Cuts and Cutting Remarks

New Hampshire hospitals have been scrambling to come up with millions of dollars in budget shortfalls.  The state legislature in its infinite wisdom voted to cut Medicaid reimbursements along with many other cuts to state and local agencies and programs.  The impact to hospitals involves money that had been counted on during budget planning for the coming year, but now the rug has been pulled out from under. 

The state  taxes hospitals 5.5 percent on  patient revenues, but returns the amount of the tax in matching federal Medicaid funds so they effectively lost no money.  That's out now, and hospitals have been cutting jobs all summer, the latest round of layoffs occurring about a week ago. 

We lost a number of positions, none of which were clip board personnel or Suits in Charge of Stupid Shit, not surprisingly.  I get to keep my job.  But there were several LPN's who lost their jobs.  Just axed.  Some genius in the public relations department of another hospital, who also cut their LPN's, justified cutting them  since, "LPN's are really just glorified nursing assistants".  Really??  Talk about adding insult to injury.

I have never worked in a hospital that employs LPN's in the ER, but I have worked with my fair share in many other areas.  Some were good, some were great. 

The first one I ever worked with was Mrs. Maccaione.  I don't know if she had a first name, you either called her Mrs. Maccaione, or "Mac".  In 1973 she had to be in her mid-sixties.  Mac wore whites from the top of her starched cap to the polished perfection of her white Clinic shoes.  She was as broad around as she was tall, and at 5 feet was an imposing and intimidating poster child for Crusty Old World War II Nurse.  With her rolling bandy-legged gait and the whoosh! whoosh! of her pudgy thighs in their snow white support hose, she bore down on me and the other two nursing assistants like a ship under full sail; usually with guns a-blazing.   She was NO NONSENSE in the flesh.  She really did try and bounce quarters off of draw sheets.  Mac was well known for her scrutiny of top sheets for precise hospital corners.  Woe to you if you were caught resting a pillow under your chin to apply a pillow case.  You would hear about it in spades if your patients weren't  bathed in a timely manner or their immediate environment was not spotlessly clean.  We were scared to death of her.

In the early 1970's, day surgery was non-existent.  If you had a cholecystectomy or appendectomy, you were in the hospital for about a week.  A tonsilectomy?  Two nights.  Wisdom teeth?  That involved checking in to the hospital the night before your surgery and staying all day.  Sometimes patients went home, sometimes they could "elect" to stay another night, like if they were vomiting or whatever. 

Mac always greeted the patients and oriented them.  This was a job that needed to be DONE RIGHT.  She strode into the room and  stood at parade rest. 

"Good afternoon!  Welcome to Unit F.  I'm Mrs. Maccaione-call me Mac.  You are scheduled for _____surgery tomorrow at 0800 hours.  Today, you will be getting a visit from the anesthesiologist and having whatever testing may be deemed necessary, if any.  You will be signing a surgical consent if you have not already done so.  For today, you will be given a regular supper, served between 5 and 5:30 PM along with a light snack at approximately 8 PM. Visiting hours conclude at 8 PM, so plan accordingly.  At this time, the switchboard will not put through any incoming phone calls to the rooms.  Lights out in this unit is generally between 10 and 11 PM; you will be needing your rest.  At 12 midnight, you will be NPO: Latin, Nothing By Mouth until after your surgery.  You will be awakened at 5:45 AM to prepare you for your surgery.  Questions?"

This monologue was delivered  rapid-fire.  I'm sure most patients didn't dare ask questions of Mac. Most of the doctors were scared of her. 

But you should have seen her in action when it came to encouraging a fresh post-op and making them feel cared for.  Or getting another 6 feet of corridor out of a tired newly ambulatory patient with a big belly wound (remember Scultetus binders?).  There was nothing she couldn't get from the kitchen staff if she thought it would entice a finicky eater to take nourishment.  For all her brusque and bossy affect she was a hell of a nurse; you would want her to take care of your family.  I learned a hell of lot from her. 

Just a "nursing assistant"?  Oh, HELL no.