This is from a friend of mine. I thought it was worth sharing: I am a registered nurse with over 17 years experience in non-profit facilities, corporate owned facilities and state facilities. I have had the privilege of working in a variety of settings: all critical care areas, medical, surgical, OR, recovery unit, high-risk Labor & Delivery, Ante & Postpartum, and disaster relief areas such as Florida and New Orleans. Ive seen excellent, mediocre and poor health care. Gov Juan F Luis hospital is the worst Ive seen; but not because of lack of supplies or equipment, not because of a run down facility, but because of the attitude and lack of accountability our healthcare community has had; because of the lack of camaraderie with healthcare workers, and the lack of community involvement. For these reasons I do not believe it is only the hospital at fault that we are now in this healthcare crisis. I strongly believe the following should all be held accountable: the hospital staff, our local physicians, CMS, Joint Commission and our local community. I left the hospital after 3.5 years because my own conscience would not allow me to continue to turn a blind eye to the inhumane treatment our patients received. These are the things I saw with my own eyes: hep-locks imbedded in a persons arm, IV tubing and IV sites not labeled with date, time or initials, dressings that hadnt been changed for days, bed sores that could have been prevented, urine and feces saturated diapers on a person all day, ignored call bells for assistance, wrong medications given, no medications given, beating patients, refusal to feed patients that could not feed themselves and force feeding patients when they took too long to chew and swallow the food they were being fed, doctors orders not being carried out, no policy and procedures and out dated policy and procedures, doctors not responding to calls, doctors not coming in when called in, poor working diagnostic machines (x-Ray, CT Scan and MRI) yet billing for the services, blankets and pillows along with other supplies being taken home by staff members for their own use, wrong diagnosis from doctors, radiology staff sending letters to patients saying they have cancer when in fact they did not, hospital walls and ceilings dripping with condensation falling into a patients open abdomen while on the operating room table, and more. While in nursing school I was taught that going to a hospital is like going to visit someone at their home. That we should treat each patient as if they were a guest in our own home; that we should treat ALL patients the way we would want to be treated and the way we would want our loved ones to be treated. Shame on all of you involved in his treatment. To the clinical hospital staff I ask: How can you continue to turn a blind eye? How can you document that an IV is clear of signs and symptoms of infection when you havent even looked at it? How can you document that youve carried out an order and really havent ? How can you not work together as a team when you know full well that caring for a patient IS TEAM WORK? Why is it that those nurses that are now in administration cannot put on a pair of scrubs and help care for patients when there is a staff shortage? I was told by the Chief Nursing Officer by the union laws they are not allowed to treat patients once theyre in administration. Really? Then why did you become a nurse? To the physicians I ask: Is it really about the money? Because thats what it looks like. Caring for a patient in a hospital is a Privilege for services that you can charge for. By getting a salary from the hospital as well as charging for your services is double dipping. Is it really because a doctor isnt born here on St Croix that you cannot accept them as colleagues and work together as comrades? That question is for nurses as well. To the administrators I ask: Why is having a title of CEO, Chief Nursing Officer, Nurse Manager, Assistant Nurse Manager, Clinical Coordinator, etc more important than Quality Patient Care? How is it that at the end of 2013 we still do not have a Scope of Practice for Nurses, Nurse Practitioners, Physician Assistants, etc? How is it that we dont have updated policy and procedures for things like Blood Transfusions? How is it that we still have inexperienced nurses working triage? How is it that we still have nursing assistants working as emergency room technicians without the proper training? How is that we do not have cardiac monitors in every ER exam room? Where are we supposed to get our patients for the new Cardiac Care Center if our front door (the Emergency Room) is not prepared? Do we really need sooooo many administrators when we have such a global shortage of nurses? What about overseeing the housekeeping staff? Surely this small facility could be a little cleaner. What is it that you are Administering? To the community I ask: How is it that the community hasnt come together to address these issues as well? Why is the community going off island for healthcare treatment? Including the same doctors that were born here and live and their family members? Why is the community not actively protesting to have better healthcare? Why arent asking questions and demanding answers? Why is the community NOT OUTRAGED!!!!!! at our healthcare here in the territory? It is your body, the body of your friends and family that are being neglected, mistreated and misdiagnosed. Do you not care about yourself and loved ones? And lastly you need to know that most of us got into healthcare because we really do care. Were not here to give you a hard time; were here to take care of you and your loved ones. So when we ask something of you please remember that. It doesnt help when you treat us badly like cussing at us or threatening us with harm. You cannot put a price on saving someones life. We dont get paid that much! To Joint Commission and CMS (Center for Medicare & Medicaid Services) I ask: If a hospital is to report to both agencies as governing bodies then surely you should be held accountable as well. Clearly the hospital did not get to this point over night? Both agencies also turned a blind eye. If you hadnt our hospital would not be in the situation it is in today. CMS is the agency that governs Medicare and Medicaid services. It sets the rules and regulations hospitals, long-term facilities and laboratories must follow and meet. Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission evaluates and accredits more than 20,000 health care organizations and programs in the United States. An independent, not-for-profit organization, The Joint Commission is the nations oldest and largest standards-setting and accrediting body in health care. To earn and maintain The Joint Commission’s Gold Seal of Approval™, an organization must undergo an on-site survey by a Joint Commission survey team at least every three years. (Laboratories must be surveyed every two years.)---copied from jointcommission.org. ----did you hear that-----every 3 years for the facility and every 2 years for the laboratory!!! Where were these guys? Not here, or maybe they were paid off. Ive often wondered why the United States needs two agencies to oversee the requirements that are mandated by one CMS. It just sounds like more money for us tax payers to pay. And lastly to our local government I ask: All of this starts with you, the government. What are you thinking of? These are your people you are representing, yet you too leave the territory for better healthcare. Why arent you taking stronger actions for us regarding healthcare? Why is it that individuals still cannot get health insurance here? Its been over 3 years now. How much longer are you going to negate what is rightfully ours? This community trusted you and the education you received to do better for us. You have failed us as well. You should be setting the example for those of us in the community and yet you shame us. This hospital was set up to fail from the beginning it was just a matter of time before it finally was brought to the forefront. An organization that has so many people in high paying positions cannot sustain without falling at some point. An organization that has no inventory control cannot sustain with falling. An organization that continues to turn a blind eye at the inhumane treatment of another human being cannot sustain without falling! An organization that does not hold itself or its governing body accountable cannot sustain without falling. There are too many variables to deal with on a daily basis, including but not limited to the constant changes and demands from CMS and our local government. So now for some solutions: --This community MUST!!!!!!!! Get REALLY, REALLY ANGRY!!! --This community MUST!!!!! Get INVOLVED and EDUCATED in basic healthcare current events. --This community MUST!!!!!! Raise its standards and stop accepting mediocre at best. --This community MUST!!!!! Pay attention to their own healthcare as a whole and STOP blaming the healthcare professionals. Ask your nurses and doctors questions so that YOU understand what exactly is happening to you and what exactly are YOU being treated for. Keep a list of your medications, past medical and surgical history and your doctors names and phone numbers in your wallet. Know what each medication is and why you are taking it; not just its color and size. These are your responsibilities not ours. The same way healthcare professionals have responsibilities, so do you. --This community MUST!!!! Ask CMS and Joint Commission for an explanation of why they have continued to give the hospital here accreditation when clearly they shouldnt have. Also to possibly work a little closer with the hospital to get it to be where it needs to be to meet the standard of quality patient care we all deserve. --This community MUST!!!! Hold the government to their word. Next: Create a financial analysis. A lot of the money that is needed is within the hospital. Create an IT analysis so that we do not continue to spend money on electronic equipment we do not need. Remember CMS is constantly changing their requirements. They now want all electronic health record systems to be web based. I hear no one talking about the exorbitant amount of money that has already been spent on these systems. Create a bartering system where patients that owe money can work off part of their debt. I.e. Electrical, plumbing, painting, IT etc., services the hospital needs to maintain its facility can be done by our own community. Then: --Get rid of administrators that are clearly NOT really needed. This is part of the financial analysis. Im not saying to fire them, but maybe demote them or cross-train them to do other needed services. Those who are nurses should assist as needed when their is a nursing shortage. --Take away doctors salaries from the hospital and allow them to charge for their privileges / services. --Create up-dated policy and procedures and keep them updated yearly or as needed. --Have regularly scheduled in-services for the staff re: the policy and procedures. --Create standing orders for the emergency room (ER) for various common symptoms I.e. Urinary tract infections, chest pain, shortness of breath, asthma, etc --Place cardiac monitors in every ER, intensive care unit (ICU), progressive care unit (PCU) room and have a monitor tech monitoring them. --Have only seasoned experienced nurses working triage. --Have only ER techs assisting Registered Nurses in the ER, not licensed practical nurses (LPNs) nor certified nursing assistance (CNAs)/patient care technicians (PCTs). ER techs can: draw blood, star IVs, get EKGs done, transport patients, do glucose finger sticks. --Have CNAs/PCTs assisting LPNS and RNs on the medical and surgical wards. --Have only RNs working in the other critical areas with CNAs/PCTs assisting. --Hire a Nurse Educator to offer in-house Continuing Education classes such as Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Neonatal Advanced Life Support (NALS), medication errors, HIV and Aids, EKG monitoring and reading, infectious disease etc keeping everyone current and up to date with their licensure requirements. --Cut back on paid holidays. --Continually educate staff on the diversified culture we have in our community. By doing this it can decrease a lot of the frustration both nurses and patients have --Hold ALL staff accountable for their actions by doing regularly scheduled reviews, addressing insubordination issues and medical errors, etc --Obtain an inventory supply system such as an Omnicell and a small staff that monitors inventory control. --Modify radiology, dialysis and rehabilitation units -------Im sure there are many other solutions out there------- And finally, we all need to look at our own attitude and make the changes within ourselves. As healthcare professionals we are taught to improvise when we do not have the supplies we need. This is a small town where people working together as human beings can make it a great town. Not more, better, bigger or faster; just working with what we already have. Maybe improvising a little when needed. This is not a state side or corporate America way of doing things; I believe its just a humane way of doing things. It doesnt cost a cent to be kind to one another. After putting opinion to paper why do I feel like Ive just wasted my breath? How discouraging .....
Posted on: Tue, 23 Sep 2014 18:32:15 +0000
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