I introduced myself to the nurse as a friend of the patient. I then humbly ask, would you mind washing your hands before you treat her. “I’m not treating her” she snaps at me. “I’m just getting her vitals”. The patient lies helplessly in her bed, bloodied through her bandages under the warm blankets and sheets from a large surgical site - that I am supposed to hope doesn’t get infected through prayers?
The nurse mumbles something about all she does all day is wash her hands and use gel but that’s not enough. I carefully wash, with disinfectant wipes, the door knobs that must be touched to open and close the doors. I wash the whole doors opening in case that was touched and then everything the nurse touches.
An hour later, the cleaning woman comes in and wearing green gloves, empties the garbage by the door and in the bathroom. I hear the spray bottle in the bathroom then the wet, dirty mop glides across the floor. She uses the same gloved hand to open the doorknob of the bathroom and turn on the water in the sink. The same gloved hand that emptied the garbage, handled the dirty mop and picked garbage off the floor. As she leaves, I follow with my own gloved hand now and grab a long string of sanitary wipes off her cart. I asked her permission and she gladly agrees.
|Bloody Container |
was like this for days
On a trip to the cafeteria, in this small community hospital, I counted 4 hand sanitizers which were empty. One was broken.
On my third day, a little tired from sleeping on a chair, in sweat pants, a flannel shirt, no make up and hair messy, I visited the administrative office of infection control. I knocked and a man opened a door of a room no bigger than a large closet. I asked him if I can see his hospital infection rates. I had my friend and colleague in Florida do a search on-line of this hospitals infection rates and it came up fairly low. The infection rates were worse than the average in this state and throughout the country. I thought I would ask the administration if they would explain it or give me different numbers. “I can’t do that” he explained that it would have to go through his superiors. I told him that I looked at the public information and his hospital didn’t look very good. He agreed and was familiar with the websites I offered and shared another website with me to use. He cleaned off a chair of stacks of papers and asked me to sit down. I asked if I can share what I have seen.
He allowed me to share in detail some of what I saw and told me he is the whole infection control department. There is a large staff turnover so people who are trained to clean leave and train the next one who leaves and trains the next one. He has no middle management to oversee it. This hospital also filed for bankruptcy last year. I asked him if he was aware of the push back from nurses being asked to wash. "You give out literature in the admission packets that says we are supposed to ask" I explained to him. I asked if he knew that the country is encouraging patient participation. "I know" he said. I asked if he was aware of NPSF, IHI and The Joint Commission. "Yes, I know" he said with a shrug.
I found myself sympathizing with him as a human being, being honest and stuck in a dilemma. I can’t imagine that he wanted his department to be the cause of problems. But I can see, he was at a loss of what to do.
Reporting him to senior management would probably cause him to either lose his job or cause him more grief. I can’t imagine a hospital in this condition could suddenly come up with money to pay more staff, fix the broken hand sanitizers or train the people appropriately. My guess is that his superiors know the problems but are not addressing them or, are too disconnected from the front line staff to have any clue. Either way, I can’t imagine that they want to make changes – or they would.
What this hospital needs is a camera crew to come in and show the public what they are getting into when they enter this hospital. I would not want to see this hospital, or any hospital close. I want to see them improve care. That’s all anyone wants.
After my own 3 day stay in the hospital, I can see firsthand where hospitals are still failing us. We are vulnerable when sick but the senior staff in hospitals will not make themselves as vulnerable as I was when hospitalized. Or, any patient is. They will go in to their hospital with the words Director of Quality, CEO or Nursing Director taped to their forehead. They will be treated differently than someone like myself who went in as a “regular” patient, unprepared as to what I found during my own hospitalization or the patient / friend who entrusted me to keep her safe during her one week stay.
There is a disconnect between the administration who makes the decisions and the people who work at the bedside. The problems need to be addressed. I don’t have all the answers but I do have some.
I left the infection control office and headed back to my friends room frustrated that nothing there will change. As I passed the room next door to her it was closed off to visitors. That patient was infected.