As a Patient

I have a medical condition that necessitated a couple of surgeries and several years of hospital based treatments. My insurance was not accepted at the hospital where I worked, which was the best hospital in the area. Because of that, and because I couldn’t afford the tens of thousands of dollars my healthcare would cost out of pocket, I opted to go to the next best hospital.

That hospital is one at which I had worked previously. I knew the nurses had gone on strike a few years before and they were constantly at odds with the hospital about under staffing, poor benefits, and the constant accusation they had ‘abandoned their patient’ if they left at the end of their shift when their relief hadn’t shown up for work. This was the environment in which I was to receive my care.

During the worst of my condition and, therefore, at the height of my visits to the hospital, I knew I had no cognitive ability to protect myself. If I was even awake, I would not react soon enough to ask the nurse to double check the medications she was giving me. I had to rely on my family. Because we were prepared for that, they knew exactly what I was to receive and when by knowing my medication schedule and by speaking with my doctors.

hospital-834152_1920My daughter caught a major mistake. In all probability the drug I was being given caused me to remain on a respirator for a couple of days. The nurses didn’t understand the dosage but my family did. It took the strong will of my daughter to insist they change the dose. That meant they had to contact the one doctor I trusted and without that intervention I’m not sure I would have gotten out of the ICU alive.

My experience in that hospital was typical for many patients. Tired, overworked, annoyed nurses make errors. When I worked there, I often saw specimens come into our lab without the right labels. We would have to track down the nurse who collected the specimen and have her identify it. She might not show up until the next day. Invariably, she would be annoyed that she had to find the histology lab, identify the specimen, and sign a document that she had identified it. This was ‘cover your ass’ for the lab. If she was wrong, we could point at the surgical team. They could be sued.

As healthcare funding is attacked by Congress, this is the sort of behavior that will become more prevalent. It grows out of a number of attitudes all of which are financially based.

nurse-160228_1280Irritated nurses and techs are created by being overworked, being forced to do overtime, and being forced to rush. People don’t act kindly or care to listen to complaints when they cannot get time off for their vacation. In all the labs that I have worked since Congress passed legislation in 1988, there aren’t enough techs to cover the work if more than two to take a day off at the same time and there aren’t enough days in the year for everyone to take a vacation if only two can take a day.

People don’t remain in their position, or the field, when they don’t get vacations, decent raises, or expected pay. As experienced techs and nurses leave, new people must be drawn in to replace them, people with less experience and less of an investment in doing well. After all, they know they won’t be paid well but any job is better than no job at least for a while.

In the lab that I currently work, half the staff does not have the minimum education required to be certified by ASCP, which is the organization that certifies histotechs. In my state, certification isn’t mandatory so nothing is said when the lab is inspected. How safe is that when all of the staff do not know all of the procedures?

Management likes to tell us we can ‘look up anything in the procedure manual’. I am not a supervisor or even a lead tech, yet I had to insist parts of our procedure manual be updated in order to train the new people. There hadn’t been an update for seven years and, in that time, we had numerous new procedures, new chemicals, and updates to old procedures.

CAP logoOver the course of those seven years, the lab had been inspected multiple times but that manual hadn’t been tagged as a problem even though it was not up to the standard of the inspectors. I knew it was wrong and I trained the newcomers to do the job correctly and gave them notes on how to do it correctly. The new techs didn’t know this isn’t acceptable. They were simply happy to have a job, one they could leave for greater pay once they were trained.

That is the risk of underpaid healthcare workers. Nurses who don’t want to listen to family until a daughter forces them to listen. Manuals that aren’t updated because the supervisor simply doesn’t have time (She’s often working with us to replace those absent). The health risk is also in specimens that get identified the next day because surgery went so late, the staff was tired and missed putting a label on a container. We can only hope they really did recognize the specimen and the name of the patient.

The needs of the sick must be met. The labs, doctors, nurses, and management of the healthcare system try to meet those needs but, as vacations are denied, as overtime is demanded, as people are fired for calling off work, the needs of some patients invariably fall through the cracks. The only way to save your specimen and your health is to understand as much as you can about you condition, your tests, your medications, and your treatment and try to keep your loved ones by your side.

 

 

 

 

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