From September 2010 to May 2011 I interned with the Health Care Administration under the direction of the Executive Nursing Administrator at a hospital facility with nationally integrated service networks. I was told at the time of my hire that I would be privy to all conferences which took place with administrative officers; and that information discussed would be strictly confidential.
During the course of my internship there were conferences held with administration and other “agents” at least once a week. I attended 2 meetings during my internship— neither of them eventful—and was conveniently given my supervisor’s work to complete while she attended the aforementioned conferences. Unknown to me at the time, the facility was under investigation due to complaints filed with the Attorney General from clients, client’s families and medical staff; including nurses and medical doctors.
I learned quite recently that special federal investigators had been carrying out an official examination of the hospital since August 2010; concerning quality control issues, adherence to hospital policy and procedures; and other legal matters, including but not limited to: •Embezzlement of grants/misappropriation of funds •Understaffing Personnel employed in management positions where they were neither qualified, certified nor did they have prior experience in regard to the units they managed •Clients being admitted to psychiatric units without a 2 PC order •No PRN Protocol in place and agitated clients were admitted to units causing injury to self, other workers and clients. •Patient neglect and injuries due to accidents
One day I was instructed by the Executive Nursing Administrator (ENA) to prepare 2 spreadsheets: One was a patient satisfaction survey and the second was a unit complaint survey which was to include in the questionnaire specific areas of complaint. I prepared the surveys and since I was given no direction, I researched what questions to ask; and (with SUNY’s documented approval); I utilized my university’s survey program. I prepared the surveys and they were approved by administration (hospital director, medical director and the ENA. I was then instructed to conduct the two survey interviews, which took place from September 2010 to March 2011. Ethical Problems I Faced: At the time of my internship the Unit Complaint Survey I constructed contained the name of the complainant, person’s title and 7areas of complaint; each complaint involved a different area of concern and was to count as a total number of complaints in that particular area; (i. e. : understaffing, patient injuries/accidents, lack of prompt medical attention; admission documents incomplete, missing or not signed by the admitting physician, medication errors, etc. When Administration (who had previously approved the survey) reviewed the results of the questionnaire and observed that almost all of the units had more than 20 complaints a week, the ENA requested me to adjust the number of complaints to one per person if he/she had filed complaints in several areas of concern. In addition, I was to modify the number of complaints per Unit in regard to specific areas of concern to and combine the figures to reflect 1 complaint in that area.
In other words, if 10 units had the same complaint regarding patient injury, the10 complaints would be combined on the survey and count as 1 instance of patient injury. After I completed my internship, the administrative nursing assistant called on behalf of the ENA (who took credit for creating the survey) to request that I come in and train health administrative personnel on how to use the programs I created; and to instruct them on recreating new spreadsheets with the template I had designed for the surveys utilizing SUNY’s survey/software program.
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