One Nurse’s Case for Safer Nurse-Patient Ratios

One Nurse’s Case for Safer Nurse-Patient Ratios

Walking into the nursing home at the Coatesville VA Medical Center, the sun was coming out from behind soft, white clouds. A large flock of Canadian geese rested on the dew-covered grounds near the nursing home.

Joe, the night nurse, had nothing new on morning report as both shifts exchanged information about the residents. No new illnesses, no high temperatures, or behavior changes.

Lights flashed at the nurses’ station—call bells, veterans waiting for someone to answer their request for help. I talked to several veterans to see what their needs were and walked into their rooms as they ate breakfast.

It is Mother’s Day Weekend, 2010, and there is not enough nursing staff on duty to assist and meet the needs of this busy dementia unit. Speaking to Mary, the RN in charge, she called our coordinator. He stated that there was no extra help or staff, and overtime money was not to be used per administration.

Pouring the medication for Team Two’s cart, I felt hurried and pressured by other staff needing assistance with dressing and serving residents their breakfast. Many trays were still left, as night shift could not get all their work completed due to their staff shortage.

My career and profession changed forever on May 9, 2010, when another LPN requested my assistance to transfer an obese veteran to his geri chair via a Hoyer Lift. I pushed him on the Hoyer Lift, but he was too heavy for us to transfer, and everyone else was busy or not around the floor.

By afternoon, Mary had added my name to the report form. She filled out an injury form and asked if I wanted to go to employee health. With pain going from my buttocks down my right leg, I thought rest would solve the problem and my shift was over. By midnight, I had placed a call to my primary doctor who worked for Ingleside Medical Associates. The on-call physician instructed me to ice the area and call first thing in the morning for an appointment.

Instead of waiting, my husband Chuck drove me to Chester County ER. I was worried and in a lot of pain. The ER doctor informed me from working with a Hoyer Lift the diagnosis was likely a herniated disc—he was sure as I was working as a nurse. He ordered the ER nurse to give me an injection of Demerol and assist Chuck to get my limp body in the car. Soon home in bed, I slept 7 hours.

The most dangerous profession for work injuries, nursing reported over 35,000 injuries to the Department of Labor in 2015. This is more injuries than construction workers or policemen. Nurses, the heart and soul of health care, and a disposable workforce.

I called NAGE, my union, and left a voicemail since it was the weekend. Every day, unions speak to hospital administrators on safety issues, unsafe working conditions from nursing storages, and old outdated equipment, but money rules the day. It is easier to pay Workers’ Comp than teach staff safety and install ceiling lifts. Later, I learned through my union that the Hoyer Lift was not to be on the floor, and immediately after my injury, ceiling lifts were in fact installed.

That week, Ingleside Medical Associates ordered PT, X-rays, and pain medication, but my doctor noted reflexes, not a serious injury, to the Department of Labor. After speaking to my insurance carrier, lying in a cylinder machine with headphones on listening to Tom Petty, the MRI confirmed a herniated disc, with nerve impingement. My ER physician’s diagnosis was 100% correct. He also informed me that many studies show health care workers are injured from Hoyer Lifts and disabled the rest of their careers.

Later in January 2011, I agreed to my first back surgery, as I could not sleep or bear the daily pain and involuntary spasms from my work injury. Doctor Aksu made a small incision at the base of my spine and the area was covered with a Band-Aid.

My sisters Gail and Holly, their husbands Tom and Bob, and my husband Chuck waited in the surgical waiting room for many hours. Eventually, my doctor requested that they go home as he was sure I would sleep overnight at Brandywine Hospital. I surprised him and the staff and awoke quickly after returning to my room from the OR.

Pressing my nurse call bell, she came into my room to take down my side rails since pressure made me have to void quickly from all the IV fluids given during my surgery. I surprised the staff as I put on my jeans and asked for Chuck because I wanted to go home. PT gave the OK after they observed me walking the hall and taking several steps up and down in front of them. Determined as supper was served, Chuck picked me up and I went home to bed!

Many weeks passed and many PT sessions completed, but the involuntary spasms would not cease in my right leg and foot. I returned to VA no longer in the role of nurse but as technician—making beds, serving snacks, and taking urine samples over to the lab across the street. Twenty years of service, and no flowers or cards were sent to my home address from administration.

I went through the stages of grief. First, denial—my nursing career would come back. Then, a lot of anger. I often cried at home and yelled at Chuck for no reason. Life became different. My appearance on the floor caused resentment for a male NA, as he stated I made the foot staff short.

Time went by, not knowing what to expect. I hired an attorney for Workers’ Comp as the VA never offered forms or explained any of this complicated system during my long rehab. I called NAGE since I was not having anything placed into my account from VA or the Department of Labor. I was payless!

The last position offered was in their call center. I accepted, though my involuntary spasms increased with long periods of inactivity. My restrictions sent by my surgeon were not carried out.

Calls were nonstop from veterans needing appointments, drug refills, the Veteran Advocate, etc. The call center staff was assigned to any department by need. Some days, the call center was myself and one other coworker. My spasms worsened, so I hired a neurologist for his opinion. He started me on Klonopin.

Awake at 3 a.m. with right leg spasms, my leg arched in excruciating pain and twisted. Chuck would run over to our dresser to give me a Klonopin pill hoping it would calm down my pain, and the spasms would cease.

Inflammation of nerves caused these unexpected events, and the call center was making my condition worse. I resigned from VA, never to have any workmans’ comp during my rehab or disability until I hired another attorney and went with my medical records before a judge for a hearing.

Life was different. No more hiking Hawk Mountain, no bending over to garden, as this was too strenuous at that time. But my favorite PT was a morning walk on a trail across from our Citadel Credit Union. A small stream often carried newly hatched fuzzy baby ducks. Spring is a favorite season of mine with baby ducks, fawns, and geese.

Before Spring 2015, I was ill and slumping as I walked and I was very tired. Dr. Aksu stated I needed a spinal fusion due to the deterioration of L5-S1, a recurrence of my work injury. After careful thought, I agreed and signed consent. One sunny morning in May 2015, Chuck drove me to Paoli Hospital.

Just the words spinal fusion sent chills down my spine!

On May 13th, everything was in order and I went for the spinal fusion. I was greeted by two nurses who instructed me to wash my body with warmed germ wipes, get into a gown and then the ER-type bed. Soon they hooked me to IV fluids and took my blood. Hours passed. Chuck took a walk.

Dr. Aksu said hello and I was off to the OR. I said a prayer, and the OR nurses introduced themselves, making me more comfortable. I had full confidence in Dr. Aksu. We have known him from years before when he operated on Chuck’s mom, Anne.

I awoke in a spacious bedroom and bath. Chuck gave me a goodbye kiss and my friend Peggy took off to drive home. Traffic was already thick.

I did not sleep until after midnight. The nurse came in, took vital signs, and gave me all medications as ordered. She also helped me order an open-faced turkey sandwich before the kitchen closed.

I rang the bell a lot during my operation, but their technicians and nurses were first-rate. I wrote their nurse manager a thank you card for all the excellent care I had.

I requested ice bags all night since that helped with the pain. Then breakfast came, oatmeal and coffee. Just as I started adjusting in bed, Mr. Perry came to check my incision, change the dressing, and discharge me.

I was delighted to leave and showered quickly. Chuck picked me up after lunch. I would have never imagined being disabled at 55, yet it happened.

Congress needs to pass across-the-board safety laws for health care workers, and the VA needs to pay money to their injured workforce. I used my annual leave and sick leave for my surgeries, which were never reclaimed because the VA had so many roadblocks.

If you aspire to be a nurse, be sure to get yourself a good disability plan and pay your premiums, as one fine day you may need that money. I loved serving veterans, but my treatment after the Hoyer Lift injury was awful. From one seasoned nurse to another, I urge you to research your potential employers before accepting a job.