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Disappearing Nurses

The staff at Jackson Memorial Hospital routinely performs miracles. Real, true, bringing-people-back-from-the-precipice-of-death miracles. At Jackson, through the 400 or so organ-transplant surgeries performed every year, the surgeons and nurses revive the hopes and bodies of people who would have been unsalvageable a couple of decades ago. One of those people...
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The staff at Jackson Memorial Hospital routinely performs miracles. Real, true, bringing-people-back-from-the-precipice-of-death miracles. At Jackson, through the 400 or so organ-transplant surgeries performed every year, the surgeons and nurses revive the hopes and bodies of people who would have been unsalvageable a couple of decades ago.

One of those people is my mother-in-law. Afflicted with an incurable liver disease (among other ailments) and suffering from a dire decline in health over the course of 2004 and 2005, she was quite literally saved when the liver of a donor from Mississippi was transplanted into her body on June 2. My wife and I live with my mother-in-law, and after watching her heart-rending attempts to remain buoyant in the face of an increasingly untenable situation, we felt an indescribable relief when we learned the transplant operation had been successful.

If only the recovery Jackson affords its patients did justice to the wondrous feats performed by its surgeons.

Following a week-long stay in the Surgical Intensive Care Unit, where the doctors and nurses were extremely attentive and the environment sterile and pristine, my mother-in-law was taken to West Wing 15, a floor filled with post-transplant patients, all of them on drugs that suppress their immune systems (to thwart rejection of their new organs). This means their exposure to bacteria or any other potentially sickening substance is extremely dangerous. In fact when doctors explained to us the dangers posed during the recovery period, we tore the carpeting out of our house and installed wooden floors, which are much easier to maintain and don't collect dust and dirt like carpeting. Then, at the urging of the doctors, we gave our two cats to a friend for a month and sentenced the dog to outdoor exile. We also spent hours scouring the house, creating something as close to a sterile environment as we could.

Imagine our surprise when my wife, after a morning spent disinfecting the house, walked into the hospital room where her mother was recuperating from surgery and found her scrubbing feces from the toilet seat in the bathroom. She had informed the nursing staff several times about the problem, she said, and although two hours had passed, no one cleaned it. This was not a singular experience.

My mother-in-law, a middle-age schoolteacher with an angelic disposition, was moved to West Wing 15 the week of June 5. There were a number of wonderful nurses who demonstrated professional competence and a helpful bedside manner. Others were rude and dismissive.

After her first night on the floor, my mother-in-law and her roommate -- a Palm Beach resident also of middle age -- told me they were frightened because the nurses had been fighting all night, yelling at each other and arguing loudly. I hastily explained they were dealing with life-and-death situations and that such a high-pressure environment wasn't always conducive to perfect manners. I said the arguing probably wasn't an indicator of any lack of professionalism, and the most important thing was that patients were well cared for.

Today I cringe, thinking of myself explaining to these two transplant patients about the pressures of life-threatening situations. But I'm more embarrassed to think I explained away their concerns. As it turned out, they were right to be worried.

I personally witnessed two incidents in which the roommate rang for nurses for at least ten minutes, needing their assistance to get out of bed and go to the bathroom. Both times she was virtually howling in pain by the time they got to her. One of those times I ran out to track down a nurse myself. My mother-in-law described to me another occasion in which the roommate lost control of her bowels in her bed after ringing for a nurse for some twenty minutes. On two other occasions, and despite her extremely limited mobility, she got out of bed herself, without assistance.

One time, after fruitlessly attempting to summon a nurse, the woman dragged herself out of bed and made her way to the bathroom, trailing a wheeled IV stand. She seemed unaware she was urinating on herself and the floor as she walked. A nurse arrived while the woman was in the bathroom. My wife pointed out the urine on the floor. The nurse dropped a paper towel that partially covered one of the puddles, and said someone would be along to deal with it. Then she left. A half-hour passed. An hour. Another half-hour. Finally, two hours later, someone came along and swabbed it up.

Another time my wife arrived at the hospital and found the same woman lying sideways on her bed, unable to move. She claimed she'd spent ten minutes pressing the call button for the nurses, then hobbled to the bathroom on her own. But she couldn't maneuver her way back into bed without assistance. My mother-in-law rang for a nurse for another ten minutes. At last my wife helped the woman into her bed. No nurse ever responded.

But learning that my mother-in-law had donned latex gloves and set to cleaning the bathroom herself was by far the most disturbing discovery during her time on West Wing 15. It followed another of her roommate's accidents, this one explosive. There was feces all over the floor and the toilet seat. My mother-in-law informed the nurses, who said someone would come by. Again a half-hour passed, then an hour. After two hours, my mother-in-law began to fear she would have her own accident if she couldn't use the bathroom. Rather than sit on the stained toilet seat, she began to scrub it herself.

My wife was furious and told the nursing staff someone needed to attend to this right away. One of them came in, wiped the rest of the excrement from the toilet seat, and announced that a member of the janitorial staff would mop the floor.

Two hours later no one had done anything. Totally exasperated and a little worried about incurring the ire of the nurses, my wife called me at work and told me about her morning. Despite her objections, I called and spoke with a supervisor on West Wing 15. I was blunt. My wife says someone cleaned the floor immediately after my phone call. That would be, for the record, about four hours after the initial calls -- four hours of potential exposure to fecal bacteria.

Turns out that although Jackson hypes its transplant program and employs topnotch doctors and nurses to do the work, the hospital has exactly two full-time janitorial staffers assigned to West Wing 15. On a floor with 40 beds, most of which are occupied at any given time by recovering transplantees, Jackson pays two people to cope with the inevitable messes that greatly endanger the welfare of these immunosuppressed patients.

Spokeswoman Lorraine Nelson says the hospital is looking into the problems I described to her. She also says we could have spoken with a representative from the hospital's patient-relations department: "They go up and visit with you and resolve problems one by one."

Neither my wife nor her mother were aware such a department existed. I had no idea myself. At the time we had more pressing concerns, like making sure the bathroom didn't become a health hazard.

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