“Fish Tank is not Allowed” ??!!

[Fish Folk]

On 2/17/2022 at 11:14 AM, xXInkedPhoenixX said:

When you are as sick as a cancer patient small joys like that are a welcome sight- it is a proven fact that mental state directly effects physical health- fish tanks are beautiful and peaceful and a distraction from a terrible illness. Better than a TV with the news constantly streaming through.

This is the nurses’ studied opinion. Of course they care deeply about the science of their discipline. Lives depend on that every hour. But the joys brought through patient’s encounter with this aquarium have been affectively measurable.
 

One cancer patient was there when I was wrapping up. He asked the nurse what was going on. She told him the truth.

His reply is unrepeatable on the Forum, it may have sounded like “#&@$!*#% cowards.”

😬

[KatFish]

On 2/17/2022 at 10:14 AM, xXInkedPhoenixX said:

I can understand the POV that immuno-compromised people (especially cancer patients) need to protect themselves from exposure. However, like @Mmiller2001 very accurately pointed out with the inside/outside air....there is NO way cancer patients are going HOME to sterile environments. We also should point out hospital environments are often where people pick up the nastiest of the nasties- more likely from the person sitting next to them. Likely NEVER from a fish tank in the doctor's office. When you are as sick as a cancer patient small joys like that are a welcome sight- it is a proven fact that mental state directly effects physical health- fish tanks are beautiful and peaceful and a distraction from a terrible illness. Better than a TV with the news constantly streaming through. 

I'd bet all my money they'll get complaints from the patients about it having been removed. 

As an person who lives with immuno-compromised people we (everyone in out house) all agree with this. 
I can tell you that personally, my mental health boosted considerably when I got a fish tank again, and the same for my family.
We all were ecstatic. 

If our local hospital had a tank, and then tore it down because of this? I think there would be a lot of complaints. 
Especially since my town does a lot of Hospice work. 
 

[Fish Folk]

An actual e-mail from the JOINT COMMISSION said, "the tank exposes patients to gram-negative bacteria."

I don't know . . . I kind of thought that gram-negative bacteria are found in virtually all environments on Earth that support life. Are they especially amplified due to an aquarium aerasolizing bacteria from tank water?

Here is a very fascinating study of a particular individual that is believed to have become infected this way. The child was treated for Cystic Fibrosis very early. A careful examination of the root causes of his chronic cough found that an aquarium air-stone aerosolized harmful bacteria that impacted his lung function at ca 7 months of age in the room he was living in.

 I don't know . . . it's reaching, if you ask me. But at least there is _some_ shred of study to point to . . .

[Patrick_G]

I’m at the hospital/medical center regularly for my daughter’s mental health care. This is the biggest medical group on the west coast and they have a beautiful tank in every waiting room. My kid loves checking them out at her appointments. It gives her something to look forward to. 

[Beardedbillygoat1975]

I have seen what JCHAO has wrought both good and bad. They've created a million if not billion dollar consulting industry on accreditation, mock accreditation and all sort of off shoots, They've also brought to light some truly horrifying situations at some hospitals. 

As for the tank @Fish Folk 1 thanks for what you did for the patient's and nurses, 2 thanks for tearing it down 3 until the big payers or the feds speak/stand up JC will remain what they are. 

[Fish Folk]

On 2/17/2022 at 1:25 PM, Patrick_G said:

I’m at the hospital/medical center regularly for my daughter’s mental health care. This is the biggest medical group on the west coast and they have a beautiful tank in every waiting room. My kid loves checking them out at her appointments. It gives her something to look forward to. 

Awesome. So glad they have them. Really enjoyable! 

[jwcarlson]

We have (had) a family doctor "complex" here in town and it's been here for 40+ years.  It has something like probably 30+ providers (doctors, PAs, etc).  Of course a ton of support staff and auxiliary functions including a lot of specialists.  Anyway, I'd been going to the same doctor all of my 35 years and he was the doctor for all of our kids and my wife after we got married.  Super great doctor as far as they come.  Really personal... all that.  He had paintings and drawings and all sorts of stuff that his kids did over the years all over the walls.  And various art/decorations.  A homey feeling.  Comfortable.

 

He retired a couple of years back, shortly after the complex was sold to a larger medical conglomerate.  I rarely go to the doctor, but took a kid in shortly after the sale and they'd sanitized any personal feel from the entire building.  Zero, NOTHING allowed hanging from the walls.  No decorations of any kind.  All sorts of new rules for staff.  Drove a lot of people away, they've gone through a number of specialists (ENT, etc) since.  Really sad to see.

 

Anyway, I say all that to say that highly regulated industries tend to start "eating themselves".  Or at least that's how I put it.  I'm an engineer and used to work at a nuclear power plant.  There's just not a lot of wiggle room for... sanity?  The liability or risk-thereof becomes all consuming and it just becomes a race to see what makes the business/industry insolvent first.

 

Good on you for helping set it up originally and now helping to salvage it.  Sorry that we have to share a species with a whole boat-load of dummies! 😄

[Fish Folk]

Spoke with my friend in the NIH today. He's an expert aquarist, and cares a great deal about diseases, infections, and the impact of environmental factors on human health.

He searched this out, and thinks really the only standard guidance for immune-compromised people ought to be in relation to actually touching potentially contaminated aquarium water. Either get another person to do your aquarium maintenance, or wear gloves.

Here is a clear explanation of guidance from an article kept in an online library by the NIH concerning "Pets and the Immunocompromised Person."

Anecdotally, he shared that the NIH keeps large aquariums in several of their waiting rooms...

Edited February 17, 2022 by Fish Folk

[Intuos]

That's really sad, while I appreciate that there may be a slight risk blah blah blah, but surely the therapeutic benefits of having them outweighs that. Am really sorry to hear that you're having to undo the amazing gesture and work to support those people during a difficult time in their lives you have done. The world needs more people like you! 

[Cory]

Sounds like you got out while you still could. I've seen lots of red flags here. The nurse and yourself should have been no where near this aquarium. This is a lawsuit waiting to happen. Hospitals almost exclusively rent aquariums so that the maintenance company carries the high insurance policy. Everything in a hospital is astronomical in price, the damage from a 120 gallons of water like that could shut it down for quite a while, requiring new flooring and drywall work at best. Shorting out power and causing power surges to equipment can be millions.

As for bacteria from an aquarium, sure the odds are low. However a business has virtually nothing to gain by providing an aquarium and will see it as a liability. I run a store with aquariums, no matter what we do, virtually you always have the public putting their hands in water. You can detour it as much as you want, but nothing will really stop a kid or an adult from getting into the water. Short of physically stopping someone. Which isn't allowed either due to lawsuits.

Steps can be taken to mitigate risks, such as building the aquarium into the wall with access only through a locked door. Having a 3rd party carry the insurance policy etc. Using thick acrylic instead of glass and other factors.

Aquariums are  beneficial, however they are also a liability. It's up to a business to evaluate the risks and do what they think is right to mitigate it. It seems especially unfair after being in place for so long, but people are just doing their jobs. I found it best to focus my efforts away from things like hospitals and more into co-op schools and schools in general. With co-op schools being the most open to an honest aquarium in the class room for kids to be a part of.

I'll commend you if you change their mind, but in my experience the more it's fought the more they just dig in against it and maybe even pass policy that is even more restrictive. I've seen that happen in schools.

[Intuos]

@Cory while I agree with what you say, it is still sad that that's the world we live in, where the risk of a lawsuit outweighs the potential benefits. It really makes me sad and wish for better. 

[Torrey]

On 2/16/2022 at 9:25 PM, Fish Folk said:

May, 2021 and later on I September, 2021, I was so excited to donate fish and plants to our local hospital Cancer Treatment & Oncology Center. The tank is in the patient and family waiting room. Here’s what it looked like then…

And here is the very happy nurse who cares for cancer patients all day, every day, who 100% understands what a simple but profound joy this aquarium brings to her patients…

So, today, she messages me quite upset:

”So I have some bad news, [the hospital]  has informed us that a fish tank is not allowed in oncology waiting rooms. To say I'm heartbroken is an understatement. And even though [our hospital] has had this tank for 15 years, apparently it's a problem now. So do you know of anyone that would want to take the fish?”

What on earth happened? You and I both ask…

Apparently a hospital accreditation group called the JOINT COMMISSION  did a mock run-through with the hospital administration, and to quote the nurse,  “…they said it exposed the patients to a certain bacteria.”

Whaaaaatt???!!!

The hospital admin literally told her to tear it down by Friday. This week. A 120-gal. tank. She went to the hospital admin, who tried to raise it with the JOINT COMMISSION, but to no avail. Fish tank is not allowed.

I called my LFS Owner to ask if he had tank space. (I don’t!) He was… not happy…

Tonight I called to talk about this with an expert aquarist friend in my fish club who may or may not have worked in the CIA for many years. He had never heard of anyone ever raising this concern before.  His line was, “Sounds like they’re smoking it…”

Has anyone got a clue what in the world these people are on about? What bacteria? What published scientific studies support this decision? 

At 7:15 am Thursday morning I am meeting this nurse 75 minutes before her shift starts to catch all the fish and pull all the plants, bag them, and take them to my LFS. Now, I promised her I’d not risk getting her fired by calling the local paper, or something.

But… someone really needs to explain this. Or at least pick up after their 🐂

I will not share my JCAHO experience. It's definitely frustrating to deal with any bureaucracy...

On 2/17/2022 at 7:32 AM, dmurray407 said:

You can't fight Joint Commission. If hospitals don't comply with their rules (no matter how silly) the hospital can lose their accreditation which means losing big bucks. It's not hospital leadership making this decision, but they have to enforce the rules.  I worked in a procedural area of a hospital and we would all get really nervous when it was Joint Commission time.  The last time we got "dinged" in my department was because the person doing the "pause for the cause" didn't speak loudly enough. I mean, the "pause" was done-the JCAHO people were in the next room (procedure room is sterile) and listening over a speaker,  the patient was sedated by then and everyone else in the room knew what was going on, so???? It wasn't a huge deal, but we had to promise to comply the next time around. (and they did come back to observe us...)

 

Thank you for the work you do, you benefit a lot of families if your pause for the cause is the same pause for the cause where the staff read out an uplifting message while surgery takes place after the pause.

@Fish Folk there are ways to hold JCOHA accountable, without sacrificing your nurse friend. 

Due to patient confidentiality, names of patients can't be shared with congresspeople who are asked to investigate incidents like this.

As you are not an employee of the hospital, you also don't have to worry about retribution...

If someone were to contact their elected representatives to share research about the mental and physical health benefits of being able to watch an aquarium in fighting cancer, and were to include pictures of the safety measures of said aquarium that was required to be broken down due to a Joint Commission dictate, then the elected representatives would have the scientific data showing the health benefits, the droplet and aerosol safety measures that had been put in place, the CDC statement regarding immunocompromised individuals and fish tanks, and would therefore be able to make a more informed decision. 

In fact, one of the most important elected representatives that a person can send an email to, with all of this information, is our duly elected president, who happens to have a more intimate knowledge of the impacts of cancer treatment on people's mental health. 

Of course, if there were any cancer patients who ask why the fish tank is gone, if they were to have access to a petition that included all the research, asking the Joint Commission to revamp their recommendation to be in alignment with the scientific evidence, that would help as well. 

 

If a person wanted to take that on, of course. 

Not everyone has the spoons to advocate for the communities that are most impacted by bureaucratic decisions that are not science based.

[dmurray407]

On 2/17/2022 at 7:34 PM, Torrey said:

your pause for the cause is the same pause for the cause where the staff read out an uplifting message while surgery takes place after the pause.

 

Our "pause for the cause" was performed by the circulating nurse immediately prior to the procedure-pt has been prepped (draped), physician at the bedside and everything is ready-the "pause" states everyone is ready and all necessary equipment is in the room. I retired a year ago so I don't have to do that anymore-now I just have to keep my fish happy🙂

[Fish Folk]

Thank you @Cory for taking time to offer this perspective. Very helpful. Though bewildering, at some level — given all the hospital has already allowed with it — everything you’ve brought forward makes excellent sense. Yeah… 120 gallons on the floor… oof!

Thing is, other waiting rooms in the hospital _are allowed_ to have Aquariums. But given the cautions you’ve outlined, I’ll take a pass on any going forward. I love fish. Lawsuits not so much.

The bacteria thing I’m still a little puzzled by. That was the cited reason for the tank to come down in a waiting room with immunocompromised patients. With the hood on, I think it could have been reasonably secured from hands in the water. 

But if they’d just made a policy against non-insured individuals (i.e.me, nurse) managing an aquarium for legal reasons, I think that would have made total sense to me.

Well! Fortunately nothing awful from any of these scenarios did happen! Instead… just shouldering a bit of disappointment for folks who enjoyed it. Good to count up avoided disasters too.

And I have zero plans to chase down the Joint Commission or the Hospital at all. 

Edited February 18, 2022 by Fish Folk

[Torrey]

On 2/17/2022 at 6:59 PM, dmurray407 said:

Our "pause for the cause" was performed by the circulating nurse immediately prior to the procedure-pt has been prepped (draped), physician at the bedside and everything is ready-the "pause" states everyone is ready and all necessary equipment is in the room. I retired a year ago so I don't have to do that anymore-now I just have to keep my fish happy🙂

ORD, life is much simpler in retirement 😍

[Hobbit]

Wow, I’m sorry you had to go through that @Fish Folk. Maybe they can set up a live webcam to one of your tanks (or the fish store’s tank) and display that in the waiting room instead?

This whole conversation was helpful to me from a different perspective: it looks like my husband is getting diagnosed with a primary immunodeficiency, and on top of that it’s possible I have reduced capacity to fight bacteria and parasites. So @Fish Folkthe resources you found were very helpful to me on a personal level. 🙂 

[dmurray407]

On 2/18/2022 at 12:24 AM, Hobbit said:

Maybe they can set up a live webcam to one of your tanks (or the fish store’s tank) and display that in the waiting room instead?

Great idea! (Though not as nice as the real thing). I wonder if a fishless aquarium would be an option...just plants couldn't harbor that much bacteria, could they? Not as interesting, but the water movement is still calming.....

I hope everything turns out OK with your hubby.....

Edited February 18, 2022 by dmurray407

[Fish Folk]

Just wanted to close this thread off by sharing a text I just sent to the nurse who I mentioned at the start. This brings into focus some of the helpful points others have shared:

“A word of encouragement and some perspective this morning. First, thanks for caring to beautify and enliven the waiting room by helping to give that tank an uplift. It certainly brought a nice diversion. Second, on the whole, I’ve had some time to gain perspective. I think a tank like that which isn’t properly insured or professionally maintained by an outside party is a huge liability for the hospital. If that aquarium is 15 yrs old, those seams could burst. 120 gallons could shut down your entire treatment center for weeks and cost millions. Plus, there’s liability in terms of possible lawsuits. Though the risk of immunocompromised patients getting sick from any airborne contaminates is very low, lawsuits are very costly. Furthermore, it’s best if you (and I) step way back and give that risk a very wide berth. On the science, I’m eye-rolling the JC. But on the liability, I understand the hospital position better. After some reflection. And sleep! Keep doing good for people. Grace and kindness, even on their dying day, you will never regret giving.”

Edited February 18, 2022 by Fish Folk

[OnlyGenusCaps]

I just caught this thread.  What an emotional ride!  I probably would have done anything for that nurse too.