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?”

