One hot day I visited my son at his home at the state operated intermediate care facility where he lived. There was a portable oscillating fan going in the living room. I was glad to see that they had provided some sense of cooling to the room.
As my son made his way over to the fan I knew he would try to touch it as this would be typical behavior for him but I wasn’t concerned since fans have covers on them which prevent him from putting his fingers into it. As he stuck his finger into it and the blades stopped and he pulled his finger out yelping, I suddenly realized that this fan had no front screen protector on it. I could not believe that the staff would put such a fan right out in the open.
The two direct care staff were right there and when questioned, they stated they knew there was not a cover but they had asked the charge about it and there was not another fan to use. I then left to go ask the charge myself about the fan. The charge staff just shrugged his shoulders and said there had been a cover yesterday.
At that time I saw another fan that was not being used and asked the charge if I could take that one to use. He was non-committal and totally unconcerned and was not going to do anything. Since he wasn’t going to give an answer I asked what I could do and he told me I could go to the duty office. So now I went to the duty office to inquire about a fan.
At least the person in the duty office had an answer – that unused fan belonged to someone else and I couldn’t just take it to use in my son’s home. That was an answer that I could work around but what I couldn’t grasp was the total lack of concern of common sense on the part of the direct care staff or the charge person for the unit.
When I brought this safety concern to the attention of administration I was told that the staff are not trained to think – they are only to take orders and they fear that if they make any deviation from that order they will be reprimanded. This answer also made sense and was obviously correct from my observations of what had occurred but was far from reassuring that these direct care staff were in charge of the care of my son and his housemates. .
I thought of this situation yesterday after I had a meeting with the new Clinical Director of the Outpatient Specialty Healthcare Clinic I work at. He referred to the book by David Marquet Turn the Ship Around . As I was listening to the talk and watching the video I realized that part of the problem in the state operated Intermediate Care Facility was the fact that the direct care staff are paid to not think. They have no ownership, do not feel valued and are uninspired by their lack of decision making power.
This total lack of accountability is something that I have now witnessed from the bottom ranks of the organization to the top of the state operated intermediate facility and the agency that licenses it. While I fully believe we need to have the continuum of care I am angry at the lack of accountability and the fact that when issues of concern are brought to attention they are covered up rather than dealt with.
We are entrusting the care of our loved ones to a work force that is not allowed to think. This scares me and is great concern and I can’t keep quiet about it. While I understand that a state operated facility works withing the government and change may be hard, change is not impossible.
Denial is a powerful tool.