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?”