The answer: send someone a letter

I had a day yesterday that (again) questioned my faith in the leadership of the Hotel at the very tip top. The root cause: BS plain and simple.

How in Hades do we have people (with credit to do so) purchase equipment, tell everyone "go out and get some patients to use it" then suddenly drop it? This happens (of course) once you get the ninnies at your location to buy in. When asked late last week, when I went to order and couldn't find a gadget available, I got an e-mail that said "Well, we don't know if we'll have money next year to continue this" as some very valuable pieces of equipment sit unused on people's desks throughout the system as a totem of "Look what I have..this cool gadget!" As such, these "gadgets" which are really FDA approved health care tools, do nothing for patients.

I know they work. Some of my patients have them. I got them through a loophole, which I willingly followed policy and procedure TO THE LETTER to get. They are making a difference in the lives of these people. I see it on a regular basis. Some of our people were back and forth to the Hotel several times in a year. Guess what? One character hasn't been back in six months (and counting). Another is over four months and we haven't readmitted him/her.

When I asked our technical gurus (who have way more experience with this sort of shenanigans) what I should do, the answer was "write a letter to someone who can do something about it". The consequences of doing that, could very well cost me my job.

But after years of waiting, working, busting butt for things that turn to vapor, I'm just about there.

Will be writing, editing, and thinking very carefully this week about that very thing...

Stay tuned.

One step forward, two steps back...

This seems to be the story of the unit I work with. Our upper Manglement wants to beat the Hotel into submission, then not be responsible for the consequences.

Here are a few shining examples:

1. Demanding staff be rushed through orientation because "they are not new nurses." 

Hello folks! Rehab nurses with a clue are not born, they are made by training and learning on the job. Notice: TRAINING comes first.

If we don't train our people properly while they are in orientation, we suffer the consequences.

One of my coworkers told me of a situation that nearly had me in tears. One of our patients with a newer trach went home without supplies for it, without any apparent instruction AND without an obturator!

This was just one complaint regarding this patient's stay. There were others. If I worked there, I'd fear for my license.

2. Don't do care coordination

Somebody should be doing it, everybody knows about it and nobody seems to be doing it in our neck of the woods.

My personal favorite: we now have "RN case managers" who say it's not their job.

3. Have a fit because our patients stay a long time at the Hotel.

Case in point: Guy gets discharged after lengthy hospital stay through no fault of his own (got sick with not one but several nasty bugs). Lived to tell about it, then our department gets yelled at because the patient didn't leave fast enough.

He/she was there  so long that he/she was discharged earlier than should have been expected (needed to do transfers independently).

Lo and behold, we get a call less than two weeks later. Guess what Patient X wants to do? Come back for rehab.

There went that readmission rate. Oh well!

Can you tell I'm glad it's Friday? I knew you could. Happy weekend to all!