[Dysphagia] Christmas coverage

[connorswa at ph.upmc.edu (Connors, William A)]

I absolutely agree with you concerning staffing recruitment and retention issues.  

The fact remains however if we are being asked to contribute to decisions concerning NPO status, diet levels and feeding tubes etc. which so dramatically impact patient safety, quality of life, length of stay and patient satisfaction, then we are ethically bound, and probably legally bound, to provide corresponding coverage just as other shift workers do. The hospital pays for plenty of everyday costs and this is just one more.  Just because it's difficulty to accomplish does not excuse us from our duties and responsibilities.  Who would be satisfied with their spouse or mother being NPO from Friday 9/3/04 at 5pm to Tuesday 9/7/04 at 9am because it's hard on speech therapists?  (That's not a rhetorical question.)  If we want to dance to the 'professional' tune we must pay the piper.  We should not whimper and bemoan the situation, but instead realize that medical speech pathology, since we have assumed the responsibility for and reaped the professional benefits of oropharyngeal dysphagia, requires daily coverage and find creative ways to accomplish safe and quality patient care.  Since upwards of 75% of long term, SNU and IP acute  SLP care revolves around dysphagia, recruitment/retention would not be an issue if we gave up that service provision.  Most of us would be laid off.

-----Original Message-----
From: Buckie,Marcia [mailto:mbuckie@dmc.org]
Sent: Sunday, September 05, 2004 4:44 AM
To: Connors, William A; Neubert, Rebecca R *HS; dysphagia@medonline.com
Subject: RE: [Dysphagia] Christmas coverage


This is a tough issue. I agree with some of the sentiment here, but at the same time, SLP staffs are usually so much smaller than other services that cover all the holidays, and therefore the burden falls on a relatively small group of people to cover a lot of holidays. If we were expected to cover major holidays, we would need budgetary approval to have some type of incentive pay, and I doubt that would happen. 
 
Other professionals that have services available 24/7, 365 are shift workers (such as pharmacy, nursing, respiratory care) and are staffed accordingly (i.e. midnight shifts have premiums, as do weekends, are paid atleast time and half for the weekends , etc.)
 
 
Our Physical Therapy staff is expected to cover 365 days a year, however they have over 15 staff memebers. I have to question whether patients on the rehab unit really have to have therapy on THEIR major religious holiday (whatever it may be.) Therapy/consultative services are not "emergency" services, and therefore, it being missed one day is not of great clinical detriment. (The coverage is all payor driven for PT)
I believe the services that we provide at our hospital are highly regarded, and we have a goal of a 24 hour turnaround time for consults. Although the hospital I work at is not a designated level 1 trauma, we see a lot of trauma patients. We do not provide 7 day a week and all Holiday coverage (we do have 6 day a week coverage.) I suspect if we did, and with our staff of three FTEs, we would have serious recruitment problems.
 
Marcia Buckie

	-----Original Message----- 
	From: dysphagia-bounces@b9.com on behalf of Connors, William A 
	Sent: Sat 9/4/2004 9:35 PM 
	To: Neubert, Rebecca R *HS; dysphagia@medonline.com 
	Cc: 
	Subject: RE: [Dysphagia] Christmas coverage
	
	

	JCAHO requires consistent levels of treatment everyday by all disciplines.  Common sense would say that if what we do, especially relative to nutrition, is of value relative to medical care of a patient on a Wednesday (or non holi-day), it is of equal value to the patient on a Sunday (or holiday).  That's difficult to disagree with.  Many would say if we SLP's want to be treated with respect as  health care professionals then we need to work the heath care calendar.   The problem appears to be the practicality of coverage and the annoyance of working on holidays/weekends. 
	
	-----Original Message-----
	From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
	Behalf Of Neubert, Rebecca R *HS
	Sent: Friday, September 03, 2004 9:05 AM
	To: dysphagia@medonline.com
	Subject: [Dysphagia] Christmas coverage
	
	
	I would like to hear from ACUTE CARE speech pathologists in LEVEL 1 TRAUMA CENTERS as to what coverage you are required to have at Christmas this year, which falls on a Saturday. And, just for future reference, what Christmas coverage you have when Christmas falls on a weekday.  The more responses the better, so we can get a good number of comparisons. If you don't mind, sharing the name of your institution would be helpful. Thanks a lot.
	
	Rebecca Neubert
	UVA Medical Center