I came to work today only to find nurses and administrators in a state of subdued panic.  I wondered why everyone looked like they had just seen werewolves; I was informed of the following:  ‘Joint Commission is here!’  It was said in a whisper, with a glance over the shoulder.  It was expressed with the same sort of emotion one might use when saying, ‘Comrade Stalin is stopping by today!’ Or maybe ‘The SS scheduled a visit!’ 

All afternoon, nurses and administrators have been running about, checking medical records, explaining inconsistencies, sweating blood over the mere threat of a sanction, a bad report, a raised eyebrow or a ‘tsk, tsk’ from the evaluators.

How has this happened?  Wasn’t the whole idea of JCAHO to make hospitals better?  Do we do that with fear?  We’re told that torture does no good, but surely the anxiety caused by a joint commission comes close to the pain of an  afternoon spent having your fingernails removed up to the elbow. 

I think it’s tragic and comic.  Here we are, nurses, physicians, administrators doing our best, day in and day out at hospitals with vastly different missions and capacities. 

And yet, JCAHO descends like a pack of hyenas, dismembering order and good sense, and leaving all the staff scurring around in terror; and hiding their coffee cups, call schedules, food and anything else one might reasonably expect to see at any sane nursing station.

I wonder, what is the rate of medical error on days that JCAHO visits?  There’s a study for you!  Frankly, people could probably die for the nursing and medical staff gesticulating and genuflecting before the gods and goddess of the Olympian Joint Commission. 

In the light of all this, explain to me one thing;  why do we pay them to do this to us?


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