Latest posts by Joan Shields, RN (see all)
- Women in Agriculture - July 3, 2017
- The Battle at Standing Rock: Stop the Dakota Access Pipeline - August 28, 2016
- I Used To Be An Angel - October 25, 2015
Florence Nightingale was a British nurse who helped soldiers during the Crimean War. She was often referred to as the, “Angel of Mercy.” Quietly tending the sick & injured, not seeking anything more than to help people during a scary & vulnerable life moment. Over the years the term became synonymous with nurses.
For me, I wanted to be a nurse since I bandaged my dolls as a little girl. And I succeeded, passing the NY State Board of Nursing two-day test on my first try. I became a Registered Nurse & I was good at it. Really good at it. Not saying so in a cocky way. I could connect humor in caring for my patients with compassion. I was able to explain the course of care for people. I loved the job with all its flaws… until I didn’t.
The health insurance companies along with the AMA enacted Diagnostic Related Groups (DRG’s). The idea was to limit the coverage of a patient’s hospital stay to a designated time frame i.e.; A woman scheduled for a hysterectomy would be assigned 3 days of hospital time. Before DRG’s, the average stay would be 7-10 days. I was a surgical post-op nurse that had a set number of eight people who I cared for. These eight patients would be in all stages of post-op needs. Some were being setup for discharge, others were “fresh post-ops” 24hrs or less since surgery. DRG’s meant all patients were in critical need being new post-op patients. It was at this time that hospital’s began cutting the number of RN’s per unit. The workload doubled, the number of complications increased & policies would be broken, all the time. MRSA is not a new diagnosis. It’s been around for some time. And when a busy NYC Trauma Center breaks its own policy of isolating an MRSA patient , in an effort to gain another bed spot, another patient, just for the money, you know things will go down bad . Health and safety are only concern when someone finds out it is not being maintained. For example: A nurse caring for a person who was on a respirator was never to care for more than one respirator patient with no more than three patients, total, for each shift. Fewer nurses meant more patients per nurse. One evening,I was caring for 16 patients and three of them were intubated, which means there is a tube to bring breathing to the lungs via a respirator.
As time progressed and lawsuits became the norm in American culture, malpractice insurance rates skyrocketed. (insurance, ugh!) Legal fees & insurance rates in healthcare settings went up so high that many facilities were forced to shut their doors. I was losing my confidence & feared making a mistake with a patient. I was risking my license, my job which I cherished.
I took a shot at public school nursing & worked for three yrs as an RN in the public school system in NY. Taking a drastic cut in pay, I found the incompetence of the educational system too much to tolerate. I resented the pay for such an important job. As childhood diagnoses were increasing so were the medications. I took care of numerous Type ll Diabetic children requiring blood glucose monitoring & insulin injections. Pediatricians were prescribing Ritalin at record numbers. I administered antidepressants, like Buspar, for an eight year old and Zoloft for 11 and 12 year olds, tube feeding for the children whose budget cuts had them now mainstreamed in the public schools of NY. I had a large problem with pediatricians during a chicken pox outbreak not once but two years-in-a-row. The children I called them about had chicken pox in spite of having been vaccinated. The MD’s wouldn’t want me to tell the parents it was chicken pox. I was to tell them “it’s a rash that we’ll treat with Benadryl & Calamine Lotion.” I was administering a prescription of liquid Benadryl to children! They were falling asleep & once one fell (passed out sleeping)
Later, I switched & worked the opposite end of the spectrum working in Nursing Homes in NYC. I became a Geriatric Care Manager, administering seniors, with triple dosing of medications that were prescribed in an effort to receive extra Medicaid and Medicare money. It was here that I learned of the corruption of healthcare facilities. The feared Joint Commission and State Evaluators would enter and the facility would put up a front for the inspections. Staffing would be increased to its highest level. Housekeeping departments would put a shine on the facility never seen before. If an elderly resident were to have a problem they would be removed from earshot of the inspectors. It was a charade and it was wrong. I learned that for the right money, a failing, dirty nursing home with an unusually high number of patients with bedsores and infections (signs often associated with neglect and poor care). I saw nursing homes that were darkly lit with large spaces of no staff, wreaking of urine, with patients crying in pain…these would be able to pass the state inspection. I’ve witnessed lies, broken policies, real negligence in all areas of healthcare. Social workers refusing to speak with AIDS patients, medication error cover-ups, untrue documentation causing liability. I’ve witnessed IV drug addicts who worked as anesthesiologists, drunk RN’s (drinking in the hospital occurs in any dept). I’ve see the mishandling of medical waste & the overlooking of MD mistakes. Social workers helping some people by breaking the rules with health coverage as well as those being cheated on heir medicare costing the entire healthcare system billions. I followed the chain-of-command reporting to the next in line only to be told to basically shut up. I wanted to be a nurse but I couldn’t under these circumstances. It was too hard & I couldn’t give the care my patients needed.
I left the US healthcare system when I got sick. I had leukemia & long story short, the oncologists that were caring for me stopped accepting my insurance in the middle of treatment. (insurance again!) Try finding an MD that would accept me as a patient while having a “preexisting” condition. It cost us $12,000/month. There is a positive side to all of this. I learned more about the body & it’s relationship to the food we eat. Before if someone had heart disease I would know the meds & their side effects. Now, I know how to heal in a safer way that is lasting and without side effects. Ive perfected my gardening skills & have begun teaching others how to grow their own food. I’ll always be a nurse, I just have a new approach. I resent having to leave my job as an angel. I loved the excitement of helping another feel at ease while in the intimidating hospital setting. I suppose we can all be angels of mercy… Just in a different way.