Dealing with emergency situations in Puerto Rico

One of the most difficult situations we had to deal with on the island was a medical emergency. First of all don't call 911 for medical care. The ambulance drivers in Puerto Rico are only that - drivers. They are not trained EMTs, so it is best to drive yourself to the hospital. Centro Medico in San Juan is the main trauma center on the island so although you can get emergency care at the other hospitals, you will be transported to Centro Medico for any kind of trauma.

The hospitals are not what you are expecting compared to the US. We actually found the doctors to be good, but the nursing care, the organization, the cleanliness are different standards from the US. So if you end up in the hospital, here is what you need to know. You need a family member or friend with you at all times because the low number of nurses and care they provide is not RN level. You will need to bring your own help.  Most doctors do speak English. Most nurses do not speak English is what we found.

You need to bring everything you need to the hospital. Most hospitals provide a flat sheet for the bed - that's it. So sheets, blankets, pillows, towels, paper towels, your own Lysol wipes - we cleaned blood off of crib slats - tissues, etc. Walgreens sells a hospital kit with bed pans, etc. You need that also.  Because we weren't planning a hospital visit, we had friends who jumped into action and met us at the hospital with all the above supplies.

Find a good family doctor when you arrive to PR. They will be your best advocate at the hospital. We had two different hospital stays in PR. On one of our stays, our doctor gave us her cell, and she had worked at one of the hospitals in the past. Anytime we had a problem, we called her, and she got things moving at the hospital. You always have to be your own medical advocate even in the States, but in PR you need to speak up even more.

And when we moved there, we had the option to keep our insurance in the US so that we were covered Stateside and on the island. It was a little more expensive than having PR insurance only, but it was so worth it. PR is short on medical specialists, and we did a lot of medical care back in the States. And for both medical emergencies we were close to flying back to the States if we had needed more medical care. Fortunately the situations stabilized, but it was a huge help to have that option.

Just be prepared mentally and emotionally for a different standard especially in the hospitals.

Matmor,

          Thanks for your input and advise. I agree with everything and when recently our grandson had surgery and I spoke about the care, service etc. at the hospital, I forgot to mention the thing about the bed pan.  They don't provide them, you can buy one down at admissions for I think $3.00 (imagine not providing one). I also had to buy a pair of surgical socks which the patient wears to blood clots don't form and it was a good investment at $35.00 because the nurse hooked them up to a machine that circulated the blood in the legs of the patient while he was in the bed. I had gotten some socks at the local pharmacy but they were the right type.

          Anyway, definitely bring blankets, pillows, and anything that will make the patient more comfortable. Don't count on the t.v. being hooked up soon unless you happen to catch the tech doing his rounds, byt the time the tech came, we were ready to leave the hospital.  Also don't expect a phone in the room, I guess since everyone have cell phones, there is not much call for telephones in the room.

       I just hope that if at any time, I have to go into the hospital, it is not for something where I can't get up and take care of myself or maybe if it isn't urgent I can just fly back to NY to take care of whatever, but I will keep the name of the hospital you mentioned and may go there.


Take care and stay healthy,

Tonie

Any WIFI in the rooms?
WIFI emergency if not.

In a hot day hang around the mall or hospital, check!

There was no wifi in the hospitals we were at, but the AC was always on full blast so we needed sweatshirts, socks, warm blankets. Centro Medico is the main trauma center and will have the most specialists like neurosurgeons, etc. but it is not an easy hospital to deal with.  It is packed crazy and usually very crowded. So if you have something more minor definitely try another hospital. But if it is trauma or you will need a specialist, then you should go to Centro Medico. And you will need cellphone chargers. I was usually able to find outlets and depending on the hospital, a camping fold up chair was helpful for the family member that is there with the patient. Often chairs were hard to come by. I think the shock of the hospitals being so drastically different from those in the States made our situation worse. Just being prepared and knowing what to expect will make a huge difference.

Hospitals are probably the one thing that will keep me from staying in PR long term.

Had a medical emergency that sent me to Ashford Presby in Condado, only one doctor was around. Freezing the entire time, half asleep but in pain and the doctor who saw us just left w/out saying anything. Had to find another doctor who sent me home with a misdiagnosis and no help. Went to Pavia in Santurce the next day -- one ER doctor for the entire hospital. He barely spoke English, the nurses spoke none at all. One of the nurses injected air into my IV while switching bags, nearly killing me. I wound up catching the next available flight to Boston and going to MGH where the difference was night and day.

I've had other hospital experiences in PR as well (Centro Medico) which were also bad. Nine hour wait to get some stitches in my finger, freezing temperatures, no instructions, hallways full of sick people, no outlets or phone service, nobody speaking English. Then being locked out of my car until the morning because their 24hr hospital has a parking lot that closes at 11pm (I arrived at 2pm). Etc etc.

That stinks.  I guess it varies and you get the luck of the draw.  My mom was taken to a very tiny hospital in Arroyo and received great care.  Six months ago I cut off the tip of my finger and went to Ryder Hospital in Humacao.  Although the waiting room was full I was taken quickly-maybe because of the bloody mess-and the finger tip was sewn back on. 
Since I am generally healthy, I have not been to an everyday doctor.  The advice I have had is to find out if the doctor makes appointments, not just the typical Puerto Rican cattle-call method.  They do exist.  Word of mouth is the best source of information in my neighborhood.

Yeah, I've actually come to sometimes prefer the cattle-call method because you don't have to wait months for an appointment and can just show up the same day.

Perhaps the rest of the island differs, but out here in the metro area many of the hospitals appear to be understaffed and that doesn't appear to be changing anytime soon. If anything, going in the other direction.