The Fireside

After much hoopla and publicity, the Stinkwater Mountain Hospital is opening next week!

Does anyone but me have any reservations about this?

Doesn't anyone remember 5 years ago, when the Mary Fisher Clinic was expanded with two fully equipped trauma rooms so that Stinkwater could have a 24/7 Urgent Care? I know most of the people who now live in Stinkwater weren't living here 5 years ago, but it's not too hard to find out the history. What happened then? They couldn't fund it, and they couldn't staff it, and that building has been sitting empty since then.

Can they now fund and staff an 11 bed acute care hospital in addition to a full-fledged Emergency Department when they could not even keep the Urgent Care afloat?

I am an RN. Like many local health care professionals, I sent in a letter of interest and C.V. to the new CEO back in August, when they first started seeking applications. I heard absolutely nothing for months, not even a postcard to say that my application was received and I would be contacted soon. You must understand that nursing today is an extremely competitive field. I generally take short-term contracts in various facilities throughout the Southwest, and I am very experienced in Acute Care, Critical Care, and Emergency Medicine. When I finish a contract, I generally take some time off, and then, when I'm ready, I contact one or two hospitals, and I always hear back from them, not within days, but within hours, and a new contract is signed within days. The Stinkwater Mountain Hospital, while actively seeking applications since August, did not contact me until December, almost 3 months later! Any hospital, but especially a new one, must realize that attracting good, experienced nurses today takes a proactive stance. Ignoring a resume for three months is not proactive!

When I did get a phone call from the newly hired Director of Nursing (DON), I was told how they intended to staff the facility, and I was stunned. They are only going to hire 2 RN's per shift to care for 11 acute care patients and EVERYONE who comes in through the Emergency Department. Safe staffing ratios in acute care settings are generally 4 patients to 1 RN, or, in a pinch, 5 patients to 1 RN. To expect 2 RN's to care for 11 beds is already exceeding safe standards, but to then expect those RN's to see and treat everyone who comes in to the ER on top of it is outrageous. Not only that, but she told me that they were not going to hire any part time or fill-in nurses. This means that the nurses they do hire will be expected to work overtime on a regular basis, and that if one calls in sick, they will be even more short-staffed. A nurse who agrees to work in such circumstances is putting her license at risk, because she cannot provide safe care to that many patients alone.

I have worked in ER's in towns that are similarly sized to Stinkwater. Those ER's generally staff with a minimum of 1 doctor and 2 or 3 nurses 24/7, in addition to ancillary staff, unit clerks, etc. They need to, because of the high volumes of patient visits. The ER in Alamosa, for example, sees on average 60 patients a day! Why would Stinkwater be any different?

Part of the problem, as I see it, is that the new DON does not have any hospital experience, nor does she have any Emergency experience. She has worked in a nursing home for the past 5-6 years, and before that, she worked for the military as an OB delivery room nurse for babies born to military wives. She told me that they were not expecting the ER to be very busy, because the ambulance in Stinkwater is not very busy.

But you can't judge by that! You have to understand the demographics of exactly who uses an Emergency Room. It's not like you see on TV, where it's one true life-threatening situation after another, with the staff constantly saving lives. Far from it.

Since a certified ER must see, examine, and treat everyone who walks in the door, regardless of their ability to pay, the number of times they have visited already for the same complaint, or the nature of the complaint. This means that the vast majority of ER visits are made by people who are not experiencing an emergency. This includes people who are mildly sick but cannot get in to see their doctor, people who are mildly sick but can't AFFORD to go see a doctor, people with mosquito bites that are red and itchy, people who called in sick to work in order to have a day off to go skiing and now need an excuse for their employer, people who want narcotic pain medications but their doctors won't give them to them, people who are lonely (or psychotic) and just want somebody to pay attention to them. Sore throats, ingrown toenails, and mosquito bites are much more commonly seen than heart attacks. That's the way it is. The "real emergencies", people with serious injuries, heart attacks, and other things that require immediate interventions, are few and far between, in every emergency room in this country. It will be no different here.

Newspaper articles quote the CEO as saying that the budget will be very lean at first, and there will be no room for extra expenses. The same article tells us that "injured people" have been entering the construction site, thinking the hospital is already open. The handwriting is on the wall for those who care to read it.

I think we all agree that we need a hospital here in Stinkwater, and it's high time that we got one. Nobody likes to go all the way to Durango for our hospitalization and emergency care. Yet, can we afford another effort that fails due to inadequate funds and unsafe staffing? Do we want another building to sit empty for years until the Board decides to try it again?

If they staff adequately for patient safety, employee retention and a quality and profitable hospital can surely benefit our community. I hope that they do, for if they do not, it is bound to be a disaster, and we have seen enough of those in our community lately.

If there are any die-hards out there who still check my blog every once in a while, I'm sure you have noticed that I have removed all the former posts regarding LC-MS issues, nor am I posting any new comments, nor am I writing any new articles regarding those issues for publishing elsewhere.

I have been off the blog for over a year, due to my own personal reasons. I intend to begin posting again, but be advised that the character of the blog will be changing to reflect other issues of interest, such as local mountain community issues, thoughts on vocation, life and death issues (I work in an Emergency Room!), yet still from the perspective of a confessional Lutheran.

However, as far as the LC-MS is concerned, I have nothing further to say on the issue. I watched the debacle of the 2007 convention, read the first meeting minutes of the Board of Directors, and it must now be completely obvious to the most casual oberver that the bus that once was the LC-MS is in the ditch. In spite of many efforts by some valiant people to dig it out, it is stuck fast and there is nothing more that can be done.

Yet, I grieve for the tragedy that has befallen the Synod in which I was first brought to faith in Christ. In spite of the fact that, like suicide, this tragedy comes at the hands of those at the helm of the Synod itself, this is no less a tragedy, for the LC-MS could have remained a strong Confessional Lutheran body in our communities and in our country, yet it has freely chosen to leave that path of righteousness, leaving a very small group of faithful individuals, who still do remain confessional, to carry on in solitude, much like the 7000 Israelites of Elijah's day who refused to bend the knee to Baal. Of course, our current Baal is the contemporary society, social gospel, and post-modern relativism, which we see reflected and embraced in the LC-MS of today.

While I'm sure there is much that remains to be discussed about the state of the LC-MS, that discussion will no longer happen on this blog.

I say this for myself primarily, but also for others who feel as I do. And that is, that we must keep in mind that, although the Synod has betrayed us, Christ and His gospel, His love, and His forgiveness, never will.

Kyrie Eleison.

Back in January, I had a reminder of how fragile life can be with a close-up brush with my own mortality. I went in to see my doctor for a routine exam, as I have dozens of times before. While palpating my abdomen, I saw a “different” look come across her face. She felt around a little more, and finally, carefully, told me that she could feel a lump on one of my ovaries. I needed to go to Durango right away for an ultrasound to see if it was a cyst or cancer.

Well, “right away” turned out to be a few days, which gave me more time than I really wanted to think and worry about it! On the other hand, it gave me some time to begin to prepare for the worst. I started thinking seriously about my own mortality. Death as an abstract concept is not that hard to grasp. We all know intellectually that we will die “sometime”. But death knocking on your front door is a different matter. I wasn’t ready to face that yet!

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Paul writes in this text, For I am convinced that neither death, nor life, nor angels, nor principalities, nor things present, nor things to come, nor powers, or height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord. Romans 8:38-39 NASB

I have had questions about the translation of this verse, and in particular the Greek word translated here as “principalities”. First of all, what exactly is a “principality”?

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My husband committed suicide a little over seven years ago. While his story is important in order to really understand what happened, I’m not going to write about that, for the real story is in all the people his death affected. This is the first time I’ve ever wanted to write about it and to share this story of tragedy and pain with others. I do so now with the hope that this story will help you if you have experienced it yourself, either directly with someone you love, or to help you help someone else. For it seems no one is completely untouched by this kind of death.

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Let me briefly introduce myself to those of you who don’t know me well.

I am an RN and am currently working on various seasonal contracts with hospitals in three of the Four-Corners states, and I live in Pagosa Springs, Colorado. I have done many other things in my life as well, from management and technical positions in IT, to flight paramedic and emergency room nursing, to ski patrol, forestry, and construction work.

Life may be short, but we do seem to have time to develop a vast range of experience if we so desire!

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