New memo from Admin

Ran across this at a website on medical/nursing humor. It is quite extreme, but is it really anymore extreme than some of the real ones that are seen everyday?

Memorandum

To: All Hospital Employees

From: Administration

Effective immediately, this hospital will no longer provide security. Each Charge Nurse will be issued with a .38 caliber revolver and 12 rounds of ammunition. An additional 12 rounds will be stored in the pharmacy. In addition to routine nursing duties, Charge Nurses will patrol the hospital grounds 3 times each shift. In light of the similarity of monitoring equipment, the Critical Care Units will now assume security surveillance duties. The unit secretary will be responsible for watching cardiac and security monitors, as well as continuing previous secretarial duties.

Food service will be discontinued. Patients wishing to be fed will need to let their families know to bring them something, or make arrangements with Subway, Dominos, Wendy's, or another outside food preparation facility, prior to mealtime. Coin-operated telephones will be available in the patient rooms for this purpose, as well as for calls the patient may wish to make.

Housekeeping and Physical Therapy are being combined. Mops will be issued to those patients who are ambulatory, thus providing range of motion exercise, as well as a clean environment. Families and ambulatory patients may also register to clean the room of non-ambulatory patients for discounts on their bill. Time cards will be provided to those registered.

Nursing Administration is assuming the grounds keeping duties. If a Nursing Supervisor cannot be reached by phone or beeper, it is suggested to listen for the sound of the lawn mower, weed eater, or leaf blower.

Engineering will also be eliminated. The Hospital has subscribed to the Time-Life series of "How to..." maintenance books. These books may be checked out from Administration. Also, a toolbox of standard equipment will be issued to all Nursing Units. We will be receiving the volumes at a rate of one per month, and have received the volume on basic wiring. If a non-electrical problem occurs, please try to repair it as best as possible until that particular volume arrives.

Cutbacks in Phlebotomy staff will be accommodated by only performing blood-related laboratory studies on patients already bleeding.

Physicians will be informed that they may order no more than two (2) X-rays per patient per stay. This is due to the turn-around time required by the local Photomat. Two prints will be provided for the price of one and physicians are encouraged to clip coupons from the Sunday paper if more prints are desired. Photomat will also honor competitors coupons for one-hour processing in an emergency. If employees come across any coupons, they are encouraged to clip them and send them to the Emergency Room.

In light of the extremely hot summer temperatures, the local Electric Company has been asked to install individual meters in each patient room so that electrical consumption can be monitored and appropriately billed. Fans may be rented or purchased in the Gift Shop.

In addition to the current recycling programs, a bin for the collection of unused fruit and bread will soon be provided on each floor. Families, patients and the few remaining staff are encouraged to contribute discarded produce. The resulting moldy compost will be utilized by the pharmacy for nosocomial production of antibiotics. These antibiotics will be available for purchase though the hospital pharmacy, and will, coincidentally, soon be the only antibiotics listed in the hospital's formulary.

Although these cutbacks and changes may appear drastic on the surface, the Administration feels that over time we will all benefit from this latest cost cutting measures.

Maybe I shouldn't post this. It may give some admin-types too many ideas.

Original Source

Moving Day

I had previously hosted my blog on Wordpress. Today, I have decided to move it here as blogger has more of the features I am looking for. It seems to be much more open to my own personal touches, so here I am. I will move all of my old posts here as well. That will take a bit of time, then I will be on to new posts. I promise to post more regularly, as least every few days.

Docs vs Nurses vs Docs

Notice I put nurses in the middle in the title? There is a reason for it. This is how things work at the hospital I am currently working at. We have our ICU docs who run things in the ICU. We also have the cardiologists and the cardiac surgeons. The problem comes in when they don’t seem to communicate with each other. I had a patient the other day that illustrated this the best.

They were in town on vacation and their daughter had a congenital heart condition that had been repaired surgically in their hometown. She was having some complications and was admitted to our ICU to manage. The cardiologist on-call was the one in the group with the largest ego. He was in the room discussing things with the family when the patients home cardiologist called, the one who had treated the child since birth. When Dr. M, as I’ll call our cardiologist, was asked if he wanted to speak with him, guess what his answer was? “No, just tell them to send the records.” Here begins the problems as this was stated in front of the family.

Later on that evening, the parents asked why he wouldn’t speak with their doc, the one they trusted totally. Let me also add that these parents were very knowledgeable about their daughters condition and very involved in her treatment. The kind of parents we love to have around. I had to honestly answer that I didn’t know. They had a few questions concerning what we were doing as far as treatment was concerned,so since it was a Sunday evening, I asked our ICU doc to speak with them as Dr. M had gone home. His answer to quite a few of their questions was that cardiology had to make that decision. So he had us page Dr. M at home and put him on the phone with the parents. Dr. M, from home, told the parents that the ICU docs should make those decisions. According to the parents, he seemed like he just wanted to get off the phone and get back to dinner with his family. He may have even said so, I don’t know why else they would have thought this.

In case you’re wondering, the big question was why was their child not receiving their home medications. I have to side with the ICU doc on this one as most of the home medications were cardiac medications. Something I think the cardiologist should be deciding. But then again, I’m just a nurse. What do I know. These medications were never ordered even though they were on all 3 medication reconciliation forms we had filled out, a subject for another post.

Bottom line is that I had a patient and family that had good, important questions concerning their child’s care at 5PM that were not addressed until the next morning. Not at all acceptable in my book. This is a facility that is totally run and controlled by the physicians for their comfort and convenience. I have yet to see anything done which in any way involves nursing at any point. Worse yet, many of their practices, in my opinion, endanger their patients. We can have patients being treated by 5 or 6+ specialties, all of whom can write orders and none of whom are ultimately managing the care.