Wednesday, October 3, 2018 // The Statement
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Wednesday, October 3, 2018 // The Statement 
 
5B

Nurses describe cuts to patient care at Michigan Medicine

M

egan Duncan, a cardi-
ology nurse at the Uni-
versity of Michigan 

Hospital, began filing reports with 
her superiors detailing concerns 
with the hospital’s new remote 
heartbeat monitoring program in 
Summer 2017. She was met with 
little-to-no response from the 
Michigan Medicine administra-
tion.

Beginning in July 2017, Michi-

gan Medicine moved almost all 
cardiology 
patients 
— 
outside 

of the intensive care unit — to a 
remote heart rate monitoring sys-
tem, referred to as remote telem-
etry, that largely replaced licensed 
nurses with technicians. Before 
then, almost all hospital patients 
with heart monitors had their 
heart rates monitored by live nurs-
es; outside of eight patients linked 
to a limited remote screening pro-

gram moni-
tored by a single nurse.

As soon as Michigan Medicine 

began using remote telemetry was 
rolled out in scale, Duncan and 
other nurses in her unit began 
experiencing issues with the tech-
nicians.

“Sometimes I found 

myself having to edu-
cate (the technicians) 
when 
they 
didn’t 

report an incident in 
time or didn’t report 
it at all,” Duncan said. 
“We 
noticed 
lags. 

Sometimes 
a 
heart 

rhythm would change 
and they would never 
call or call much later. 
Often, 
they 
didn’t 

know what it was, 
which was alarming. They’re sup-
posed to be trained.”

Duncan 

explained 
technicians 
are stationed 
in the base-
ment of their 
respective 
unit to watch 
the 
heart 

monitors and 
report 
back 

to the nurses 
when chang-
es occur; she 
added 
there 

were no sen-
tinel 
events 

in her unit, 
but there was 
still concern 
about 
harm 

coming to the 

patients.

Technicians within the remote 

telemetry unit typically monitor 40 
patients at a time and are allowed 
to monitor up to 64 patients, 
according to Duncan, a stark con-
trast to the personalized attention 
nurses could offer patients when 

they were only able to see three at 
a time. Before the hospital began 
employing the technicians, only 
eight of the unit’s patients were 
monitored remotely by a single 
nurse in the cardiology unit base-
ment for the cardiology unit, while 
all the other patients with heart 
monitors had in-person monitor-
ing by nurses.

While the technicians work 

in 
the 
basement, 
technicians 

and nurses within the hospital 
do not interact personally. Dun-
can explained the only contact 
the nurses within her unit had 
with the technicians was over the 
phone. The lack of contact within 
the cardiology unit resulted in 
hostility between the two groups.

“I think the technicians thought 

we didn’t trust them after we 
started filing incident reports,” 
Duncan said.

Many nurses such as Duncan 

believe the hospital’s implemen-
tation of remote telemetry with 
technicians reflects a devaluation 
of nurses under a management cul-
ture at Michigan Medicine that has 
become increasingly profit-driven 
at the expense of staff and patients. 

Ian Robinson, the president of the 
Huron Valley Area Labor Federa-
tion — who was involved in the 
recent nurses’ strike — said he 
has seen a drastic shift at Michi-
gan Medicine toward a corporate 
mindset.

“It’s a new model that is taking 

place at the University,” Robinson 
said. “It is a model that has moved 
from focusing on the interests of 
the public to profit.”

In an email statement, Michigan 

Medicine senior communications 
representative 
Beata 
Mostafavi 

said the hospital’s new remote 
telemetry practices were intended 
to improve patient care by enabling 
immediate, continuous monitoring 
and by facilitating greater collabo-
ration across hospital staff.

“Remote 
telemetry 
provides 

real-time monitoring of patients 
who are at risk for cardiac events, 
significantly improving the ability 

to observe and monitor hospital-
ized patients’ hearts around-the-
clock,” Mostafavi wrote. “A skilled, 
highly trained team of registered 
nurses, cardiac technicians and 
other Michigan Medicine staff 
monitor patients in every unit that 
has cardiac monitoring. These 
teams 
collaborate 
to 
interpret 

patient cardiac rhythms and iden-
tify patients who require clinical 
attention, which helps improve 
patient care and outcomes.”

Despite 
Michigan 
Medicine’s 

claims, Duncan fears the practice 
has actually created a barrier for 
communication at the hospital and 
the lapses of communication that 
seem to accompany the practice 
could negatively impact patients’ 
health.

“Overall, we feel that remote 

telemetry is a barrier to interdis-
ciplinary 
communication, 
and 

can result in delay of care; both of 

which can result in negative out-
comes for the patients and family,” 
Duncan wrote.

Though the University invested 

a significant amount of money in 
the change — it remodeled a level 

of the basement and purchased 
new monitors — Duncan believes 
this was part of a long-term strat-
egy by Michigan Medicine to cut 
costs by reducing the number of 
nurses needed, at the expense of 
patient care.

“Remote telemetry isn’t a cut-

back issue,” she said. “They spent a 
significant amount of money on it, 
but in the long run it’s speculated 
they invested in remote telemetry 
in order to possibly down-staff 
nursing in the future. If they don’t 
need a nurse to monitor a patient’s 
heart and a technician can monitor 
more hearts at once then they can 
staff less nurses.”
W

hile staffing has been 
a key issue in the 100 
days of bargaining-

leading to the University of Michi-
gan Professional Nurse Council’s 
tentative contract agreement with 
Michigan Medicine, nurses also 

cite 
cutbacks 
Michigan 
Medi-

cine has made in other aspects of 
patient care.

Allison Carroll, a nurse in the 

pediatric hematology and oncology 
unit at C.S. Mott Children’s Hospi-

tal, said budget 
cuts inhibit her 
role as a care-
giver 
to 
her 

patients.

“As 
nurses, 

we feel deval-
ued,” 
Carroll 

said. “We real-
ly aren’t asking 
for 
anything 

we didn’t have 
before.”

Carroll 

explained 
the 

hospital 
used 

to keep graham 
crackers on her 
floor for dia-
betic 
patients 

or 
patients 

undergoing 
chemotherapy 
who struggle to find their appetite, 
but the budget cuts have eliminat-

ed important amenities 
like this.

“We can order them 

through food services 
but it can take up to 
an hour, and by then 
the patient undergoing 
chemotherapy 
might 

have lost their appe-
tite,” Carroll said. “It 
sounds insignificant but 
patients in the oncology 

unit struggle to keep down food.”

Similarly, Lynn Detloff, a nurse 

within 
the 
Brandon 
Newborn 

Intensive Care unit at Mott Chil-
dren’s Hospital, said Michigan 
Medicine’s cutbacks on programs 

designed to support nurses in pro-
viding personal care to patients 
have negatively impacted her role 
as a caregiver.

Detloff explained the hospi-

tal has significantly cut back on 
bereavement trays — trays of food 
that are brought to families follow-
ing the loss of a loved one. 

“If there was a death in our 

unit or any other unit, we would 
set them up for the family so they 
wouldn’t have to leave the bed-
side,” Detloff, the chair of the 
bereavement tray committee in her 
unit, said.

Until a cutback on bereave-

ment trays in May 2018, nurses 
could provide food to up to 15 fam-
ily members per patient. Bereave-
ment trays included anything from 
bagels, cereal, pastries, oatmeal or 
yogurt and juice for breakfast or 
an array of sandwiches and cook-
ies. Now, the nurses are limited to 
offering 8 trays with a limited menu 
of a blueberry muffin and orange 
juice for breakfast or a granola bar 
and a piece of fruit. Michigan Med-
icine did not respond to a question 
about how much these bereave-
ment trays cost, or how much was 
saved in cutting the choice of food.

“The bereavement trays are just 

one of the things we do in the hos-
pital to show empathy for families 
going through a difficult time,” 
Detloff said. “(Michigan Medicine) 
has a surplus of $103 million for the 
2018 budget. It seems heartless for 
them to cut back on bereavement 
trays when it is our job to care for 
families.”

Bereavement trays are not the 

only patient care item Michigan 
Medicine has dropped from their 
budget.
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.

File Photo/Daily 

The University of Michigan hospital.

“Sometimes a heart rhythm would 

change and they would never call or 

call much later. Often, they didn’t know 

what it was, which was alarming. 
They’re supposed to be trained.”

“As nurses, we feel devalued. We 
really aren’t asking for anything 

we didn’t have before.”

Emma Richter/Daily 

The University of Michigan hospital.

REMOTE TELEMETRY AND 

GRAHAM CRACKERS:

by Grace Kay, Daily Staff Reporter

See NURSES, Page 6B

