8.23.2009

A sign of the times

A few weeks ago I was taking care of a 7 month old diagnosed with a terminal illness. It was one of those work days where a majority of the discussion with the parents is regarding where they want their daughter to die, at home or in the hospital and how we can make those arrangements so she is as comfortable as possible. Overall, it was a sad day. I never enjoy being a part of these decisions because what it all boils down to is that this family is at the point where they are realizing that their daughter, their flesh and blood, the love of their lives is going to pass away far before the time any parent ever imagines.

Part of my family-centered care involves me making sure that the families of my patients eat and drink throughout the day because often times it is hard to remember to take care of your basic needs when you are consumed with the illness of your child. As I left the room after suctioning, changing the diaper and playing with their daughter I asked "Is there anything I can bring in for you? Juice, crackers, oreos?" The mother just looked up and with a weak smile asked for cranberry juice. All she wanted was a box or two of juice. Of course, the PICU's nutrition room had every juice but cranberry. So, I simply walked down the hall to the CVICU and grabbed 2 boxes from their fridge. I walked back down the hall and handed them to my patient's mother, glad that she would at least stay hydrated that day.

As I exited the room, the CVICU's unit assistant immedietly and harshly asked me if I just took 2 boxes of juice from her unit. To which I bluntly replied "I sure did just take 2 boxes of cranberry juice and gave them to my family." She then thouroughly explained that those boxes of juice would be charged to the CVICU and not the PICU and that if I needed juice then I need to have our fridge restocked. She literally talked for 3-4 minutes, right outside my patient's room, about how I shouldn't be using another unit's juice. I looked at her, smiled and said I'd be more than glad to replace her juice but that I would not remove them from the room. She turned around and walked away.

I looked in to how much these juices cost. Fifteen cents is the answer. So 15 times 2 equals 30. Thirty cents. Thirty cents worth of cranberry juice and I am getting reprimended. Why? The answer is simple. Budget. Economy. Crisis. It is affecting everyone, everywhere . It is to the point where I apparently can not borrow from a neighbor. It is to the point where I can not walk down a hall and use another unit's 30 cents in order to meet a devastated mother's simple request. I am sorry, but I refuse to let this go further. I will not put budget before my patients and their families. I am being pushed and pulled and punished by people who sit and crunch numbers and then dictate my patient care based on the areas that come up red. Healthcare is a nasty industry to work in right now. Everyday as I go into work I remind myself that I take care of critically ill children and I pray that I never let anything come before them. Not a CEO, not a budget crisis, not a fridge missing cranberry juice. These are just signs of the times that I hope dissapear down the road.

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