HJAR Nov/Dec 2022

VOTE OF NO CONFIDENCE 20 NOV / DEC 2022 I  HEALTHCARE JOURNAL OF ARKANSAS  where the population is 17,826, according to the 2020 Census and oil, chemical, and manufacturing industries otherwise domi- nate the local economy. Vicki Gilliam, a Mississippi-based attor- ney, was retained by 11 MCSA physicians in the course of the investigation. She told the News-Times in July 2021 that the hospital had retained the services of Bass, Berry & Sims, a Tennessee law firm, to conduct the investigation into the claims the medical staff made in their letter to the hospital’s Trustees. Gilliam said the investigation was “the only known reaction from CHS and the Board” to the healthcare workers’ no con- fidence vote as of July 25, 2021. On July 29, MCSA Trustees heard a report on the investigation. In a memo circulated to MCSA staff the day after the board meeting, Street told hospital staff that several recommenda- tions made by the attorneys who investi- gated the medical staff’s complaints, includ- ing strengthening the relationship between the MCSAadministrative team and medical staff; hiring an interim chief medical officer; establishing a physician advisory council; adding a second OR call team; and “work- ing on additional training related to patients transferring to our hospital.” However, the board “did not vote to implement those recommendations,” Street’s memo states. Instead, they “did vote to request a new administrative structure.” “In the weeks ahead, we will be discussing what that means about how our administra- tive team is structured and operating,” the memo continued. Days later, onAug. 2, MCSAstaff received another email, forward by Street from CHS Regional President Kevin Stockton. He said a “resource team”would be visiting the hos- pital in the following days to “better under- stand the Board’s actions” and “evaluate various options moving forward.” “No decisions have been made, but we will work swiftly to put a plan in action,” Stockton said. On the front line Meanwhile, those who had been on the front lines of the pandemic since it started in February 2020, began speaking out. On Aug. 1, the El DoradoNews-Times published a story recounting interviews with two nurses who, at the time, remained employed at MCSAand spoke to the newspaper on the condition of anonymity. The nurses — both decade-plus veterans in their jobs — told the newspaper that the hospital’s ICU was severely understaffed. One said she was often caring for double or more the number of patients she would have expected to have been assigned before the pandemic, and another said, more than once, all the nurses on the floor would be responding to a coding patient when another patient’s code alarms would begin sounding in a separate room. “It put us in a position that when the alarms were going off in one room, but you had a code in another, so you couldn’t go check on them, so they were left to the grace of God whether they would survive or not,” he said. MCSAadministration’s response was dis- heartening, to say the least, according to the newspaper’s report. “They have personally spoken to many of us and given us negative comments. They told us to quit complaining, quit asking, they don’t want to hear it anymore,” one nurse told the newspaper. “We see their faces, with them telling us to our face, ‘I don’t want to hear from you again; you deal with this or you cannot work here.’ … I called almost daily asking — begging — for help and being told ‘this is what you get’ and ‘deal with it.’” One nurse pointed to the private health- care industry’s profit motive, saying, “It was a bad situation and it was handled poorly for the sake of money with no regard to the safety of staff or patients.” “It would be so understaffed that the monitors at central station — there was no one there to watch them, no one was there to answer a phone, no one was there to intervene… I didn’t see administration answering phones or wearing N95s,” he added. And both nurses said they believed the chronic understaffing of the ICU probably contributed to some patients’ deaths. “We were put in a situation that was impossible to deal with,” one said. The next week, onAug. 8, the News-Times reported on interviews with two different nurses, who said virus control protocols put in place early in the pandemic were no lon- ger being utilized, and that several patients seemed to have caught COVID at MCSA over the summer. “When it got bad in the winter here and we were in the second surge, it was handled appropriately. Patients were placed in a unit that was separate from the rest of the hospi- tal, appropriately trained nurses were work- ing in this unit and things were handled the way they were supposed to,”one nurse said. “When we started having a third surge, that’s when new policies and procedures came