an hour before your on-console time. You spent the first 30 minutes on situational awareness, getting up to speed on what was happening at the moment. (You'd be amazed at how much things could change while you slept.) Then, you'd go to your console and sit with the person from the previous shift watching and listening, and that person would brief you for 30 minutes. Then you swapped places; you took over the console while the person coming off shift sat alongside. They'd stay and watch/listen for another 30 minutes to help with any issues spanning the shift change, or finish up any paperwork that needed to be done.

From what I've seen, this doesn't happen in hospitals. The person going off shift disappears as soon as their shift time ends, and the person coming on shift is expected to be able to pick up everything they need to know by reading charts or computerized logs. They seem to try to band-aid the problem by reducing the number of shift changes, hence the long shifts.

"If you are in the hospital, ask whether the residents treating you have been on for extended hours, and if they have, consider ask for someone who has not been on so long." - Amy Alkon

"Sure! We can put you on the waiting list for that doctor. He'll be able to see you in 15 hours."

"When I was working mission ops for NASA, a standard shift was 9-1/2 hours."

Ah - a steely-eyed missile man like EECOM John Aaron, huh?

Always thought highly of those guys. I went to school with the Padleader's daughter Norma!