Roy Exum: Erlanger Woes Worsen

Sunday, June 14, 2020 - by Roy Exum
Roy Exum
Roy Exum

Several weeks ago, according to any number of reputable sources, three of Erlanger Hospital’s very talented Registered Nurses, all long-term members of the legendary West Wing 8 ‘family,’ arrived at Chattanooga’s largest and only Level One hospital to take their shift. It was two weeks ago on a Saturday when, according to an eyewitness, “They came in to find a ridiculous ratio of seven and eight patients each. They never clocked in or accepted assignments and all just called out sick.”

It was not because they have been underpaid for years, endured the harassment of their equally harassed supervisor, or lack of support aides.

It was because they were collectively scared that they might kill a patient. Understand, these are three nursing professionals at the top of their game, who each feared their inattention due to absurd under-staffing may, and could, end in a patient’s death.

They were immediately confronted on Monday (June 1) by an indignant management that has allegedly scoffed at patient safety concerns, fearsome patient-nurses’ ratios, and unacceptable working conditions. After their reasons were made clear, the eyewitness said, “They were all three terminated on Monday by Erlanger’s Chief Nursing Officer Jan Keys and her assistant, Angie Basham. One had been here 20 years easily, the other two at least 11-12 years each. Their ages? Oh, I know one is 54 and the other two in their late 30s. They all had more seniority on the floor than anyone currently does.”

Many veteran nurses believe that never in their 10+ year history has the internal staff become as horribly compromised by gross and flagrant mismanagement. (See accompanying story, “Some Erlanger Nurses Considering Forming A Union,” on Chattanoogan.com)

On May 21, I wrote a well-reasoned story that Erlanger was in chaos. The response from the Erlanger Board of Trustees and other medical leaders was to heatedly reject what they labeled as an “attack,” instead of the stated fact it was meant as a warning. They labeled me as “a gossip columnist,” among other things, and the Board of Trustees gave CEO Will Jackson (who has been in his position for less than a year after a somewhat questionable hiring) a unanimous vote of approval.

Mind you, not a person disputed the facts included in the warning that was written, just that it was “professionally and personally disappointing,” according to Trustee Chair Linda Mines. “I abhor (an) attempt to sensationalize what we as a hospital are doing at a most critical time in our community’s history,” she added.

On Thursday of this week, at a surprising and hastily called “public meeting,” of which most of the Erlanger medical staff were unaware, the embattled Jackson was extended a two-year contract extension. There was no other reason for the impromptu meeting, other than the obvious: Erlanger’s fiscal year ends June 30 and, with what is yet to come, it is easy to imagine Jackson will need additional support from his detractors as the fiscal year-end numbers are expected to be disastrous.

On Friday, it was somewhat raggedly announced that Jackson had fired 11 of his top mid-managers, including the head of Children’s Hospital – Don Mueller – and others, some believed to have disagreed with the vindictive CEO in the wake of top doctors and an amazing number of nursing resignations. It is hardly any secret other doctors are planning to leave. It is said Parkridge Hospital carpenters are making way for an incoming group from Erlanger, and Memorial Hospital, after just announcing the arrival of nationally-renowned neurologist Tom Devlin and “superstar” Melanie Blake, has contracts pending with “quite a number” of current Erlanger-employed physicians and high-level staff.

Later on Friday, top Erlanger leaders and the Trustees received a formal announcement that some Erlanger nurses and certain other employees were in the legal process of seeking affiliation with “organized labor,” a very threatening slap-in-the-face in the South. This is after the corrupt UAW and other unions have been run back up North ‘on a rail’ in recent decades and no new union has been established anywhere in the Southeastern United States in years. As one nurse told me late Friday night. “In other words, even you don’t know how bad it really is.”

* * *

I RECEIVED THIS E-MAIL FROM AN ERLANGER NURSE ON MONDAY, JUNE 8

[NOTE: Certain parts of this e-mail have been redacted or removed) to protect the identity of the sender.]

“After walking to a far-off distant parking lot, after my long 12-hour shift. I have such an incredible view of Erlanger Hospital. Being employed here, I used to consider it one of my greatest achievements.

Not anymore.

I stare at the immense building and think of all the grandeur that brought me here as a young nurse, and I am heart-broken over how almost none of it was real.

I have been a nurse here for quite some time (date redacted). I have seen the highs and lows the nursing community goes through, and we always bounce back, but this has been one of the worst times I’ve experienced.

Roy, you have been on top of Erlanger’s news, and you’ve vocalized that many of the problems come from the CEO, however no one mentions the struggles the nurses are going through. I wonder what your readers’ opinions would be if they really knew what happened inside these walls. I’m hoping to bring light to it. I find it is worth risking my job to hopefully allow a change to happen, but I pray for my sake, you keep me anonymous.

It is no secret that we have lost nurses. The COVID pandemic created furloughs that had to happen; the hospital is a business and there has to be money coming in to spend money. It’s simple logic. However, the struggles of the nurses started before that.

It started when the nursing heads began taking away our privileges. Did you know, if we call out sick, we are forced to pick up another day? We do not get “sick” days. Now we don’t get PTO (personal time off) or our retirements matched. In 2019 the executives forced staff to have “mandatory overtime”, and this lasted for several months... then the hiring freeze happened... and the nursing executives demanded that the nursing managers/directors go back to bedside to fill in the gaps so we didn’t work short.

While that’s not completely unreasonable, I just find it unfair to ask a nurse who put in his/her 30+ years of bedside nursing, to go back to bedside. We lost many directors when this happened. Erlanger lost many experienced and passionate nurses when (former hospital CEO Kevin) Spiegel mandated a hiring freeze to make budget.

Out of this staffing shortage that Spiegel created, the nursing CNO came out with this “new” matrix called Team Nursing. How would your readers feel knowing their loved one is only one of 12-14 patients to a nurse? Sure, it’s 12-14 patients split between two nurses and one patient-care tech, but can you understand how little time is spent with each patient when both nurses are supposed to go room to room to do an assessment and pass meds? Not to mention, it is a lot of information to try to keep up with on each patient to help them recover and to keep them safe during their hospital stay.

I am an experienced nurse and I am good at handling a heavy patient load, but this is how mistakes are made, fatal cardiac rhythms and new neurological symptoms are missed; this is how patients die from a broken healthcare system. This matrix has been force-fed to all employees, and everyone has pushed back. The nursing leaders do not care.

When Dr. Jackson became CEO, he made it a habit to round on the units. He would ask about problems and ask how our day was. I never felt the need to be anything less than completely honest with him in regard to our nursing issues. However, the CNO (chief nursing officer) informed the nurses that we do not bother him with nursing issues, it doesn’t pertain to him, it’s not his problem. I honestly feel the nursing leaders have hid so much from Dr. Jackson and, unfortunately, he gets the blame for all the problems we have.

The nursing leaders threaten nurse directors and managers telling them that if they don’t participate in team nursing and make staff team nurse, the directors will be disciplined.

Erlanger lost many more nurses when we moved to this matrix. And more are still leaving.

Currently, the med-surg floors are running with 6-8 patients per nurse (12-16 per team) and almost no tech to help with vitals, baths, or keeping patients safe. ICU nurses have had as many as four patients to a nurse. These (critically ill) patients quite literally are hanging on for their life and require a lot of one on one attention, yet because of staffing shortages, they can’t get it.

The ER is back to being over-crowded now, too, and the nurses down there take as many as med-surg nurses are, and they even have ICU level patients on their workload too. Recently some nurses were fired because they refused to take eight patients. They didn’t want to risk the safety of these patients by taking this many, and so they walked out. They didn’t clock in. They didn’t get report. They didn’t abandon their patients. They just didn’t roll over and take the abuse from the nursing executives. And they were fired for it.

We continue to lose more nurses as we continue to take this many (additional) patients.

This nursing problem that the CNO states “isn’t Dr. Jackson’s problem,” needs to be known and addressed. We have tried to speak to her about our qualms and concerns, but she shuts us down and completely dismisses us. Additionally, during this extreme time of staffing shortage, you will not find the CNO or either of the two assistant CNOs taking patients. They’re holed up somewhere in their office, only coming out to micromanage staff and ensure we are team nursing.

Please, Roy. Look into what is happening here with the nurses. Look at how unsafe this is. We are killing ourselves trying to keep the patients alive. We came into nursing because we wanted to take care of people, now the only thing we can do is keep them alive. And sometimes, we can’t even do that.”

* * *

On Thursday, when CEO Jackson accepted his two-year contract extension, there was a curious, yet vague clause cited in in his new contract. It was reported by Chattanoogan.com: “Trustee John Germ said either side can get out of the contract with a 90-day notice. Mr. Germ said there is an expanded ‘disparagement’ clause. He said it prevents hospital staff from being critical of the CEO in written or verbal form.” (which would forbid emails like the one you just read.)

This clause, obviously pressed for inclusion in the contract by insecure Jackson himself, is in fact highly illegal under federal laws, the First Amendment of “free speech” and more current whistle-blower protections the first federal prosecutors will note. What is unfortunate is that such folly immediately attracts federal oversight because Erlanger is a public hospital that receives federal funding. As such, it is expected to become such a blatant red flag it will attract both the Office of Inspector General for the United States Department of Health and Human Services, and – because it violates the Constitution – the U.S. Department of Justice.

Hospitals around the country are experiencing a rash of OIG investigations over complaints of fraud in connection with the coronavirus. This is not meant to include nor hint Erlanger is involved in such, but there are genuine concerns among Erlanger nurses that there have been instances of mistreatment of employees in a hostile environment, a lack of patient safety and well-being in a government-funded public facility, and other arguable offenses. Which brings us to another email:

* * *

I RECEIVED THIS E-MAIL FROM A ‘REPRESENTATIVE’ OF AN ERLANGER NURSE ON FRIDAY, JUNE 5

Mr. Exum … I read your article about Erlanger and I have some inside information you might be interested in. Did you know that since the start of this pandemic, Erlanger has stopped all matching of hourly employee 401k, they have also halted all vacation earning, and that hourly employees are no longer earning any vacation time?

On top of this they are making hourly employees clock out for their lunch but are not allowing them to take the lunch claiming … they are short staffed and therefore they can't have employees taking lunch. One supervisor had a nurse work until 10 p.m. and went back and clocked her out himself at 7 p.m., telling her they couldn't afford overtime right now.

Also, Erlanger has laid off countless hourly employees while hiring and giving raises to management, such as the new CSL at Erlanger North, and the former CSL is being promoted and given a nice raise to boot.

I do not work at Erlanger, but I have a relative who has been there for over 25 years, this person will speak to you but only with complete anonymity out of fear of job loss or repercussions.

The last thing is this, they told employees that it was doubtful that the 401k match would resume, and that there was no money in the budget for any form of hazard pay during this pandemic.

* * *

P.S.: SO, WHY AM I SO INVOLVED IN THIS?

I have struggled more times than you would think about “sticking my nose where it doesn’t belong” into what I perceive as the worst avalanche to befall “my Erlanger” that I can ever remember. For a number of years, I have championed the little guys in many a fight. When I was a little kid I can remember going into my grandfather’s study as he pored over Erlanger’s problems in the 38 years he labored as the hospital’s chairman of its Trustees. Many a Sunday afternoon I was instilled with lessons that our family must forever view our largest hospital as our city’s greatest asset. It remains as the only source of health care for the indigent.

When I got word that John McCravey had parted ways with Erlanger, it broke my heart. His new allegiance, Tennessee Oncology, still maintains an office in the hospital and John still heals people there, but there is something more; the neurosurgery building on the Erlanger campus is named “The McCravey Building” after John’s father, “Doctor Gus” McCravey, who instilled a love for medicine and the hospital into John as my grandfather did in me.

I believe Will Jackson has hurt more people in the last nine months than any other person that I’ve ever known and John McCravey, his healing brilliance renowned, is among Jackson’s very worst victims. When anyone can hurt John McCravey, Larry Schlabach, Tom Devlin, Melanie Blake, do not dare try to tell me the Board of Trustees then unanimously endorsed their confidence in Will Jackson because that is an out and out lie.

You see, I know and love many of the MDs who demeaned my initial story and, while they may not have appreciated my choice of words, perhaps, I know that Phil Burns – just honored as one of America’s greatest surgeons for his honor to medicine and mankind - is dying inside while watching this fiasco.

Chris Young, the great anesthesiologist, has pulled me repeatedly out of one horrible pain episode to the next for 50 years, coming often before he was ever called. I know the doctor that he truly is, and the man he truly is. He knows my unfading love for him. A unanimous vote? Poppycock.

Jay Sizemore? Far and away among the best infectious disease specialists in the nation, I met him when he has playing baseball for Baylor, neither of us knowing back then he would literally save my life, time and time again in our 30-plus years of misery together. His loyalty rides with McCravey, Blake and – more to today’s point -- the countless nurses on whom he has relied for almost his every ‘save,’ a baseball term that fits him so perfectly as a new legion of COVID survivors will gladly testify.

I have never heard of current Chief of Staff Jim Bolton, nor recall his name in any medical conversation I have ever heard. While I am told he is an expert on me … again, I’ve never heard of him, this in keeping my life’s pledge that Minnie Mouse, yelping chihuahuas, and little people fail to draw my attention.

I am told octogenarian John Germ championed Jackson’s unwarranted contract extension, yet John has been a warm family friend for years. I happen to know what he did creating our Blood Assurance, once served on the Orange Grove board with him, and I appreciate him, although it does appear, he needs more fiber in his diet.

So, yes, with me this is personal. We must protect Erlanger from opportunistic interlopers and forever enhance our greatest asset. When I find our nurses are being abused to the raucous point they feel the only chance to survive is to unionize, the Board of Trustees must replace its talkers with its doers and regain control of the hospital.

Mind you, the hospital’s Board of Trustees do not answer to the hospital’s executive suite. Instead they represent the “owners” of Erlanger, i.e. the citizens of Hamilton County. As a citizen, I represent many who insist the board ‘Clean up this debacle.’ There is no doubt severe and urgent surgery is needed and leadership must be restored.

Otherwise, I’m just getting started.

royexum@aol.com

 


















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