LYING ON A GURNEY IN THE HALLWAY OF THE EMERGENCY DEPARTMENT AT THE LOCAL REGIONAL MEDICAL CENTER! A couple of weeks ago I had to be admitted to the DCH Medical Center and thus began my journey to and through hell for those 40 plus hours. It is not my intent to find fault with the care provided by the medical staff, especially the nurses. They are working under what is obvious adverse conditions with what also appears to be little to no appreciation or recognition. The hospital is losing nurses day after day, and many are going to work at other hospitals for double the pay and fewer patients. Once I left ICU for a room on the sixth floor, I recall a conversation that my doctor had with the attending nurse. She stated that earlier in the week, six nurses left to go work at a hospital in Montgomery for double the salary and a smaller patient to nurse ratio. Similar stories abound with nurses leaving for better working conditions and more money in Birmingham and other cities throughout the state. Where is the Board of Directors in all of this? You cannot sit idly by and not be concerned with what is happening, yet little seems to change. I recall one of the nurses caring for me mentioning that a travel nurse, doing the same job as she is doing, will earn up to triple the pay, but she is expected to ‘suck it up “and not complain. Her comment was that it doesn’t do much to make you feel appreciated.
If other hospitals can siphon off these nurses, why can DCH not do what is necessary to keep trained staff? What responsibility and accountability does the administrators of the hospital have for what is going on and how do they continue to keep their employment? The CEO has been in that position for several years and during this time there has been obvious deterioration, especially with staff morale. While lying in the dialysis unit I overheard one of the nurses mention to a small group of technicians that the nurses would have left if it were not for them stepping in and helping. Over and over, you hear the same stories. Who, if anyone is listening? Based on what is seen, the board seems to be impervious to an obvious sign of a problem—high turnover. It is not a mystery that individuals leave one position for another for several reasons. Better working conditions and more pay are the most prevalent reasons given for moving to a new position. Apparently, that is what is happening at DCH, and action must be taken to bring some semblance of order to what has become a chaotic environment.
I mentioned to a friend, who is a physician, that I felt like I was a patient in the MASH sitcom and his response was , you would hope you would get that level of care. Although the pandemic has certainly impacted the local medical facility, it is not the basis for the problems with the hospital. Over three years ago, long before Covid, my wife spent several days as a patient at DCH and should have been in a private room, but remained in a two-person room for most of her stay. Rooms were available, but as I experienced, there were not sufficient staff to make the rooms available. She wrote a letter to the members of the Board of Directors expressing her concern for the conditions at the hospital. Being a nursing educator, she often had students in clinical rotation during the better days so she is aware of how it should and can be. The response from the CEO to her letter was the same old crap and boiled down to “we’re trying our best”.
Often the doctors expressed dismay for the conditions they are working in due to the shortage of staff, hence patients languish in the ED for days. I am aware of a friend’s mother who at age 88 laid in the ED for over four days before being assigned a room. This is unconscionable and mirrors what might be found in some of the third world countries. There are frequent accolades strewn about that brag on the outstanding medical facilities that exist in this country, yet this does not compute for the local facility. Recent statistics indicated that it was common for bed occupancy to be around 60% plus; therefore, 40% plus percent of the beds are not being utilized. The beds are there, the staff are not there.
Not only are staff shortages contributing to the problems in the local facility, but there is also the increase in the number of hospitalizations of those with Covid. Less than 50% of the adult population in the state have been fully vaccinated. The overwhelming number of admissions for Covid patients are due to the unvaccinated coming down with the virus. It is no mystery that Alabama is one of the states that has a substantial number of anit-vaxers and much of this revolves around politics. Witness the current barrage of political ads. One candidate strives to outdo the others with anti-masking, anti-mandates, and promoting individual rights at the expense of others. The real frustration is that the vaccines do prevent individuals from coming down with the virus or if they do it is not as severe and does not, typically, lead to hospitalization or death. Certainly, there are some unknowns, but the same people who will “chow down on a hot dog or a baloney sandwich, question what’s in the vaccine. What’s in a hot dog? What’s in in a slice of baloney? Anyone who has had to decide about whether to take a drug to offset the symptoms of some malady is aware of potential side effects. One must weigh the pros and the cons and do what seems to provide the best odds. The vaccines provide, overwhelmingly, the best odds. The number of people in this country who have died from COVID or experienced deadly consequences because of the virus are legion, and it did not have to be what it has become. The politics of it all lead to some degree of cynicism. We have all done things in our life that were not very smart, but to avoid death by taking some action seems to be a no brainer. Guess that’s not true for everyone!
I have addressed this issue in previous blogs, but when it “hits close to home” it begins to have a bit of a different impact. While lying in the hospital for ten days, I had a good amount of time to think about my own mortality. Around the time I entered, a good friend who I have known for 40 plus years died. She was in her early 80’s and had lived a good and full life, but it led me to give pause to the inevitable reality. Just before I was being taken for emergency dialysis, I had to answer the question about the use of life-saving actions. I had never been asked this, directly. There is always the question about a living will and we have those, but the nurse asked if I wanted to be resuscitation and I said yes, but as he lingered a moment I recanted and stated that I did not want that to be done. While I was in ICU my bed faced the wall with a white board that was there for notes to be written and at the bottom were the initials “DNR”. Sort of gives one a bit of that reality check. “Life is but a vapor”.