Work with nurses to improve care

By Cokie Giles, RN

Nurses at Mount Desert Island Hospital have struggled since 2004 to make new technology a safe and effective tool to enhance patient care. But management has not taken the nurses seriously when they reported “near misses” with medications. Due to the nurses’ diligence, a new group of remote pharmacists have been employed, and so far, the mistake rate has declined.

Registered nurses (RN) at the hospital continue to document near misses and delays in care, the majority of which are caused by the hospital’s poor management of healthcare technology and a refusal to give a voice to those who use it on a daily basis. For example, the hospital’s electronic health record system should provide RNs and doctors with quickly accessible up-to-date patient care protocols. Instead, they find protocols that are incomplete or out of date.

Patients’ bracelet scanners function inconsistently. The computers on wheels, which are an integral part of coordinating a patient’s care, “freeze” at times. All of these problems cause delays in care.

Despite the fact that RNs at the hospital have been pushing for improvements in technology for over 10 years, management has been extremely slow to respond. RNs at the hospital have a professional responsibility to advocate for their patients so they can receive safe and effective healthcare. It is the nurses’ job to flag problems and work with management to resolve them. Management, however, has been unwilling to maintain a working relationship with them towards this end.

Since June, hospital administrators have refused to negotiate with the nurses and have walked away from bargaining. Key proposals on the safe and appropriate use of technology have been left unresolved. Instead of focusing on solutions, hospital management is indulging in legal maneuvers and stalling tactics that waste the hospital’s money on attorney’s fees.

Last spring, nurses requested a meeting with the hospital board of trustees. The board is entrusted with monitoring the hospital’s operation and ensuring the quality of its services and programs. Trustees are also charged with holding the organization accountable to its mission, which includes “embracing the time-honored values” of “compassion, community, improvement, integrity, respect, [and] teamwork.”

So far, the hospital’s board of trustees’ response to the nurses’ request has been silence.

We believe that as the community representatives and guardians of the hospital’s mission and values, the board of trustees should want to gather as much information as possible on the critical patient care issues that the nurses have been raising. We call on the trustees to uphold the organization’s values and work with the nurses for the hospital’s improvement as soon as possible.

We also call on hospital’s management to immediately move forward on an agreement with the RNs. This includes agreeing to contract language that allows bedside nurses significant input in the implementation and use of patient care technology as well adequate training on all equipment, technology and medical devices.

The public’s health relies on safe hospitals with working equipment and appropriate technology protocols. When nurses flag problems in these and other areas, they have a right to do so in an atmosphere that is free from fear and intimidation. If that right isn’t respected and protected, the health and safety of their patients, families and neighbors are in jeopardy.

Many Mount Desert Island community members understand this, and the nurses appreciate the support they have shown. The RNs will continue to do their part as patient advocates and look forward to working with the hospital board of trustees and hospital administration to improve patient care at hospital.

Cokie Giles, RN, is president of the Maine State Nurses Association.

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