The shortage of nurses on Guam has forced the local public and private hospitals to go into a divert status – when patients are backed up at the emergency room and unable to be moved to a room.
One recent patient at Guam Regional Medical City is saying this shortage of nurses affected his aftercare.
Alfredo Antolin, who was admitted to GRMC on Dec. 14, 2019, was diagnosed with osteomyelitis, an infection of the bone that had developed in his left foot. He had to undergo angioplasty and two surgeries – the second being the amputation of his fifth, or pinky, toe.
Antolin said he was initially told his discharge date would be Jan. 5, the Monday following his second surgery. Additionally, he was told he would need wound care, which would involve a weekly visit to his attending physician and a daily IV infusion of antibiotics for a month or more, depending on his medical prognosis.
And yet, the day after his second surgery, on Jan. 2, he was told the hospital was discharging him that day.
“I was panicking,” he said. “I didn’t have the opportunity to get things set up – wheelchair, walker, nurse ... not even a ride home and I live alone.”
GRMC officials, in response to queries from The Guam Daily Post, confirmed the hospital had been in divert status the weekend following Antolin’s surgery. GRMC added there is a “worldwide shortage of nurses.”
Guam Memorial Hospital also has had to go into divert status due to a shortage of nurses.
“Like every hospital, GRMC would always welcome more nurses,” hospital officials said. Regarding GRMC's discharge policy, spokeswoman Cindy Hanson said, “Patients are discharged per their previously agreed upon discharge plan. However, discharge plans can be modified if the attending physician decides it would not be safe to discharge the patient on the agreed upon discharge date.”
She noted that the hospital can’t release much more information about the specific case due to regulations in the Health Insurance Portability and Accountability Act. She added, “Mr. Antolin received the very best care. He was sharing with staff that GRMC is his favorite hospital and how he will only come here. So we’re confused by his complaint.”
According to Antolin, doctors said the diagnosis was a “rare but severe condition (that) will take longer to treat and heal.”
“The doctors had to perform angioplasty on my foot” before the surgery – they had to remove the bones that had been infected, he said, describing the process. And though he thinks the surgery itself went well, it’s what came afterward that was an issue.
“My surgeon had told me he would come and see me ... for an evaluation,” Antolin said, noting he anticipated that part of the discussion with his surgeon would be when he’d be discharged from the hospital and additional details of the aftercare required.
“That was Thursday.”
So it was a surprise, he said, when on Friday he was told he needed to be discharged that same day.
“Imagine, I didn’t have anything set up. ... I needed to get a nurse to assist me with the (intravenous therapy) for the house, a wheelchair to help me get around while I recover,” he said.
Antolin said when he asked why he had to leave the day after his surgery, he was told they needed the room. When he explained his situation to one of the doctors on his treatment team, they agreed Monday would be the date of his discharge and Antolin thought the matter was settled.
But the following Sunday, another person from his team of health care providers told him he needed to be discharged before Monday “because there were four patients waiting for a room,” Antolin said.
When he pointed out the number of vacant rooms on his floor, a doctor told him it’s because they don’t have the staff to monitor all of the rooms.
“So now they’re saying it’s because of a staffing issue,” he said. “I’m like, 'Oh my gosh, does this hospital have no empathy? I just got out of surgery and they’re kicking me out.’”
Antolin said he was ultimately discharged Monday afternoon but feels like it was only because he spoke up.
“What about people who don’t know how to ask questions? Or who are afraid to disagree with an authority figure? I don’t want this happening to them,” he said.