Sick Hospital

greenspun.com : LUSENET : TimeBomb 2000 (Y2000) : One Thread

If Gary North & Paul Milne got together to write a hospital Y2K article, this is what it would look like after getting diced by an editor.

All along, Ashton & I have been saying the hospitals are toast. This from personal experience. Hope there's a few that still function.

Hospi tal Critics Issue Y2K Alert

Sunday 24 January 1999
Hospital Critics Issue Y2K Alert
Equipment Could Fail During Surgery, Experts Claim In Plea To Board

Tom Spears, The Ottawa Citizen

The Ottawa Hospital faces an uphill struggle to make vital equipment survive the arrival of 2000, according to some of its computer experts -- including a former vice-president.

They say there's a "brain drain" of technical staff needed to upgrade computer-related systems -- including medical equipment like CT scanners and the pumps that keep blood flowing during surgery.

And they say the hospital has turned down an expensive but crucial step in getting computers ready for 2000 -- an independent audit of how ready its systems really are.

They are scheduled to put their criticism to the hospital's board of trustees at a public meeting tomorrow night.

Neurologist Chris Skinner, one of the hospital's Year-2000 critics, was the vice-president in charge of the hospital's computers until he was fired from that job in October. (He's still on staff as a neurologist).

As vice-president, he tried unsuccessfully to adopt a $41-million budget for Year-2000 problems -- money for consultants, hardware, software, labour, and an audit by Ernst and Young.

More than just computers with obvious reliance on dates is at risk, Dr. Skinner said yesterday.

"It's possible a given ultrasound machine, CT scanner or MRI may not work," he said.

For instance, some of them have internal clocks that force operators to do maintenance every 90 days, and these clocks could go haywire in 2000.

"My priority has always been patient care, to ensure that all systems -- information, clinical, technology which includes scanners, IV pumps, profusion pumps and so on -- be adequately prepared."

A profusion pump keeps blood flowing when a patient's heart is stopped in surgery.

"If you happen to be on a profusion pump and it doesn't want to profuse, you can't substitute for that," Dr. Skinner said. Even telephone systems and pagers could crash because of year 2000 problems, he said.

"The switches at the Civic and General are both Nortel switches which need an upgrade for the year 2000 and to go through the merger," he said. "That (set of switches) manages the whole telephone system, dial tone to voice mail to paging."

The Year 2000 problem is a widespread computer problem that stems from the old habit of designing computers to keep track of years in two digits -- i.e. 99 instead of 1999. When 2000 arrives, computers that haven't had upgrades will show the year as 00 and either make major errors or even shut down.

Dr. Skinner says the hospital's top management hasn't yet shown that it is ready for 2000.

"It is incumbent on senior management to present evidence to the board" showing that the hospital is ready, he said.

At least six staff with experience in the hospitals computers and the year 2000 problem have left recently, he said. Some quit, and others were pressured, he said.

"The brain drain on the department --Jwe've gone through one wave and anticipate another," said Brent Warren, a technical support analyst at the hospital.

He said there are "blatant discrepancies" between the plans on paper and the hospital's real level of preparedness.

For instance, he estimates the hospital will have to upgrade or replace 2,200 desktop computers in the next 11 months.

The last time it did a major replacement of computers it took a year and a half to replace 100 of them, he said.

He also cautions that the biggest components -- mainframes and servers -- are not as advanced in year 2000 work as they should be.

"If they're not compatible (with the new millennium), nothing else matters," he said. "As of right now they haven't been completed." Mr. Warren said he is speaking up about the problem because he is afraid massive lawsuits stemming from Year 2000 problems could take money away from health care.

The hospital's management presented a four-page list to trustees in December showing which computer systems have been made compliant with 2000, which are underway and which are not started.

Hospital vice-president Victor Simon also wrote last month that "the Year 2000 millennium project will not affect patient care" as long as the hospital's suppliers do their jobs properly.

"I am pleased to confirm that Year 2000 activities are effectively co-ordinated in a systematic manner at a corporate level," he wrote in response to questions from a hospital volunteer.

The volunteer who asked the questions, Richard Hogan, is scheduled to speak at Monday's meeting. He works on informatics in the hospital's medical learning centre.

He plans to tell the trustees that an effective set of Year 2000 measures "has not happened at The Ottawa Hospital."

Darcy Coleman quit his job as a systems analyst a month ago because he was dissatisfied with management after Dr. Skinner was fired as vice-president.

He says some areas listed as complete in the Year 2000 project -- especially laboratory computers -- still need extensive testing.

Testing will continue through the late summer, "which is kind of a scary thought," he said. "We would have though we'd have that (finished) by early this year, February or March at the latest. "That's not a good standing for them."

The contingency plans are the weakest area, he said. "If things don't work they have nothing to fall back on" that has been prepared for the year 2000.

Hospital spokeswoman Judy Brown said yesterday the hospital believes it's on target in its Year 2000 efforts, and will give the details at Monday's board meeting. Other hospital administrators couldn't be reached yesterday.
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-- Leska (allaha@earthlink.net), January 25, 1999

Answers

A nightmare riddled with turf wars and public relation clamps. So many computer technicians leaving ... what a mess. Wonder how many hospitals this scene is being duplicated in, just hasn't broken out yet.

mmmmmmm mmmmmmm mmmmmmm mmmmmmm mmmmmmm

-- Ashton (allaha@earthlink.net), January 25, 1999.


My sister is nursing VP at a small community hospital. They already have generators, because hospitals have to. They will be installing a 10,000 gallon fuel tank and a 10,000 water tank. The water tank will be only the potable. For other use, they have plans in place to use a generator to pump water from a nearby creek. She won't talk much about y2k. Just says it's the biggest headache she's ever dealt with.

-- margie mason (mar3mike@aol.com), January 25, 1999.

"As vice-president, he tried unsuccessfully to adopt a $41-million budget for Year-2000 problems"

Dr. Skinner cared too much, he was fired.

Of all the businesses I know, hospitals are the most ruthless. I could go on forever with scary stories. Money is priority #1, patient care is just a side effect of hiring nurses and doctors.

It's worth noting that a volunteer has to speak out at the meeting, he has no job to lose.

-- Chris (catsy@pond.com), January 25, 1999.


Let's see if we can do the math on this one: The last time the hospital upgraded desktops, it took a year-and-a-half to install 100 new ones. Now they have to upgrade or replace 2,200 machines in 11 months. Pray tell, all you Pollyanna, how they gonna pull this one off in time? (Not to mention all the equipment and devices that Dr. Skinner says could fail!)

-- X-man (x@x.x), January 25, 1999.

We wondered last year why we felt so impelled to work at a hospital. Not our inclination at all. 7 months of hell, but learned a great deal. Glad we have the experience, because it really helps us empathize with our patients when they recount their horror stories. Chris, we'd enjoy hearing some of your scary ones! You're 1000% right on.

This article should jolt medical personnel. But they're indoctrinated with the "It's not my department" attitude. But it is their paycheck, patients, job, all about to vanish. After all that training and rat-scratching up the medical ladder -- there'll be a mass of angry workers, believe me. Don't get sick.

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-- Leska (allaha@earthlink.net), January 25, 1999.



Not all of us who work at hospitals are "indoctrinated!!"

I'm a registered nurse in Labor and Delivery at a large, inner-city hospital in a large city. OUR HOSPITAL WILL BE BURNED TOAST!!

I've been tracking the "progress" of Y2K work at our hospital for the past 9 months and it's pathetic. My manager received a memo that she shared with me. It said that all of the staff is to be told to give this answer to any patient or visitor who inquires about our Y2K readiness: "Our computer department is doing very well on getting computers ready for the year 2000 and we will be totally ready by Jan. 1, 2000." Well, that's a bold faced lie. The memo goes on to say that the truth is that the hospital is still in the ASSESSMENT stage and still trying to figure out what equipment needs fixing!!!!

Our unit uses not only computers, but also many pieces of equipment with embedded chips, such as: fetal monitors (Very Important), blood pressure and oxygen saturation monitors, IV pumps, pain medicine pumps, ekg monitors, and anesthesia machines. My manager said that all the embedded chip equipment must be totally replaced, but so far NOT ONE THING

-- Mary (Beachyfe@hotmail.com), January 25, 1999.


Mary, wish you had been on our unit! How many of your co-workers are interested? We worked Cancer/Bone Marrow Transplant, and were floated everywhere else :P We tried to bring up Y2K ever-so-mildly, and *nobody* cared, not the lab technicians, Drs, surgeons, RNs, secretaries, managers, social workers -- nada! Just saw the RN social worker from our unit at the library, she's left Cancer Care (huge attrition), waved whole topic away, "Sheesh, it's nothing, not my problem, not being paid to think about it."

The rigid indoctrinated hierarchy in that place renders it stone. Very sad. So many ppl depend on it for life in so many ways. How can ppl be so willfully blind?

Ashton & Leska in Cascadia, glad to be outta there, still think of the ppl we care about there

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-- Leska (allaha@earthlink.net), January 25, 1999.


Not all of us who work at hospitals are "indoctrinated!!"

I'm a registered nurse in Labor and Delivery at a large, inner-city hospital in a large city. OUR HOSPITAL WILL BE BURNED TOAST!!

I've been tracking the "progress" of Y2K work at our hospital for the past 9 months and it's pathetic. My unit manager received a memo that she shared with me. It said that all of the staff is to be told to give this answer to any patient or visitor who inquires about our Y2K readiness: "Our computer department is doing very well on getting computers ready for the year 2000 and we will be totally ready by Jan. 1, 2000." Well, that's a bold faced lie. The memo goes on to say that the truth is that the hospital is still in the ASSESSMENT stage and still trying to figure out what equipment needs fixing!!!!

Our unit uses not only computers, but also many pieces of equipment with embedded chips, such as: fetal monitors (Very Important), blood pressure and oxygen saturation monitors, IV pumps, pain medicine pumps, ekg monitors, and anesthesia machines. My manager said that all the embedded chip equipment must be totally replaced, but so far NOT ONE THING has been replaced!!

The anesthesia machines in our operating rooms and the ventilators in the Neonatal Intensive Care Unit have little yellow stickers on them that say "Y2K". I asked the manager if that means that they have been fixed/replaced, but she said, "No, that just means that they need to be looked at." WOW - how scary!

So, I'm absolutely sure that I definitely won't have a job on 01-01-2000. The hospital won't take on that kind of liability and stay open when it cannot provide safe care according to our policies and procedures. And especially in Labor and Delivery where we take care of healthy, young mothers and their precious babies!

I'm planning on working (mainly bartering my services) as a midwife and nurse in my home community. Luckily I live 40 miles away from the city in a quiet rural area. I am concerned about the future of health care, though, as I'm sure many more people will be dying without the hospital facility being available.

Mary

-- Mary (Beachyfe@hotmail.com), January 25, 1999.


Oh yeh, I forgot to mention how my co-workers are thinking about this.

When I became a GI (Apr. 1998), I felt compelled to tell all my co-workers about Y2K because I cared about them (I've worked on the same unit with the same people for almost 9 years). But what a "cold shoulder" I received from them! One person actually got rather hostile. But one gal has done some minimal preparations (better some than none).

Later, while I was reading Time Bomb 2000 at the desk at work, two doctors (obstetricians) asked me what I know about Y2K. One was already preparing and the other was very open. He eventually began to really prepare and both of them are GI's.

In the past 2 weeks I've found out that 2 nurses from the Neonatal Intensive Care Unit are actively preparing! It's so nice to find some "comrades" that I can talk to. Long ago I quit talking openly about Y2K at work for 2 reasons:

1.I could sense that it was making others uneasy and defensive. I figure that if they have any questions or if they get interested, they know that they can talk to me.

2.Many of my co-workers are low paid people who live in the slummy, inner-city and they started saying things like, "Oh, we can just come out to your house for food and shelter if this thing gets bad." I DON'T THINK SO! Actually they don't know where I live and we're moving further out into the country on another farm next month, so they wouldn't be able to find me, but I don't want to take any chances.

I think one reason that medical people don't believe is because they are intellectuals and the whole idea of such a disrupted society just doesn't seem to make sense. Plus, it's hard to swallow the idea that your whole career and living might be ended.

Mary

-- Mary (Beachyfe@hotmail.com), January 25, 1999.


What a mess!

Almost looks like some health care entrepreneurs can go back to providing alternative care based on modern skills minus some of the key equipment. Rather like the old herbal healer deep in the lone cottage within a green forest. Home health care appears to be a likely result, beyond 2000. Call it a potential trend, or a result of the collapse of existing HMO models.

Among other things, learning to grow and use medicinal herbs, seems wise for anyone not a nurse or doctor. Shared knowledge may be the way to help communities.

Diane *Big Sigh*

-- Diane J. Squire (sacredspaces@yahoo.com), January 25, 1999.



Leska, ok, one story. Just take the "team leading" business for example, re: loading one RN on a med floor with responsibility for 14+ patients, to coordinate tests/surgeries, admitions/discharges, give I.V.'s & meds, do treatments etc., with only one nurses-aid to help. One time while I was in charge during the evening shift, I gave myself the least load of 12 patients with an anticipated admitions later on from the ER. A co-worker RN called out last minute. We tried to replace her but couldn't. I asked the supervisisor to take her place, but she refused saying that the ER was hopping and she was too much needed all around (which I didn't doubt.) I then told her that I could split the 14 orphaned patients among only 2 RN's, giving us unsafe conditions (it's already unsafe with regular load of 14.) I insisted that she called an agency and get an RN. Short of it is that she threatened me with insubordination. I stood my ground, she got the DON on the phone, I was threatened in no uncertain terms. I stood my ground, I got the agency nurse, but was asked the next day to sign a "resignation". This incident is commonplace, I've had nurse friends tell me of similar incident happening to them. Put up or shut up. Well, I would have, were it not for people's lives on the line. Anyway, for that I was called a "trouble maker".

Agency nurses are expensive, over 2 1/2 times the rate of a staff nurse. So they try to squeeze the eyeballs out of staff nurses.

Mary you said "I think one reason that medical people don't believe is because they are intellectuals and the whole idea of such a disrupted society just doesn't seem to make sense." It's not because they are intellectual, it's simply denial, like all Polyannas in all proffessions go through. And when you've done your research, you'll find out that it indeed all makes sense, it's just quite fantastic when you first learn of it.

-- Chris (catsy@pond.com), January 25, 1999.


correction above:

"could split the 14 orphaned patients " should read "couldn't split".

(that's what happens when I write while cooking dinner in a hurry ;-))

-- Chris (catsy@pond.com), January 25, 1999.


My wife is a CNM doing home and hospital birth. The small rural hospital's administration where she has privileges is wilfully determined to blow-off Y2K. Their most successful family practice doc (big-time GI who gave up trying) is leaving in May to start his own practice. 70% dependent on Medicare/Medicaid. Toast. There is no humor in this: the entire county, one of the most rural in the state, relies on this hospital.

While I would rank "electricity" and "water" as top two Y2K concerns, "medical care" is third and receiving mere shreds of attention, even from this NG. Medicare doesn't have to fail 100%, only slow down 2X more than its currently glacial pace to send many hospitals under. 2X to 10X with Medicare, if not outright collapse, is a done deal.

On the "positive" side (sheesh), home doctoring, nursing and midwifery is going to assume huge importance for the next 5-10 years. And, while I am NOT optimistic about decentralization of feds, military and much else, I don't think Humpty Dumpty will be able to put the "hospital system" back together again, or, at least, not for decades. If we can look past the criminal neglect and the lives that will be lost (this isn't a hypothetical), good riddance.

-- BigDog (BigDog@duffer.com), January 25, 1999.


We had the head of the IT department come through our sleep lab several months ago. He's definitely a DGI. Imbedded systems - no problem. Computers - being replaced (I believe 1100?) in 1999 with Y2k compatables. My co-workers think that I'm nuts to think there will be ANY problems, never mind the 7 I'm preparing for. My supervisor has told me that if I don't write my somnography exam this year, I'll lose my job. I responded that I am willing to spend the ~$1000 required, but not until spring of 2000. I'm not convinced that a sleep disorders lab will have the priority to recieve funding next year in any case (assuming not TEOTWAKI), so the threat to lay me off kind of lacks teeth IMHO. We are supposed to be getting in a new system (since November - now they're saying end of February); our current one is NOT Y2K compliant. Wonder how many more there are in the hospital???

-- Tricia the Canuck (jayles@telusplanet.net), January 26, 1999.

Forgot to mention - we have a regionalized health system (government funded health care). I work in the Capital health care district, one of the two largest in the province, and in the largest hospital in the region. Not good news...

-- Tricia the Canuck (jayles@telusplanet.net), January 26, 1999.


" Anyway, for that I was called a "trouble maker". "

catsy, do you feel that you are the only honest person left on earth?

I do.

Guess how I was rewarded when I told my boss we cannot dump carcinogens into the ground?

Bon voyage.

-- fly .:. (.@...), January 26, 1999.


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