Arriving in his office Saturday shortly before his shift began, Doctor Brackett was confronted by not only his usual paperwork, but also by a couple stacks of paperwork. Sitting down, he wondered out loud, "What the heck is this?"
"Well, I'm not sure about one of those," Dixie informed him as she barged into his office. "But one of them is some information about New Horizons I thought you might want to read."
"How on earth did you get that information so quickly?" he glared at her.
"I have my sources," she stated. "And let's leave it at that."
Grunting, Kel figured she had gone ahead and used his credentials for any potential information on New Horizons that she could find. It wouldn't be the first time she had done such a thing and he was sure it wouldn't be the last.
Not that it's a bad thing, he reasoned. Without her thinking ahead of the rest of us, I have the feeling this ER would fall apart. Not that I would ever mention that to her.
"I also discovered some nurses have quit that facility because they hate the way its run," Dix went on, ignoring the fact that Kel was riffling through the papers. "I'm told that some of them discovered that the director more or less tells the doctors there what he wants done and since he has, or has had a medical degree, they follow the director's guidelines. The nurses have also felt as though their jobs are at stake if they don't do as directed by those above them. The other problem many of them have encountered before quitting is the fact that they were ordered what to put on reports."
Raising an eyebrow at her, Kel asked, "Are you sure about that?"
"Positive," she said simply. "Unfortunately, because the staff is forced into confidently clauses that won't allow them to reveal what is taking place, they can't report it without breaking their contract, even after they leave New Horizons. If the staff does file a report against the place, either about how a patient is treated or how they themselves are treated, then the facility can sue them. Once that happens, no one will want to hire the person."
"I don't get why the staff would sign such a clause then," Doctor Brackett asked, befuddled.
"I was able to see a copy of the employment contract. It's fairly long and complex," Dixie explained. "Whoever wrote it up was very smart and stuck that part in where it's difficult to pick it out. Even if you carefully look over everything a few times, you more than likely won't catch it."
"That almost seems, well, illegal."
"A few nurses thought so too," sighed Dixie. "They hired lawyers, but couldn't get out."
"I have to say, I'm surprised word hasn't gotten around," Kel said, scanning the documents on New Horizon and the staff.
"You have to understand something though," Dix reminded him. "Us nurses are about a dime a dozen. We are easily replaced and so many nurses are too worried about being caught breaking a contract. They know that it will mean it will be a lot harder, if not impossible, to find a new job."
"That isn't right," Kel huffed.
"No, it isn't, but that's how it is."
"And you were right Dix," Kel announced, pointing something out in the paperwork.
"What's that?" Dix moved around to see what Kel had found.
"Robert, the director of New Horizons, had gone to medical school. Even got a medical license and kept it up for a while. Once he became director at a nursing home about five years ago, he didn't really keep up with his requirements," Doctor Brackett let out a noise of disgust. "He barely kept up enough medical hours. Now, it looks like since he has moved to New Horizons, his medical licenses is out date. "Yet, on the pamphlet for those consider the facility, it claims he has a licenses so that even though there are on call doctors," Kel put up invisible quotes. 'Robert can be the primary doctor for all patients so that families can know their loved ones are getting the best possible medical treatment.'"
"How disgusting!" Dixie claimed in anger. "How is he getting away with that?"
"I honestly don't know," Kel said. "But I don't think that's the worst part."
Sitting down on a chair next to his desk, Dixie steeled herself, "What could be worse?"
"Besides the fact that this facility is less than two years old and smells like it's been around a decade? Or the fact that the nurses seem to be in control of everything? How about the fact we saw a man there who had to be over-medicated and yet, he was strapped down on a thin mattress. Not just with his hands and ankles restrained either, but there was a strap going across his chest and legs as well.
"It's made worse by the fact Joe knows this patient. I guess he saw him about five years after his initial accident and a few years ago. According to him, in the fifteen years or so that this man has had a brain injury, this man has never acted out violently. Joe says he does get a bit hyper at times, as he believes he is a young child, around eleven years old and acts that age, but that's it," Kel ranted.
"I guess even worse was I saw two types of reports, one was labeled 'Internal Reports' and another labeled 'External Reports'. I think they made a mistake because I'm pretty sure I never was meant to see the internal ones," Kel let out a harsh laugh. "The external ones are fairly standard-the patient was acting out and becoming violent towards self or others and so they had to be taken to the time out room, sedated, or restrained. However, the internal ones show a whole other side.
"I could match up almost all the internal reports with the outside ones and while some of them were more or less the same, some of them showed a whole different picture. Some reports said that the patient wasn't focusing on the appropriate task, was hyperactive, wasn't participating in the planned activity, things like that," Kel told Dixie. "The last internal report was on the brain injury patient. I guess they sedated him and restrained him because he was 'too excited' about having visitors. I saw too many times where the facility just medicated the patient instead of finding other ways of coping with the behavior."
"Are you serious?" Dixie's eyes were filling with tears at the thought of how the people were being treated. "That's almost down right abusive."
"I thought so too. So does Joe and Karl. We're not sure what to do though. I mean, this place is better than others as it has activities and a place where patients can be rehabilitated. Yet, to be medicated so they are docile? As a physician, I can't condone that. The director and doctors at New Horizons can argue for it in some cases, but for every single case?" shaking his head sadly, Kel took a deep breath. "There is just no way that is needed for everyone. One thing is for sure, we cannot allow Johnny to go there. We're still unsure if he can go with his family, but definitely not this place.
"The only thing I know for sure is that I need to report New Horizons, or at the very least, the director. As good of a concept as it is, no one deserves to be treated that way," Kel said sternly. "No one. I'm just glad you got this information for me."
"No problem. I wasn't about to let anyone ship Johnny anywhere without knowing everything about it," Dixie said, smiling. "So what's in that other stack of papers?"
"That appears to be the paper work to make Roy and Joanne temporary guardians of Johnny," Kel peeked through the papers. "I'll give this to them today when they stop by and let them know about the decisions us doctors made."
"Are you sure they'll know how to fill it out?" Dixie asked skeptically.
"Nope, I wouldn't know how either," Kel said ruthfully. "That's why I figure while we're waiting for Johnny to wake up on Monday, they can fill it out here in my office. My lawyer already offered to come here and help them out free of charge once he heard the circumstances. The paperwork that would need to be filled out in case things last can also be filled out Monday, but I'll hang onto them until we know for sure.
"It'll give them something to do while waiting for Johnny to fully wake up and for Joe to run the CT scan anyway."
"Sounds good," Dixie said.
Sighing, Kel weakly smiled, "I just hope I got the bases covered. I know the DeSoto's have a lot going on and as much as the crew wants to help right now, it's going to be hard enough for Johnny to deal with Roy, Joanne, Chris and Jenny."
"Speaking of dealing, have you heard anything back about his childhood?" "Not yet, but I'm not too surprised," Kel admitted. "I was told by Roy that his aunt doesn't really care, so honestly, I'm not expecting anything from her. And considering that from what I've learned over the years from Johnny that things work a bit more slowly on the reservation, it might take a while for things to be processed and sent from there."
"Ah, the joys of waiting," Dixie said sarcastically.
"Yep, but until then, we do have work my lady," Kel informed her, holding open his office door as they stepped into a semi-peaceful ER.