Letters (Sep. 5, 2018)

• A Traveling Nurse’s Coast Hospital Experience
• Coast Hospital Responds
• Mendo Refuses To Enforce Law
• Second Chances
• Petaluma Art
• It’s The Cold That’ll Get You?
• Clear ’em Or Underground ’em
• How About It, Libs?

A TRAVELING NURSE’S COAST HOSPITAL EXPERIENCE

Editor,

(I was a traveling nurse assigned to Mendocino Coast District Hospital earlier this year. On Wednesday, May 30, 2018, at 8:17pm I sent this letter of resignation from the operating room at the Mendocino Coast District Hospital to the chief nursing officer at Mendocino Coast District Hospital.)

* * *

Regretfully, I compose this letter of resignation from the operating room at Mendocino Coast District Hospital. My reasons are numerous and I know you may have heard most of what I am about to state. I am a traveling operating room registered nurse and I am wrong if I don't report my concerns.

The operating room staff does not like traveler nurses. This is obvious the way we are treated, talked about, and completely disrespected. It's no wonder you have not kept but a few for very long. Those who have stayed are hounded all day by a micromanager with a big heart but who still is very overbearing and will nag you to the point of ridicule. The other is so limited and brainwashed that he blindly defends the chief operating room nurse’s violations of Association of Operating Room Nurses (AORN) standards

Using the same blue foam pads repeatedly on each and every patient (for padding around the hands, wrists and elbows) is disgusting and a major violation regarding sanitation in an operating room. The cost for foam pads is miniscule and should be passed on to the patients. Even if there is a MRSA patient there is nothing in writing that addresses the disposal of these blue foam pads. This is a major AORN standards violation. The standing charge RN is so adamant on some issues and ignorant on others. It makes no sense and is not within standards.

Those in scrubs should be wearing only hospital washed or contractor washed scrubs. Some MDs don't, specifically Dr. Kerman. This practice is not the standard at Mendocino Coast District Hospital. Some doctors walk in the scrubs-only zone in civilian clothes in clear violation of AORN standards. Dr. Jack Bellah violated this rule twice this week because he feels he can break the rules and no one, I mean no one, has the gall to challenge him. Dr. Kerman violates the standard on a daily basis.

Dr. Kerman violates the wearing of scrubs on a daily basis. His scrubs are not laundered in accordance with surgical standards. They have allowed so many exceptions and he has been very generous and helpful in the past, but this is still not acceptable practice. And it presents practice violations. He even has a special key to the exit door that no other employee in the operating room has. This is so that he doesn't have to walk a little bit further through the front door like all other employees do.

The fact is that Dr. Kerman is so obese he can't urinate completely in the toilet in the operating room. The result is that 30 or 40 milliliters ends up on the floor and is walked in and then spread all through the operating room office, hallways and operating room. The smell when he has urinated is obvious. This only happens when he is in the operating room. When this fact is pointed out to the staff male nurse he is in denial. He responds with "it's a locker room and they all smell like urine." I'm not buying that since it only happens when Dr. Kerman is working. Think about all the aseptic techniques that go on in an operating room when the urine dragged throughout because someone is urinating uncontrollably on the floor of the operating room's men's bathroom.

Many wear scrubs outside the operating room and think wearing an open gown is a clean protocol when they don't close the front. Some don't wear a gawn, again violation AORN standards. Dr. Bellah never does. The wearing of an open gown not secured in front is a joke, since this only covers nonsterile areas. The clean area is open and and exposed so this is a ridiculous practice and a clear violation of surgical standards.

Dr. Bellah always uses his feet to open a sterile operating room door. Think about it. Does a professional surgeon open a sterile operating room door before he is about to scrub with a kung fu kick to the outside door handle to the surgery room and fling it open? He stands in blood and bone chips for half his cases and does not change his shoe covers. Really, kicking a door latch with urine, blood and bone chips on your shoe covers is a third world scenario. And no, I don't ever plan to have a surgical procedure at this place. Not after witnessing these clear and flagrant violations of sanitary practices. There is no AORN standard that would encourage that stupidity, yet this staff turns their heads to this ridiculous and asinine practice. Another clear violation of surgical standards. It really is hard to believe this practice continues.

The books are cooked when Dr. Kermen wastes narcotics. He never shows his waste and I refused to countersign when he did not show me. In contrast to Dr. Phil Conwell, a consummate professional in the operating room is Dr. Kermen, the opposite. Phil is a great professional.

When Dr. Bellah and Dr. Kermen are counting down the days when the traveling nurses are leaving it becomes a semi-violent workplace. The demeaning words and tone from Dr. Bellah reveal an anger that creates a very uncomfortable workplace. His uncontrolled temper makes an unsafe workplace that puts all staff on edge. Dr. Kermen has a similar capacity when he has to stand up and move operating room equipment, telling us to "get this shit out of my way."

I signed a contract to be an operating room registered nurse, not a recovery room registered nurse. This is entirely against AORN practice. That is, a 20 minute orientation to the recovery room is not in my comfort zone when I'm expected to recover a patient after hours by myself. Another AORN violation is not having an on-call recovery room registered nurse, standards dictate that two registered nurses be in the recovery room, not in the emergency room, ICU or medical surgical ward. Two trained RNs with one RN with recovery room experience.

The hospital blood policy is violated when Dr. Kermen orders blood to be infused without a pump and again when liced [sic] by a pressure bag after a patient loses 1100 millliliters of blood from a total hip case. This is clearly against hospital policy yet there is no enforcement if one was to read it. The hospital has a “the blind leading the blind” policy.

We had a locums general surgeon for a few days. She was estimated to be 400 pounds. She was rumored to be let go when she fell asleep during orientation in front of a computer. Where are the hospital standards with this precedent when an estimated 500 pound head of anesthesia at Coast District Hospital falls asleep on a regular basis during surgical procedure?

What's the concern if I were to copy send a copy of this e-mail to the local papers?

Sleeping in the operating room when you are anesthetizing a surgical patient is not in accordance with AORN standards or any surgical standards. It is a wonder why the surgeons allow this practice. I think that it will take a sentinel event for this hospital to get a grip on things.

Playing games like covering, hiding, or leaving obvious medical papers and records are games that Dr. Bellah, Dr. Kermen and Dr. Sussman do. They go out of their way to trip up the traveling nurses. On that note, so do the resident staff. The doctor preference cards have many many obsolete items and when the traveling nurses pull or open a case and the items are wrong it creates dis-harmony, and whining from the sensitive and spoiled MDs. Those cards set traveling nurses up for failure on a regular basis. These surgeons are so coddled that it is an inhospitable place for traveling nurses.

I am concerned about the way traveling nurses are treated, about the unsanitary practices that occur almost daily in what is supposed to be the cleanest place in Fort Bragg. A sentinel event is about to happen and when it does I do not want to be part of it. The multiple issues I point out are just the tip of the iceberg. This hospital’s sentinel event is coming and I do not want to be part of it. Good day.

Name withheld

COAST HOSPITAL RESPONDS

Dear Community,

On May 30, 2018, Mendocino Coast District Hospital (MCDH) received a letter of resignation from a traveling surgery nurse, which was recently published anonymously in the press, and which makes a number of unfortunate allegations about the Hospital’s surgery department. MCDH is committed to providing high-quality, patient centered health care in a safe, caring and professional environment, and we take allegations like these very seriously. Contrary to the allegations in the letter, I want to assure you that MCDH provides safe care, and I am very proud of our strong track record of patient safety, and our employees and doctors who work hard every day to serve this community.

Our surgery department is subject to rigorous standards and inspections, and none of the entities which regulate and inspect our hospital have ever identified evidence to support these types of allegations. The fact is that MCDH has had a 0% infection rate in our surgery department over the last five years, as confirmed by our Infection Control Committee and patient care results.

We are inspected and accredited by The Joint Commission, the organization that accredits more than 20,000 US healthcare organizations and programs, and they have found no deficiencies that resemble any of the allegations in this letter. The California Department of Public Health regularly inspects our facility and examines our processes with amazing attention to detail, and they too have not found evidence of any of these claims. In addition, the Office of Statewide Health Planning and Development (OSHPD) visits and inspects our surgery department, and are actively monitoring the HVAC construction project in our surgical area. They too have not reported or raised concerns about any of the topics from this letter.

Nonetheless, once we received this letter, we immediately investigated the allegations. We did confirm that there were valid concerns raised regarding the proper use of scrubs, and we promptly implemented a plan of action to address those concerns.

MCDH policy, as well as Federal and State regulations, requires all staff to report any safety concerns immediately. It is concerning that this traveling nurse waited so long before reporting many of these allegations. Regulations require that any safety concerns need to be reported immediately at the risk of losing the ability to maintain a registered nursing license. An anonymous letter in a local paper does not follow proper Association of Operating Room Nurses (AORN) standards.

The concerns brought forward in the letter have become a part of both our Medical Staff Peer Review process and Medical Staff Performance Improvement process. Lynn Finley, Chief Nursing Officer at MCDH commented, “I have had several investigative meetings with the Surgery Department and our Providers to get a clear picture of what actually happened. I can tell you the few allegations that have truth have all been addressed, and processes are and have been in place to prevent things like this from ever occurring.”

Sincerely,

Bob Edwards, CEO, Mendocino Coast District Hospital

MENDO REFUSES TO ENFORCE LAW

Editor,

The citizen’s initiative Measure V became law June 8, 2016 and declares “…INTENTIONALLY KILLED AND LEFT STANDING TREES A PUBLIC NUISANCE.” 

As of August 2018 this law has been ignored.

It is unconscionable that our county government ignores the will of the people. No one knows why. Does the threat of a lawsuit trump the will and welfare of the people of Mendocino County? Measure V is designed to help lessen catastrophic fires, death and destruction in this time of severe drought and climate change. 

When supervisors Brown, McCowen, and Woodhouse refused to join Hamburg and Gjerde to enforce V, County Counsel Katherine Elliott asked the state’s Attorney Generals lawyers for a legal opinion in February 2017. AG attorney Catherine Bidart wrote it 13 months later in April 2018. It’s been “circulating” among AG attorneys since and Bidart cannot give anyone a date for release. 

I put in a Public Records Request on August 13 and received an almost immediate reply from Bidart herself stating that Opinion 17-202 cannot be released while being “reviewed” due to attorney-client privilege (between attorneys of the same AG office). 

This may be legally defensible but is morally reprehensible! We can only guess as to why the holdup, but we the people have had enough. We don’t want to wait any longer. 

Mendocino County burns and top brass at Calfire called the millions of bone dry dead standing trees as a major problem. In the meantime, MRC and other timber operators are continuing hack & squirt and leaving millions of dead standing trees near our homes and roads.

We want the board of supervisors to enforce, retroactively, Measure V, and we want it now. This is, after all supposed to be a democracy and our supervisors are elected to represent our interests and they should follow the law.

Els Cooperrider

Ukiah

SECOND CHANCES

Editor,

Trump’s friend Paul Manafort was convicted by a jury of an $18 million tax fraud and cover-up. The "Off The Record" comments from last week, do not show an understanding between the legal offshoring of money and the criminal-lying, fraud and hiding, that he was found guilty of. 

Trump pardoning Manafort would be an abuse of power, as pardons were never intended to excuse these partisan criminal acts. 

US intelligence is guilty of many bad things, but it was the Bush criminals who were responsible for lying us into the Iraq war. 

Senior intelligence officials had a press conference before the war started, saying that the Bush administration was misusing and "cherry-picking" the Saddam WMD evidence. The "unrelieved bungling" is a direct result of the lies and cover-ups, all from Bush's illegal invasion of Iraq. 

There were no "intellectuals" saying that Saddam had nukes. The Bush crime family alleged they did with fake "proof," then rushed the US weapons inspectors outtathere to begin bombing Baghdad, against the advice of the intelligence agencies. Yes, the mainstream media is complicit, as they make huge $$ off their lies. 

But, so much of what you think you know about 9-11 is completely wrong! I remember how you and Cockburn insulted people who studied the details and devils behind 9-11, calling us "Conspiracy Nuts." When we paid attention and learned of the truth behind 9-11, you sneered calling us "Truthers," as if that were some kind of insult! What was insulting was watching a majority of Americans, stick their heads in the sand, unable to discern the obvious truth, that Bush had lied, on purpose, to bring us an illegal war. This is now well known among most people who have paid attention, what's your excuse? 

Those who support Trump and his web of lies and deceit are foolish and ignorant of the immoral, illegal and unconstitutional crimes he is directing upon us. If you say that you are for Trump, then you have sadly lost your ability of intelligent discernment. Please try again. 

Regards,

Rob Mahon

Covelo

ED REPLY: Individuals and corporations hide money overseas and lie about it all the time. The whole Manafort-Mueller Show is aimed at bringing down Trump, not any noble search for truth. Anyway, Manafort's small potatoes compared to lots of tax evaders. The "truth" about 911? Nineteen fanatics, funded by our medieval ally, the Saudis, managed to hijack four airliners and fly two of them into the World Trade Center. The FBI ignored the information from one of their own field agents that the hijackers were enrolled in a Florida flight school where they'd made it clear they weren't interested in learning how to take off or land. All they wanted to know is how to keep the planes airborne and how to steer them. Subsequent events were preventable. PS. Do I get at least a C in conspiracy-think for this outline of what I believe are the known, verifiable facts?

PETALUMA ART

Editor: 

Somebody should pull the plug (pun intended) on those tubs in Petaluma. I can already visualize the first daredevils scaling the stilts to get their photos taken perched in the tubs for YouTube fame.

Has anyone ever heard of this artist/creator before? He certainly is getting a lot of free notice now. If only I could remember his name.

Ellen O’Neel

Healdsburg

IT’S THE COLD THAT’LL GET YOU?

Editor,

Stephen Essrig is worried about a new ice age, but is wrong to suggest it presents a greater danger than global warming.

https://www.theava.com/archives/85746/comment-page-1#27

We have an internal temperature of 37°C that we control via perspiration (or air-conditioning). We cannot survive above a “wet bulb temperature” of 35°C, meaning a temperature of 35°C at 100% humidity, or at a higher temperature with lower humidity. As things stand, the planetary surface temperature will increase by 2°C over the course of this century owing to carbon dioxide and methane already emitted. These two gases are respectively at 1.45 and 2.5 times their 1750 pre-industrial levels, having been steady before that for the 11,700 years since the most recent ice age.

There isn’t the remotest chance that we will spontaneously enter another ice age. However, we do in any case now have the proven ability to raise the planetary temperature (by 0.8°C over the last hundred years). The most efficient and safe way to do this is to release methane, which has a 35 times greater warming effect per molecule than carbon dioxide and remains in the atmosphere for just eight years before being oxidized to carbon dioxide and water. So if there did happen to be a cataclysmic volcanic eruption or unexpected meteor fall leading to a drop in global temperatures, our response should be to release the appropriate amount of methane to keep us warm even in a world of temporarily darkened skies, with controlled recovery in a decade or two. In the world as we know it, however, we are going to be cooked alive unless we rapidly change to solar and wind power.

Malcolm McGeoch

Little Compton, Rhode Island

CLEAR ’EM OR UNDERGROUND ’EM

To the Editor:

The Mendocino County property that my family has owned since 1983 has a quarter-mile long high voltage branch line along our drive to reach our structures. My dog and I walk its route every morning I am there to get our copy of the local paper. The Redwood Fire last October came close enough that we had to evacuate, but we dodged the bullet. It has changed my outlook on what needs to be done to protect our homes, to protect our environment from air pollution and fire produced greenhouse gases and last but not least to keep firefighters safely in their firehouses, or if volunteers at home, etc., waiting for calls that come less often.

In the early 1980s when they built, my parents under-grounded the last 200 feet of power line, the 220 volt portion, for how it would look, not safety, reasons. Few were thinking of safety concerns then, and we were no exception. Under grounding the high voltage portion would have looked nice but was way more than my parents wanted to spend.

For years I have urged PG&E to cut more, much more, around the lines on our property. “Don’t just nip that limb, take the whole tree out. It will save in the long run.” The answer was almost always: “No, we can’t do that.” I once got them to take out half of a large Live Oak but it took many phone calls after the crew had come through to get a supervisor to come look and the crew to come back.

This year, surprise, surprise, they cut more than they ever have. Still, much more could be done. Limbs are still over our lines and nearby trees still lean at dangerous angles.

I was told by their contractor that some property owners, unlike us, even tell them to cut less not more and that PG&E has to listen if the line is on private property, as long as the minimum California State Public Utility Commission requirements are met. That needs to change. Besides themselves those property owners are endangering the whole community.

In places the lines on our property are still in a tunnel, meaning trees are directly overhead, though at a distance from the wires, meaning they won’t rub them. Falling on them is still a distinct possibility. In last October’s wind two trees came down, but not near the power lines. We have had a number of trees fall on our 17 acres over the years with no wind at all. Most were living and by all appearances healthy. The majority were oaks that appear to have gotten “over extended,” or spindley, as it were.

Once again this year, after the PG&E contractor left, we hired a tree service to cut more, and more than ever. They were here for two days but they are restricted as to how close to the lines they can work.

I saw an opinion article in another paper by former State Senator Noreen Evans urging the under-grounding of power lines as a solution to what I have described. Increasing the tree trimming and removal along the routes of rural power lines would be much cheaper than under grounding. Because of the cost, under-grounding will never happen in rural areas like most of Redwood Valley.

Unfortunately it is most often falling trees and tree limbs that are the catalyst for power line generated fires. I wish that was not so, because I would prefer to take my walks along our drive under the shade of a forest. But weighed against the danger of fire, it is a luxury worth losing. I’d also prefer to drive along roads with beautiful trees right up to the edge. But if there are power lines along the edge of that road I am willing to see that change. It would be cheap insurance against the kind of destruction we have experienced, and much cheaper than unrealizable hopes for under-grounding.

Michael Toivonen

Redwood Valley

HOW ABOUT IT, LIBS?

Editor,

About 15 years ago Polly Klass was kidnapped by a man who’s still on Death Row being fed by the taxpayers as he watches tv all day. I think people remember that name. How do you think she felt in the back of that van, bound and gagged, driving around on back roads, all alone. How do you think she felt? And then being stopped by two deputy sheriffs and they could not search the van because they didn't have probable cause. Political correctness, again. Polly Klaas was in the back of that van. He later killed her and raped her and did everything he could do to her and then threw her body out on the highway south of Cloverdale. How do you people think about that? Why don't you Republicans stand up and say something about this? Why don't you? And you liberal Democrats sit there and sneer. Yeah, we want political correctness. We want open borders, rotten bastards. Another thing, what about Molly Tibbetts, a girl who grew up in Iowa and then being run down and killed and stabbed to death by an illegal immigrant. How do you think she felt? All alone. Scared. Look around. Look around your room at your kids! How you think they'd like that? You rotten liberals. Stand up and say something! Come on! Come back to me about this! I hope Donald Trump buries all of you people. 

God bless Donald Trump

Jerry Philbrick

Comptche

PS. The man who killed and raped and did everything possible to Polly Klaas, is still in jail. He will never get put away. He's eating the best food, three nice meals a day, shower, TV, probably gets to see his girlfriend, medical, nobody can touch him. Political correctness is to blame for that. They have a lawyer watching him all the time. He will never have any harm coming to in.  And then that guy who just killed Molly Tibbetts. Nothing will happen to him. He will get cared for and groomed and put in jail and he'll have a liberal lawyer working with him and then a rotten liberal court judge will probably do nothing, I mean nothing! Isn't that something? Liberal judges let killers live. Come on people! Wake up! Get rid of the liberals!  

PPS. Any liberal who wants to confront me face to face about this letter I would welcome it! Come on! You want to get your face slapped? Come on! If you dare. But you don't. You have no balls. None of you people do. You are just ugly rotten people.