Monday, March 1, 2010
Recently I was involved in the transfer of a patient to another hospital. Due to his illness it was a very time sensitive situation. Within 2 hours of getting the call that this needed to happen, I had it all arranged. The legalities of transferring a patient from our facility was met (open bed at the right level of care, and an accepting physician able to take care of him), the consents were signed, the helicopter was being called for. And then I got a phone call asking me to tell the family about their insurance. In this economy, I had a hard time justifying not telling them. It wasn't that the hospital was turning them down, they just wanted them notified. So I did. For better or worse, I did. The family then chose to go back home instead of using the hospital that I had arranged for. Now I want to say here and now, they had been in touch with their home hospital, and that the wife and daughter were both nurses. We made sure they understood that this delay could endanger the patients life. And they accepted and signed the waiver. I then arranged another transfer to the neighboring state and the patient lifted off within the hour.
And then it happened. I was told by another nurse and someone that I admire that if anything happened to the patient during transport, the responsibility rested directly on my shoulders. I never should have told the family about what the hospital said to me. I was devastated. And to an extent, I still am. I have been having nightmares, anxiety, tears and fears about work since the incident. I am making it into work, but my style of dealing with people and my interactions with my co-workers have changed. I am quiet instead of outgoing, hesitant instead of walking point, I let others tell me what to do instead of taking charge. In short, I don't know if I can really do my job well anymore.
As of last report, the patient had to be transferred to another hospital for open heart surgery. Not something that I could have foreseen. But I play the "what if" game with myself. Would his outcome had been any different if I had kept my mouth shut? And what would have happened when the hospital asked for their deposit and let the family know that I was told and didn't pass the message along, would I have been blamed for that too?
Since the intense discussion of healthcare reform here in the United States, I have been one who has advocated for personal responsibility in one's own healthcare. Don't live an unhealthy lifestyle and expect Doctors and Hospitals to fix you up so that you could go out to do it again. As nurses we can only do so much. As soon as a patient or family member tells me "No" about a plan or refuses to take their medication because they won't afford it (think Wal-Mart $4.00 prescription program, we use that A LOT to help our patients stay healthy, so please don't blast me about the impossibly high drug costs...I know that already.) but can afford artificial nails, cigarettes, alcohol, or drugs, there is nothing I can do anymore.
I have no answers. But I have plenty of questions, concerns, worries, and fears. Time and possibly a lawsuit, will tell me if I did the best I could.