My Experiences of A Stressful Situation:

Downsizing the W.A.R. Room


Audrey Gaither


"All positions have been eliminated and your services are no longer needed. As of December 31, 1998, this department will close."

These are the words that I had to say to my loyal staff of two years. I have never experienced such a stressful situation as this one. What’s the old cliché "Don’t sweat the small stuff"! Well, the small stuff just turned to big stuff.

Centralized Telemetry a.k.a. the Telemetry W.A.R. Room is a monitoring system that can monitor a patient's heart activity approximately 24 hours a day for as long as the patient stays in the hospital or until the physician discharges the order for telemetry. This service assures the patient that has been admitted with heart problems a fast diagnosis of any cardiac problems or potential ones. The W.A.R. room is a 24-hour department staffed with telemetry technicians that are certified and proficient at cardiac rhythm identification. The W.A.R. stands for Warning Armed Rhythms, due to fact that at any given time a patient's heart rhythm can become lethal. This involves life threatening rhythms that, if left unattended, could cause symptoms that could in turn lead to death. As W.A.R. rooms workers, we must provide a second pair of eyes (although we’re usually the first) to the nursing staff. With the demand of nursing care placed on nurses, having a centralized Telemetry W.A.R. room in place is certainly an asset. Whenever there is a lethal rhythm has triggers an alarm by the monitoring system, followed by identification by the telemetry technician has life-threatening and not merely an artifact, a nurse is paged and called, alerting her to the emergency. Thus, the patient has fast attentive care from a team of Health Care professionals, Telemetry and Nursing.

Downsizing is a legitimate tool but not necessarily the best choice for every circumstance. Placing complete control in a clinical setting will lead to many consequences. Because people aren’t perfect, systems aren’t perfect and frequent mistakes will be made and covered up unless clinical in-service and QA’s are done about the proper use of the system. The saying of "too many cooks in the kitchen can spoil the soup" is true. Therefore too many users can cause problems with the system, e.g., discharging the wrong patient, forgetting to admit a patient, case history erased, losing important information, inaccurate documentation. If the system fails, and bio-medical needs to repair it, there isn’t a back up system in place as there is now (the W.A.R. room) to view critical patients. In essence the system will be overwhelmed, and without additional help this system is being set up for failure.

What administration failed to realize is that the W.A.R. room has been in operation for two years, which is certainly not enough time to evaluate the system properly. In order to get close to accurate benchmarks of success or failure the system would have to be operational for at least 5 years. I feel that you just don’t buy equipment that cost thousands of dollars and know that it’s working well, just to take it apart because upper management is too lazy to understand the potentials of centralizing such a system.

During a meeting I attended about decentralizing the W.A.R. room, it was stated that this move should take place in two weeks. This was so unrealistic. Management doesn’t understand the cost incurred with such a move. It was also mentioned that there isn’t any capital to do this. So the million-dollar questions are: How will administration make the move with no money and why is it so important to move this system? Is this a personal vendetta? Clinical vs. Technical? No matter how many times I brooded over this decision that administration made to downsize and eliminate our department, I still don’t understand why.

Countless people have repeated this phrase; "Stress is the number one killer in America." Although it didn’t kill me yet, I was slightly incapacitated. I was physically, mentally, emotionally and socially stressed. My solution to my own managed stress was to STOP! I took a week off from work during Thanksgiving, put all schoolwork aside for three days, and aside from my daily obligatory prayers I did extra prayers, enjoyed my family, and really relaxed.

When I went back to work, I rolled up my sleeves and got tough with this stressful situation. I became an advocate to my staff in job placement, even though I was asked not to. I initiated a memo offering to train nurses and ward clerks to the system for one week. My stress was alleviated once I accepted the inevitable that the Telemetry W.A.R. room was going to be eliminated. I’m happy to say that with my help my staff has found other positions, with the exception of one lady who is retiring.

I hope that no one has to go through what I experienced or even be on the receiving end of downsizing. If ever placed in an inevitable stressful situation, get tough with the stress. Take a positive approach to stress management. It can open doorways to opportunities and personal growth and development.