Apparently, Howard Dean is a contender for the Surgeon General. Sanjay Gupta has bowed out, and the spot is open. I forgot that Howard Dean was a physician.

The plot thickens…..

From Reuters

I’ve written about the “service with a smile” previously, and about how hospital administrators (the ones who never got close enough to a patient to see the blood and poop) think that they are running a 5 star resort. Nurses are a combination concierge, housekeeper, cook, and slave, and administrators make sure that their customers (aka patients) are aware of that.

Even if it kills the patient.

And from what I’ve been reading, it seems that nurse managers and supervisors are also so busy brown nosing administration, that they too, forget that patient care and safety is the first priority. This is a story (which I have condensed and paraphrased) that a nurse posted on allnurses.com. It is really scary.

A child was admitted with a viral illness and febrile seizures, and the mother was a local physician’s secretary (uh-oh). The mother wrote a formal complaint to the hospital management about the nurse, because she committed the crime of checking the baby’s temperature every 4 hours. Now, if a baby is admitted with seizures due to fever, I would certainly hope that he was being monitored closely. In fact, I would expect temps to be taken every two hours. The baby also had an IV in, which does need to be checked–make sure it hasn’t infiltrated, flowing properly, sufficient fluid in the bag, etc.

But this parent said that the nurse “compromised the sleep of her baby and her” by coming into the room and checking the temp, and that the nurse’s actions were “insensitive to her needs” and that basically, the nurse should have just said “night, night,” and closed the door behind her, and left them alone for the shift. Unless, of course, mom wanted room service at 2am, or eggs benedict at 7am with a mocha latte (hold the foam).

I don’t know if the mother complained to the nurse or not, or if anything transpired between them–ie, mom telling the nurse not to disturb them, etc. If so, I would have told the mother that she is in the hospital for a reason (or did she think she was at Disneyworld?) and that her child needs to be closely monitored. This is the standard of care at this facility, these are the physician’s orders, and that we can’t care for her child if we are unable to look at him and assess him. If that speech failed, I would have phoned the physician and the nursing supervisor, and dumped it into their laps. Bottom line–you want a peaceful night of sleep without a pesky nurse trying to take your baby’s temp–then don’t come to a hospital. Or check out AMA.

Most shocking was the reaction of the nurse manager, in response to the complaint. It goes to show that a working brain is not required for the job. The manager told the nurse that in the future, she should check with families if it is “okay” to disturb them at night for vital signs and assessments. The nurse then asked her manager if she would be held responsible for a dead or seriously ill baby, should the family refuse to be disturbed during the night. The manager hesitated and said she wasn’t sure.

Double, triple and quadruple..DUH!

The poster doesn’t say how she responded to the manager, but again, her reaction to the complaint is so inappropriate–she should have her license revoked. The manager should have supported the nurse without question, and told the recipient of the complaint that this was unit policy, physician’s orders, and it was for the safety and well being of the patient. Throw in the word malpractice a few times, and lawsuit, and they start to get the message.

And her response that she wasn’t sure if the nurse would be held responsible? How about she take the responsibility instead? If a family again decides that they are at a poshy resort and don’t want their sick baby disturbed at night, the nurse calls the manager and lets her make the decision–and then charts it? For further back-up, the nurse should also call the physician and the nursing supervisor–and let everyone know that this family has come to the hospital to sleep, and not get their baby treated.

The customer service bandwagon is galloping out of control, but I’m sure that the weenies who came up with this bright idea never imagined the worst case scenario–that disgruntled customers, like the family whose baby dies from neglect because of their stupidity, are going to the sue the hospital and not the nurse. They are going to head for the big pockets.

…and it was for being naughty. As in endangering patients, and being overall negligent. It’s high time that rules and regulations were enforced. The fine is $25,000, which isn’t a huge amount of money but still a real sum–like half a year’s salary for a nurse.

From the Mercury News:

LOS ANGELES—The California Department of Public Health issued fines to 10 hospitals Tuesday for health code violations ranging from poor food refrigeration to leaving foreign objects inside patients during surgery.

Each violation carries a $25,000 fine. Hospitals have the right to appeal the citations by March 13, but none has ever been appealed successfully.

All cited hospitals must submit a plan of correction to the state, addressing the violation.

Since Jan. 1, 2007, the state has issued 71 such violations to 49 California hospitals.

The article then goes on to describe the various violations. For example, at Bakersfield Memorial Hospital, the hospital’s anesthesia equipment didn’t function properly, which was discovered while a team was performing an endovascular aneurysm repair on March 10, 2008. Nice, I wouldn’t have wanted to be that patient.

At Marin General Hospital, the hospital “failed to follow its own policy to count sponges used in surgery, resulting in a lap pad sponge being left in a patient’s abdominal cavity after surgery.”

And a really sad one–at Northbay Vacavalley Hospital, the hospital didn’t follow procedures to prevent a fall, in which a patient was left unattended, fell off a bedside commode and re-fractured his left hip.

A patient recovering from a fractured hip was left alone on a commode?

As I said, its good that these things are getting spotted, reported, the hospital fined, and supposedly, being rectified so they don’t happen again.

Strong words, I know, but nurses and other employees scored a major victory in Alaska. Providence Alaska Medical Center rescinded its policy that every employee receive a flu shot as a condition of employment, right before the deadline to do so.

From Anchorage Daily News:

Providence Alaska Medical Center on Thursday rescinded its policy that every employee receive a flu shot as a condition of employment.

The flu shot requirement “was the right decision for the safety of our patients and community,” said hospital administrator Bruce Lamoureux in a press release. “We do acknowledge, however, the strong feelings that the requirement and its swift implementation elicited in some employees.”
The move brings to a close a controversial month for the state’s largest hospital, which employs 3,100 people. Some employees supported the preventative measure while others balked, calling it a violation of their rights.

Interestingly enough, healthcare workers are some of the people least likely to get flu shots. Surely, if flu shots were so effective, and if hospital patients were really dropping like flies–due to catching the flu from their nurse or respiratory therapist–health care workers would be more compliant, n’est-ce pas?

In reality, about 60% of doctors and nurses refuse to get flu shots. I think this policy that Providence Hospital tried to enforce merely has to do with trying to cut down absenteeism in its workforce and has nothing to do with patient health and safety. I’ve yet to see any real data that large numbers of hospitalized patients are contracting the flu during their stay, and that the transmission is coming from healthcare workers.

Research anyone? Stats? Any real information and numbers, other than the CDC’s dreary “36,000 people die of the flu every year and 200,000 are hospitalized with it?” The CDC has not released any real numbers on death rates and certainly, nothing on the supposed connection between unvaccinated healthcare workers and passing the flu to unsuspecting patients. As any nurse knows, you are more likely to contract something from the patient, than the other way around.

I thought I had already blogged on the Alaska situation, when they first passed the mandate, but I guess not. FYI, physicians were not included in this ruling. I guess its okay for them to carry the germs, but not nurses. My guess is that the hospital rescinded because of the grievance filed by the Alaska Nurses Association, and also fear of lawsuits. They would have no way of defending their ruling, in the absence of any real data or the fact that it didn’t extend to doctors. And if patients are really contracting the flu when hospitalized, then the most likely source of transmission are visitors.

This is from Newsminer.com, about the original ruling.