Shutdown

Located deep in Any State, USA, at the MEDDAC on Fort Somewhere: A rare look inside the experience of an active duty Army nurse during the government shutdown and the far-reaching consequences for a military and civilian workforce at war. Specialties Government Article

Shutdown

"How much do we have left?"

My boss, Angela, stood in front of me with concern bordering on desperation in her eyes. She bit her lower lip unconsciously, tapping the paper in her left hand against her leg. Her anxiety was palpable from where I sat a few feet away.

"Not much. If they start up again within a week or two, we can make it. But until then, it's going to be tight." I weighed my words carefully as I responded.

"I've gotten instructions from higher. We need to conserve supplies as much as possible just in case this doesn't end soon."

"Not that we waste it anyway."

"You know what I mean. Every NS flush, every blunt fill needle, every NS bag, every primary tubing set--keep it locked up at all times until it's in use. We can't have scavengers coming in from other areas. It'll drain us even faster."

"Who will cover me if my clinic stays open?" I asked, suddenly realizing that all of my covering physicians, specialists, were civilians--and soon to be furloughed indefinitely.

Angela's eyes clouded over again. "It'll have to be LTC Jameson. He's the only one over us that's military."

"He's the department chief." I said incredulously. "He's a busy man!"

Angela shrugged and held up her hands. "I mean, what else can we do? If this continues, the rest of us will eventually be furloughed, but you can still run this piece of the clinic. We have patients. We have the supplies...for now. All you need is coverage."

"And the drugs themselves." I reminded her.

Angela's shoulders slumped. "I can't believe I hadn't even thought of that."

"There's no funds to get anything else? Nothing?"

"Not even a Tylenol until this is over."

I paused a moment. "We've got enough for Mr. Campbell's weekly dose. That's something."

"Right. But other than that, everything is in short supply. Some of the other stuff doesn't have long before it expires." Angela shook her head, rubbing her temples. "Maybe the ER can use it up for us."

"The ER? Why would they stay open?"

"They have to. For emergencies." Angela explained. "And that's probably where you'll be sent if the clinics close. Either there or inpatient."

"How can they keep this place open without a pharmacy? There are drugs that they'll need that they won't be able to access." I mused, disbelieving. "And I mean, we're running out of supplies. I can't imagine the inpatient wards. Between supplies and drugs alone, the wards and ER will be forced to shut down."

Angela sighed and seemed to ooze into the seat across from my desk. "I don't know, LT." She shook her head. "All of our patients are going to have to go to the network. It's going to be a mess."

"And expensive as all get-out." I added, thinking of the number of patients we were going to have to defer to outside care and the staggering cost associated with treating patients outside of the MTF (military treatment facility) system.

"It makes about as much sense as the sequester did--we're going to end up spending money so we can appear to save it." Angela shook her head in disbelief. She gave me a faint smile. "Well, it isn't a total wash. At least Congress will still get paid."

"What a relief." I returned dryly.

"Have you guys heard the news?"

Tessa, one of the specialty nurses, walked into my office and haunted the doorway, her face grim.

"About what?" Angela asked.

"Surgery is shutting down. That knocks us out of business until further notice. I mean, what's the point of seeing patients if we can't diagnose and treat?" She said, exhaling in irritation.

"Oh, go figure!" Angela murmured. "And your clinic was just catching up with the demand, too."

"Ladies, let's not bring up access to care at a time like this." I begged. "I think I'm having chest pain as it is. We might as well drive down the highway and throw government money out the window for all the good this situation's doing anyone."

"Chest pain, eh? I'll bet you're not the only one. At least cardiology will keep busy." Tessa smirked, the side of her mouth tugging into an ironic smile.

"That's right." Angela grinned.

"Yeah, if they can keep it open." I pointed out.

The three of us fell silent again, all of us pausing briefly before simultaneously reentering the conversation.

"All right, well, I've got to head to the desk. Jessica has some paperwork for me to sign." Angela stood up and headed into the hall.

"I'm heading back to my patients." Tessa said, turning for her end of the hallway.

"And I'll be right here." I said, glancing back at my computer and the waiting reports.

"All right" echoed back at me twice, and retreating footsteps in different directions sounded the end of the discussion.

All around my hospital, similar conversations echo through quiet hallways, behind the closed doors of command wing offices, and in the shadows of nurses' stations. No one talks politics--this goes far beyond either side of the aisle, and everyone knows that beating the political gamut to death will only serve to flare tempers and stir the already boiling pot. At the end of the day, we'll still be defunded, our supplies will dwindle, and our patients will defer.

The colonels and senior NCOs move like flighty birds, meeting to chat briefly before fluttering away; the longtime GS civilians speak in confidential tones, their faces set in determination and disappointment; and the rest of us watch and wait for word on what will happen next.

**Names as well as details have been changed for the purpose of privacy, while attempting to remain true to the spirit of the experience**

I am a first lieutenant at Walter Reed National Military Medical Center.

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Editorial Team / Moderator

Lunah, MSN, RN

14 Articles; 13,766 Posts

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Nothing really changes out here, but I do expect supplies that are difficult to get (most of them) will become even more difficult to get. Sigh. We can't even get our regular mail as it is.

tokebi

1 Article; 404 Posts

Specializes in Hem/Onc/BMT.

I'm just shaking my head... ugh.

nrsang97, BSN, RN

2,602 Posts

Specializes in Neuro ICU and Med Surg.

I too just shake my head at the nonsense of our government.

Elvish, BSN, DNP, RN, NP

4 Articles; 5,259 Posts

Specializes in Community, OB, Nursery.

As usual.....the folks in charge act like complete morons and the wrong people bear the brunt. Thumbs down.

Specializes in Hospice.

Thank you for sharing your story. The more perspectives I hear from real people being affected by the shutdown, the more furious/baffled I am at our government.

cav5

68 Posts

Specializes in School Nurse; ICU.

I know exactly what you mean. I am working but under an IOU status-meaning I have to work as I am not exempt but I may or may not get paid. My husband isn't getting paid or working at all. We have over 40 years combined government service work and now here we are.

I wanted to call in sick today-fever, flu, you know the drill. However, the minute I do so I become put into a different category of furlough--not just for today but for the weekend with no housing benefits, COLA, etc until Monday. 1 day of probably getting paid vs 3 days of definitely not getting paid wasn't worth it.

Add the 14 days that they furloughed us this summer (some were just coming back to work) and it makes for a lot of frustration.

I still love what I do, still think it is the most fantastic job in the world but some days you wonder why the people who make the decisions got a pay raise and we may or may not get paid at all-how is this legal not to mention fair....

TashaLPN2006RN2012, ASN, RN

1 Article; 1,715 Posts

Specializes in Home Health, Podiatry, Neurology, Case Mgmt.

Lovely and intriguing writing...As a Veterans wife, and nurse this whole debacle is frustrating. For my disabled and purple heart husband is not completely focusing on all these governmental issues which may or may not affect him, but it's made the PTSD rear it's ugly head! =( I used to work MTF's as a civillian when hubby was in the Army. It's not as if most clinics have everything they needed anyway, let alone being able to even get those supplies now. It's such a shame that those who make the decisions aren't affected by it at all, while everyone else suffers...

AZ_LPN_8_26_13

462 Posts

Thanks for posting this article. People ask me all the time how this is really affecting ordinary people. Your story brings this home in a real way. It's really outrageous how our "leaders" still get paid, but regular hard working folks have to do without.