Roy Exum
Several weeks ago, I was alerted to a series of mounting problems at Erlanger Hospital since Will Jackson, who had been the medical director at the hospital, seemingly had orchestrated a take-over from then hospital president Kevin Spiegel. Jackson, who in my opinion should have been booted from the campus, instead was named as Spiegel’s replacement by the hospital’s Board of Trustees in a rush that stank to high heavens, and has since decimated our region’s Level One trauma center to a degree I never suspected when my first article appeared.
Both the article and its writer were booed and guffawed by the Trustees and medical leaders, which was okay in today’s environment of shooting any messenger, but something was still very wrong, so I delved a bit deeper.
I uncovered a cesspool where three nurses were just fired rather than accept floor duty where they, and many other floor-service nurses genuinely fear a patient will die due to double the acceptable nurse-patient ratio.
Every patient in the hospital right now is endangered by woeful under-staffing, a sadistic oversight of hospital nurses that has led to a record flood of “nurse fright and flight,” an unparalleled number of resignations from the hospitals best and most respected doctors, the soon-demise of Chattanooga’s fabled Children’s Hospital, and now total chaos throughout the system. There is even the very real threat of a union by the abused nurses and, much larger, an administration who could care less, this accentuated by the yawning Board of Trustees.
Are you kidding me? The Hospital’s Board of Trustees, on the brink of year-end financials that are predicted to be the most damning in the hospital’s history, responded by giving CEO Jackson a unanimous “vote of approval” and extending his contract to a further two years.
As you may guess, I have received many dozens of emails about Erlanger’s blatant mistreatment of its nurses in recent weeks. For the record, I have received well over 100 in support of my revealing articles, and only one in opposition from a bullish Christian in Dr. Jackson’s church. The Christian castigated me for writing “terrible things” about Dr. Jackson, with no mention of the “terrible things” that have been proven Jackson has actually done. It all gets back to the sacrosanct “Kool-Aid” and, I must share, I have loved this Christian for 10 times as long as he and Jackson have ever shared a hymn book. Note it’s the Christian who does his own judging, not me.
Allow me to share a bouquet of the many emails that have arrived in the last week:
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OVER 200 ERLANGER LAYOFFS PREDICTED FOR FRIDAY
As we arrived at work today the rumor was already spreading that another 200 eliminations would occur this week (believed to be Friday). The rumor mill referenced this forthcoming group as non-clinical staff. For those of us within the clinical setting, we have no misconception that we take care of patients in a vacuum.
We must have support services in place to provide those things necessary for patient care. What happens when the clinical staff lose dependable non-clinical support? But we’ve lost so much else -- what is a few more layers of support at this point? And what of those career non-clinical workers being sacrificed at the expense of saving those C-Suite positions? Does the Board of Trustees or anyone else for that matter actually care? If rumor hold true, again 200 more jobs lost, while those same executives remain. Jan Keys. Britt Tabor. Gregg Gentry.
To paraphrase Dr. Jackson’s words from his ‘Message from the President/CEO’ emails: “Please stay after it.”
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“I WAS THERE, ON THAT VERY SAME FLOOR … “
Hi Roy,
I’m pretty sure you get thousands of letters regarding Erlanger. I’m just praying you take the time to read mine.
I sent something similar to this in a letter to the editor just over a week ago. It was never acknowledged.
I was there; on that very same floor where the nurses refused to work. On that 12-hour shift; I never saw a nurse, except a Np they pulled off education to help and who did not even know how to make my bed that had been soiled days prior.
There are so many things I could tell you about one of the worst nightmare experiences I’ve ever had. I’m a very positive person, but my experience drove me to making out my last will as a holographic will and to the point of finding and hiding a pair of scissors left in the room to commit suicide with. I even told a few about it and it got brushed aside.
When I finally got discharged; I sobbed all the way back to Murphy.
Someone thought I should get a lawyer.
One nurse even told me that now since there were no patient advocates, that they could do whatever they wanted.
If you ever want to expand on your story; please feel free to contact me.
And Oh! By the way, I am a practicing Nurse Practitioner.
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“100% TRUE AND TO A “T”
I have just read the article titled "Erlanger Woes Worsen." Do not let anyone tell you this piece is "gossip" or over exaggerated. It is 100% the truth and to a “T” how the culture is towards Erlanger's nurses. I am (among the majority nurses who have been at Erlanger with less than three years’ experience). But that is health care, that is nursing.
What is not health care is forcing a DANGEROUS "team nursing" matrix when EVERY SINGLE ONE of your nurses has pushed against it. They have told nurse managers if they do not enforce it, they will be terminated. The "team to team" report takes priority over splitting up high patient acuity. Management would rather us nurse as a team in the same hallway than make sure sick and critical patients are split up among nurse assignments to ensure quality care. However, that is not where I have the problem.
In my (early experience) of being a nurse I witnessed the most DISGUSTING and unethical behavior from my CNO, Jan Keys. During the beginning of the COVID pandemic, Erlanger went to a zero-visitor policy. That was to keep our patients safe, less exposure, and to keep us health care workers, safe. Apparently, a VIP patient was admitted for a procedure. A procedure he would be admitted for overnight and discharged in the morning.
We were called by the OR to inform us of the patient VIP status and that his wife was asking to visit. The answer was obviously no. I had held the hand of dying patients as they said their goodbye to their loved ones via facetime due to the no-visitor policy. No, she could not visit.
Jan Keys CNO, did not like that answer. She escorted this woman up to the unit, in plain clothes but made sure to have her badge on, as if to dare any of us to question why this woman was on our unit. I wanted to throw up. This was the beginning of a pandemic and my CNO was making a public statement that she did not care about my safety, my patients’ safety, or even hospital policy. Neither one was wearing a mask. Now, that COVID has subsided for now, every staff meeting, email, notification is about how we need to follow policy, or we will be disciplined.
Don't clock in early or you will be punished, team nurse or you will be punished, take 8 patients, or you will be punished. HOW DARE this woman hold up accountable to follow policy when she is incapable of doing the same thing? HOW DARE you tell me to team nurse when you break policy meant to keep us safe during a pandemic??
I have lost all respect and faith in my CNO. She should have been immediately terminated due to those actions; however, she is still there. Firing those who refuse to allow their license to be placed at risk and possibly killing someone due to an issue she created.
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HOW DO YOU DISCIPLINE A NURSE?
Since I have never heard of anything so preposterous, multiple RNs said it goes on all the time. “They make your life so miserable and then have the supervisors use that person as “an example” for everybody else on the floor to spread intimidation and fear. Anytime you see a nurse working only nights, always including weekends, with a huge patient load, every nurse knows what is going on. And if another nurse, who just clocked out, sticks around to help her for an hour or two, you can bet that ‘Samaritan’ will get a tongue lashing. The sickest part is that Keys, Basham, and Nelson really enjoy watching nurses who are being punished. That’s a big part of why there is record nursing turnover.”
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“THE BELITTLING AND UNCONCERN HAS GOT TO STOP”
I have been a pediatric nurse at “Children’s” Hospital for (many) years. Me and every coworker I know are so grateful to you for shedding light on our dying little children’s hospital. (Many of us) have spoken with board members, Jan Keys, and Dr Jackson about ALL the concerns you wrote about. It has gone to deaf ears. My heart breaks for children’s because we (the children’s nurses) no longer have a hospital. There are NUMEROUS things I and my coworkers would love to share with you. The belittling and unconcern has to stop as it is negatively affecting out precious pediatric population. I appreciate you keeping my name silent because of my fear of retribution.
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MANAGEMENT LACKS EXPERIENCE, COMMON SENSE
“After reading your articles about Erlanger I felt that it was a need for you to get the perspective from a medical assistant. We only have been given face masks every few days if that. Amongst not accruing any (personal time off) or 401k matching, we no longer have anybody screening patients to get into the hospital on the medical mall side.
I expect the numbers to increase even more which is a risk for us as employees and Erlanger doesn't care at all. We have only been allowed to work 37.5 hours a week. Getting sent home in the middle of clinics, leaving few staff to cover three and four clinics causing doctors to be upset. Not having any supervisor in the office at times when trouble arises. And even having our timed rolled back without our knowledge if we get over 37.5
We've had to see patients who come in with fevers. The rule now states that EVERY person who comes into the hospital is supposed to wear a mask. I heard of patients who have tested positive wait in the lobby of an office not wearing a mask or know that they are positive. Employees testing positive showing all the symptoms but coming in anyway risking others getting sick.
Management that has no experience, compassion, or even common sense when it comes to scheduling. Even when you are sick, they still expect you to come in, even with a doctor's note. I feel as though the hospital is more worried about making money than they are their employees. I don't blame anybody for wanting to quit and when I'm asked if we're hiring, I flat out tell people don't apply to Erlanger because it's just not worth it.
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AT ERLANGER-EAST IT’S JUST AS BAD
The Erlanger East campus faces the same dangerous conditions as Main. Unsafe ratios going up as high as 1:8 on the cardiac telemetry and medsurg floors, each shift there is only 1 charge nurse forced to be in charge of 58 total beds (the 6 bed ICU, the 23 bed cardiac telemetry unit, and the 29 bed medsurg unit) WHILE being required to take a minimum 1:6 ratio of their own- The nurses in the ICU have been forced to take a 1:3 ratio. Many shifts the units lack PCTs (or have no PCTs at all) leaving many total care, bedridden patients in unsafe situations. Keep in mind these patients have NO voice as family visitation is currently limited due to Covid-19.
Erlanger East also abuses their LPNs by requiring them to work outside of their scope of practice. They are required to take a full patient load of 6+ patients without the supervision of an RN. They perform what's called "admission assessment documentation", which the Board of Nursing requires an RN to complete, and they are required to take higher acuity patients requiring continuous cardiac monitoring and continuous infusions such as Heparin infusions (an anticoagulant considered a high risk drug), both of which require a higher level of education and training to safely perform. The bottom line is, LPNs are paid much less than RNs yet it is cheaper for Erlanger to utilize LPNs in an RN role - Risking the safety of both patients and the LPN.
Many of our strong PCTs, bedside nurses, and CSLs have left due to the unsafe work conditions. Martha Weeks our CEO is fully aware of the situation and has given us all the impression that she does not care about her staff and patient safety.
Our Paid Time Off (PTO) and sick time accruals were suspended by Dr. Jackson when Covid-19 hit, along with the suspension of employer match retirement contribution. The remaining staff members continue to work diligently for our patients and our community, yet administration continues to take and take and take - a constant slap in the face to their staff.
I hope more staff will continue to voice their concerns to you Mr. Exum - You ARE the only one who continues to advocate for us. Thank you.
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IT'S DIFFICULT TO WATCH THIS UNFOLD
Thank you, a hundred times, over for your excellent writing on the debacle at Erlanger. It is difficult to watch it unfold, but at least we have someone with the courage to speak about this issue. The TFP is noticeably silent.
The ouster of Mr. Spiegel was by the contrived manipulation of the new CEO, and now he is wrecking everything and breaking all the alliances that got him the job. The real target is not the CNO or her two underlings. She can only do what she is told to do by the CEO, both past and present, or she will be fired. The policy and the patient ratios emanate from a totally unrealistic budget process set forth by the administration. This is the fantasy world, created by the CFO. Not meeting budget is the bug-a-boo that leads to dangerous nurse patient ratios. It is a dishonest process that needs to be exposed as well.
In short there is a lot of existing monies hiding in the non-patient care areas of the Erlanger budget. It always has mystified me why a hospital -- and I mean most hospitals in the country -- so blatantly ignore the core business of the hospital in order to empire build. Just do your d--- job and take care of your core business, your patients. And, by the way, the hospital is dirty and poorly maintained.
Administration continues to take and take and take - a constant slap in the face to their staff.
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ERLANGER HIRING CONTRACTORS INSTEAD OF OWN MAINTENANCE WORKERS
Have you heard anything about the Maintenance Crew? They have cut the hours in half for those guys, they only get 42 hours every other week. So, guess what that means, nothing is getting taken care of that needs to be done on a daily, weekly basis. Gosh forbid you need light bulbs changed in your office cause guess what that is not of importance unless you want them to hire a contractor to come out and change them. Did you catch that? Yes instead of bringing back our full time Erlanger Maintenance men they are hiring contractors to come out instead.
Places like Erlanger North do not have either one of the maintenance guys at hand when we need them. We have 2 guys that are supposed to be full time here and both of them have been moved downtown. Will Jackson needs to do the right thing and bring back the fulltime staff ASAP!!!!
Yes, this has really made a lot of people very, very angry and something needs to be done ASAP!! I am so glad you have brought all of this to light for people that have no clue what actually goes on behind closed doors inside of Erlanger.
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ERLANGER’S NAME TURNS TO MUD IN MURPHY, N.C.
Your writings regarding CEO Will Jackson have been spot on regarding Mr. Jackson and the chaos and failure he has introduced and blamed on COVID. However, please look across state lines at Erlanger Western Carolina Hospital in Murphy, NC where Jackson just eliminated a very respected and successful leadership team under the guise of “restructuring “.
Physicians in this hospital have no confidence in Chattanooga leadership and are outraged. Staff morale has been low since Jackson took his seat. Now it is evident to the medical community that Erlanger does not care about Murphy. No one will speak out for fear of retaliation. Please, look into Murphy, NC where Mark Kimball and Matt Huff were eliminated at a critical time. It is hoped that someone of your stature and influence can shed some light on this situation.
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ONE NURSE ASKED, “WHO ARE YOU ANYWAY?”
Who am I? I'm a 71-year-old man whose heart bleeds as details of abuse and cruelty come in each email from Erlanger’s people. I was the sports editor of a Chattanooga newspaper for 36 years and have somewhat of a lifetime history in taking up for underdogs and those who cannot fend for themselves. I hate bullies and the intentionally mean, and I love helping the downtrodden in every way I can.
If you'll Google "Roy Exum" you'll get … [About 257,000 results (0.40 seconds)] All that means is I’ve stuck around long enough to have lots of scars.
There is a scene from a popular movie, “American Sniper” where a father tells his young boys: "There are three types of people in this world. There are the wolves, there are the sheep, and there are the 'sheep dogs' who protect the sheep from the wolves.”
I was raised to be a “sheep dog.” .