My wife just prevented a negligent homicide today. Ah, the wonderful German medical system!

[DFW]

A friend of ours, a 75 year old woman who needed open heart surgery (which, thankfully, went well) earlier this week, is still convalescing, although she is getting out of intensive care. She is VERY smart, was an active international businesswoman who used to travel to the United Arab Emirates, Russia (even dined with Putin some 20 years ago), and all over the place. Now a widow, she and my wife frequently meet up for coffee or meals, and she is also a frequent guest at our place, where she doesn't need to call first. We are that close.

In German hospitals, they do not put the name of the patient on the bed or on a sign outside (invasion of privacy laws, apparently). The doctors and the nurses have a list. When medications are disbursed, the lists say who in which bed in which room gets what, and how often.

Today, my wife went down to Düsseldorf to visit with our friend, and while she was there a nurse came in with some medication our friend was to take. She asked what it was, and the nurse said she didn't have to know what it was, it was ordered by the doctor, and she should please take it. As a former CEO and director of this and that, our friend wasn't used to being spoken to like this, and she insisted on knowing what the medication was. The nurse was pissed, but looked and told her. Our friend is not entirely ignorant about the field of medicine, and recognized that the medication was exactly the opposite of what she was supposed to get, and might easily have killed her. She said so, and demanded to know who the medication was supposed to be for, as no doctor would ever have prescribed it for her. The nurse said it was for "unknown name," and our friend blew up at her, pointing our that she had gotten her patients mixed up. She checked and saw that our friend was 100% correct, and that if she had taken this medication (for someone in a room nearby), she might have died within hours, or even minutes. The nurse was a wreck, apologizing profusely, and our friend was quite shaken as well, as she is in no shape to go tearing through the hospital looking to reorganize it--something that she, in good health, is probably perfectly capable of doing.

My wife, who was there, and told me all this, was also shaken, as it mirrored a scene she had lived through when she was in a hospital over 20 years ago. Some nurse came in and told her to take some pills. She asked what the pills were for. The nurse told her she didn't need to know what they were for, she just had to take them. My wife blew up at her and said she wasn't taking anything given to her by someone with a line like that, and asked to be told what the medication was, and what it was for. In this case, the medication was indeed for her, and had been prescribed for her. But to be told, "you don't need to know what they are for, you only have to take them," is not what we think of as a confidence-building bedside manner. In today's incident, our friend might have been killed, and right before my wife's eyes. In a country where obedience to uniforms and authority are a long tradition, people like my wife and our friend are not always welcome with their attitude. On the other hand, they probably live longer.

[mahatmakanejeeves]

1. Team error

Team error

Team Error refers to errors that occur in settings where multiple people are working together. Dependency increases the likelihood of human error due to interactions with other seemingly independent defense mechanisms. Engaging multiple people to perform a task does not ensure that the task will be done correctly. One potential dependency is team error, an error of one or more members that allows other individual members of the same group to make a mistake.

{snip}

[DFW]

4. Facilitated by the system

My wife traveled to New York a few years ago when our US-based daughter had her thyroid taken out. It was starting to get tumors on it, and the all the cancer in our family, she was OK with it being removed, and the thyroid function replaced by medicine.

At the hospital in New York, my wife was surprised to see our daughter's name on the room and her bed. German privacy regulations do not permit this (so say the hospitals here, anyway). Also, when she was taken down to the operating room, she was asked, before getting put under, if she knew what she was there for. If she had said anything OTHER than thyroidectomy, they would have stopped right then and there.

That's just not the way it's done here. USUALLY nothing goes wrong. But when it does, sometimes it goes VERY wrong. A major disaster was narrowly averted today. I'm betting that patients in that particular hospital will be particularly safe for a few months until the news of what almost happened today gets old.

[paleotn]

35. Check, recheck and recheck again.....

One tool in the design and implementation of procedures and protocols that "idiot proof" processes as much as is humanly possible. My better half could write volumes on this very subject and has. An OR nurse most of her career, she can tell numerous horror stories of near amps and ectomies of wrong limbs and organs. In a busy surgical department, it's easier than one might think.

[Boomerproud]

42. That's crazy. Sounds like a recipe for disaster. Do the patients

at least wear coded wristbands?

[DFW]

43. I would hope.

I wasn’t there.

All life here presumes that the state or the one in a uniform is always right, and the individual is never right.

[calimary]

31. Wow... scary stuff!

Forewarned is forearmed, though. I bet there are many people who were brought up not to ask too many questions.

[CaliforniaPeggy]

2. Thank goodness your wife and her friend were on the ball! And what if they hadn't been?

Disaster.

Medicine errors happen, but that was very bad. There are safeguards in place to keep that from happening, and that nurse obviously had not taken the time to be sure.

May your wife and her friend have many more years of living!

[rubbersole]

3. Medical mistakes are made everyday...

Only the fatal ones get noticed/reported.
I had intestinal surgery two months ago. I was supposed to receive a blood thinner by injection twice a day. I was getting it every two hours. The hematoma (dark purple bruise) across my entire abdomen was the indication that something was seriously wrong. My doctor caught it early enough that I only had to stay in the hospital three extra days. I guess I'm one of the lucky ones....

[DFW]

5. I'm sure the near misses get filed under.....

The rug.

[AnotherMother4Peace]

6. Thanks for this important post. Friends/Family should always be w/patients to help answer

important questions, to show that the patients have people that love them, to ask important questions, to do those little extra loving things. The hospital staff love this kind of support, & we always remember to bring cookies to the staff.

I learned this the hard way. My Mom was older, hospitalized, and did not look her best (who does when sick & hospitalized). It was a military hospital & the young corpsman were not the most attentive to an elderly/sick woman. I stayed there with her after several errors were made (kinda big ones). Anyway if someone you know is hospitalized, make sure someone at least visits regularly.

[Lunabell]

7. Wow, bad nursing 101.

We are supposed to check the medication. Make sure it's the right medication and not expired. The right dose. The right time. The right route. And lastly, the right patient by either asking a cognizant patient their name or looking at their name band. Nursing for beginners.

I don't know about Germany, but in the US too many nurses skip important steps due to time constraints. We have required continuing education classes about the problem of medication errors. It's unfortunately all too common.

I'm happy your friend stood up for herself and is doing ok.

[AllyCat]

9. Right?!?! This is precisely what we do.

Every single patient has a need to know what something is for. If they don’t ask, I TELL them. Then check for their understanding.

It’s how every nurse in the US is trained.

[DFW]

14. I'll bet that German nurses who have spent time working in American hospitals have recommendations

I'll bet that when they return home, they are ignored, as well.

[AllyCat]

17. I considered relocating to Germany. Then I heard how low the

Esteem and respect for nurses is in Germany. No thank you.

I don’t need sunshine blown up my backside, but if people won’t listen to the folks at the bedside most of the day, it’s unsafe.

[DFW]

10. Thanks, she is shaken, but OK.

The system here hinders efficient patient recognition and relies too much on their technical ability to recognize who is ailing from what and where. Patients are rarely asked about anything. In Germany, there is a "doctor's line" that is universally known: "Wer ist hier der Artzt, Sie oder ich?" (Who is the doctor here, you or me?). Now, sort of a joke, it sprang from the fact that this is exactly what patients heard in every hospital and clinic in Germany. The system skips important steps all by itself, was designed by doctors who consider them unnecessary.

[PoindexterOglethorpe]

8. Refusing to tell the patient what the medicine is?

That's a terrible practice.

When I was in hospital at the end of 2020, every single time I was given a pill I was told what it was and what it was for.

And not at least having the patient's name inside the room? That's completely stupid.

[DFW]

11. Agreed on all counts!

That is the way it is done here.

[Lunabell]

13. That's supposed to be the standard in the US.

I'm happy to hear that you had this positive experience.

No names is the standard due to HIPPA. But, name bands are mandatory.

[PoindexterOglethorpe]

41. Maybe no names posted on the outside of a room,

but my hospital stay included a large whiteboard in my room which had my name, the nurse on shift name, and several other pieces of information. Not sure how common that is at other hospitals, but it's an excellent thing in my opinion. If a nurse with meds, or or anyone else intending to do something with or for the patent walks into the wrong room, it will be immediately evident.

[Bernardo de La Paz]

12. Study after study says fully informed patients have better outcomes. . . . . nt

[DFW]

25. Here patients are better off informing themselves

It didn't help that the chief surgeon left Friday on vacation, and the main assistant wasn't expected back until Monday. My wife said the German equivalent of "when the cats are away, the mice will play."

[Ziggysmom]

15. The hospital we utilize in Milwaukee has a system where all medication is individually wrapped with

an identifying bar code. The nurse scans the medication bar code AND the patient's bar code on his wrist band. Alarms sound if it is not correct. Sounds like the hospital treating your friend needs something like that. She was lucky indeed, we must question everything

[AllyCat]

19. We have that in Madison too. We still ask the patient every time:

“Please say your name and date of birth” and then ask about allergies.

[mountain grammy]

20. What a great system. Probably zero errors.

and the person dipensing the medicine should say, This is , name of medicine, your dr prescribed for , name of disease or condition. Any questions?

[thucythucy]

16. These sorts of errors are much more prevalant in nursing homes

and "rehabilitation centers," sometimes with fatal results.

I've seen it happen personally.

[iluvtennis]

18. So glad your wife's friend inquired about the meds and this ended well. n/t

[Sogo]

21. Have read this post twice.

Still trying to figure out how it was your wife and not the patient herself that prevented the negligent homicide....


Nevertheless, it's a story of great caution to anyone who will be in the hospital one day....

[DFW]

26. She was the one who grilled the nurse first

Our friend joined in when something seemed off, and took over when their suspicions seemed justified. My wife was the one who had had this line fed to her before ("you don't need to know what it is" ) and said "hold on here" first.

[COL Mustard]

32. Eerily reminiscent of

“Step into the shower, please”.

[ms.pamela]

22. Preventing Homicides

Always question. My youngest daughter is an RN and she is one of the few who probably triple checks all medications she gives out. I have been wanting to ask you if you posted on the Democrats Won site years ago. I remember a gentleman whose father was a Washington D.C. journalist and he was married to a German lady. We had a mutual friend, Linda, her true name, her site ID was the Swordsman. She became seriously ill about five years ago and I have not heard her from her since 2018, I believe she died due to liver failure from all the strong medications she was required to take. I always enjoyed your posts, so much information in them, so if you are that gentleman, hi from Miss Pamela in Washington State.

[DFW]

39. I vaguely remember that site, so it's possible I posted there at one time.

I also remember a poster named Swordsman, but I don't know what her real name was. Do you know where she was from?

Your description of me certainly fits. My father was indeed a prominent DC print journalist, and my wife is most definitely German. So, in case I am the one you remember, hi back from the cold and rainy German Rheinland!

[PuppyBismark]

23. Medical computer systems work hard to prevent

Today American hospitals give patients barcoded wrist bands. Before any medications are given the nurse scans the band and the barcode on each medication. Also only nurses dispense medications. If they don’t match the process stops. Also the nurse tells the patient what each medication is.

These systems really work.

I’m surprised the German hospitals don’t do the same thing.

[DFW]

27. Germany is very technologically advanced in SOME things

But very old-fashioned in others. Innovation is often frowned upon here when a system is deemed to "work."

[Historic NY]

24. In my hospital they have a board on the wall with patients name

Dr's and the nursing staff assigned, including the cleaners.
Any special orders are also listed. I still would ask what the medicine was for, hospital are dangerous places.

Invasion of privacy thats crazy

[DFW]

29. It is totally nuts, agreed.

The invasion of privacy excuse--"Datenschutz"--is used to make all sorts of things complicated here.

On the other hand, if you go to your own bank now and ask for change for a $100 bill (or €100 bill), even if you have been their customer for decades, you must give your ID and your account number, before they will change your bill for you. Logic is not always the determining factor. Welcome to Europe.

[XanaDUer2]

36. We were fine with Mr X's name on the board

And his nurses' names.

[Tadpole Raisin]

28. Scary! And infuriating that they get annoyed when a patient asks them a reasonable request!

They should think of it as another double check in a system that should have multiple checks but they don’t.

I knew a woman who had a kidney transplant who temporarily had anti rejection meds held just until she had a diagnostic test done. After it was over and she was in her room the nurse (?CNA) came in and the patient asked to get her meds. The nurse was adamant that orders were in the chart saying she was not to get them and walked out. She came in a little later and they went through it again with the ‘nurse’ walking out in a huff.

Then a doctor came in the room who was a renal specialist and the patient frantically explained that the nurse would not giver her the meds. The doctor left and came back with the nurse and said “you show me where it says she can’t have these meds! Do you understand if she doesn’t get them she could die?”

That was the last time that person was seen on that floor. This happened years ago at a major Boston hospital. I’ve heard many other stories but the common thread is that the patient is being difficult. I don’t hear things like that anymore but I would never just take something without being told what it was.

So glad your friend is ok and your wife was there!!

[DFW]

30. What scares us is this:

If our friend had died, we are fairly sure that we would never have found out the real reason why. But both women are tough, and between the two of them, no one was going to force something down our friend's throat, especially with both doctors absent.

[highplainsdem]

33. Thank God a horrifying mistake was prevented! As a caregiver for years,

I often had to be my mom's advocate in dealing with doctors and nurses. I caught and prevented a number pf mistakes.

If possible, you should ALWAYS have a trusted relative or friend with you when you have to be hospitalized. Someone who knows all the necessary medical details.

It's outrageous that anyone would ever be told they don't need to know what medication they're being given.

[3Hotdogs]

34. New Jersey, 3 years ago. Pharmacist sees a conflict with prescription. Wife is across the counter.

He calls physician...... "Looks like Dr X made a mistake...."

Woman at physician's office: "Doctor doesn't make mistakes."

"Pharmacist: "Whadd'ya' mean, Dr. doesn't make mistakes. Put him on the phone."

SHE REFUSED !

Wife: get in her car, goes to physician's office. Loudly, "You're fired."

[Demovictory9]

37. Wow..kick

[NJCher]

38. It's good to be smart

With "smart" go other behaviors, like confidence and the refusal to be intimidated, such as in this situation.

[DFW]

40. The refusal to be intimidated is strong with these two.

Our friend was a tough CEO in a country where diminutive women aren't expected to be that (i.e. Germany). My wife, after years of being a social worker, fighting both FOR those on whom the system would crap on, as well against those who merely wanted to use the system to their selfish advantage, has a very solid "Gerechtigkeitssinn." That is one of those put-together German words that foreigners stumble over. It means "sense of justice." She hates it when the good guys lose, or when the bad guys win.

She also developed a very good sense of when someone was trying to put one over on her. One of her charges was a youngish Russian immigrant who was by nature lazy, although he didn't seem to be very lacking in intelligence. Just conditioned by the Soviet (and post-Soviet) system to think that work is optional and the best way to get something you want is to take it. He used to duck interviews and appointments by claiming his German wasn't good enough yet to understand what what asked of him. My wife, fed up with this, told him one Friday afternoon to be in her office at 8:00 AM the next Monday morning to try to straighten him out. He said, uh, "DA," sure, Monday, acting as if he hadn't quite understood what she had told him. When she got home that evening, she called him in his apartment, and put me on the phone. I said, in Russian, "listen up, my wife wants you in her office at 8:00 in the morning on Monday. Have you understood what I just told you?" Since he was Russian, he couldn't wiggle out of it this time. He WAS in her office at 8:00 the next Monday morning, his German having vastly improved over the weekend (what a coincidence). The guy DID straighten out, and she finally placed him in a decent-paying job, where he could actually afford more by working than he could by taking state handouts. He never really thanked her, but his success was thanks enough.

Our friend, the former executive, is similar in nature, and HATES being taken for a timid little old lady just because she might look like one. She has no problem with correcting people who underestimate her. You'd think that after 16 years of Angela Merkel, Germany would get the hint, but this remains a very macho society, and the attitude still prevails even after Merkel showed them how wrong that attitude is.

I contrast this with my office just over the border in Holland, where women have some of the higher positions, and none of the men seem to have any problem with it. It's definitely a cultural thing. I have to wonder, in retrospect, if this wasn't my lucky charm in winning my wife all those years ago. With her looks and personality, she could have had any man she wanted, and there were plenty of them interested in the position. But I had a totally different attitude toward women from what she was used to in the rural Catholic northwestern German farm country where she grew up, and apparently that was the big factor in my favor. Americans who spoke German were considered rather exotic in those days, too, so that helped.