Nysha Recent News

With Everything Happening, Hamaspik Staff Happen to Perform Like It’s Nothing

February 2, 2017        

By Mendy Hecht, Hamaspik Gazette

Audit, Resident’s Rush Surgery, Parents Overseas: a Day at the Seven Springs IRA

When it rains, it pours.

But at Hamaspik, they have good strong umbrellas.

It was Wednesday morning, Feb. 1.  And it was enough that the Seven Springs Shvesterheim, a Hamaspik of Orange County group home, was in the midst of a two-day unannounced audit.

That inspection by three officials with the New York State Office for People With Developmental Disabilities (OPWDD), though later passing with no negative findings and the usual words of praise, was cause enough for pressure.

Manager Mrs. Neuman and her professional team were “caught in the act” of providing ‘round-the-clock family-like support for the home’s residents, from morning hairdressing to evening dinner.

But in terms of precipitation analogy, in light of what was about to transpire over the next 48 hours, the unexpected visit was at worst a spring shower.

Forecast: unpredictable

The audit had actually begun the night before, when auditors first showed up to observe Seven Springs’ evening dinner/bedtime routines.  As expected, nothing was amiss.  Auditors even joined the individuals at the dinner table, chatting and otherwise keeping them company as they ate.

For the audit’s Day Two, the officials had returned promptly at 6:30 a.m., first personally witnessing (and commenting on) the loving, motherly and professional support provided by live-in staffer Mrs. Grossberg and her fellow Direct Support Professionals (DSPs).  Also on hand to answer any questions was Solomon Gelb, Hamaspik of Orange County’s diligent Assistant Residential Services Manager.

But then, as the audit’s second day was winding down, there came a proactive mid-morning call from Mrs. Niederman, Manager of Hamaspik of Orange County’s Day Hab women’s division.  Mrs. Niederman notified her fellow Manager that one Seven Springs resident, a Day Hab regular, was “not feeling well.”

Though easily justifiable, especially in the middle of an involved audit, the Manager put caution over convenience and opted to not wait for a next-day doctor appointment.  That was also despite the fact that two other residents, and their one-on-one staffers, were already out of the house at routine doctor appointments.

Later the afternoon of Wednesday, Feb. 1, then, accompanied by a DSP, the resident was seen at a local clinic for what at the moment seemed to be gastrointestinal upset.

Two red-flag symptoms prompted the doctor to immediately suspect appendicitis.

A few moments later, Mrs. Neuman got an urgent call from her DSP.  The doctor wanted x-rays done, and now.  And the rainstorm got under way.

The young woman was immediately transported to Orange Regional Hospital’s emergency room for those images—which shortly confirmed the doctor’s suspicions of appendicitis.  Considering the internal inflammation, the ER team called for immediate surgery—a call that might not have happened without the Seven Springs Manager’s compassionate foresight.

But while at the ER before being officially admitted as a patient, the Seven Springs resident underwent preliminary medical care over the following late-night and early-a.m. hours, including x-rays and an MRI scan—throughout which Seven Springs DSP Mrs. Drezner stood by her side.

Though being at her own home all that time, Mrs. Neuman herself had been on call all night.

As such, the Manager was informed by Mrs. Drezner at 4:00 a.m. Thursday morning that the patient had been admitted to the hospital for acute appendicitis.  That emergency appendectomy was scheduled to take place at 10:00 a.m. (which only began hours later—do read on).

With that update, the Manager called a knowledgeable community medical activist in the wee hours of the morning on whether to proceed with the surgeon on call or scramble for an even better one.  But as it turned out, that specific surgeon happened to be a highly-recommended recent retiree who was substituting at Orange Regional that very night (well, early morning).  The Hamaspik patient stayed on.

But as night faded to early daylight, the storm was just picking up speed.

Weathering the storm

Under OPWDD regulations governing group-home operations, Hamaspik keeps parental consent forms on file at all times.

These forms, signed annually by biological parents, specify that the agency’s registered nurses (or other officers, if necessary) may make therapeutic, dental, medical and even surgical decisions on behalf of supported individuals in the event of emergencies.

However, hospitals like Orange Regional will typically request an additional layer of non-OPWDD-required consent in such situations, asking for direct parental awareness and involvement despite their previous signing of standard agency consent forms.

As such, while the on-site signature of IRA Nurse Mrs. Shira Kaplan, R.N., Seven Springs’ official nurse was enough under OPWDD rules to authorize the emergency surgery, Seven Springs staff also needed to secure verbal consent from the resident’s biological parents before Orange Regional would anesthetize her and roll her into the operating room.

It was now 7:30 a.m. the morning of Thursday, Feb. 2 and Mrs. Neuman was back on the phone.  She now tried calling the patient’s biological parents.  (On top of that, another Seven Springs resident was moderately under the weather, and Mrs. Neuman simultaneously directed staff via telephone in tending to her as well.)

But no one was home—and at the perfectly worst time.

Thinking quickly, Mrs. Neuman called siblings and other family members of the parents—but with same results.  As it turned out, virtually the entire extended family had traveled overseas for a family event, and father and mother could not be reached when they were most needed.

Joel Weiser, Hamaspik of Orange County’s Director of Residential Services, stepped in to assist.

Mr. Weiser immediately worked the phones for some rapid information-getting—not only shortly learning where the girl’s parents were, but getting their direct number, too.

Mr. Weiser swiftly passed that contact information to Mrs. Neuman, who called right away.  One can only imagine how startled the parents were to have been tracked down overseas!

But they were grateful—and only too happy to grant direct verbal consent for their precious daughter to undergo emergency surgery.

By that time, it was well past noon at the hospital.  With consent cleared, surgery was set to begin—when the next storm of crisis erupted.

Seven Springs’s corps of highly trained DSPs was called upon to deploy their finest direct-support skills under highly trying circumstances—as the young patient, overwhelmed by the surroundings and adversity of the situation, locked herself in a room and refused to emerge, causing quite the scene.

But the Hamaspik team rose to the occasion—strongly impressing on-call nurses and hospital staff with a 30-minute textbook display of the OPWDD’s strict adverse-behavior rules in action, not to mention Hamaspik’s sincere and abundant love and concern for the people it supports.

With eminent patience, the warmest of words and the gentlest of reassurances, and with astonished surgeons and RNs looking on, Nurse Kaplan and DSP Ms. Schonbrun professionally and delicately coaxed the scared young lady out of hiding and into their caring and loving arms, from which she shortly passed into surgery without protest.

Agreeably adapting to the circumstances, hospital staff worked as a team with the Hamaspik contingent, even agreeing to the patient’s insistence that all pockets be emptied to prove they were carrying no surgical cutting tools, further allaying her fear of surgery.

Hospital OR staff also agreed to a fellow professional’s request—and, at Nurse Kaplan’s behest, Ms. Schonbrun soon found herself fully dressed and prepped in sanitary protection, including face mask and shoe covers, so that their patient would feel supported and remain calm on the operating table until the anesthetic kicked in. 

It was thus around 3:00 p.m. when surgery finally began.

Several hours later, the young lady’s emergency surgery was a complete success (thank God!)—with patient, out-of-town parents, staff and medical professionals alike grateful that the problem had been caught in time.  And the downpour largely came to an end.

By that evening, the Hamaspik resident was alert and oriented in a recovery-room bed—and surrounded by doting Hamaspik staff, including Mrs. Kaplan, who made her feel as comfortable and safe as possible in the unfamiliar environment.

Seven Springs’ hardworking nurse, for her part, had pulled a nine-hour shift on the hospital’s premises, from 12:00 p.m. before the surgery through the procedure’s afternoon onset and right up to 9:00 p.m.  “I’m grateful to her,” Manager Neuman later told the Gazette.  “I’m thankful.”

While there, she hadn’t just discharged her duties as the home’s resident medical professional, but had also supported her fellow medical professionals with patient-specific information—and evidenced the high standards of caring maintained by all Seven Springs staff and indeed, all Hamaspik group-home staff.

“After surgery, one of the nurses that was so compassionate and caring during the whole fiasco, came over to me and told me how it’s so amazing how we care for her and we’re so gentle with her and take such good care of her!” Mrs. Kaplan later reported in an e-mail.

The IRA Nurse also noted that a hospital nurse had suggested that the patient be physically removed from the room in which she had confined herself—a suggestion respectfully dismissed out of hand by Hamaspik staff, knowing as they did that it would only cause more distress.  (Despite that measure being possibly warranted even under strict OPWDD behavioral response rules, there was ultimately no need for it what with Hamaspik’s caring touch.)

Hamaspik’s core values were further evidenced in the following rotating presence of several Seven Springs DSPs.

Under official OPWDD guidance, staff with any disability-support agency like Hamaspik need not remain on the premises once a patient with disability is officially admitted at a hospital.  With the patient’s direct care (and Medicaid billing thereof) now handed off to the hospital’s professionals, non-profits may step back, having done their job.

But, points out Hamaspik of Orange County Executive Director Moses Wertheimer, that’s anything but the case at Hamaspik.

“It’s Hamaspik’s responsibility to care for and support our residents, especially when parents cannot or will not show up—and we’ve done that,” he says.  “We go the extra mile doing extra bedside shifts when our individuals are in the hospital, even though Medicaid doesn’t reimburse us for that.  In many cases, we are the only family they have.”

As such, beginning at 9:00 p.m., the residential DSPs replaced the IRA Nurse at their beloved patient’s bedside, staying at Orange Regional all Thursday night and Friday morning.  They remained with the Hamaspik resident until her 12:00 p.m. Friday discharge—and went well above and beyond the call of duty without so much as batting an eyelash.

Back to outstandingly normal

By the time Friday night rolled in, the Seven Springs resident was back home in Seven Springs.

It was Shabbos.  The house was clean.  The floors were shiny.  The table was set.  The silverware was gleaming.  And seated around the dinner table, residents shone in their Shabbos best, smiles glowing.  Everything was as it normally was—happy, serene, and blissfully ordinary.

The scene was as storybook-normal as it had been the Wednesday morning on which, a mere two days earlier, a trio of OPWDD delegates walked in: residents laughing, living life, and loving each other as staff stood by in the background, providing the most tactful and well-trained person-centered supports—the very scene of one big happy and healthy family.

A cynic may have thought, “That’s all fine and good when everything’s fine.  Let’s see what it looks like when everything happens all at once!”

Had he walked in a day earlier, he sure would have found out.