Monday, July 29, 2013

Failed Inspection

A survey team swept through for a regular inspection.  All prior inspections seemed to be conducted by surveyors who could not see or hear.

Not this time!

Multiple citations in every area from the cleanliness of the building to emergency plans to medication errors.  They were even cited for not using computers!  Management walked around the last two days of the inspection, dazed and numb.

Certifications, credentialing, new admissions:  SUSPENDED.  The hospital has to stay open for its current patients because, frankly, there is literally no where else that could accommodate them.

My main ward was inspected on the second day.  Management pulled one of their Favorite Children to supervise the ward.  The surveyors asked questions of Favorite Child.  She deflected all to me, including blame when she thought there was a problem.  The surveyors asked her repeatedly, "But don't you work here too?" and "So you don't have anything to do with patient care?"  Favorite Child could not understand why her honest response was not accepted, "Sure I work here, but my job is to tell people what to do, not do it myself."

My medication pass was beautiful.  The trick is to select your best patients and least complicated medications.  If you give liquids, you had better have a proper device to accurately measure the medication.  Such a device was not available to me, so I did not select patients who needed liquid risperdal or haldol.  Had I given the liquid meds with the substandard, though only available pipette, that would have been another citation.  Management was not grasping the concept that a lot of the citations were not based on errors made by individual workers, but rather from lack of supplies.  (For example, the building has no apparatus to guide people down the stairs who cannot walk in case of a fire.  "You know how to put someone on a bed sheet and have five people help you down the stairs," was management's response.  Nevermind that we have more patients than bed sheets, the bed sheets rip with normal use, and there are not six spare staff members to carry several people down flights of stairs when the building is on fire.)

After the surveyors finished, rumors swirled that there would be firings.  I was walking through the lobby when I was introduced to the New Director of the Hospital, after I overheard him telling security, "If Dr X comes back, he is to be treated like any other visitor."  Dr X was the Medical Director.  I had heard that another doctor was appointed.  The rumored new medical director is someone I already know, and I think he admires my work ethic.  (Though I am usually wrong at predicting outcomes.)

Amazing.  I am wondering how far down the Cleaning of the House has reached.  Nursing management to go?  We shall see . . .


  1. Is this fiction or creative nonfiction? Just curious...JHACO makes our group groan with frustration, but we get a fair warning of their pending arrival!