Complaint Review: Clarian North Hospital

In June I delivered a baby at Clarian North Hospital in Indianapolis, Indiana. The brand-new facility is marketed as a beautiful, cutting-edge hospital in a hotel setting. The marketing hype boasts that it offers a nurturing, caring environment and top-notch medical services. After staying in the hospital for 6 days, I can attest that all the advertising is a lie. While it may look like a spa or resort, the experience was more aligned with a third-world prison than a hospital.

After I was released from the hospital I wrote a 6 page letter of complaint to Jonathan Goble, President and CEO of Clarian North Hospital and I copied his management minion: Kathy Mathena, RN, Chief Nurse Executive, Sue Finkham, Manager of Marketing and Public Relations, Ann Sawyer, RN, Patient Advocate, Laurie Helms, RN, Manager Postpartum/Gyn and Jeff Stafford, Chief Operating Officer of Clarian Health Risk Retention Group.

After 4 weeks, I did not receive acknowledgement of the formal complaint much less response or resolution so I sent a second letter to the corporate executives: Daniel F. Evans Jr., Chief Executive Officer and President Clarian Health, Samuel L. Odle, President and CEO, Indianapolis Operations of Clarian Health and Richard Graffis, MD, Executive Vice President and Chief Medical Officer of Clarian Health.

A few days later, Dan Evans (CEO and President of Clarian Health) personally called me. He's worth every dollar of his fat salary (in 2004, it was reported that he earned $1,071,000 as CEO of Clarian Health). He kept me on the phone for an hour sympathizing with me, trying to pacify me, attempting to diffuse the situation and attempting to distract me with rhetoric about the challenges of the national healthcare system. When he finally realized, I was not interested in being sweet-talked, that I was looking for tangible resolution his tone quickly changed and he abruptly ended the call.

I then sent a third letter to Mr. Evans and Mr. Goble informing them that I did not receive adequate resolution to my complaints and therefore would not pay my hospital bill. Other than healthcare, in what industry do consumers regularly pay for horrible service and unprofessional treatment? Not I.

At this point, I want to warn other soon-to-be mothers that Clarian is not a safe place to have a baby. I will not pay my hospital bill on principle. Once insurance pays, my responsibility will be negligible, but I want to make a point that people cannot be treated like this and hospitals have an ethical responsibility to their patients and the communities they serve.

While Mr. Evans feels my experience at Clarian North is typical and is symptomatic of the healthcare industry as a whole, it is in his power to make his hospitals the exception to the rule starting with me.

Here is the blow-by-blow account of my stay in Clarian North Hospital I encourage others to share their stories with me as I plan to continue to make my story public:

1. On Thursday, June 7 Kelly (a delivery nurse) came into the room and disrespected me and my family by lecturing us in a very inappropriate manner. First, she berated us because she thought my other family members where sitting in the chairs directly outside my room. She claimed these chairs were not meant for waiting family members and their presence in the hallway presented a potential HIPAA violation (if they heard nurses talking about other patients). I let her know that I was bedridden (I had already received an epidural) and did not know who was sitting in the hallway and could not control what (if anything) my family members were doing. I was focused on my contractions.

She continued to lecture us about HIPAA which I know is not the patient's responsibility privacy is, in fact, my right as a patient. It's the healthcare provider's responsibility to protect my privacy. If those chairs or the facility design present opportunities for HIPAA violations, then Clarian North is negligent. As it turned out, it was NOT my family sitting in the chairs outside my room.

Later Kelly came back to lecture us again about the number of people she would allow in the room during the actual delivery. I let her know that during the tour of Clarian North, we were told we could have as many people in the room as we felt comfortable AND my Ob-Gyn already approved my four guests (my husband, mother, mother-in-law and sister). She continued to lecture us. Her tone, erroneous information and rants were inappropriate and distressing to me and my family. If my physician felt the number of people in my room would negatively impact the delivery, that's all that was necessary to respectfully state.

As it turned out, my Ob/Gyn had no problem with my four family members assisting with the labor and delivery. We were all relieved when Kelly's shift ended (before my delivery).

2. On Friday, June 8 between 1 2:00 a.m. I was placed in a post-partum room on the 4th floor after a full day of labor and then an urgent c-section. Food stocks on the floor were depleted. After not eating or drinking since midnight Wednesday, this was very frustrating. Also, the security monitor in the recovery room was not working properly. The system that was supposed to provide an unprecedented level of security for me and my baby was faulty and Clarian's nurses said it was reported to the security department or engineering.

I mentioned the security malfunction every day of my 4 day stay in the post partum unit at Clarian North; nothing was ever done to remedy the situation. The monitor continued to flash on and off all day and all night every time my wristband passed underneath the signal receiver. The randomly flashing red and green lights woke me up in a panic several nights.

3. On Friday, June 8 (day) there was a parade of nurses as shifts changed and I struggled to get information about my medical condition from any of them. All day I kept waiting for and asking for someone to tell me what to expect from my recovery process at Clarian North no one could/would answer my questions. I thought information about my plan of care was my right as a patient.

For instance, I wanted to know how long I would be in the hospital and when I would be able to get out of bed (I was bedridden due to the catheter and I.V.) responses were vague, varied or absent. My family and I kept asking one another who's in charge around here? I didn't figure this out until Monday when Laurie Helms (manager post partum/Gyn) finally introduced herself to me. By then it was too late because I was being released from the hospital.

4. On Friday, June 8 (night) I thought my questions were finally being answered when a very efficient nurse, Sonia, started her shift. At first she seemed very competent and took charge of the situation when she saw I had questions.

At this point, she found a folder and packet of information from Clarian North that had been thrown on a shelf behind my bed and asked if anyone had reviewed the information with me no one had. Since I was still bedridden, I could not see or reach the packet. Once Sonia learned I was having problems with breast feeding, her demeanor changed. She told me she was going to get this baby to latch-on during (her) shift. It seemed to be a personal mission. While her intentions may have started off good, her technique was flawed, her zeal was overwhelming and her intensity was unwelcome.

My daughter had a very difficult delivery and had jaundice so she was expectedly tired, not hungry and probably in some level of pain from the labor process. Regardless, Sonia fixated on feedings throughout the entire night trying to force my daughter to latch-on and feed. She was inappropriately rough (physically) with my daughter's neck and head (which were severely bruised by the vacuum and contributed to the bilirubin) and inappropriately forceful (verbally) with me. She insinuated that my daughter might die if she didn't feed that night. While this couldn't be farther from the truth, due to the intensity of the situation and my vulnerability, I believed her.

Under Sonia's care, things escalated to where my daughter and I were both hysterically crying and finally I ordered Sonia to leave us alone because I felt she was hurting my daughter physically and she was making breast feeding a negative, violent experience for both of us. I feel Sonia preyed on my vulnerability to accomplish her own personal achievements. She did not take into account that I was in pain and on medication, I was very hormonal after giving birth, I was alone in that hospital room, I was bedridden, I was exhausted and sleep deprived, it was the middle of the night and I was a new, scared mother. I needed nurturing and support on my first night as a mother, not pressure to perform.

After I finally trusted my own instincts and dismissed Sonia, I would not allow her to take my daughter away from me and put her in the nursery because I no longer trusted her or her intentions. I spent the next 2 hours rocking my baby and hysterically crying, alone in my room. I do not think Sonia handled the situation appropriately, she did not take into account all the factors surrounding my difficult delivery, nor did she adequately attend to the mental well-being of a new mother.

5. On Saturday, June 9 my mother had to ring the nurse's station to request that my catheter be emptied before it overfilled (it was not being monitored frequently enough) and she had to request that the nurse on duty change my bed pad because I had been laying in my own filth, as my mother put it. My family and I felt the nurses were not adequately attending to me or focused on basic hygiene and cleanliness.

6. On Saturday or Sunday I noticed that my bathroom smelled like cigarettes every time I used the sink. I asked the nurse on duty to send a plumber to my room to investigate. My request was denied because it would cost too much money to get a plumber in here on the weekend, I was told. I'm quite certain a hospital of Clarian North's reputation would have engineering staff on duty 24/7. My only option was to switch rooms, but packing up my belongings and relocating was a ridiculous proposal considering my physical and emotional state. So, I was forced to endure the nauseating smell of cigarettes and I had to use the shower for water (to wash my hands, brush my teeth, etc) rather than turn on the sink for the rest of my stay at Clarian North.

In general, the room was not cleaned on a regular basis (such as trash being removed) unless my family requested it or we placed trash in the halls ourselves. During my 4 days in the post partum room, the floors were never swept or cleaned. By the time I was released from the hospital, the floor in my room was disgustingly dirty from all the foot-traffic.

7. On Sunday, June 10 around 6:00 a.m. Maria (a nurse) barged into my dark room as I slept and yelled, Where is your baby? Is your baby in here? I could barely answer, No because my adrenaline was running so high. She immediately ran out of my room without another word and she did NOT return to tell me what transpired. I immediately rang the nurse's desk and asked to be helped out of bed.

A few minutes later, Sonia (the nurse who tormented me Friday night) entered my room. I explained what happened. She was very blase about the whole incident and said Maria was just confused because my baby had been taken out of the nursery for some blood work. I was panicked and I asked her to bring me my baby immediately. She shrugged and said my daughter was still having blood drawn. I then demanded that Sonia bring me to the nursery to see my baby for myself. She was completely indifferent to my distress and tears as I explained how concerned I was about my baby's whereabouts and well-being especially considering the security monitor had not been working since my arrival and I did not trust this nurse with my newborn. My baby was in the nursery but by this point I was inconsolably upset. I spent the next 2 hours rocking my baby and hysterically crying (again), alone in my room. Sonia did not come back to check on me.

8. On Monday, June 11 Laurie Helms (manager post partum/Gyn) met with me after being alerted to my situation by Martha the lactation consultant. While she was very receptive to listening to my concerns about my experience at Clarian North, I still feel my issues were left unresolved. I believe the entire situation could have been avoided had I met her and had access to her on Friday, June 8.

In conclusion, here is a list of the operational and procedural problems I experienced at Clarian North:

- Lack of a patient ambassador to welcome and guide patients throughout their stay at the hospital: expected discharge date, resources (facility, medication, food options, support, nurses shifts, education, etc). Since many post partum patients are extremely vulnerable due to the procedures they receive, it is imperative that they have a trained, competent advocate or care coordinator to look out for their needs and rights throughout their stay.

- Lack of a known and well-defined escalation process for patients to raise issues or concerns without putting themselves in jeopardy or fearing retribution by reporting bad healthcare practices to the attending nurse. All of the nurses knew I, and my family, was not happy. Are they not empowered or too fearful to take care of the situation by notifying a manager immediately?

- Lack of consistent philosophies and systematic best practices with regard to breast feeding. Every nurse had a different perspective and various techniques for breast feeding. As a new mother I expected the hospital to train its post partum nurses about this critical topic. Some nurses actually said they didn't know anything about breast feeding and I'd have to wait for the lactation consultants, others were very laid back about the process, others were very forceful and others were very hands-on and helpful but all of their techniques, philosophies and approaches were different which was confusing, conflicting and ineffective.

Additionally, while the hospital room had plenty of seating for guests, it did not include a basic foot stool for breast feeding mothers. I purchased one for my home for less than $20 it makes all the difference in helping me achieve the correct body position and techniques for effective breast feeding. The only stool in the hospital room was way too tall to be of any use. I ended up using an upside-down plastic container to prop up my feet. This is absurd for such a high-end facility as Clarian North.

- Inconsistent and burdensome drug dispensation practices. Some nurses would automatically give me stool softeners and pain medication, others would not, and others would tell me I had to specifically request the drugs. I was in no condition to make these decisions or remember to make specific requests. I expected expert medical recommendations from the nursing staff and at a minimum that they would ask if I wanted the medications at the prescribed time (and remind me what I took at the last dosing). The current practice forced me to remember my own medication regimen and schedule this is an undue burden on the patient who is recovering from major surgery, emotional and vulnerable.

- Lack of communication and consistent knowledge among the nurses: how to breast feed, when/if the lactation consultants are on-site, etc. I was told there was no lactation consultant on-site on Saturday and Sunday by several nurses. Apparently this is not the case, but many of the nurses were ill-informed. Regardless, a post partum unit such as Clarian North must have trained lactation consultants on-site 7 days a week and must consistently train all of their nurses in the basics.

- Lack of focus on the mother's mental health. From my experiences at Clarian North, the majority of nurses offered either good clinical skills OR a good bedside manner, but not both (except for the few stand-out nurses I listed). There needs to be education among the nurses to teach and remind them that new mothers are dealing with a lot of complex issues that make them extremely vulnerable: hormones, fear, pain, strong medication and sleep deprivation.

New mothers require extra sensitivity, patience and compassion most of the nurses on the 4th floor seemed to forget (or not know) this. I realize many nurses claim to be overworked and units understaffed. If Clarian North truly wants to be regarded as the patient-centric, maternity center of excellence it claims to be in the media, then its nurses MUST deliver on this promise or the hospital is just engaging in minimally misleading, if not false, advertising.

- Lack of basic education for new mothers: how to hold a newborn, how to diaper a newborn, how to burp a newborn, how to breast feed a newborn, how to clean the belly-button, etc. Other than the lactation consultant, there was zero training, instruction or discussion about basic newborn care. It seems irresponsible to leave a newborn alone in a hospital room with a new mother who has not been educated with basic care practices and American Medical Association approved recommendations.

- Lack of communication regarding the c-section: how to care for the incision, how long is recovery, physical limitations, short-term and long-term impact on the mother's body, etc. Again, had a Clarian patient ambassador been assigned to me, I would have at least known who to ask these questions. None of the nurses could or would answer these questions, nor did them find anyone who could. Where were my discharge instructions? I received none.

- Lack of proper sanitation: You would think basic cleanliness would be a foregone conclusion for a hospital of Clarian's stature but apparently it's not.

After 4 days of heavy foot-traffic in my hospital room there was literally blood, sweat and other bodily fluids all over my room and the bathroom not to mention accumulating trash and dirty dishes. It looked and smelled more like a Mexican jail than an upper class hospital in America.

- Lack of properly working security system: With all the publicity about baby-snatching you'd think Clarian would be more concerned with its security systems. Apparently not. I complained every single day about the faulty security equipment (sensor and wrist brand), but nothing was done that's scary!

Outraged patient
Indianapolis, Indiana
U.S.A.