Weekend Blues
Another week and weekend has come and gone. Frustrations grow amongst nurses, physicians and patients.
Diversion is once again the issue.
The hospital was repeatedly on either critical care diversion or total bed diversion for the majority of the weekend. Patients needing admitted had to remain in the Emergency Room for several hours and overnight because we either had no beds or not enough nurses to staff the beds.
Physicians are being asked daily to get patients off of monitors or discharged from the hospital. It occurs so frequently that you’d think they felt we admitted and kept patients in because we had nothing better to do.
In addition, there is now talk about not changing all of the rooms to private rooms as was touted during the advertising of the new addition. This also is causing more animosity amongst the nurses and staff. It may be out of both the need for beds as well as staffing issues.
All of this certainly makes you wonder if another hospital wouldn’t be a bad idea. Do you think Floyd County leaders will grasp the concept before it’s too late?
Diversion is once again the issue.
The hospital was repeatedly on either critical care diversion or total bed diversion for the majority of the weekend. Patients needing admitted had to remain in the Emergency Room for several hours and overnight because we either had no beds or not enough nurses to staff the beds.
Physicians are being asked daily to get patients off of monitors or discharged from the hospital. It occurs so frequently that you’d think they felt we admitted and kept patients in because we had nothing better to do.
In addition, there is now talk about not changing all of the rooms to private rooms as was touted during the advertising of the new addition. This also is causing more animosity amongst the nurses and staff. It may be out of both the need for beds as well as staffing issues.
All of this certainly makes you wonder if another hospital wouldn’t be a bad idea. Do you think Floyd County leaders will grasp the concept before it’s too late?
posted by Anonymous at 6:00 AM
16 Comments:
Do you visit the hospital to see patients or to scrounge for dirt to use on your blog? You make sweeping statements purporting to speak for "nurses, physicians and patients." Just how much empirical evidence do you have to suggest widespread “frustration?” I notice that your profile mentions an interest in “creation science.” Should that give us some indication of the rigor you apply to your analysis? Your highly selective use of partial, and out of context, information seems designed to “prove” a pre-ordained conclusion.
"Do you visit the hospital to see patients or to scrounge for dirt to use on your blog?"
That's an either/or fallacy. There's no reason why Dr. Dan couldn't do both, and equally well.
Those concerned with empiricism must apply it to their own arguments, too.
Yes I make rounds every day trying to care for my patients. It is difficult when you cannot even get them out of the emergency room and onto the floor for further testing.
As of 7:00 a.m. this morning, there were 15 patients on hold in the Emergency Room. Our Emergency room only holds 18 beds total. These 15 that should have been upstairs in rooms were taking up the space, nursing time, physician time etc. in the ER.
All this while empty beds are upstairs without appropriate nursing staff to cover them and the staff we do have are overworked.
How is that for empirical evidence!
And by the way, I did send this same information to the current Board members so they will hopefully maintain some accountability to the Administration that you seem to support.
For the life of me, I can't figure out why you admit your patients to Floyd Memorial. According to you, senior management is inept and unconcerned about employees or patient care, units are dangerously understaffed, physicians are unhappy and morale is terrible. Either you must be exaggerating or you are purposely putting your patients at risk by having them treated at Floyd. Medical malpractice attorneys must be salivating!
I have had to deal with these same problems at Floyd Memorial Hospital, many times, over the past 5 years. My 82 year-old mother has been stuck in the emergecy room, waiting for a room (sometimes when one was empty, but not able to be staffed), very uncomfortable, for hours upon hours, time after time.
So, once again, Dr. Dan has shed light on a real problem that some apparrently refuse to be accountable for. Can't people see that HB is trying to make the hospital THE BEST THAT IT CAN BE, to put it ahead of it's future competition (which will come someday). He's not saying the people who work there are not good, on the contrary...they make the place operate fairly well in spite of shoddy administration!
Once again I must add, anonymity lessens the credibility and legitimacy of many comments.
Roz Tate
What is really frustrating with the remarks from anonymous is that they are typical of what we deal with in administration.
I have simply stated facts that point to an ongoing and recurrent problem.
Rather than come up with creative ideas like our nursing staff tries to, anonymous and this administration just shoot the messenger.
I have said it before; the hospital survives and maintains great quality of care in spite of administration, not because of administration.
That is pure silliness. The difference between excellent organizations and poor or mediocre ones is that in the really good ones, there is a standard of excellence established by management which is maintained by constant reinforcement and inspection. I know lots of people who work at the hospital or have relatives or neighbors who do. I don't pretend to speak for all employees based on what I hear, but what I do hear is so different from what I read on this blog that it is hard to imagine that they are talking about the same hospital. What I hear is enormous pride in the quality of care provided there and a belief that Floyd is better than other hospitals in the region.
I pick up the paper every day and read about all the problems facing hospitals, nursing homes and doctors. Reimbursements are tighter every year, there are shortages in several skill categories and competition is brutal. Many hospitals are running huge deficits (I read where Jewish hospital in Louisville has real financial problems right now). We seem to have an excellent community hospital which, I understand, operates without County subsidies. Why wouldn't we applaud the people who are successfully managing through these challenges?
Dr. Dan tells us that his income has been falling for several years. Does that mean he is lazy, or a bad doctor or a bad manager or insufficiently creative in overcoming the environment in which he works? Could be, I suppose, but I would be more inclined to first want to know how he is doing compared to his peers in a tough economic climate for medical providers.
From what I see and read, it sure looks like our hospital is doing comparatively well in fighting through the challenges facing healthcare organizations.
Why is this an either/or scenario.
Employees, physicians,etc. can have pride in their hospital yet still acknowledge problems and want things to be better.
The hospital can be financially solvent for now but still need problem areas addressed.
We may compare and be average with other hospitals, but that doesn't prevent us from striving to be better than average.
The mentality of anonymous is very similar to what we see every day.
Wait till the problem is so big and glaring that it has to be addressed.
There are many who would rather be proactive and not allow these problems to grow to that extent.
That must be a radical concept for anonymous.
At Floyd Memorial Hospital, the "standard of excellence" has been established by the doctors, nurses and staff.
The upper management has helped little in this cause and has apparently failed to see it, or appreciate it.
As for the Board, not only do I think that there should always be a physician on it, I personally think that the Board should be dominated by physicians! The hospital is fairly good, but it can be the BEST!
We, in NA and Floyd County must abandon the "can't do/won't do" attitude, "good ol' boy" cronyism and lack of accountability and we must recognize impending realities and LOOK/THINK TOWARDS THE FUTURE!
Roz Tate
HB,
I have to admit that anon makes some good points, as you do also.
My point here is, you ask why it has to an either/or. Have you not really set the bar there? From reading many of your postings on the Hospital it is hard not to come to the conclusion that the top administrator either goes or the hospital goes down the tubes.
Roz,
I do believe that the board ought to consist of 1 or 2 physicians with admitting priveleges. Dominate the board? That would be like giving a fox the keys to the henhouse. No way. I would not want any one profession to dominate.
iamhoosier,
As always, I appreciate your comments and perspective.
My viewpoints regarding the CEO is very much like you describe. It comes after trying to work with him for 13 plus years.
It is unfornunate that the only time people will actually listen is when you have to go to extremes to present the case.
The facts are available, they have been shown, but no one wants to take any steps to rectify them.
As with many organizations and institutions, nothing happens until there is a complete meltdown. I would much preferred a different route and I tried for the past 4 years in the more diplomatic manner.
If people hear these things enough times, they will begin to wonder, then question, then finally take action.
I just hope it won't be too late.
How much longer should your wife tolerate your declining income before she takes action to replace you as family breadwinner? Should she wait for the bankruptcy filing or take action now before the "meltdown?"
I was about to question your diplomatic skills until I went back and read the first line of your response to me. Yeah, you can be diplomatic!
I'm not taking sides due to admitted ignorance of facts but a couple of questions are bugging me:
If Mr. Hanson has been in charge for 13 years, providing leadership (or lack thereof) as bad as HB describes and FMH is in better shape than most other area hospitals, what does that say about their administrations?
Is it that difficult to find adequate hospital leadership in general and, if so, what's the answer to that much larger problem?
Just to clarify, the ER has 19 beds not 18; however, it's a moot point with 15 ER holds!
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