Roy Exum: Children's? Oh My God

  • Tuesday, June 16, 2020
  • Roy Exum
Roy Exum
Roy Exum

It came as a shock to the area’s medical community Friday when Erlanger Hospital’s beleaguered CEO Will Jackson and its Board of Trustees “laid off” the chief executive officer of Children’s Hospital, a position heretofore that was deemed “untouchable.” There was a very sound reason for that; opened in 1929, it was to be its own entity, a “protected” shrine where the mother ship or “outside budgets” could not raid its resources, this to enable its children “the best of everything.”

Time and time again over the last century, “The Best Little Children’s Hospital in America” has been honored as one of the truly best in the nation. Children’s is the only certified Comprehensive Regional Pediatric Center, the highest designation in the state for pediatrics. It's a level of care for children often found only in cities more than twice the size of Chattanooga.

Easier to understand: Children’s Hospital is the only accredited and federally recognized hospital for those 17 years and younger within a 100-mile radius or, in the center of 34,500 square miles. You can well imagine how many children that includes. Further, Children’s Hospital is the top referring hospital of world-famed St. Jude Children’s Hospital and, through a wonderful partnership, is the No. 1 outside provider of St. Jude’s mission in treating childhood catastrophic diseases, this in addition to serving as a full-service resource to hundreds of thousands of our little children… easily over 50,000 cases a year.

So why it is beyond all imagination that in just the nine months since Will Jackson levied himself into the CEO’s chair of Erlanger, has Children’s Hospital taken the brunt of a shameful folly. Quite frankly, it is being decimated so that it will soon be destroyed. For instance, since Will Jackson was named last September, here is what has happened at Children’s Hospital …

* -- CEO Don Mueller, regarded as one of the top medical administrators in the Southeast, has just been deemed “non-essential.” And, yes, you betcha’ the Erlanger Board of Trustees knows about it.

* -- The chief financial officer has been removed.

* -- The director of Out-patient Services has been removed.

* -- The Patient Safety coordinator has been removed.

* -- Multiple managers have been removed and not replaced.

* -- Pediatric surgery, pediatric outpatient surgery, and recovery have been placed under Erlanger’s director of Surgical Surgery, who freely admits his staff knows nothing about pediatric surgery.

* -- Children’s Emergency Room services have been placed under Erlanger’s Emergency Services director who has had no training in much-different pediatric emergency medicine and its specialized science.

* -- Children’s Pediatric ER nurses are now being pulled to adult emergency rooms, this with little or no training --or experience -- in adult medicine. Gives you a fuzzy feeling, huh?)

* -- Children’s Hospital lost an entire acute-care floor to adult trauma.

* -- Children’s NICU nurses are constantly being ordered to Erlanger units due to Erlanger’s inability to retain nurses. “We are told there are now over 50 NICU openings at Erlanger … and when our 'borrowed' nurses come back, they have livid stories that illustrate why the Erlanger turn-over has gotten so bad,” said one Children’s manager.

* -- Children’s current chief nursing officer also has “a day job” as Erlanger’s director of Women’s and Children’s Services at Erlanger East and the downtown campus. (Wonder what that time card looks like?)

* * *

“The loss of our NICU physicians and practitioners was a tragedy that is beyond comprehension,” some nurses conveyed to me. “Our littlest patients deserved better. Our NICU doctors had been there for years and had great working relationships with our top-notch medical staff. Also, when that group’s contract was not renewed, some of our most experienced nurses left for greener pastures. Our NICU has still not recovered.”

And those left at Children’s mourn. “We, too, are Erlanger employees. At one time it was one of the greatest little children’s hospitals in the country. We had everything we needed to be the very best. As the Erlanger budget has gotten tighter, Children’s Hospital has been morphed into just another service line of Erlanger,” one said. “Management has made us feel like an afterthought.”

There is a trembling of sorts in their voices. “Our facilities are over 50 years old. We have had makeovers, but the infrastructure is failing. We have had sewage leaks, burst pipes, and water damage. The rooms are cramped and crowded. Nurses move more furniture than bellhops. Cleanliness is certainly a concern because housekeeping staff is bare bones. “Our nurses mop, sweep, clean beds, and empty garbage routinely, along with taking care of patients and families, giving medication on time, hourly rounds, assessing pain, checking IV’s, giving baths, performing linen changes, and documenting everything in a timely manner.”

In other words, this is business as usual, in this the unusual. The dedicated Children’s staff has fiercely fought to serve children but sense the Erlanger commitment is steeply wavering. Is this the death knell?

What’s Will Jackson going to do when 90 years of generations finds out it’s his breath, in just nine months, that is blowing out the candle?

* * *

I can remember once, maybe 30 years ago, when my lifelong confederate, Judy Bellenfant, called me frantically during dinner one night to say there was a little girl in Bradley County who was going to die if she didn’t get to St. Jude in Memphis within hours. “Can you find us a plane?”

The child was then at Children’s and they were in constant contact with Memphis. My mind goes hazy here, trying to remember, but I do know that within 30 minutes I called Judy back. “Rush her, her mom and dad to Hangar One, and see if you can borrow a nurse and oxygen and whatever the nurse might need… listen, Judy, the last three tail numbers are ‘XXX.’ The prop will be already turning on the side opposite the plane’s steps. The runway gates will be open, and you drive right to the plane’s stairs but avoid the right side of the plane. We’re cleared the minute you get here and by then I’ll come off the plane to get her loaded …”

“Okay, okay … “said excited Judy. “But … there’s one more thing …”

“C’mon, Judy! We ain’t got time for ‘one more thing.’! The Jude team is already gathering to meet the plane!”

“I’ve got to ask … Can I come, too?”

“Hey, idiot head. I thought this was your idea. You’re still in charge … now c’mon!”

Jeez, its been years since we flew through a storm to get that precious child there but somewhere down the line, in the many years that have followed, I learned our miracle child and her husband had another baby. Incidentally, wait ‘til God in heaven gets His hands around Judy after all she’d done in her life for others. Whew!

* * *

And so, now the deal is to tear down what 90 years of love and trust and countless philanthropy dollars have meant to over 50,000 children and far more particularly their moms and dads every year. Is that right? Are the telling signs true? Adults have a choice in hospitals. Children have only one. And this community is gonna’ sigh, roll over, and shrug?

“We just felt like the community who have been so gracious and generous in supporting our little hospital need to know that we are in trouble. We are being sucked into the mother ship. We no longer have an identity. The care we give our kids is beyond reproach. It is something we will always be proud of, but the conditions are difficult, and the fact of the matter is we need the region’s support to become better than ever.

“We have tried to report our concerns for years, but they have fallen on deaf ears.

“Maybe,” Mr. Exum, “Maybe … you can help.”

royexum@aol.com

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