Ninyanve: ke log jo dil ki dhadkanon ko nigaah rakhte hain, aam taur par “telemetry” technicians hote hain, un nurses nahin.
Ninyanve: HCA Healthcare ki suvidhaon mein, woh ek saath 80 mareezon ko bhi nigaah rakh sakte hain.
Teen hafton ke azab bhari dino ke baad, 68 saal ka Terry Downs sehat mein behtareen hone ki raaste par tha. Boeing ke purane engineer, jo stealth bomber ka design banane mein madad karta tha, Downs ko HCA Healthcare ke Wesley Medical Center mein Wichita, Kansas mein July 2022 mein dakhil kiya gaya tha, jahan se uski dimagh mein bleed payi gayi. Mahine ke end tak, use 760-bed facility se discharge karne ka intezar tha aur woh rehabilitation ki taraf ja raha tha.
Magar woh wahan kabhi nahi pahuncha. 1 August ke subah ke waqt, ek nurse ne uske kamre se guzar rahe waqt use saans lene mein pareshani mehsoos ki aur uski dhadkan ko kamzor paya. Downs ke 2,200-page hospital record ke mutabiq, sirf aadhi ghante pehle uski dhadkan taqatwar thi, lekin jab uski dhadkan ka rhythm badal gaya, usne use monitor karne ka kisi ko bhi nurse ko alert nahi kiya tha.
Wesley Medical Center mein, aur aaj kal ke bahut se hospitals mein, jo log mareezon ki dil ki dhadkan, khoon ka dabav ya sans ki functions ko nigaah rakh rahe hain, woh nurses nahi hote jo unse interact karte hain. Ye “telemetry” technicians hote hain jo electronic devices se mareezon se transmit hone wale vital signs ki meaningful changes ko nurses ko batane ka zimma lete hain.
Telemetry units ke technicians aam taur par ek saath bahut se mareezon ke liye screens dekhte hain – kabhi kabhi dozens – aur aksar woh patients se door ek kamre mein baithte hain. Downs ke case mein, telemetry technicians doosre building mein the.
Us nurse ne jo kuch suna, usee ne Downs ki saans rokne mein madad karne ki koshish ki oxygen dekar, uske record ke mutabiq. Usne kamzor dhadkan mehsoos ki aur doosre staff se kaha “tele,” yaani telemetry unit, ko bulane ke liye dil ki parhne ke liye. Telemetry unit ne kaha, record ke mutabiq, “koi rate/rhythm nahi hai.”
Code Blue team ne Downs ko nurse ne use pareshani mehsoos kiya lagbhag chaar minute baad CPR dene laga. Dimagh ki maut aam taur par teen minute ke oxygen ki kami ke baad hoti hai.
Downs ki biwi, Cindy, ka kehna hai ki usko lagta hai hospital ne uske ilaaj mein kai galtiyan ki. Uske record ke mutabiq, uske doctors ke hukam ke mutabiq uski vital signs ya neurological condition ko uski maut se ghanto pehle niyantrit nahi kiya gaya tha.
Hospital: Magar, usne kaha, telemetry unit ke nurses ko uske rhythm ka badalne ka fail hona bahut zaroori tha. “Agar telemetry ke log kaam par hote, to unhe pata chalta ki uski dhadkan nahi hai,” Cindy Downs ne kaha. “Maine apne high school ke premi ko khoya, jise maine lagbhag 50 saal tak shaadi ki.”
Ninyanve: Cindy Downs ko apne pati ke dil ki dhadkan ka badalne ka waqt nahi pata chala kyunki Wesley Medical Center se jo records mili, unme usne pareshan hone se pehle kuch ghante tak telemetry history nahi mili. NBC News se baat karne wale kuch telemetry technicians ne kaha ki unka ek mukhya kaam mareezon ke readings ko record karke unhe unke records mein rakhna hota hai. HCA ke doosre facilities mein telemetry records ki kami ko malpractice lawsuits aur federal aur state regulators ke dwara file kiye gaye hospital investigation reports mein bhi dekha gaya hai.
Ninyanve: Lagbhag 180 facilities ke sath, HCA Healthcare, sari America mein sabse bade for-profit hospital chain ka malik hai. HCA ne is saal ke pehle nau mahine mein $4.2 billion kamaya, aur is industry ke leader ke taur par, uske practices doosre competitors ke dwara bhi anuyayi ki jati hain.
Pichle saal, NBC News ne scores of doctors, nurses, administrators, aur doosre HCA ke employees se mulaqat ki hai, jo kehte hain ki company profits ko mareezon ke mukable pehle rakhti hai. Kuch log kehte hain ki company ke telemetry units ki staffing bhi iska ek example hai.
Harlow Sumerford, HCA Healthcare ke ek spokesman, ne ek statement mein kaha: “Hum apne clinical safety improvement program ke hisse ke taur par apne telemetry protocols ko barabar analyze karte hain, aur hum apne workflow, training, utilization aur documentation processes ko sudharne ka kaam karte hain, taki hum aur woh physicians jo telemetry order karte hain, behtareen patient monitoring aur care de sakein.”
Usne ye nahi kaha ki telemetry history Downs ke record mein kyun nahi thi, ya uski maut tak pahunchane wale haadse par kyun comment nahi kiya. “Telemetry zindagi bachata hai,” usne kaha. “Isliye hum iska istemal karte hain.”
Ninyanve: Ye kahani un dozen HCA clinicians, technicians, executives, aur administrators ki mulaqaton par mabni hai jo company ke telemetry operations ke bare mein jante hain. Iski bunyad bhi hai HCA ke hospitals par hui malpractice lawsuits aur hospital investigation reports par, jo federal aur state regulators ne file kiye hain.
Telemetry ka istemal hospitals mein 1960s se shuru hua hai. Pehle, telemetry par patients ko unke paas ke nurses monitor karte the. Isse dil ki dhadkan mein kisi badalav par jaldi jawab milta tha.
Nurses ke paas qareebi hone ka tareeqa ab bhi ICU patients ke liye yahi hai jo telemetry par hote hain. Lekin ab, kam risk wale patients ko aksar technicians monitor karte hain, doosre floors par aur shayad hi hospitals ke douran. Technician banne ke liye ek high school diploma ya uske barabar ka qualification chahiye hota hai; optional training programs kuch mahinon se lekar ek saal tak hoti hain, National Telemetry Association ke mutabiq. Technician ki salary