Like any small town, Lewistown, Montana boasts a hospital. Central Montana Medical Center serves a huge area, over 17,000 square miles, making it the largest hospital between Billings and Great Falls. They are one of the largest employers in Lewistown and pride themselves on hiring qualified staff. Their seventeen resident physicians and fourteen visiting/consulting staff members provide inpatient surgical services, rehabilitation, diabetes management, education nutritional and diagnostic imaging. From the outside, CMMC looks like a typical country house.
The report is deeper than that. Many of the inhabitants do not know what is going on within the walls. While doctors, including nurses, doctors and EMTs, are well trained, many critical life-saving tools are commonly found in urban areas. Many residents do not know this, and their health and safety depends on them being educated about what they need to protect themselves.
The service involves ambulance crews in most rural villages, and they claim that they can reach most cases in seven to nine minutes. While this is certainly true in the city, there are stories in other villages. When an emergency call comes in, the ambulance crew must respond first. Because rural communities receive so few calls, many ambulance crew members live their daily lives at the time of the call, whether this involves delivering food, delivering, fixing a fence, or doing many other village chores. Then the crew must respond to the warehouse (yes, it really is a warehouse) and prepare the ambulance for the call. When everyone is on board, the ambulance must head to the place of the call, which may be many miles from the town, and need not even be on the road. After they recover the patient, they drive to the hospital, which may be fifty or seventy-five miles away. Often in critical cases, they ask the Louistown Ambulance or Mercy to intercept the flight from the Great Falls.
Lewistown Ambulance has a dedicated and trained crew, but, unlike ambulance crews in larger cities, they have no paramedics. They have some intermediates, but the majority of their respondents are EMTs. While being treated in an ambulance by an EMT is certainly better than being transported in a private vehicle, many advanced lifesaving techniques cannot be performed until the patient reaches the hospital. In the city the arrival can take a few minutes, but in the rural areas, the arrival can be half an hour or more.
The staff has an emergency room which is good for dealing with emergencies, but the room is a bit small and the patients are of a different size. Some patients who are not critically injured may have to wait hours before a doctor is available to see them. During that time, the patient could be driven to Billings or Great Falls. If someone is admitted to the hospital after the time of the room visit, he is no longer cared for by the doctor who initially treated him. For those who do not have a local doctor, this way they are treated by someone who does not know their medical history, and who does not understand all the symptoms that the patient has. This leaves room for error, and this is where many patients are harmed rather than helped, in the hospital.
Tragic stories are told. A woman with sleep apnea who was admitted to the hospital because of a back injury stopped breathing at night. The nurses didn’t notice until it was too late. The patient suffered severe brain damage and was taken off life support eight days later. A man burns with violent bandages that are not changed in time, and indeed do not heal at all. The nurse covered him in silvadyne cream and did not dress him. He suffered an infection, and his recovery was very long. Graves still has scars from the ordeal. Tragedy ensues. Like any hospital, people will die, but some deaths can be prevented.
It is best not to educate the public about these tragedies. Once diagnosed, learn all they can about the condition. WebMD provides information on many conditions and appropriate treatments for them. If the doctor is not treating the condition appropriately, he should be informed and another doctor found. This may mean moving to another facility. People go to the hospital to be helped, not injured, even inadvertently. Education is the best prevention.
CMMC’s story is not unique. Small hotels across the country are facing the same problems. Nurse shortages, tired doctors, and poor doctors all contribute to errors. The public needs to know the hospital’s strengths and weaknesses. The hospital administrator will have this information. Patients need to know who to respond to when they have an appointment and who will treat them in what ways when help arrives. The best way for the public to stay safe is to know what to expect. This is one way to prevent future tragedies.
