Sunday, December 9, 2012

Effects of Hurricane Sandy on Medical Institutes


With Some Hospitals Closed After Hurricane, E.R.’s at Others Overflow
A month after Hurricane Sandy struck New York City, unexpectedly shutting down several hospitals, one Upper East Side medical center had so many more emergency room patients than usual that it was parking them in its lobby.
Maimonides Medical Center in Brooklyn had 1,100 more emergency patients last month than in November 2011; the increase was mostly attributed to a hospital shut by the storm.
Angel Perez in a makeshift emergency room last week at NewYork-Presbyterian/Weill Cornell, where emergency visits have increased 25 percent.
White and blue plastic screens had been set up between the front door and the elevator banks in the East 68th Street building of that hospital, NewYork-Presbyterian/Weill Cornell. The screens shielded 10 gurneys and an improvised nursing station from the view of people obliviously walking in and out of the soaring, light-filled atrium.
“It’s like a World War II ward,” Teri Daniels, who had been waiting a day and a half with a relative who needed to be admitted, said last week.
Since the storm, a number of New York City hospitals have been scrambling to deal with a sharp increase in patients, forcing them to add shifts of doctors and nurses on overtime, to convert offices and lobbies to use for patients’ care, and even, in one case, to go to a local furniture store to buy extra beds.
At Beth Israel Medical Center, 11 blocks south of the Bellevue Hospital Center emergency room, which was shuttered because of storm damage, the average number of visits to the E.R. per day has risen to record levels. Visits have increased by 24 percent this November compared with last, and the numbers show no sign of dropping. Hospital admissions have risen 12 percent compared with last November.
Most of the rise in volume is from patients who had never been to Beth Israel before. An emergency room doctor at the hospital described treating one patient who said he had been born at Bellevue and had never before gone anywhere else.
Emergency room visits have gone up 25 percent at NewYork-Presybterian/Weill Cornell, which in Bellevue’s absence is the closest high-level trauma center — treating stab wounds, gun wounds, people hit by cars and the like — in Manhattan from 68th Street south. Stretchers holding patients have been lined up like train cars around the nursing station and double-parked in front of stretcher bays.
In Brooklyn, some patients in Maimonides Medical Center’s emergency room who need to be admitted are waiting two or three days for a bed upstairs, instead of four or five hours. Almost every one of the additional 1,100 emergency patients this November compared with last November came from four ZIP codes affected by the storm and served by Coney Island Hospital, a public hospital that was closed because of storm damage.
The number of psychiatric emergency patients from those same ZIP codes has tripled, in a surge that began three days before the hurricane, perhaps fueled by anxiety, as well as by displacement from flooded adult homes or programs at Coney Island Hospital, doctors said.
The Maimonides psychiatric emergency room bought five captain’s beds — which do not have railings that can be used for suicide attempts — at a local furniture store, to accommodate extra patients. The regular emergency room had to buy 27 new stretchers after the hurricane, “and we probably need a few more,” the department’s chief, Dr. John Marshall, said.
The emergency room and inpatient operations of four hospitals remain closed because of flooding and storm damage. Besides Bellevue and Coney Island, NYU Langone Medical Center and the VA New York Harbor Healthcare System, both near Bellevue on the East Side of Manhattan, are closed.
While the surge in traffic to other hospitals has been a burden, it has also been a boon, bringing more revenue.
On the Upper East Side, the storm has helped Lenox Hill Hospital, which has a history of financial problems. It took two or three wards that had been turned into offices and converted them back to space for patients. Emergency room visits are up 10 percent, and surgery has been expanded to seven days a week from five.
“We usually operate at slightly over 300 beds, and now we’re at well over 550,” Carleigh Gustafson, director of emergency nursing, said.
Conversely, administrators at the shuttered hospitals, especially NYU Langone, a major teaching center, worry that their patients and doctors are being raided, with some never to return.
NYU’s salaried doctors are being paid through January, on the condition that they do not take another job. But at the same time, they need a place to practice, so NYU administrators have been arranging for them to work as far away as New Jersey until the hospital reopens. Lenox Hill alone has taken on close to 300 NYU doctors, about 600 nurses, and about 150 doctors in training, fellows and medical students.
Obstetricians and surgeons from the closed hospitals have been particularly disadvantaged, since they are dependent on hospitals to treat their patients. Many displaced surgeons have been reduced to treating only the most desperately ill, and operating on nights and weekends, when hospitals tend to be least well staffed.
“I think there’s no question that a lot of people have postponed anything that they can postpone that is elective,” said Dr. Andrew W. Brotman, senior vice president at NYU.
In mid-November, Dr. Michael L. Brodman, chairman of obstetrics at Mount Sinai Medical Center, sent out a memo saying his department had taken on 26 NYU physicians, as well as nurses and residents, but “clearly, that is too much for us to handle long term.”
Since then, 15 of the physicians have gone to New York Downtown Hospital, while Mount Sinai has retained 11 doctors and 26 nurses.
“We are guests in other people’s homes,” Dr. Brotman of NYU said, “and we are guests who have to some degree overstayed their welcome.”




Natalie Knight                                                                                                                       12/13/2012
Current Events #2                                                                                                     Core Earth Science

Hartocollis, Anemona. "With Some Hospitals Closed After Hurricane, E.R.’s at Others Overflow." Nytimes.com. New York Times, 3 Dec. 2012. Web. 9 Dec. 2012.

            I read the New York Times article written by Anemona Hartocollis entitled “With Hospitals Closed After Hurricane, E.R.’s at Others Overflow.” This account is one of several hospitals and tells of population influxes as a result of Hurricane Sandy, which hit just five weeks ago. A majority of the hospitals that are still open in New York City have been required to accommodate more patients, making up for the hospitals that remain closed for the time being. Many emergency rooms, including New York-Presbyterian/Weill Cornell, have purchased and began utilizing new gurneys and stretchers, placing them wherever they will fit. In many cases, this includes surrounding elevators and in lobbies. At a different hospital, Beth Israel Medical Center, within the past month there has been a 24 percent daily increase compared to the number of E.R. visits last November. Here, stretchers “…have been lined up like train cars around the nursing station and double-parked in front of stretcher bays.” At many medical centers in which patients are being cared for, some people are waiting 2-3 days for attention, instead of what was before a mere 4-5 hours. However, Hartocollis also highlights the benefits that the storm has had on some medical institutes. In some cases, including that of Lenox Hill Hospital, Sandy has brought in a considerable increase in revenue, along with many new patients. The hospital, which apparently has a history of financial problems, is starting to recover from the recent economic downfall over the past few years by using business to its advantage. Although most doctors have found new hospitals at which to work, considering there is no shortage of patients, some specialty doctors, such as surgeons, are out of work for the most part because operating rooms are being used for patients.
            After reading this article, I was reminded of the long lasting effects that Hurricane Sandy has had. Based on where I live, I was not presently aware of many of the effects of the storm other than the several day power outages for the residents of Bronxville. Now, I realize that the consequences for many people were much more severe than that, including the loss of homes and lives, and much of the aftermath is an ongoing process. It is interesting that the hospitals that I have read about in this article are not just caring for people who were physically harmed by the storm, but also common illnesses and injuries. The article principally addresses the state of care centers for people that need help, rather than why people need help. For this, I enjoyed reading the account because it varied from many of the articles that have been written since the storm.
            I really liked that Hartocollis wrote about both positive and negative sides to the current hospital situation, while highlighting the fact that the negative influence has been greater. She drew information and statistics from a multitude of hospitals and medical centers, however she did not focus a great deal on any of them. I would have preferred if she had gone into detail on one or two hospitals, and specifically told about the trauma some patients are facing, and the struggles the hospitals are enduring in order to meet their patients standards. Other than that, I enjoyed reading the subject matter of the article and appreciated that, even a month after the storm, people are not dismissing it, but are focusing on how to readjust.

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