
This coverage sponsored by the SEIU.
If you haven't been following the SEIU nurse lock-out story in Las Vegas, it's time you got up to speed. Because this isn't just about Las Vegas. It is about the fight for accessible healthcare in this country that has the patient's best interests at its core. It's also about supporting the caregivers who get caught up in tragedy because for profit hospitals have the bottom line in focus before patients. But the bottom line isn't about unions or for profit hospitals. It's about allowing nurses to do their jobs, which is much more than showing up and punching a time clock. It may sound hokey, but for nurses, caring for patients is a calling. Anything that gets in their way is not only counter-productive, but it can actually costs lives. That is just what might have happened recently on one November day.
The good news is that the public outcry of support and the progressive blogosphere's wholehearted backing of the SEIU nurses in the Valley Health System finally forced David Bussone and Universal Health Services back to the bargaining table. But considering Bussone has people like Brent Yessin involved in this fight, it's impossible not to get the real point of Bussone's lock-out of the nurses. He wants to keep unions out of his hospitals. We need to make certain Bussone not only loses the battle in Las Vegas, but the war he's waging against unions in hospitals. Because there is more and more evidence that SEIU nurses are not only important, but critical to saving lives.
This one is going to break your heart. It happened at another of Bussone's Universal Health Services hospitals in Las Vegas, which happens to be non-union. It's also going to make you ask if this tragic story could have been prevented.
Richard and Kathlene Shinn were eager to visit their first-born baby the morning after physicians removed breathing tubes from her delicate 21-day-old body.
But they weren't prepared for what they witnessed when they entered the intensive care unit at Summerlin Hospital at 9 a.m. that November day.
"Alyssa's hands and feet were white. She was critically ill," Richard Shinn said Wednesday.
Within hours, their daughter was pronounced dead.
(snip)
Now, the Shinns said they are desperate to learn what happened to their baby between the night of Nov. 8, when they left the hospital, and the morning of Nov. 9, when they returned. Alleging hospital officials have not answered their questions, the couple hired attorney Richard Harris.
The trio spoke to the media Wednesday to notify the community of their ordeal and warn others to beware of what could happen to their infants.
"People need to know what happened to Alyssa. They need to hear her story," a sobbing Kathlene Shinn said.
Harris acknowledged that he and the couple know little about the tragedy but speculated that the nursing shortage and overcrowding in the neo-natal intensive care unit might have contributed to Alyssa's death.
"Most people come to see me because they want to have answers," he said. "I urge the hospital to be forthcoming."
In a statement Wednesday afternoon, Summerlin Hospital officials acknowledged the death.
"We are aware and saddened by the situation and extend our heartfelt sympathies to the family," the statement said. "As is the case with any adverse outcome, we take this very seriously. Therefore, we are thoroughly investigating the circumstances of this case." ...
Preemies are a challenge to nurses, mothers, hospitals and all concerned. One of my dearest friends gave birth to a preemie little boy just last year. They fought together, father, mother, child and hospital, sometimes wondering if they could all make it through it. What the nurses go through to care for preemies is the stuff of true selfless heroism at times. Talking to people who know, you learn that nurses wake up in the middle of the night fearing the worst with intensive care patients and preemies. But it also takes a hospital director who understands the demands on nurses in these units to get the job done. Enough nurses need to be on duty in these high risk and high stress wards to make sure mistakes are not made.
Again, UHS Summerlin Hospital is non-union. Bussone likes it that way. What the SEIU nurses are fighting for in the Valley Health System is not about money. It's about lowering the patient-to-nurse ratio, banning mandatory overtime, and getting "floating" policies in place so nurses are not moved into areas of the hospital where they have no expertise.
This raises an important question. Did Summerlin Hospital have enough nurses on staff to take care little Alyssa? Why wasn't the IV changed on this preemie at the scheduled time? Were too few nurses on duty? If so, you certainly cannot blame the nurses when their worst nightmare plays out in real time.
Hospital staff administered intravenously Total Parenteral Nutrition, a common nutrient mix that includes zinc, to help Alyssa's metabolism.
A pharmacist sent a new dose of the solution for Alyssa on Nov. 8, and nurses began the drip about 10 p.m., Harris said. At 6:30 a.m., the pharmacist sent a memo to the nurses notifying them of a possible error in the prescription.
"Send new TPN stat," Harris said, reading from the memo.
But the IV was not changed until 1 p.m. on Nov. 9, when the nurses began flushing her body with an antidote, Harris said.
That morning, Kathlene Shinn called the hospital before visiting hours to see how Alyssa was coping without the breathing tube. She said nothing was mentioned of Alyssa's condition.
The Shinns were not told of any problems until after they arrived at the hospital at 9 a.m., walked into the intensive care unit and saw their ailing daughter.
"They didn't tell me to come in ASAP and spend the last three hours of her life with her," Kathlene Shinn said.
Hospital officials escorted the Shinns away from their baby and shut down the intensive care unit, kicking out other parents, Richard Shinn said. The couple then sat in a conference room for hours with no information.
The Shinns, who both work in the health care field, said hospital staff continued to tell them their baby was alive after her skin turned blue and cold.
"Some days it's hard for me to realize this actually occurred," Richard Shinn said. "It seems so senseless. It really does."
After reviewing the prescription by Alyssa's physician, Harris said the requested dosage appeared to be appropriate. How the lethal dosage of zinc was included in the solution or why no one at the hospital caught the mistake before it was administered was unclear, the Shinns said.
"There's five, six, seven people that have their hands on the TPN and review the dosage," Kathlene Shinn said.
Harris said the Shinns simply want answers for closure, but he did not rule out the possibility of legal action.
"I'm not here to point fingers," Kathlene Shinn, a registered nurse, said as she sat near a tiny pair of black shoes and photos of her only child. "I am urging the public, anyone who has been treated at a hospital or who has a family member or friend who has been hospitalized to listen. As health care consumers, we need to insist that hospitals institute all the technology that can prevent these types of medication errors."
There are many questions that need to be answered about little Alyssa Shinn's death. However, one obvious point rings out on this tragedy. If you don't have enough nurses in every area, especially critical care units, a nurse simply cannot perform her or his duties up to the standard each and every nurse pledges to their patients. My heart goes out to the nurses on duty the day Alyssa died.
What happened at Bussone's Summerlin Hospital? We don't know yet, but the Shinns deserve answers.
And remember, what happens with Las Vegas doesn't always stay in Las Vegas. As we debate national healthcare, with the intent of covering every American, this very situation could be coming to a city or town near you. Because if you believe little Alyssa's story and the Shinn's heartbreak can't happen to someone you know, you just don't understand the ramifications of putting nurses under pressure with patient-to-nurse ratios sometimes as high as 10 to 1, while patients suffer the consequences, sometimes with their very lives.
NOTE: Commissioner Rory Reid and Speaker-elect Barbara Buckley, both of whom were inside the negotiations between SEIU and UHS, will be guests on Taylor Marsh LIVE! today, 6-7 p.m. eastern and 3-4 p.m. pacific, podcasts available.
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fitz
yay!
Taylor!
This is for my RN mother, RIP.
Hiya Taylor
Yeah this smells like a union busting war..Can you give us more details of that aspect of the struggle?
Has this company ever successfully busted a union before? Where? When? How?
Apparently only a portion of the 800 nurses were willing to strike. What percent? And what was the position of those who were not willing?
What are the prospects for organizing the other hospitals in the area, etc…
Give us the real scoop!!
Thanks
TAYLOR MARSH!!
Hey jeffreyw, what a hero she must have been. The nurses I’ve met so far are so selfless. Bless your mom’s sweet soul.
This is the size baby we do heart surgery on in Russia.
On my most recent trip we did one baby that was 700 grams = 1.5 pounds and another that was 900 grams = 2 pounds. They are both doing well.
But during their young days they need a LOT of care. Experienced care.
When I was young I was going to be a nurse, but then ended up in public health and international work.
Nurses in both the U.S. and Russia work hard for a salary that is too small, $100 a month in Russia.
God damn it, I am so fucking tired of American indifference to human life.
OT - over at Raw Story: Lieberman co-starts group to consult on Iraq… Developing…
Sorry to be so far OT so early, but WTF??? New Jersey???
Allstate to stop insuring new N.J. homeowners
EvilDrPuma @ 9
what he said.
twolf1 @ 10
Fuck that lying, hypocritical, toadying bastard.
Can we pull the plug on Lieberman?
-GSD
Egregious, you got it. Preemies need a lot of care. As for your questions rwcole, I jumped into this story and was immediately neck deep in a lock-out that surprised everyone. But not half as much as the outcry over UHS’s actions surprised Bussone.
Taylor, thank you for this report. We are all Las Vegans.
As NOlans say, “This could be you.”
Taylor Marsh @ 6
She was my hero, anyway. She worked for years at a local Catholic hospital, and butted heads with the Sister in charge. Moved to a hospital in another town and worked for a spell, then went into Public Health. Supervised home health care for a while, till one of her nurses was murdered while on a call. tore her up. A new boss came into the picture, another Catholic MD, and devastated the family planning program, forced her out. She managed as President of the State Nurses Association in her spare time. Her first job as a nurse was as a second lieutenant in the Army Medical Corps, something she was more proud of than any other thing she ever did.
My daughter is working on a project to get hospital meds online so they can be triple checked before the patient gets them. It will absolutely save lives.
It is difficult to know a child has died under any circumstances. But to see it happen because of preventable error….
The whole concept of my work is to keep children from dying for stupid reasons. In 1997, 2 babies died because there was no prostaglandin—not even black market—in the entire city of St.Petersburg, the size of Chicago. So we started a lab project.
Heart-rending post, Taylor.
So many heroes in the Army Medical Corps, jw. You must be so proud.
TeddySanFran, you just said the bottom line. Like NOlans, this could be any of us.
JF @
11
The insurance companies are pulling out of New Orleans, too, making meaningful recovery impossible.
My wife got out of hospital nursing because of the “factory work” mentality that pervades the for-profit health care systems in this country. It’s really bad out here in Dr. Frist’s America.
Taylor:
thank you for bringing us up to speed on the SEIU vs UHS situation. Union busting can only be prevented by disseminating information and analysis on the disputed issues. Often, the unions are characterized as greedy, when in reality they actually only want to improve the type of service they give. The air traffic controller’s union bust by Reagan was another example of this.
Union busting is a threat to a democratic society. Only people who want to replace democracy with oligarchy allow the absolute rule of the capital over the workers. Everybody with the slightest sense of decency should support the nurses.
TeddySanFran @ 16
Actually, this could have been my (maternal) grandmother if she were still alive today…
Her last home was in a 55 community in Summerlin.
Thanks, Taylor, for the update on the LV nurses…
And thanks, Teddy, for showing some compassion to the folks in Vegas.
Oh, and btw, sorry that I’m late…
There’s another flame war on DKos…
It ain’t lookin’ pretty over there.
Taylor Marsh @ 15
power of da toobz
Titanyum, HinTN and all, sign the SEIU petition for these nurses. They would be so grateful for your suppport.
SUPPORT THE SEIU NURSES
Taylor Marsh @ 26
Consider it done! : )
Taylor, it’s great to see that you are reaping some benefit from from the SEIU, and that they are getting more than fair value, in return.
Does this association presage more to come?
I hate to use the word, synergy, but it seems appropriate to the case. Will the work you do for them continue? Or is it a one time deal? I hope it sets a pattern of cooperation that will be emulated.
There has been a lot of “ink” spilled on the notion that the left needs it’s own support infrastructure. Most of the time the lack of think tanks and foundations is the complaint. Others say that our own support system need not copy that of the right, and I think this may be a step in another direction more suitable to our strengths.
Brava Taylor and SEIU!
HinTN @ 22
Fiance heard Fristy say in his farewell that he will travel the world helping those with AIDS. I guess the video method of diagnosis doesn’t work with the AIDS; otherwise, why travel around?
Frist’s a crock. Harry Reid sure damned him with faint praise, talking about how Fristy got into Princeton and Harvard Med, a testament to his intellect and social position, or “ability to get along well with others.” {para}
Great writing and great work Taylor - thank you.
I look forward to the day RICO statutes are used against hospital administrators who conspire with employee torment experts (”labor consultants”) to destroy adequate nurse:patient ratios.
Failing RICO (which requires prosecutorial power and hence official OK), the other tool to use directly against the hospital administratrs as individuals is the Federal False Claims act: the administrators are conspiring to defraud the Feds by deliberately creating and maintaining dangerous staffing levels.
Let’s stomp these greedy corporate servants’ economic life out of them in the courts.
Let’s bring patients and their families on “informational tours” of the hospital execs’ neighborhoods and - (if any will have the leeches) their professional organizations.
May every union-busting hospital administrator never know a moment’s peace from legally permitted gatherings outside their office and home.
May they find silent vigils on their route to their place of worship - with large signs asking for the administrators’ spiritual salvation.
(Not at the place of worship - just on the route from the
perp’sadministrators’ homes.Let them - and their spouses, families, and neigbors - be reminded daily of their murders by proxy - and reminded the hit man lives next door.
Patients and their families can do to the for-profit murderers what survivors of child sexual abuse or durnk drivers have done - pathologize the perpetrators.
No place to hide for union-busting hospital adminstrators - ever.
When they stop afflicting patients and their families, we’ll leave them alone.
Until that day, the only options they deserve are suffer or surrender.
And when they whine, we can point out we’re feeding them the same choices they seek to force upon us: and we will cram them down their greedy, lying throats.
Bon appetit, baby killers.
Your protectors lost, and you will lose even more - good riddance, ghouls.
Now go back to selling used cars and get the fuck out of our hosptials and clinics.
From the SEIU website’s FAQ:
Emphasis added. Kind of sad, though, that something like that needs to be emphasized in order to stand out.
From the Universal Health Services website, we see the UHS mission statement:
Nice words, but given the tale Taylor’s telling, you have to wonder about the way in which this mission is carried out. When one recognizes that patients are often constricted in their health care choices by the insurance options provided by their employer (assuming they have both an employer and medical benefits), then its easy to see how UHS prioritizes these five ideas. I’m guessing the order of importance is investors, purchasers, physicians, and then employees and patients or patients then employees.
Hey! Nothin’ wrong with sellin’ cars for a living. *g*
{{what kirk murphy said.}}
Taylor–Were there an adequate number of nurses on duty at the time of the baby’s death? Would more nurses have detected the problem with the wrong prescription?
According to The Blue Line
Las Vegas is rated 9th in police salary. Salary range is $43,819 to $68,742.
Compare to RN salaries in Las Vegas.
RNs have to have at least an Associate Degree in Nursing.
Cops and nurses both need unions, and we can’t do without either cops or nurses.
Margot @ 34
And it looks like nurses are $26K to $61K…
The average is $56K…
How abysmal for someone who saves lives. : (
egregious @
18
egregious -
How many of those babies arrive with a patent ductus arteriosus? Isn’t prostaglandin used now instead of open heart surgery to ligate a PDA? How many of those babies are rubella patients?
So, the claim is that six or seven people observed or participated in this error of mis-prescription, mispreparation, or maladministration? Not excusing the treatment of the flummoxed and (now) grieving parents, but how exactly do staffing levels relate to this tragedy? Should more than six or seven people have been involved? Were the wrong six or seven people involved? Were the six or seven people overworked, overscheduled, over-overtimed?
What’s the relationship between the sorrowful death of this baby and the valid, life-affirming and -saving goals of the SEIU nurses?
This is unbelievable:
Nine years ago next Sunday, I gave birth to a preemie who was hospitalized for four months. It was a maddeningly stressful time for us, even while his care was overseen by NICU nurses 24/7.
I remember one day coming in to see my baby before I had to go to work (because I couldn’t get sufficient time off from my job), and I nearly said something glib to another parent, there to see her daughter.
Thank God I didn’t say the wrong thing, because a few minutes later I heard the nurses explaining how the little girl’s organs were slowly shutting down, and that the mom & dad were free to stay any time, before, during & after death, to say their goodbyes.
I thought, wow, despite all my whining, at least my baby is alive — and he eventually came home with no lasting problems. You never appreciate what you have until see someone watching their baby die. And I owe so much to my baby’s wise, loving care.
This is a fight that must be fought for nurses, parents and patients.
HinTN @
22
I caught a few minutes of Harry Reid’s farewell to Frist on C-SPAN. He was telling Frist what a great guy he was and how he had made America a better place. barf barf.
Sorry for OT - CNN “President didn’t just drink the kool-aid, he made it”
and
Lieberman, Collins set to announce new Iraq group
Worked as a Risk Manager in a hospital for years. One of our RN’s decided to drive 50 miles up the highway to a “for profit” hospital that paid much higher wages. I saw her about six months later, back at the hospital. Asked her if she was working some extra prn stuff for us. No, she had left the city hospital and come back. She told me that the staffing ratio was so bad - that she “feared for her licence” every day she worked. She would start her shift with the full compliment of patients (per the staffing “guidelines”) and then have three or four new admissions on her shift. For those of you not in the know, a new admission is very labor intensive for a nurse. So she would have not enough time for her new patients, let alone enough for the other seven.
That hospital chain eventually turned union after a nasty fight. They are still fighting over staffing ratios.
The only lawsuit that I am aware of where punitive damamges were awarded by the jury (over and above the cost and malpractice damamges) was a for profit hospital where they had shifted a temp (rent a nurse) with no OB experience to cover a busy OB floor and a problem was missed on the monitor strips ended up in a severely brain damaged baby.
I would not work for a for profit institution, nor would I want anyone I care about the hopitalized in one. When $$$ are the bottom line on decisions, IT DOESN’T MATTER HOW FANCY THE BUILDING IS, the staffing ratio will be too thin.
egregious @ 1:12 pm (#8)
Am I wrong to think of a premie ward as a form of intensive care? If I’m not, there’s an obvious implication that it isn’t just premature babies that can suffer from this sort of oversight. Anyone who is in intensive care is there because he has serious health problems that could be exacerbated by the wrong prescription or extended periods of not being watched. It took them six hours after a high-priority instruction to change the baby’s prescription before someone got around to it.
My grandmother, mother and sister were nurses, my sister now a nurse practitioner.
She works in clinics in little farm communities in the central valley. She is their only access to health care. In fact, she actually makes her own medicine and gives it to her patients free of charge. She grows the herbs herself, combines them according to her extensive research, and cures people. All she asks is that they return the jars and let her know how they worked. It is shocking how well these natural medicines work. I can’t even go into the work she does, researching, growing and making these medicines. But there are cures out there, used by humans for thousands of years, that require no pharma companies, HMO’s, etc. My mother is on no prescription medication, just my sister’s, and is doing so much better than if she was on Lopid, cholesteral meds, blood pressure meds, and arthritis medication. People are becoming more empowered to take control of their health, and not put it soley in the hands of the medical-pharma complex.
kristinejoy @ 42
bless you, your family, and your sister, kristinejoy!
Thanks Taylor for keeping on this issue!
I find it most disturbing that the family was not informed immediately of the worsening condition and were ushered out with no information given– that’s cruel and unnecessary.
Errors do happen, unfortunately, and a complete investigation should be conducted of this sentinel event with a root cause analysis by the hospital, and JCAHO encourages that these events be reported to them. There are so many ways that this could have gone wrong– mislabeling after improper dosing by the pharmacy seems the most likely… the delay in hanging the new bag could be overworked staff or neglected receipt of stat information by nursing.
very sad…
It’s hard to find a thread where something this meta is on topic, so I”ll slip it in here.
A few days ago, Christy mentioned that the ladies of the lake were always ready to hear suggestions about how to improve the site. I mentioned that I would like to see a nice search engine for the blog, one that would let you search for posts by a specific poster, comments by a particular commenter, or to find a post from way back in archive hell.
Duh! We have one! Google is so cool. It will do a site specific search for you. Just go to Google, type in site:firedoglake.com xxxxxxx, where the xes are your search terms.
Example: site:firedoglake.com Christy returns 2,270 English pages from firedoglake.com for Christy.
Of course, it will work for any site.
Who is the most prolific commenter? Interesting question.
jeffreyw @ 46
FDL can use that search string as the basis for its own searches. In short, just submit a search to Google when someone fills in the “Search” box above, that search string is executed as an HTTP request to Google with “site:firedoglake.com” embedded in the search string.
I don’t think there are any commercial licensing issues involved.
jeffreyw: fun! 902 here, includes mainpost shoutouts and quote of my comments, right?
TeddySanFran @ 45
Yes, I think so. I did the search for jeffreyw 1 and found all the posts that I have the zed for. Had to cull through all those with a 1:xx time stamp or a 1 in the date. Such fun!
jeffreyw @ 17
That’s why I never did home health aide work. We have some scary neighborhoods here.
Jeffrey, my first supervisor was an Army nurse.
I just can’t tell you how much I looked up to her. She thought it was funny that the people in our Catholic hospital would call her “Sister.” She said she was the only Methodist ’sister’ she knew. She told such great stories of setting up hospitals in the Middle East.
RIP, Miss Bailey.
For those who were looking for more recent JARs for Clusterfuck- here’s one- from Fox- just released:
38%
.
Approve
Disapprove
Unsure
%
%
%
.
12/5-6/06
38 54 9
11/4-5/06 LV
38 54 8
Well the formatting on the JAR chart got pretty garbled- what it says is that the 38% JAR was the same as last month from Fox.
new thread
rwcole @ 52
cnn just showed a chart giving chimpy a 38% JAR too
TeddySanFran @ 29
I have a different perspective. He could spend the rest of his life coasting on his reputation and doing nothing.
Instead he is going to work in international health, on one of the most confounding issues of the day.
I give him points.
Stephen Parrish, CPA @ 36
No rubella, their vaccination system is thorough. Same % of patients with PD as the rest of the world, nothing hinky. Prostaglandin is only used for stablizing them until they can get either a cath procedure or surgery. We are transitioning to cath but right now our surgeons are are lot better than the cath people, so ironically surgery is safer.
Cujo359 @ 42
A premie ward imo is definitely intensive care.
So much can go wrong. You want someone on top of things every second.
Taylor and all:
Here is a great resource for statistics of all kinds. It is called Nationmaster, and has comparative statistics for many countries on many, many metrics. Below is a list of union memberships (as a percent of all workers) for first world countries. The US is next to last on the list with France dead last.
http://www.nationmaster.com/gr.....membership
Google comments: 1,340 here.
Margot says
December 7th, 2006 at 2:36 pm*
My mother always said Sisters! with a tone that sounded as if she was spitting. I’m not really sure what the bad vibe was for her, she would never really say.
I do know, that on the last day of her life, in severe pain from her second heart attack, she directed my sister to drive her past that hospital in favor of another, 30 minutes farther away.
We sat vigil through the night, my sisters and I, with the night shift nurse. She was failing, the beeps from the monitor telling the story. The night nurse stayed beyond her shift to stay with her, saying that she would not leave a comrade “We nurses stick together”.
I think we should all stick with the nurses, we’re all in this together.
egregious — Frist has run up a debt on points; I will give him some ONLY when I see results. I suspect when Frist says he’s “going to work in international health”, he’s really going to promote HCA elsewhere around the world so that healthcare expenses increase abroad while he makes a profit.
In regards to nursing profession: my mother is a nurse, has been an RN her entire life, now 40-plus years, still works in ER at the age of 66. Very much in demand because of the current shortage, can get a contract nearly anywhere. She is not union, but she tells the same horror stories that unionized nurses tell of crappy management.
What most of us forget about nurses is that they must earn continuing education credits in order to maintain their licensure, and more continuing ed if they have specialties (like my mother in emergency care). And they must also carry malpractice insurance; the cost of malpractice insurance is why my mother left OB/Gyn after 20-plus years. Part of the problem is the dark, flipside of the case outlined in this post: every parent expects and demands a perfect birth and a perfect child, no matter the health of the mother, amount of prenatal care, environmental exposures or genetics. Compound this expectation with management’s insistence on low staffing and nurses are caught in a double bind.
Do police have continuing education, licensure requirements and malpractice insurance requirements? Sure, they could be injured on the job, but a nurse can just as easily, maybe even more so.
egregious @ 2:57 pm (#59)
A mere 824 for YT.
While the story is heartbreaking, there are many leaps of logic and implied causality which are not supported by the evidence provided in the story.
There is definitely a possibility that an error of some type occurred, but it is not proven in the story.
Every accredited hospital will have an incident reporting system of some type in place. At a minimum it includes obtaining a written report of whatever occurrence was identified by the person or persons who discovered it. A healthcare quality analyst will interview all of the people who were associated with the occurrence. A meeting (or likely several meetings) will be held to work through the root cause or causes of the occurrence. No fault/no blame is aimed at the person making the mistake in the absence of intentional harm or malice.
The causes identified will be addressed in system, education, policy and procedure redesign with the input of the users of those policies and procedures.
The aim is to prevent future problems and to strengthen the system.
Someone at the hospital - a social worker or nurse executive, for example, should be the point person to stay in communication with the parents, to anser their questions and to address their concerns.
While nurse staffing is certainly a possibility, it is not supported in the story, and it does no good to imply that.
The SEIU, while supporting your reporting of nurses and union issues, should not be promulgating spurious data. And as a responsible reporter, neither should you.
Any nurse, pharmacist or physician who has ever made a medication or treatment error takes it very seriously and suffers emotionally from it.They know full well what the potential harm it may effect is, and in no way do they wish to make one or repeat one.
I blog about nursing issues and patient advocacy at http://www.universalhealth.wordpress.com, and I am not associated with the SEIU, the hospitals in question, the staff referenced, or the patient/parents in the story.
TeddySanFran @
29
Yes, he has been so much more horrible than I ever imagined. All his pandering and look where it got him: wandering the world looking for some way to care…
Taylor Marsh @
26
DONE!!! And gladly so. Thanks for this post.
[just came back here to see if anyone could “top” my google hits, and saw this]
universalhealth @ 3:30 pm (#63)
While I agree that the evidence shown doesn’t prove that understaffing was the cause of this death, one has to consider it as one of the possibilities. Overwork and understaffing can lead to such bad decisions, which I think was the real point here. There was a six-hour delay between the time the pharmacist issued that a high-priority correction concerning medication and the time someone finally acted on it for a patient in intensive care. That’s either extreme negligence, poor communications, or bad staffing. I don’t think there are any other reasonable conclusions.
BTW, most commenters here know this, but I’m not a medical professional. Some things are just plainly obvious.
rwcole @
51
who are these people, these 38%? who?
TeddySanFran @ 66
Somewhere at or below the 38th percentile, I should think.
cujo359 66 — agreed; although the case does not clearly point to inadequate staffing as causal, it could have contributory.
No matter, though, if extreme negligence, poor communications, or bad staffing, or some combination were causal; all three have their roots in poor management.
p.s. 1050 — good thing I’m not chattier!
UH @ 63 - It is you who are leaping. Questions are being asked here. Parents were not consulted properly after a horrible tragedy. You also obviously do not know the details of what is going on in Clarke County, Nevada. We’re asking for answers and raising the questions. Let’s keep the facts straight.
Taylor, I really appreciate your staying on this issue. (Disclaimer: I’m an RN, not currently in patient care, and have not worked with any union hospitals).
Some commenters have observed that it is hard to see how this is related to staffing issues (ratios in particular).
I’m inclined to agree: this particular instance is not clearly an understaffing issue, but it certainly could have contributed.
I think it is definitely emblematic of the disaster that our MBA run, payer driven healthcare system has become.
To me it suggests a real failure in both policy and training. This type of TPN error should have triggered some immediate actions. either the RN was not aware of a policy/procedure, or an appropriate one did not exist.
Unfortunately, I watched as so-called “quality measures” became increasingly remote from patient care, and focused on cost proving. Hospital “educational” offerings were largely either BS cheerleading sessions to make staff “feel more empowered” (barf!) or training to use some order entry system. Any real professional continuing ed. was increasingly on your own time (using vacation time or days off).
I also endured years of token pay increases, benefit and staffing cuts, and learning of executive bonuses.
Many experienced nurses get fed up, and areas are left with a high number of less experienced staff.
Now, the emphasis to replace nursing staff seems to be promoting nursing in school and funding accelerated RN programs.
Great. Perfect. Feed a bunch of new grads in to a system lacking experienced nurses to train them, with the same shit in place that ran many nurses out to begin with.
For myself, I could see that my years of commitment were going to leave me with a bad back, a lousy retirement, jeopardizing my license, and a nice warm feeling of having helped a lot of people.
I don’t see private enterprise deciding to start treating nurses fairly on its own.
I’d better go ahead & submit this before the thread gets too much older!
Again, thanks!
Rayne is really exactly on target (61, 69) especially about Fristy (what a tool!)
Thank you for keeping us posted on what the real scoop is in Vegas, and yes in a way like the commenter said above we all are LasVegans- just like NOLANS…As a nurse I can tell you it is a job that may mean everything, and serve many, the pay is abysmal…and considering many of us don’t have good benifits or even health insurance ourselves- we do the best we can.