You park right at the entrance and dash to the automatic entry doors, clutching your very ill and weakening child.
BAM! You and your child hit the doors when they don’t open automatically. Slightly dazed, you realize the doors don’t open at all. You bang on the doors yelling for help, yelling for a nurse. No one comes. You look inside and realize most of the lights are off. And then you see a handwritten note taped to the glass door. It reads: “We are sorry but the hospital is closed from 5 p.m. to 8 a.m.
Please return in the morning. We apologize; however, we have no nursing staff to keep the hospital open 24 hours.”
Is this scenario far-fetched? A year or two ago it would have been inconceivable. Now, however, it’s edging towards a reality. With dismay, I read that the nurses in Tinian are not getting paid. I have had the opportunity over the last five years to occasionally work at THC when providers were unavailable. I know these nurses well and can state that they are some of the best nurses with whom I’ve worked during the last 30 years. Some of nurses have been there for years and are every bit as competent as any well trained nurse you’d find in a big city hospital.
Despite extremely frustrating circumstances during the last several years, these nurses keep the hospital running, have a proven history of dedication, work as a cohesive team, and often end up doing extra work to maintain the hospital and patient care, without the benefit of any extra pay. The fact that they still work under these conditions speaks highly for their dedication. The fact that they deserve higher compensation for all that they do would be an argument against which only a fool would pursue. But despite all of this, the nursing staff is not getting paid with any regularity and, for some, their status is in limbo.
THC is a public hospital. The ultimate responsibility comes from the CNMI central government to pay for the staffing. No reasonable person could argue against healthcare as among the top priorities of any RESPONSIBLE government.
Now then…let’s consider the possibility that the nursing staff will be reduced because of lack of payment, frustration, attrition, etc. Having worked in similar situations in other countries, experience dictates that there are two possible options: 1) they are not replaced, or 2) they are replaced by very cheaply paid, poorly trained third world nurses. To the fine folks in Tinian, I encourage you to do all you can to retain your current nurses; the alternatives can be a healthcare nightmare, as I have witnessed in other countries with mismanaged and declining economies.
I have tremendous respect for the nurses currently working at THC. The local Tinian government is attempting to retain the nurses, but they have very limited funds. Nearly every aspect of CNMI is under emergency status, giving the power to the governor for prioritizing funding. With a mere signature, the central government can freeze all discretionary funding to the legislators, boot out unnecessary and overpaid lawyers, consultants, and department heads, and subsequently free up funding to pay for the nursing staff at THC (note: this simple and reasonable concept applies as well to many other folks not getting paid for their work ).
Unless priorities change at the highest levels of government, there may come at time in the not too distant future where the inconceivable becomes the reality. Where the backbone of any hospital — the nurses — are no longer working. And where you arrive at the hospital with an ill family member only to find a note on the door: “Closed due to lack of nursing staff.”
BILL WEISS, PA-C
Puerto Rico, Saipan
