Wednesday, October 3, 2018 // The Statement
6B
Carroll explained the hospital
also eliminated meal passes, cer-
tificates given to family members
of patients, typically patients who
had been in the hospital for a long
period of time.
“Social workers would give
the vouchers to families because
they know what families will be
there for a while,” Carroll said.
“It was a way to look out for fami-
lies of extremely sick patients and
help cut down on their personal
expenses.”
Ultimately, Detloff said the hos-
pital has made it more difficult for
nurses to provide genuine, per-
sonalized care. Ironically, when
Michigan
Medicine
launched
its Victors Care concierge care
service in Spring 2018 — which
offered more personalized medi-
cal attention for patients willing
to pay a costly membership view
— it drew criticism from many
hospital staff for being elitist and
exclusionary.
“Michigan Medicine puts nurs-
es at a disadvantage when they
take away things like meal pass-
es,” Detloff said. “We want to take
care of them. We want to comfort
the crying child, offer to send
them down for food or give them
something, but we can’t. We want
to buy them food with our own
money but we’d get in trouble for
that too.”
W
hile Detloff and Car-
roll explained cut-
backs by Michigan
Medicine have made it more dif-
ficult to care for their patients
both physically and emotionally,
Duncan said the nurses in her unit
fear for their patients’ health and
feel obligated to hold the hospi-
tal accountable. As a result, these
nurses took a stand against the
practice of having technicians
conduct remote telemetry.
According to Duncan, when she
and other nurses expressed their
fears of patients’ heart arrhyth-
mias going unnoticed by the tech-
nicians, they were told by their
managers to write up incident
reports detailing their safety con-
cerns. The nurses documented the
lapses in the technicians’ respons-
es to irregular heart rhythms with
forms called Assignment Despite
Objection. ADOs allow the nurses
to notify management of a poten-
tial issue that could be detrimen-
tal to patients as well as maintain
documentation for their own job
safety.
“It was really alarming for all
of us once (remote telemetry with
technicians) started that this
was happening,” Duncan said.
“We would print a copy of the
rhythm strip, go back through
the monitor and find the event,
print it and attach it to an incident
report. We must have filed dozens
over the course of months.”
Due to the strong response from
nurses within Duncan’s unit, 7C,
Michigan Medicine temporarily
suspended the practice of remote
telemetry in Fall 2017, but only
from 7C. The hospital maintained
the practice throughout the hospi-
tal and in other cardiology units
like 7B. The practice was rein-
stated in Duncan’s unit in January
2018.
After that reinstatement, nurs-
es began filling reports on the
same issues again, to which they
received no response from the
hospital once more.
In May 2018, the nurses within
7C took a new approach. They sent
in ADOs to the union represent-
ing the 6,000 registered nurses in
University of Michigan Hospitals
— the UMPNC — instead of solely
to Michigan Medicine. This esca-
lation began to bear fruit.
“We noticed once we got the
union involved that’s when (Mich-
igan Medicine) began to listen to
us,” Duncan said.
As a result of the 7C nurses’
reports and the union’s support,
the hospital relented and remote
telemetry was removed from 7C in
July 2018. However, the practice
was not removed from any other
units within the hospital, includ-
ing the 7B cardiology units.
“Remote
telemetry
was
implemented
in
other units in the hos-
pital and is still used
today,” Duncan contin-
ued. “It’s just an exam-
ple of the squeaky wheel
getting the oil because
other units haven’t filed
reports.”
When remote telem-
etry with technicians
was first implemented
at Michigan Medicine
in July 2017, it was used
across the hospital —
not just for monitoring
patients within the car-
diology unit.
Duncan
explained
remote telemetry is not
used on every patient
because
not
every
patient within the hos-
pital needs to have his or
her heart monitored, but
many patients outside the
cardiology unit are moni-
tored for potential complications
— now through remote telemetry.
“An example of a patient on a
general care unit that may require
cardiac monitoring could possibly
be someone who came into the hos-
pital for knee surgery but is having
complications from the surgery
that may result in dehydration
and electrolyte imbalances which
can cause heart arrhythmias (an
abnormal rhythm) or maybe that
patient who just had knee surgery
has a history of some irregular
heart rhythm so the doctors might
want to monitor their heart more
closely while they recover from
that surgery,” Duncan wrote.
As far as Duncan knows, her
unit was the only unit within the
hospital to file incident reports
detailing the negative effects of
remote telemetry.
Duncan owes her unit’s prompt
response to the faulty practice
to the remaining monitors in her
unit. When remote telemetry was
implemented, other units in the
hospital lost their heart monitors.
Their only source of information
on a patient’s heart rhythm was
through the technicians.
Therefore, other units would
not be able to see any lapses in the
reports from the technicians. The
failure to address heart arrhyth-
mias could lead to other medical
complications, Duncan explained.
If a nurse is never informed of
the heart arrhythmia or is not
informed in a timely manner,
the nurse has no way of reacting
appropriately to the arrhythmia,
nor of correlating the abnormal
heart rhythm to its corresponding
complication.
While Detloff, Carroll, Duncan
and 6,000 other UMPNC nurses
continue to detail other cutbacks
by Michigan Medicine such as the
elimination of parking passes for
families and cutting the patient
sitter budget in half, the three
nurses agree they will continue
to fight for safer staffing, a bet-
ter contract and the importance of
thoughtful patient care.
“It started out with taking
away graham crackers,” Detloff
said. “Now it’s meal tickets and
bereavement trays. What are they
going to cut next?”
From Page 5B
Danyel Tharakan/Daily
Audience members wear red in support of University hospital nurses in their ongoing labor dispute at the Regents’ Meeting at
the University golf course Thursday.
“It started out with taking away
graham crackers. Now it’s meal
tickets and bereavement trays.
What are they going to cut next?”