Two nurses fired for emptying local area hospital geriatric med/surge unit for Holiday Weekend:
Thirty-six patients were unexpectedly discharged from MG Hospital in Gaitlin, Tennessee. Patients and their loved ones were overjoyed and seen celebrating at Fourth of July parade on main street the following day. Many in an impromptu decision agreed to meet up at the firework show. Some were still wearing hospital gowns and medical IDs. They said the discharge nurses were like angels on roller skates as they watched red and blue explosions ignite the sky.
Family members described the chaos at the hospital the day before as discharge social workers, ambulettes, transporters, and other personnel struggled to keep up with the two palliative care nurses that descended on the unit and provided intense patient education – often bringing patients and their families to tears accompanied with in some cases uncontrollable sobbing.
Our news reporters uncovered that this result was listed in their termination notice and was lifted directly from a nurses shift summary notes. However, our reporter was able to get a confidential copy of this summary, and the full sentence was not in the termination summary.
It read; “A code was accidentally called when Mr. Ernest Blackburn was heard uncontrollably sobbing. Security and medical staff promptly arrived for a behavioral emergency but were quickly informed by RN Clancy and Mrs. Blackburn that Mr. Blackburn was uncontrollably sobbing at finally being free to get the hell out of here.”
Hospital administrators, however, were none too happy. They had left early for the fourth of July holiday, and Unit 3B was filled and fully staffed. Despite the unit being a med/surge unit, all of the staff worked the Ghosted unit.
Only one of the thirty-six patients were, unfortunately, readmitted. Mr. Gasten reportedly had heart pains during the firework finale and was returned by the high school fire department volunteers before they realized he had only been fighting with Mrs. Gasten about staying for the entire firework finale.
Hospital administrators further officially stated that premature discharges place patients at grave risk, but that was not free to discuss what risk was posed for any of the 36 patients due to privacy laws. One administrator was off the record quoted as accusing the two mavericks as effectively greenlighting euthanizing geriatric patients by removing necessary life-preserving medical treatment.
All this patient informed choice, and declining top of the line medical treatments was interfering with discovering more effective ways to treat chronic disease he said. “How will we know what works and will not work if we don’t get to try? We are in the business of saving and prolonging lives no matter what the cost – anything short of that is not our mission! There is a case against all this patient informed choice – we are overwhelming them with unnecessary options. Why am I paying for these specialist doctors for if we can’t apply for the best medicines at the end of the day? They come here for hope not for waving the white flag.”
The final straw was the unauthorized and expensive use of the helipad. Two patient families did a go fund me the initiative to bring their loved ones home by helicopter – and although the transport did not cost MG Hospital dime, the termination notice cited “unauthorized use of expensive MG Hospital helipad.
Administrators were also miffed as both patients released toilet paper confetti all over Gaitlin Tennesse with MG Hospital signature colored toilet paper series – MG prides itself on soft touch medicine in everything they do. That soft touch, apparently, does not apply to its staff.
End Note: This account is, of course, a fictional account. There is no “Memorial Gardens Hospital” in Gatlin, Tenessee. Palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped, and when it is clear that the person is not going to survive the illness.
Our best medicines often come with negative side effects that seriously reduce the quality of life while only marginally extending life span as measured by time. How much additional suffering and time in a hospital should a patient bare to extend life 1 hour, one day, one month, six months and in many cases have no guarantee of results? Is a patients life living at home for 90 days more valuable than an inpatient stay for 20 to 30 days with multiple treatments and eventual discharge that may extend life to 180 days?
The abacus of our life span and individual decisions regarding aggressive and perhaps even experimental treatments when return to health is in all likelihood impossible is an ethical dilemma that our death-defying culture has not yet adequately traversed. Facing death with grace and reverence and making medical decisions that are truly in the interest of the patient while being mindful of equity and appropriate use of medical resources is indeed terrain most of us are not comfortable with being the decision maker.
From the armchair of philosophical, spiritual, and ethical debate, it is an easy call. When the bell tolls for you, a loved one, or a patient you are treating – the cloud of unknowing is always in the air. The hospital administrators or direct care professionals are neither right nor wrong in these issues. The responsibility is yours to prepare and inform your family and your doctors about your preferences and choices for end of life care.
How can we face life and death decisions without a sincere spiritual reckoning? I spiritual classic that I have not read but have only received morsels from is entitled the “The Cloud of Unknowing” by an anonymous fourteen-century monk. Father Richard Rohr sites the following passage in his blog;
“Thought cannot comprehend God. And so, I prefer to abandon all I can know, choosing rather to love him whom I cannot know. Though we cannot fully know him we can love him.”
Father Rohr than says “In the later stages of the journey, of course, loving becomes its own kind of knowing—the deepest kind of knowing.”
If we seek a contemplative life in the midst of our worldly business we will be better able to face our own mortality and the mortality of others and will intuitively know, I believe, what the best decision is when faced with medical decisions that are highly complex. At the end of the day if we are driven by a love of the selfless variety – it is highly likely that we will find the correct path. Another book I have to acquire – the journey of exploration never ends.