I’ve dealt with numerous examples of this over the past couple of days, both indirectly and directly. The direct ones are those that I personally witnessed and had to handle. The indirect were what I either observed or what was told about.
First, the ones I witnessed. Well… One of them…
Got sent to the Veterans Administration Medical Center in Bedford, MA, for a patient transport to the VA Medical Center in West Roxbury. No other information than the patient was on Oxygen and needed cardiac monitoring. At the time (approximately 2230) we were doing coverage in Newton. But I’ll talk a little more about that later. We got cleared from the coverage and made our way from Newton to Bedford, a trip that took approximately a half-hour. In the dispatch we were told we were going to Unit 4A. As neither my partner nor I had any idea where in the complex that was we figured we’d start at the admissions office.
When we arrived and told the people at admissions where we needed to go, we were told that Unit 4A is a long-term care unit – in essence, a nursing home floor. We were also told that we needed to go back to the entrance we came from and go around part of the building to get to the unit. My response was simple: no way. It was below 10 degrees Fahrenheit outside and we needed to find another way to the unit. So they sent us through the tunnels in the basement of the complex. That in itself was not a big deal; the directions we were given, plus the signage, was actually reasonably straight-forward. However, when we got to the elevators we discovered that they were secured, policy there from 2300-0600. A silly policy, in my opinion, but there you go…
Eventually we were able to get access to the elevator – it took an additional 15 minutes to get this done, but we got to the unit and located the patient, an 88 year-old male status-post placement of what is known as a PEG tube, or a feeding tube surgically inserted into the stomach. His problem was that he’d developed a fever and had bleeding from his mouth and around the insertion site. When the nurse who transferred care to me told me what was going on (I think she expected me to just take the patient without asking any questions or gathering information) my initial thought was that an infection had developed. I also noted that he had an extensive medical history, including a below-the-knee amputation of his right leg from complications of diabetes as well as cancer to his head and neck.
The stupid part of this situation was two fold. First, the charge nurse on the unit gave my partner a hard time because of the amount of time it took us to get on the unit. She responded to this by telling the nurse about the delay in getting the elevator – a problem that was beyond our control. Then as we were loading the patient for transport, she made a comment about it being the next day (it wasn’t; it was about 2330 at that point) and how it was costing her “taxpayer dollars”, or words to that effect. This remark was a little more than I could stand, and I responded to her with, “it’s my tax money too, ma’am, and by the way: I rate services in this hospital. I’d hope I’d get decent care in circumstances like this.”
She stopped talking at that point. Now this could go one of two ways: either I made my point or she’s going to complain to our management and I’m going to be spoken to. Either way, though, I really don’t care.
The other part was when we got to West Roxbury and transferred care to the single nurse in their totally empty area that serves as an Emergency department. One of the other nurses who was working there came in while we were cleaning up and I finished documenting, and he started giving us a hard time. Apparently they got the notification from Bedford at around 2130 and he was complaining that we got there so much later. I stopped him cold at that point. Told him that we didn’t get the call until an hour after that plus we had to cover distance to get there. I didn’t even bother to get into the problems we had getting to the unit or getting the patient ready to go. And he was just a nasty person; a fairly common occurrence whenever I have to deal with the VA.
The indirect occurrence has to do with my mother-in-law. She is in rehab in one of the Manchester skilled nursing facilities after surgery to her back in December. The quality of care she’s received in the SNF has been less than stellar. So much so, in fact, that Martha has filed complaints with both the administration at the SNF and with the State of New Hampshire. And even after going through all of this, the people that are working on the unit there are still making stupid mistakes.
It’s ridiculous. And although I know this is supposed to be a temporary stay for her, I really hope the people supposedly doing their jobs can get their act together. These problems are simply making us nuts.