(Guest post by Mike Gordon (jgordon30@msn.com) on the Accountable Strategies blog)
I have been a Respiratory Therapist for 19 years. I have seen hospitals try to increase productivity to unsafe levels, even though there is a Medicare mandate to have adequate staff.
I was the only therapist on at night at one hospital. Things were not right. I entered into the Kansas Human Rights mediation process and cannot discuss the case further. I can tell you that if you say something is not right and leave notes, those notes can be used against you. I am living proof. Retaliation is very real in healthcare.
Mediation was the only way for me to get to work in another state. But the state medical boards would not give me a license until this mediation was resolved, which meant if I didn't go along with the mediation, I couldn't work at the only job I have done for 20 years.
You want medical retaliation. Try this: The Joint Commission will not investigate, state medical boards will not investigate, which means there is no one to complain to. The hospital really can say anything they want and you have no defense. When I heard the airline whistleblowers on CSPAN, I heard what happened to me.
Management must use the same playbook. The Kansas Human Rights Commission is "not favorable to employees" is what I was told. So I got what I could and will try to move on.
Want a really nice Catch 22? I'm terminated for bringing up wrong things, and the Medical Board, Joint Commission, and CMS all refuse to investigate. I try to go to another state to work. A second hospital hires me, lets me work 90 days, and fires me for not getting a full license. The Oklahoma Board stops me from working further. (Their reasons keep changing.) I am told they said something different to this Board.
To those who try to use mediation, don't think the charges against the employer will be the only items used in mediation. Don't expect to be believed. I had convincing proof, but it wasn't enough. If all state human rights commissions are operated like the one I used, then they need to be shut down. I thought I was going to get help.
Don't expect real reforms in the way treatment loads are handled and in interaction between the sexes. Not to mention how different disciplines interact. When the physicians, nurses, and therapists all have their own agendas, the patient has been left out and that's one way that bad things happen to good patients. As long as physicians see the hospital experience as one of "write orders and call me in the morning," the patient loses.
As long as nursing only cares for their part--"call Respiratory because they don't want to deal with the patient" --or they enjoy calling Respiratory to lord over them (some hospitals will fire you if don't play a nurse tech role), or they are too incompetent to know when a patient is going bad, or they misuse the physician order to call for every little thing, then the patient loses.
For a Respiratory Therapist, you are really caught in the middle. You are given the maximum amount of work to do, expected to find time for all the emergencies that occur during the shift, and try to survive for another day. The patient loses in so many ways. You can't fix a patient when three other nurses are calling you and the ER calls.
You can only do so much. The hospitals use consultants to cut staff. The hospitals are becoming a production line and the patient is the product. There is no quality control inspection process like there is for the airlines. The patient loses.
Why have a doctor order something I don't have time to give? Then the nurse orders therapy. Most of time, the patient doesn't need what is ordered and then I have to try and get the proper order. What does that patient need? Do I have time to give that therapy?
Into this mix is a management that only wants productivity, not patient care. It is very complex and you feel good when things go well, but this is happening less and less.