Every hospital patient has a story. Just stop anyone on the street. Ask your relatives and friends. If they’ve done time in a hospital they’ll tell you about some indignity, perhaps a nightmare or two. If you haven’t heard these stories, it’s partly because you haven’t asked, or more likely, because most people want to forget about their hospital experiences if they can.
It is hard for me to write about such minor humiliations. Why? Because in terms of science and medicine, we are blessed to be alive in the American twenty-first century—and we know it.
In the past, amputations took place without anesthesia as did tooth extractions. Miracle medicines did not yet exist, doctors infected their patients because they did not wash their hands, the mentally ill were chained to the wall and left to live (or die) in their own filth. Women routinely died in childbirth and indeed, gave birth in great pain. Infant and child mortality rates were high and, if you broke a bone or fell, you were plumb out of luck.
Today, as our aging bodily infra-structures crumble, bionic parts are expertly inserted. If we fall and break our bones, we usually get to walk again.
And yet, this is not the whole story. There is also a mountain of sorrow that accompanies one’s medically successful stay in a large city hospital. No patient wants to seem ungrateful, self-indulgent, by complaining about the “small stuff”– except its not that small.
Patients in pain are further demoralized when they have to wait for four-six hours to take a hospital test or when they have to wait for 45 minutes after they press their call buttons. Patients who are in pain and perhaps experiencing side effects from their medication, grow more frightened when they never see the same nurse twice, and always have to fight for everything they need when they are at their weakest. No one likes being woken up at dawn and sleep-deprived when they most need their strength. Patients suffer a crisis of confidence when a nurse insists upon giving them the wrong medication–even when the patient begs them not to do so.
The national silence about this “small stuff” is amazing. And yet, someone must speak out. My recent experience at a first-rate Manhattan teaching hospital qualifies me.
Please understand: I was in a hospital whose physicians routinely make all the Best Doctor Lists. The Board is a-glitter and a-glow with a Who’s Who of philanthropy and culture. Celebrities, billionaires, and Arab Sheikhs routinely stay there. Thus, what happened was even more shocking.
The physicians and their techniques may be state-of-the-art but enter most hospitals and you will find yourself in a Third or Fourth World country. Pity the patient who does not have a few loving family members whose schedules allow them to spend every day and every night in the hospital. Pity the patient who cannot afford a private nurse or “companion.” Actually, even these safeguards are not always enough.
I chose this hospital for my hip replacement because four of my physicians, including the surgeon, were on staff there. They are superb professionals and they did not fail me. Indeed, they each visited me almost every day while I was hospitalized and my internist, a living saint, visited me at home (!) for months afterwards.
It doesn’t get better than this. So what am I talking about?
I am talking about the ”small stuff.” Let’s start with the nursing care. Florence Nightingale must be spinning in her grave. When you are sick enough to be in a hospital, one expects that nurses and aides will be compassionate and competent caretakers.
But the nursing staff and aides at this hospital never, ever came when you called for help–at least not for 30-45 minutes. While statistics confirm that there is a shortage of nurses—hence, the “outsourcing” of the profession, I personally observed nurses on this ward yukking it up together, snacking, talking on the phone, hiding from their patients in the bathroom, playing computer games, and, in effect, engaging in a permanent work slowdown.
In addition, both nurses and aides—including private duty nurses– did not always wash their patients in a timely or expert fashion, nor did they change the bed linen or clean the rooms in more than a slapdash manner. Aides and attendants banged trays of food down, often stormed in and out of rooms as if they were angry, and did not always make eye contact or ask how you were.
The ward nurses and aides rarely smiled and they never offered words of comfort. I never heard any ward nurse or aide say “I am sorry I could not come sooner” or “What can I do to help you?” or “I am sorry you are in so much pain.” The smallest etiquette would go a long way to calm and console those in need.
Imagine being as helpless and as dependent as an infant, unable to walk, or to walk without help. Imagine being too weak to answer the phone. Imagine being at their mercy of such people when you are in pain and immobilized in bed.
As an eighty-five year old friend of mine, who has also been a patient at this same hospital said: “They are missing something inside. They have no feelings.” A male relative, hospitalized in another state, said: “They (the staff) just don’t care anymore. They don’t give a goddam.” A friend from another borough said: “I went in for one problem but the hospital caused a second and even greater problem. They forced me to lie in a broken bed for five days. I told them that I had a bad back. No one listened. I ended up needing back surgery.”
In a hospital, absolutely everything is a struggle. Enormous vigilance and battle-ready stamina is required in order to protect and even save one’s own life there. For example, the patient must make sure that drugs to which she is allergic are not administered by accident. In a weakened state, this is often impossible. This inability to be a good advocate for oneself is, in and of itself, quite nerve-wracking.
In addition to non-compassionate behavior, some employees also seemed to be suffering from serious mental health problems. On my ward, certain staff members were exceptionally hostile, callously indifferent, or “emotionless,” and, in some instances, dangerous. Many ward employees seemed to resent being “bothered” by patient requests and sometimes responded with outright cruelty.
In addition, many of the foreign-born nurses and aides on my ward (who may be both competent and compassionate), spoke English in accents that were hard to understand and expressed emotion (or failed to do so) in ways that are foreign to Americans. This additional communication barrier is not helpful to a patient who is in pain and frightened.
Many of the nurses and aides whom I observed acted as if they hated their jobs and their patients. And the physicians, all of whom have stellar reputations, simply overlooked and tacitly accepted this sad state of affairs, as has the hospital administration and board.
Again, I must stress: I did not die. And yet: Despite my loving and supportive family and friends, and despite the fact that I have health insurance coverage and also hired private nurses or “companions,” here are some of the things that happened to me. Multiply them by every patient in a hospital and you will have some idea of the epidemic of “small stuff.”
Right after surgery, I came to in the recovery room and was introduced to my nurse. I tried to be friendly. She was from central Asia, probably from Iran. I was in terrible agony. The pain medication wasn’t working. I told her so. She said: “I have no time to be bothered by you.” And she turned her back and walked away. I tried to calm myself. And then I grimly, desperately, tried to steel myself against the pain.
She seemed to have only one other patient. I begged her to adjust the medication or to call the doctor. She did neither. She presided over what amounted to my torture for about two hours and then she sent me up to the ward without inserting an IV with pain medication and without sending an Rx for pain medication along with me. By now, I was beyond agony. Thankfully, as I trembled in pain, the ward nurses circled me. Finally, mercifully, a nurse started an IV and shot me full of dilaudid. These nurses were outraged by the Recovery Room nurse’s failure to keep me out of pain but I doubt that they “did” anything about it.
As I would learn from one of the staff physicians, this nurse had done things like this before and she’ll continue committing sadistic acts on the job until someone stops her.
The recovery room experience was my introduction to nursing care at this hospital.
Later that same night, I thought I was safe. I had a private room and a private nurse for the night. What could go wrong? I was high on dilaudid which, unfortunately, led me to engage in projectile vomiting. After one such bout, I asked my nurse, a rather meek woman from the Caribbean, for a wet washcloth for my hair and my eyes. She said, plaintively, in a slightly sing-song voice: “But what about me? You got it all over my blouse. I have to take care of my clothing first.”
She proceeded to clean her blouse while I waited for her to give me a damp washcloth.
Multiply these two incidents by everyone in the hospital and you will begin to get some idea of the “mountain of suffering” to which I refer.
Compared to the true horror stories, I was lucky. And yet, as one demoralizing incident after another happened to me, my spirit drooped and my resolve hardened: From now on, I will resist entering a hospital with all my might—and I will dread returning if I must.
There is no other way to convey the quality of one’s experience in a hospital other than by describing some of the comparatively minor things that happened –none of which felt minor at the time.
• I had a private night nurse from the Caribbean who absolutely refused to turn off the light because she was afraid of the dark. When I insisted, she went to sit in the bathroom with the light on and the door open. So, I asked her to close the bathroom door so that I might sleep. She refused to do so and thus compromised my sleeping. (Sure, I could diagnose her but what’s the point? I was at her mercy.)
• An American-born ward nurse or nursing aide, (I’m not sure who she was), made a big show of waking me up at midnight, (I had literally just fallen asleep), in order to take my vital signs. Then, a foreign-born ward nurse woke me up again at 2am to check my blood pressure again. There was truly no justification for any of this since my vital signs had been taken at least three times during the day and two hours previously–and I was not in Intensive Care.
• As they transported me to the Rehab ward, the foreign-born aide pushing my wheelchair allowed the elevator door to close on my good foot. It broke a toe. I howled in pain and fear. This man did not even say “I’m sorry.” No one thought this was particularly important.
• One of my private duty nurses, a well-dressed and well-spoken American-born woman, was ax-murderer crazy, I kid you not. She arrived while my son was visiting me and so I told her to relax outside, that I’d call her when I needed her. But when I asked her to come in (I was in pain), she was nowhere to be found. After 20 minutes, I sent my son out to find her. She was at the computer and said she “would come bye and bye.” Ten more minutes elapsed. When she finally came in, I asked her (in a mild voice) “Did you not hear the bell, did you not see the light?” Her eyes flared back in her head. She said: “That is beyond the pale! I do not have to take such mistreatment!” And she stormed out. She then stormed right back in and said: “I don’t think I have to talk to you anymore,” (a line she delivered in great anger) and she stormed right out again. Then, my phone rang. It was the hospital-based private nursing service who had sent her. “Is there something you want to tell us about your nurse?” “Why?” I cautiously asked. “Because she just called to say that you do not respect her.” I was terrified that I would have to face the night without a private nurse—and even more terrified to keep the one I had.
• Another private nurse, a really nice American-born women with whom I had bonded, slipped away at 7am without first loosening my leg compressors which, in effect, kept me trapped in my bed. I had specifically asked her to wake me up and to “free” me before she left. She was kind not cold; perhaps she was simply tired and not professionally “smart.” In and of itself, this is no big deal but once you know that the ward nurses will not respond to the call bell (and she and I had discussed this problem at length), her “forgetting” condemned me to a 45 minute wait before I could get anyone to free me so that I might go to the bathroom.
• An ambulette came to bring me home. The foreign-born driver who could barely speak English, brought a broken and unsafe wheelchair. He kept insisting that I had to get into it. I managed to borrow a good wheelchair from the ward. This man drove like a maniac, took the long route home, and played very loud Spanish music on his radio. Now, I happen to love Spanish music but I was strapped in and utterly dependent. I actually prayed to make it home safely.
Well, in the scheme of things–each incident is no big deal. Right? Wrong–because one experiences each frustration and indignity through a veil of tears and fear. Nothing is that “little,” everything feels overwhelming and even life-threatening.
Did such “little” things happen only to me? Absolutely not. For example, here’s what happened to other people on my ward when they pressed their red “call” bell. While there were some exceptions, mainly no one came for at least thirty-forty five minutes. And when they did, you often wish they hadn’t. The very nurse or aide who had been missing in action would arrive with full frontal attitude, in a state of anger and disgust. Some staff members displayed a dangerous, perhaps disassociated passivity.
For example, on my ward, a middle aged Italian-American female patient had suffered two brain aneurysms and a stroke during surgery. She had short term memory loss. She had to go to the bathroom and could not remember if she had or had not been instructed to leave her bed on her own. She pressed her button for 30 minutes. Her roommate, another woman with whom I had become friendly, was the chair of a department at a medical school. In sympathy, she also pressed her call button. Neither woman received any response. The poor soul could wait no longer and stumbled her way to the bathroom—but along the way she peed on herself. When the staff nurse (or aide) came in she was angry. She said: “Why are you bothering me?” Then, when she realized that she would have to clean up a “mess,” she exploded, humiliating the patient completely.
“Look,” the nurse (or aide) yelled, “I’m not coming back here again so if there is anything else you want you had better tell me now because that’s it for the night.” I was told that these lines were delivered in an angry and threatening voice.
Here’s another example from the same ward. It was a quiet weekend afternoon but the calm was pierced by piteous groans and cries that seemed to come from the next room. This went on for quite some time. Finally, I asked a visitor of mine to see whether we might be able to help whoever was crying out. The poor soul, a jovial and sophisticated African-American man, wanted some water. He had had a double hip replacement and could not get out of bed without assistance. My visitor gave him water. Later, at night, he was crying out again. When I asked one of the nurses, an American-born woman, to look in on him, she said: “That man always yells at night. Pay him no mind.” When I asked my private companion, also an American-born woman, to look in on him she said “I am here for you, not him. Pay attention to yourself; don’t get involved with anyone else’s problems.”
One or two such unkindnesses per hospital stay are bearable and easy to forget. Five a day are not. They lead to profound patient demoralization.
Also, let me be clear: As a patient, you are not necessarily facing death when you call for help and no one comes. The non-response might (only!) condemn you to continuing pain, perhaps to a worsening of certain conditions, perhaps to humiliation in terms of bathroom functions. However, a patient never knows when a life and death situation might be upon them. And, we know that, chances are, no one will respond. This fact causes endless worry and sorrow.
I have worked with physicians, nurses and other health care professionals since the early 1970s. Indeed, on the day my first book, Women and Madness was officially published in 1972, I was delivering a lecture to psychiatric nurses at a medical school. As a co-founder of the Association for Women in Psychology (1969) and the National Women’s Health Network (1975 – 1976), I found that nurses were usually more “compassionate” and knew more about each patient than most doctors did. Nurses, not doctors, were involved with patients daily, often all day; doctors briefly came and went. Nurses also advocated for their patients and sometimes stood up to young interns and residents whose knowledge of drugs, side effects, and patient allergies were less sophisticated than that of veteran nurses.
However, like teaching, nursing has increasingly been unable to attract highly committed, talented, and ambitious people. Nursing activism, which in the past was usually concerned with patient care, has increasingly, over time, become primarily concerned with nurses’ rights not to have mandatory overtime imposed, to guarantee pay and cost-of-living increases, and to limit nurse-to-patient ratios –because it is good for nurses, not necessarily for patients.
However, the nurses that I once knew and worked with in the 1970s and 1980s (this includes psychiatric nurses, nurse-midwives, physician assistants, and geriatric and hospice nurses), do not seem to be well represented on Manhattan hospital wards today.
My point: We must begin a national conversation about the demoralization of patients due to a general “compassion burnout” among hospital staff. I suspect that if staff were properly “sensitized,” that the number of illnesses and deaths that are caused by staff abuse and neglect will also decrease.
Hospital personnel are easy to criticize. Could I do the job of a nurse or a nurse’s aide? I doubt it. The work is as repetitive as housework, it is “dirty” work and no one really wants to do it, one’s job is never done, there are always new patients crying out for attention and help. And yet, the salary is reasonable for the education achieved and the work is neither isolating nor undignified. While everyone assures me that there is a serious shortage of nurses (hence, the outsourcing of the profession), I myself did not see nurses overworked. What I saw were civil servants on a permanent work slowdown.
The nurses and aides on my ward seemed to have no concept of what might comfort a patient. Or rather, they did not see “comforting” as part of their job description. Perhaps they all come from homes in which they themselves were never comforted as children, homes in which they may have routinely been seriously neglected and abused.
What can be done? The hospital administration could make a huge difference here. If they allocated resources to teach compassionate professionalism to all hospital employees—or at least teach them what to say and how to say it, (“I’m sorry I could not come sooner, how do you feel today, etc.?”), one’s stay in a hospital might be less traumatic. If the administration can offer diversity and “sensitivity” training, surely they can create a one-day training program to teach common decency, professional behavior, and what constitutes compassionate care giving. And surely, they can repeat the training every year.
Hospital administrations bear a primary responsibility for this unfortunate state of affairs. However, nurses and others hospital employees also bear responsibility. In the breach, people remain at each other’s mercy. How we, as individuals, treat each other is therefore more, not less, important.
Assuming we, the people, actually manage to pay for health insurance for every American–how in God’s name will we also manage to pay for a quality of care giving that is professional, and above all, compassionate?
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60 Comments
1. njcommuter:I’ve been hospitalized several times in the last few years, at one hospital in NJ. By and large, the nurses, orderlies, etc., were a joy. There were some exceptions, including a lab nurse who excelled in painful vein punctures and a floor nurse who may have been playing control games over a simple need (a bandage to prevent a scar from coming lose when I put elastic over it). There were other problems, too, like being scheduled for two away-from-the-room procedures at once (and not finding out about it until I missed the more important one).
In fairness, this hospital is overloaded; they just don’t have enough beds. I had to spend a night in the E/R until they could get me one.
My mother recently spent a month in a community hospital in New York. I spent a lot of time with her. The hospital didn’t seem to be as busy, the nurses seemed to be busier, and I didn’t see anything untoward, except that they might have been a little too generous with the Dilaudid at one point. Whether that was because the doctors didn’t see her often enough or because the nurses didn’t have the flexibility or training to adjust it, I can’t say. I did get them to adjust the dose back down and slow the pump, which worked fine.
It’s disappointing that a major medical center has the problems you describe.
Nov 10, 2008 - 10:35 pm 2. heather:I think the most important thing any person should have in the hospital is a relative or friend AT ALL TIMES. My mother, my sister, my cousin, were all nurses.
Anyway, I had to be in the hospital for a blood clot, which meant I had to lie flat on my back for some 3 weeks. The only thing the ‘nurses’ were interested in was the IV in my arm. I lay there in filth, literal filth, for days. The person who helped me clean up was the cleaning lady. I will never forget that sweet person.
A friend, suffering for years with arthritis, in pain most of the time, on the most awful drugs to deal with that pain, with cancer of the liver… well, she was relieved to get a bed in the Vancouver General Hospital. Finally. No-one believed me when I predicted that she would be ignored and left to lie in her filth, but yep, she was indeed. You see, there is a ‘nurse shortage’.
My mother managed to be a good nurse back in the day when there was a depression, and there were no ‘miracle drugs.’ She explained to me that that was the reason cleanliness was of paramount importance back then. And the first thing nurses did when a patient arrived in the hospital was give them a ‘bed bath’.. in order to see if there were problems not picked up by the doctor.
And then another friend, in Toronto: his father had a stroke and was in the hospital, in a private room. My friend went to visit him. The nurses claimed he wasn’t there. Well, my friend, a very pushy guy, checked around the filing cabinet, and sure enough, there was his father’s file, slipped off onto the floor. The father had been left for a day without food because ‘he wasn’t there.’
My father, in the last 6 weeks of his life, was in the hospital. All of us (his 4 kids, and various others), basically camped out in the hospital. We had to. The nurses did not bother to put his hearing aids (or his false teeth) on in the morning. They did not help him eat, just plunked the food down and moved on. If it had been up to the ‘caring and compassionate’ nursing staff, he would have been left to sit there and starve. I mentioned he was there for some 6 weeks. My brother noticed that in all that time, a bunch of mud on the stairs was never touched.
I know, nurses are over extended. Right. I think they have lost all self respect, and look upon their job as a job, and not as an honourable profession.
Also, they draggle around in street clothes, with no appearance of neatness, god knows, no nursing uniform. There are signs all over to ‘wash your hands’, because, my friends, THE NURSES DO NOT WASH THEIR HANDS ON A REGULAR BASIS.
This low grade dirt, lack of interest in cleanliness, comes from generations of antibiotics, and has resulted in the good ol’ superbug thing.
I’m sorry, Phyllis, that you had such a terrible time. But tell your friends, now, and your children: support each other, stay in the hospital with the sick person, yell at the nurses for pain medication if needed (I did so, when the girl next to me was in agony… the nurses were ‘too busy’, and I became the head bitch of the ward, I must say) And don’t stay longer than you have to: realize that the modern hospital has become a true pest house.
Nov 10, 2008 - 11:42 pm 3. Pajamas Media » The Decline of Hospital Care in America:[...] Read the entire piece here. [...]
Nov 11, 2008 - 1:27 am 4. Benson:There can’t be this much smoke without fire. I believe Dr. Chesler has identified a serious widespread problem.
For some, there may be a solution. I was operated on not long ago, need another operation, and can’t wait to get back into that hospital. The people there have saved my life twice, and seem determined to do it again. Nothing’s perfect, but I have few complaints and lots of praise. What matters most to me: I’m not dreading the coming experience.
Next time, Dr. Chesler, for elective surgery, consider Bangkok.
Nov 11, 2008 - 4:00 am 5. C. Siegel:Sorry about the bad experience, Phyllis. As a nurse, it pains me professionally to hear that your pain was inadequately treated. Instead of being “the patient’s advocate”, too many of us become the advocate of the on-duty resident, or the hospital, or the nurse before us. Too many nurses are not fully trained or equipped in the art of pain relief and wimp out with meds they’re allowed to give. Plus, we don’t ride herd enough on physicians who don’t adequately treat post-op pain.
Understaffing is really not a good excuse.
Nov 11, 2008 - 4:01 am 6. Chuck Pelto:TO: All
RE: Heh
What can you expect from a virtual monopoly?
The AMA has a hammer lock on government control of their industry.
• They control the numbers of doctors generated to support the population, i.e., limiting the supply, of health care.
• They control the FDA and what medicines are allowed to be offered to manage disease. [Note: Notice I did NOT use the term 'cure' diseases. And I've evidence supporting that in my mother-in-law, on whom the AMA has thrown in the towel on her very aggressive Stage IV cancer. Oddly enough, a simple tea made from a plant seems to be curing her.]
• They control the pricing on goods and services. [Note: Since when does a quart of water with a pinch of salt cost over $200?]
This thing is a mess. And the one group that has NOT been pointed out as being a contributor to the mess, in all the 20 years I’ve paid close attention, is the AMA.
Heck, when I experienced chest ‘discomfort’ and went into the ER to see if it was a possible heart condition, my WIFE had to show the NURSE how to apply the EKG sensors.
And like the Roman Catholic Church of the 14th Century, they are VERY jealous of their control. Witness their efforts to squelch chiropracty and acupuncture. I know an MD who included homeopathic techniques in his practice. The AMA tried to have the state board remove his license on SEVERAL occasions. They failed. As a volunteer lobbyist I witnessed collusion between the AMA and the state legislators in a committee hearing on a law that would have authorized a wider range of natural medical techniques.
It’s ‘hilarious’, in a sardonic way.
These reports only add to my apprehension as to what to expect from these people when the fit hits the shan.
Regards,
Chuck(le)
Nov 11, 2008 - 4:52 am 7. Darrell:My wife has been in nursing for 30 years now. When she began, it was about patient care and she had about four patients a night. With each new governmental intrusion into medicine, her patient load grew as she was trained to become a case manager of 15 or more patients a night. Now she does nothing but inform doctors of what procedures insurance or government will allow to be covered. The patients are the least of her worries. I know I have little to add, but I have lived with her frustration now for many years.
Respectfully.
Nov 11, 2008 - 4:54 am 8. mk:Wait until socialized medicine then. Take it from a Canadian – You think it’s bad now? Wait until you have a dysfunctional system like we do where nurses don’t care, doctors honestly have way better things to do than care for you, and the whole system is based around getting you out as fast as possible because you’re costing the government money.
Nov 11, 2008 - 6:16 am 9. Lawrence Kohn:Contact St Mary’s hospital in Madison Wisconsin. It is the exact opposite. And I understand your experience from my daughter’s open heart surgery 24 years ago in Manhattan where while the ICU was top notch the night before surgery we had to call an exterminator to kill the roaches in the regular room and I found a worker show up for work and disappear for 45 minutes.
hand washing is a regular feature, the floors are clean primary and secondary care are excellent; patient care is a top priority. Contact this hospital to find out what it takes to do things right; then work from there.
Nov 11, 2008 - 6:17 am 10. realworldRN:I’ve been a nurse for 17 months now, I work in the operating room. I went there straight out of school. Let me tell you why. In school for your bachelor’s in nursing, you have so much good training, such high ideals instilled, compassion, competence and quality care are your priorities. This is fine when you are doing clinical and your teacher is there, fellow student nurses help each other… you have two or three patients and you can do every thing for them, see to their comfort and their dignity. You have time to discuss with their family, to really see your patients in the context of their circumstances and life situations to deliver the best care.
I did an extern program between my junior and senior years, working as a nurse aide II on a neuroscience unit (spinal surgery patients, stroke patients, patients in hospital for various other illnesses who have a neurologic issue like alzheimer’s or parkinsons, and some patients there because there’s no room on the floor they needed to be admitted to.) For the twelve weeks of the program I was paired with one nurse and took care of only her 4 or 5 patients. This was challenging to me and I learned a lot. At the end of my program I was offered to stay on PRN. I accepted, which was a valuably eye opening mistake.
The first day I worked in the “real world” one of the other aides called in sick. I had 13 patients to care for. Here are some of the responsibilities I had for my patients: make sure to lay eyes on every patient at least once every thirty minutes. Take vital signs every 2 or 4 hours as ordered by the doctor. Keep strict intake and output for every patient (required on that floor). Turn immoble patients every 2 hours. Help patients to the bathroom every 2 hours. Bathe every patient before breakfast. Feed the patients who cannot feed themselves. Change every bed, fill every ice pitcher, tidy every room, change linen bags, take out trash, give clean towels. Do oral care orders. Get the patients up to the chair or walk them in the hall. Change dressings, suction patients, transfer, admit, or discharge patients, call portable equipment. Get them coffee, get them nutrition shakes, make sure patients on special diets have the right trays and aren’t getting foods they aren’t supposed to get, feed them their snack. Listen to patients, listen to family, make patients wear the brace, do restraint orders for patients who are pulling out their IV and catheter, or are mentally ill and have aids and try to scratch and punch and spit on you, cursing constantly. Calm angry or upset patients. Keep smiling and do every other thing that the doctor or nurse decides needs to be done for the patient. Get specimens and tube specimens to the lab. Do all these things in the space of four hours while doctors are rounding, speech and swallowing therapists are doing therapy, physical therapists trying to do their therapy, and the pastor and family are visiting, and document it all in the computer. On top of all this, there are emergencies: code blue, seizures, toileting accidents, patients with nausea, everything you could think of. There is a call bell going off at least every five minutes. Some days weren’t so bad– I only had nine patients. I knew then I would never want to work on a floor.
This is why I went into the OR. I was waking up several times a night worrying about the patients, so frustrated because I could not do what I was being trained to do. I was yelled at, taken for granted, cursed and spit on, the family would evaporate when the patients had toilet accidents, wouldn’t even help feed patients. I had patient of at least 3 nurses who acted like theirs were the only patients I had to think about. This is the real world, and anyone who tells you that nurse patient ratios are for the benefit of nurses does not understand reality. In the OR I have one patient, and I have the time tools and supplies to take care of them properly. Phyllis, please take some time to talk to real nurses before you write something so denigrating to my profession without understanding the world we have to work in. Not all nurses or even most nurses are the slack, unfeeling people you describe.
Nov 11, 2008 - 6:27 am 11. Matthew O'Brian:Hospitals do not have enough nurses on staff.
Nurses are not paid near enough. They deserve at least double what they are paid now.
Too many low quality people are attempting to become nurses because they see it (wrongfully so) as an easy living and guaranteed job.
Pay them more, and you’ll get better quality entries into the field. But require standards, and weed out the ones who don’t make the grade.
Nov 11, 2008 - 7:25 am 12. FLMom:My husband had knee replacements almost exactly one year apart. This hospital is in a fairly small community. Without exception the staff were great. The problem, they were clearly understaffed. This became very apparent with the second surgery when we noticed cutbacks and outsourcing to save money. Just in one year’s time the overall quality had gone down. I think the staff were doing the best they could with the changes.
When my mother had surgery I flew out to stay with her and ended up staying at the hospital the entire time. The shortage of nursing staff was even more apparent than at our hospital. I fed her, placed bed pans under her, among other tasks. Basically, I did everything that I could do without assistance. I stayed with her at night because I knew she would be disoriented and have a difficult time communicating her needs.
From these experiences, I would say that family should plan to stay with a patient as much as possible during any hospital stay. If the patient is elderly or likely to become disorientated, don’t leave them alone at all.
Nov 11, 2008 - 8:29 am 13. Radtop:I just got out of the hospital suffering from a massive pulminary thrombosis. They not only saved my life, but everyone treated me with exceptional kindness. I’m sure horror stories abound, but I’m just as sure my experience isn’t uncommon.
Nov 11, 2008 - 8:30 am 14. Judy, NYC:never have elective surgery. if you are not in a car accident or having a heart attack or stroke, stay out of the hospital. the hospitals are filthy and you will get much sicker being inside one than outside. people who do not speak english language semi-fluently do not understand what you are saying. they come from cultures where, for all we know, to be sick is disgusting and low, and most of them are afraid they will get sick too. from you. the health care system is imploding anyway, like the other debacles wih which have been visited upon us. an ethos of professionalism is gone. forget our standard of living, it’s gone.
Nov 11, 2008 - 8:35 am 15. Mom:As the mother of one who has been hospitalized over 100 times I can truly say we have had experiences ranging from Excellent all the way down to Horid! On more than one occasion I have taken the time to remind the nurses that my child didn’t choose to be a patient, but that they, the non caring, had indeed made the choice to become nurses. I would then go on to tell them that if they were as unhappy and miserable as it appeared they had a choice to change careers, but as a petient you were denied that choice. This little speech usually resulted in a change in attitude, mostly for the better, but occasionally it went the other way. At that point I would have a frank discussion with the “Patient Representative” on the hospital staff. I found them to be extremely caring people who always followed up on my concerns. Bottom line here is that every patient needs an advocate or advocates who do not leave the patient alone in that bed until you are COMPLETELY convinced that the quality of care will be not just good, but excellent.
Nov 11, 2008 - 8:44 am 16. hillbilly mama:Of course there are wonderful people who are nurses. That said, the profession is not what it was a few decades ago. Firstly, Darrell #7 describes an RN position perfectly. It has evolved into a hands-off, administrative position. Unfortunately, this changes the dynamic of the entire operation in a way that has been very unintentional and therefore full of failures. Secondly, the quality of care by LPN’s and aides (the actual caretakers) varies greatly from facility to facility. In our small town hospital, we recently had my grandmother in for an appendectomy. The caregivers were wonderful but maybe a little lacking in competence for what burdens were placed on them.
Nov 11, 2008 - 9:33 am 17. Quincy:As far as the AMA goes, they are a political lobbying arm for leftist medical providers. They don’t have any say so in the real world of medicine. My husband is a physician and the entire system is being ruined by administration by non medically trained bureaucrats and by the slow and steady march of socialism. If anyone thinks that this is going to get any better going in the direction it is, they have another thing coming. My husband can’t wait to get out of the profession (along with many of his colleagues) and he is just 40. It is terrible.
The other big problem, besides the AMA, is that the hospitals know you’re NOT the one paying the bill. They know they work for your insurer or the government, depending on your age and economic status. So, they don’t bother with the things that don’t get reflected in government/insurer metrics.
The way to deal with this is to slowly wean ourselves from the “insurance for every hangnail” model. The more people who start paying their own hospital bills, the more hospitals will care about patient satisfaction. Note that I fully believe this will get worse under any “universal health plan” foisted upon us by an Obama administration.
Nov 11, 2008 - 9:42 am 18. George Jochnowitz:If anyone is interested in reading about my own experience after quadruple bypass, go to
Nov 11, 2008 - 9:47 am 19. Amanda:http://www.jochnowitz.net/Essays/Operation.html
I am a nurse and I take great offense to your “diagnosis” of what is wrong with hospitals in this piece. I have become so disillusioned with nursing that I work only enough to keep my license current. A lot of the problem is the idea that a nurse is simply a hand-maiden to the brilliant doctors, there to give bed baths, fluff pillows, and run in at the first ring of a call light. And don’t forget that we should be wearing cute little dresses and caps.
Nov 11, 2008 - 9:47 am 20. mommydoc:Nurses today have high acuity patients, and too many at one time. I may not be able to run in to fluff a pillow because I am next door dealing with a hemorrhaging patient. I am not able to immediately give an admit a bed bath as I am desperately trying to reach a flakey doctor who wrote orders for meds to which a patient is allergic.
Rarely working in a ward, I have spent the majority of my career in the emergency room. I have had drug seekers and their family members physically assault me. I have been bitten by a psych patient. I have had instruments thrown at me by a doctor, and have been verbally abused and publicly degraded by a doctor. My crime? Asking him to re-write an order that would have killed the patient (any nurses out there? He wrote for 20 mEq potassium IV PUSH, and seriously wanted it given that way). This is only the tip of the iceberg, I could go on for days on the ways physicians abuse nurses and the many ways they endanger patient safety. How many people watch to see if their doctors wash their hands? Or ask if they have cleaned that stethoscope between patients?
We have large patient loads, and very sick patients. And yet we have those who come to the ER for the sniffles, and these are the people who scream at staff because they have to wait while we care for the heart attacks, strokes, shortness of breath, etc. While I am kind to these patients, I am not sorry for their wait. They have chosen to abuse the ER. In addition to my own patient load, I must keep an eye on the nurses who can barely speak English, I must smooth things over for the disgruntled nurse who treated people without respect, I must start IVs for the new grad nurses who were not taught to start them in school, I must decipher the scribble of an MD who is too lazy to write clearly.
Nurses today are responsible for much more than the average patient assumes – most definitely more than this author assumes. I am the stop gap who keeps harmful MD orders from being implemented; I administer complicated medications; I monitor cardiac rhythms and intervene with meds or electrictiy as needed; I assess patients closely to watch for things the doctors missed, and to carefully watch a patients progress; I do venipuncture, start and maintain IV lines, manage ventilators, and obtain arterial blood samples.
I am a nurse, I am not a housekeeper – I am not there to clean mud from the stairs. Because of the greater load of specific skills and responsibilities, I am not there to give bed baths, spoon feed, or change the linens – these things are the responsibility of the aides and techs. These aides and techs are just as busy as the RNs, and are treated even more poorly by patients and their families.
I, too, am immensely frustrated by the lack of professionalism and respect in my co-horts. The most bitter of them promote away from the bedside to management – where they make patient care even more difficult for us by adding useless paperwork. The severe shortage has led to foreign nurses being imported, travel and agency nurses coming in to work with little to no unit orientation. Inexperienced nurses are being put in critical care units where they only add to the work of the experienced nurses.
I am kind, I am compassionate, I take great joy in patient teaching and helping to explain exactly what is going on in order to put patients at ease. And yet I am ready to leave my profession because of the outright abuse from management, doctors, and patients and their families.
Rants such as this one, with little understanding of the actual situation, are only worsening the situation. Your continued idolizing of physicians, and your perpetuation of stereotypes is truly disturbing.
Dr. Chesler, thank you for your insightful column. As an OBGYN who has practiced in the Northeast, California, and the Mountain States, as well as as a recent surgical patient in a large teaching hospital in the Mountain States and the significant other of someone who had 2 elective surgeries in a local community hospital, I can confirm many of your experiences and observations.
While I have worked with many excellent, smart, compassionate, dedicated and hard working nurses, I have also had exactly the opposite experience. I was fortunate recently to have had predominantly great nursing care after spine surgery; it was the intern who decided to have a power struggle with me over pain management, and I was too tired to demand that they call my attending (a colleague I had hand-chosen and who later apologized to me for the intern’s behavior.) Nonetheless, I have been on the losing end in many cases when advocating for my patients over either ignored orders which put the patient in grave danger, power struggles with nurses who thought they knew more than I did (and didn’t) and less-than-compassionate care. Unfortunately, the evolution of nursing priorities, as you have so astutely noted, has gotten in the way of patient care, as has the mountain of (I have to believe) well-intentioned regulation and bureaucracy. Much of this has been intended to improve quality of care. What has occurred instead is that the mountains of paperwork required to document patient care, without a concommittent increase in staffing, has resulted in decreased attention to patient care because it is the paperwork that can be measured. Add to this the influx of foreign-trained nursing staff, and hospital care begins to resemble calling the HP help desk! (An old but sadly appropriate joke: Q: How do you say “f**k you” in Tagalog? A: “Yes, doctor!”) And too many directors of nursing are too concerned with climbing the coporate ladder and playing politics to require excellent nursing care. The frequent antipathy between DONs and medical staff means that many doctors take the path of least resistance and stop advocating for their patients, bribing the nurses with contributions to their incessant pot-lucks. It’s no coincident that there are so many obese nurses, particularly the longer they stay on the job.
The first time my S.O. had surgery, the preop nurse (an older, clearly burned out nurse who hated her job) was incredibly rude to me, and when I called her on it, became cloyingly sweet to my S.O. The OR and recovery nurses, however, were wonderful. I quietly reported her to the patient rep, and the second time he needed surgery, I called the patient rep ahead of time. Imagine his surprise (and mine, quite frankly, as well) when the nurse manager personally came to see him at his preop and he received virtually VIP treatment the day of his surgery.
To blame the AMA for this as some well-known-in-blogging-circles-ignoramuses have done, is to lay the blame squarely in the wrong place. No physician has any interest in having lousy nursing care, and anyone who has any understanding of health care finance at this point believes that anyone on the provider side of insurance-covered health care has any control whatsoever on what is actually paid. Medicine, in most specialties, operates on a small margin beginning to approach groceries. For those of us with student loans in the low-to-mid 6 figures, an increasingly common situation, third-party payment barely covers the cost of doing business. This is why you see OBGYNs opening medical spas, doing laser hair removal (if I wanted to be a cosmetologist, I wouldn’t have racked up this debt and put myself through the misery of residency, quite frankly), and promoting weight loss programs. Something’s got to pay the bills, and when the insurance company executives are getting million dollar bonuses while mandating that we accept payments that don’t cover the cost of care, we are forced to turn to providing services that patients are thrilled to pay thousands of dollars out of pocket for. The same patients, incidentally, who b***h over a fifteeen dollar copay and try to get us to provide uncompensated care over the phone.
Do I sound bitter? Well, certainly I am disappointed with where medicine and health care have gone. I love my profession. I just wish there weren’t so many barriers to providing the wonderful care that my patients deserve.
Nov 11, 2008 - 9:50 am 21. iammefrommiami:oh that is horrible I don’t think ANY of those things were “little” Man! It sounds like you were in the hospital for hell !!! Like something out of “Jacob’s Ladder” Definitely stay away from hospitals if you can, Hope you have recovered physically and emotionally and spiritually.
Nov 11, 2008 - 9:52 am 22. Spindok:Al lot of this is due to the expansion of corporate medicine and decline of private practice and independant hospitals.
In the past the independant hospital needed to cater to private practice doctors. The doctor had an interest in maintaing hospital quality because if he/she did not the patient would complain and find another doctor.
The hospital, in turn, would respond to the doctors complaints or wishes, ie new equipment etc, because otherwise the doctor would admit his/her patients somewhere else.
Nowadays mega-corps, largly “non-profit” are huge conglomerates with a large central institution and many community hospitals, and medical centers which they have been buying up. Often these are not in the same state or country. The Mayo Clinic, for example, has over 70 facilities in at least five states.
They have also taken over the medical practices and doctors are now salaried employees with little interest in hospital quality. In the corporate environment complainers are trouble-makers and everyone is supposed to ‘get along’. In any case the physician is not consulted and staff is “not your department”.
Outcomes are measured in how many patients the doctor can see, or procedures performed, and how quickly. The hospital system provides the patients so no need to worry about building a loyal group of patients to keep a practice.
The people making all of the decisions are corporate suits far away, not caregivers where you are. They only care about the bottom line.
This is only going to get worse and very few young doctors today are even interested in private practice, preferring the security, regular hours, time off, and lack of worry offered by the corporates.
“Welcome to the machine”
Spindok
Nov 11, 2008 - 10:12 am 23. heather:This comment supports my own negative attitude to the nursing profession: “A lot of the problem is the idea that a nurse is simply a hand-maiden to the brilliant doctors, there to give bed baths, fluff pillows, and run in at the first ring of a call light. And don’t forget that we should be wearing cute little dresses and caps.”
Then who is to actually ‘care’ for patients, who are usually VERY sick? From Amanda’s point of view the ‘caring’ part seems to be demeaning, a job for the lesser breed. In my own case, the caring came from the lady whose job was to clean the floor. The nurses were too busy with the IV to take a look at my actual situation.
The idea of the nurse who washed the patient was to check the patient’s physical situation. Also, try being sick in a hospital lying on a sweaty flat pillow for days on end, Amanda. You may just appreciate someone coming along and ‘fluffing it up.’ As to ‘cute little uniforms’, the great thing about uniforms is that you could tell the nurse from the social worker from the housekeeper, something that in the olden times was a useful identification.
People are not cars. A hip replacement is not the same as changing a tire.
Nurses, in their rush to become ‘dignified’, ’scientific’, non-’handmaidens’ have lost the core reason for their profession. They have truly become second rate doctors and bureaucrats. Florence Nightingale is an object of ridicule to most of them.
So, I repeat, if you MUST go to the hospital, make sure that you have a friend/family with you at all times. And watch the nurses: make sure they wash their hands BEFORE they come near your bed.
Nov 11, 2008 - 11:55 am 24. MomRN:I notice that mommydoc forgets to mention that doctors have a huge responsibility in what is happening in healthcare today. Poorly written orders, poor assessment of patients, being condescending and abusive to nurses.
Nov 11, 2008 - 12:25 pm 25. Tony DeCarlo:In one response she makes a racial slur and states that nurses will only work if bribed by food. Lovely.
(Quite a few doctors are obese themselves. Myself, I stay in shape, and I pack my lunch. Preventative care is of the utmost importance, and it begins with proper nutrition and regular exercise.)
Most interesting to me is that an OBGYN is blaming all of healthcares problems on the nurses. OBGYNs are responsible for the most unnecessary interventions and highest number of nosocomial complications for both mother and baby. The World Health Organization has actually begged the US to move to a model of care that heavily involves midwives, after noting the increased mortality of American mothers and infants in comparison to other developed nations. Yet the AMA and ACOG are fighting this tooth and nail in order to keep their lucrative business model going. Two excellent resources to further this information: Pushed, J. Block and Born in the USA, M. Wagner.
This article is entirely one sided and factually devoid. It is obvious the author expects a nurse to be a brainless woman in a short white dress to hold your hand and give you a sponge bath. Anyone interested in an actual account of this issue should check out Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care, S. Gordon.
I live in Princeton, NJ and I must say that our local hospital, University Medical Center, provides excellent and caring service. My suspicion is that big city hospitals prefer to hire foreign-born staff to save a few dollars. Patients suffer because many of these people are ill-trained and provide minimal service. The consequence is that the few American trained personnel must work extra hard just to provide some level of care. Is it any wonder that they are angry. As to National Health, my few experiences in Europe have been very positive. In Italy the quality of care at all levels in absolutely first rate. The fact that Italians live longer than Americans and generally enjoy better health late in life is a testament to good health care.
Nov 11, 2008 - 12:40 pm 26. Guard:I work at a hospital and much of what was said above is true, a few nurses are bat shit crazy. But one problem I’ve seen is everyone is a nurse to the family. The food service worker who is not allowed to touch the patient, because they are not patient care staff, drops the tray off and leaves to deliver hot food to the rest of the floor. This looks bad but it’s a necessary division of labor. And the family complains that the nurse dropped off the food and left.
Nov 11, 2008 - 1:15 pm 27. Dr. Butler:When hospitals are run as corporations, patients are no longer people but ‘customers’ and doctors are no longer physicians but ‘providers’ (”Would you like fries with that?”
When such corporate hospitals are unsafe for physicians, hospitals are unsafe for patients. We can do better, but whether we will choose to do so is not clear. At the moment we have ‘Enron’ Medicine brought to us by our ‘Enron’ Congress.
Nov 11, 2008 - 2:29 pm 28. Susan:My 20 year old son has been hospitalized twice this year, each time for 9 days.
Nov 11, 2008 - 2:48 pm 29. Tex Taylor:I took him to St Luke’s in Houston.
We got to know many of the nurses, and for the most part, they are angels. I do feel it’s very important to stay with your family members around the clock, which I mostly did- just running home to shower and change. My son usually had one nurse he did not like very well, but even they were competent and kind. I’ve been very grateful to have had only good experiences, and to have my son treated respectfully, with loving care. If you must be sick, or need treatment, come to Houston- best place in the world for medical care. Sorry to hear of so many negative experiences.
I might have a unique perspective on this being I recently entered medical school as a second career via the non-traditional student route. I worked in what is rated as a top 100 hospital to build a resume. I have no bias in these arguments as I am only in my first year of school after 20+ years of corporate America. For what my opinion is worth:
I volunteered twice a week in an emergency room, went and obtained my CNA (Certified Nursing Assistant) in the most thankless of roles to gain experiene, and spent a great deal of time simply observing the processes.
Most you make equally valid claims. Here is what I observed over two years.
(1) Some doctors are complete asses and the bad attitude rolls downhill to the bottom of the rung. They set the tone. But most are generally caring and professional, and showed great empathy toward their patients. The amount of paperwork required for the documentation and insurance was ludicrous. Trust me, you don’t want government involved any more in medicine than absolutely required.
(2) The charge nurse, whom I came to respect a great deal, told me the turnover so bad with respect to nursing, she didn’t even bother to learn a nurse’s name until they had been there six months. There is no shortage of nurses but there are huge shortcomings nurses wishing to serve. One lady told me she left her $32 hour nursing job to become a seamstress for $8 an hour because she hated the treatment. Most loved the work, hated the hours and the demands, and were completely frustrated in the lack of an emphasis of patient well-being. And like any occupation, there were a handful of horrid nurses, better serving as executioner.
(3) CNAs and housekeeping are the most mistreated, dumped upon employees on the planet. It is a disgrace what they are paid and the amount of disrespect shown from both staff and patient. Being a future doc, I reminded myself of that fact.
(4) For every one patient who is respectful and reasonable and that you would dearly would love to help, you’ll get another you’d just as soon run out of the hospital on the gurney and push into traffic. Our general collective demeanor, expectation and attitude as a community is both unreasonable and abhorrent. For future reference to anybody interested, you get a lot more flies with sugar, contrary to popular belief. But you do need to stay firm in your demands (just be as pleasant as possible).
(5) Hospital administrators generally seemed either uninterested or powerless to do much. Staffing is difficult because you have no idea the demand from one day to the next. I still can’t figure out what purpose the administrators served, but it didn’t appear to be cleaning up the mess; more likely washing their hands of the problem…
There you have it. Welcome to the callous society we now call home.
Nov 11, 2008 - 3:21 pm 30. Sam:Darrel, #7, realworldRN, #10, and Hillbilly mama, #16, I would like to talk to you because I intend to become an RN. Odeusus@gmail.com
Dear Mrs. Chesler.
Perhaps I have been reading too much Socrates, but do you really think that compassion can be taught? Would you really feel better if you had the checkout counter style greeting?
Respectfully,
Nov 11, 2008 - 3:33 pm 31. Paul_Unalaska:Sam
My mother recently had her other knee replaced, voluntarily again I’ll add. My folks live in W. Colorado and were fortunate to have her surgery, few days healing afterward in nearby Aspen. You’d assume the mountain backdrop and small-like community, the hospital staff would be well-equipped in all facets compared to that of Dr. Chelser’s piece. Right?
My sister, an L&D (labor & delivery) nurse in Denver stayed with our mom for support and in case she needed assistance if the hospital was busy or worst case lacking. Suffice to say my sis helped out quite a bit. My mother doesn’t drink or smoke (a vegetarian of 25 + years to boot) perhaps this is why the medication adminsitered to her effected her so. She was beyond loopy. Incoherent. She’d a difficult time recognizing her husband of nearly 50 years. The dosage was fine though my mom was in a fog-like state those first few days. Thank God my sis was there to assist, regroup/console her in some manner. This coming from a rural hospital which wasn’t “busting” at the seams with patients.
The comments of realworldRN and Amanda are noted. Though many hospitals DO need more attention to their customer care, procedures and as mentioned, ‘compassion factor’. My sister is fortunate. She, like other nurses have commented, worked in wards with the elderly and other most of the time difficult areas of the hospital. With the dawn of baby boomers it’s essential we hire intelligent, qualified and experienced people in these arenas. Not playing up the P C card and hiring equal amount of ‘diverse personnel’. People’s lives/well-being shouldn’t be cast aside for political pandering.
I don’t believe there’s a quick fix, end-all solution. The health care system should be examined thoroughly. First and foremost, remember the proficient health care provider should be recognized for their incredible deeds.
Nov 11, 2008 - 4:17 pm 32. Claire Kruszka:Having been a nurse for 25 years, I must say wherever you go for care , there will be good and bad.
I consider myself compassionate, kind , and caring as a nurse.
The majority of my patients seem to be pleased with the care I give.
I will say, though, the demands put on nurses are astounding.What a previous nurse wrote is sad to say very true.
We are expected to walk a fine line of being astute of modern technology, yet are still treated as handmadiens by physicians ,patients, and their families.
I had 6 patients yesterday. For some odd reason one of my patients was way on the other side of the nurses station across the hall from my other patients. He of course was the sickest of all.
It seemed that all of my patients thought that they were my only patient.
Each expected ridiculous amounts of attention that I could not possibly give having a load of 6. Add to that a Ward clerk who would call to ask me things she could have researched herself, and a CNA who took a breakfast and lunch break, yet expected me to come running when she needed to switch a bed out for one of my patients.I was lucky to grab a 30 min break for lunch.
I basically never sat, unless it was to chart on the ever demanding computer to prove that I had done my job.
This was 12 hours, and this is typical on a daily basis. I am 45 years old, and don’t know how much longer I can physically do this.
I live in Houston, and I’m appaled at how disrespectful MD’s are to nurses. Many of these docs are foreign and seem to think of females as beneath them.So, they treat you like dirt, and you can’t understand what they are saying half the time.They then have the nerve to get mad when you ask them to repeat what they said!
This is unfortunately how nursing seems to be. It has gotten harder over the years, not easier. More work and responsibility is thrown on the nurse when no other department feels like dealing with it. Essentially we are dumped on.
Therapy got my sickest pt up to the chair and promised him they would be back to walk him. They said nothing to me, and left for the day.
I then had my pt’s family asking why therapy had not come back, and when could he go back to bed.
Naturally, I ended up putting him back to bed. This was in the throws of giving meds, d/cing another pt, answering another one of my patients family members questions about a procedure, and trying to locate a physcian for another one of my patients.
I’m not attacking you, and I’m sorry for your experience. To say all nurses are rude and lazy and only want a pay increase r/t your experience is just a bit unfair.
Nov 11, 2008 - 5:41 pm 33. Heather P.:Nursing is demanding and hard. It is physically grueling and takes a toll on anyone in it for even a few years.Please remember that.
Wow, Phyllis I am so sorry that you had such an awful experience.
Nov 11, 2008 - 5:50 pm 34. JMH:I do hope that you will copy all of these experiences into letter form and make sure that the hospital administrator, director of nursing and every member of the board gets a copy.
This type of experience should not happen to anyone, and it sounds as though it is the norm for that particular facility.
I think the diagnosis that nurses are underpaid and understaffed is correct. Those two problems are slowly but surely driving out the good nurses and they’re being replaced by self-important twits and lazy incompetents. My dad spent a couple of weeks in the hospital recently, and the difference in quality between nurses was astonishing. He had one older but not burned out nurse who was wonderful. He had a young, ignorant nurse who was a disaster waiting to happen. Interestingly, both nurses had incidents where they disagreed with the doctor. The good nurse ducked out of the room to phone the doctor, but ran into him in the hall. They had a short discussion, the doctor (who clearly respected this particular nurse) listened to her, asked a couple of questions, then told her he wanted to stick with his original orders but thanked her for doublechecking with him. The bad nurse badmouthed the doctor in front of my dad (this being the doctor he was counting on to save his life) but carried out the orders anyway. If there was anything to her concerns, the doctor certainly never heard about it. Seemed she was more interested in griping that doing anything constructive.
Clearly it’s expensive to increase pay and staffing levels, but I think we need to do it. Slash the billing and admin staff (they never seem to get the bills right anyway). Do something, it’s essential to have good nurses, they play too important a role in patient care.
Nov 11, 2008 - 6:25 pm 35. Jason Sieckmann:Nursing care in this country has long sucked-ass. No one ever wants to go to hospital or doctor for precisely those reasons. The only way to protect yourself is to not get hurt or sick; which is impossible.
So what do we do now?
Hospitals should probably crack down on staff to be more competitive, we shouldn’t offer any government programs to pay for health care (that aren’t solely paid for by the patients using them), and the government should be more restrictive on what constitutes ‘malpractice,’ in order to ensure fewer frivolous lawsuits driving up patient care.
Nov 11, 2008 - 7:13 pm 36. ic:Wait till we have National Health Care. The Brit’s National Health Services pay doctors not to refer patients to hospitals. Cancer patients are not referred to have tests done until way too late. In Canada, patients have to sue National Health to their Supreme Court to get their “conditions” taken care of. Conditions, such as a brain scan for possible tumor. The patients paid from their own pockets to have the procedures done across the border, and sued their National Health for reimbursements. Pity the Canucks for the close of their escape route when we have our own National Health Care.
As to “compassionate” care in US hospitals: you get what you paid for. Stores cut their customer service to avoid raising prices. Airlines corral their passengers like cattles. Hospitals have to keep costs down too. They have to keep prescribing tests, useful or otherwise to avoid lawsuits, have to keep costs low, and will not be fully reimbursed by insurance companies or Medicare. E.g. a doctor’s bill for colonoscopy is over $1000, but is reimbursed $400. Yes, $400 is quite a lot for an hour’s work. But the doctor has to pay his malpractice insurance premiums, his employees, rents for his office,… In Chicago area, malpractice insurance premium for an ob-gyn costs over $200,000 a year. There isn’t much money left to hire qualified helps, is there? It’s hard to be compassionate if you are running around the whole day.
So what do we do?
Nov 11, 2008 - 8:26 pm 37. keebs:Not get sick. If you do, expect the worst, and be surprised and thankful that the worst has not happened.
Amanda-Ditto.
Nov 11, 2008 - 8:40 pm 38. Roger Godby:I have been a nurse for 21 years. I love being a nurse and I am damn good at it. I can fluff pillows AND take care of the patient bleeding out down the hallway. But, I only have so much in me and feel burned out and frustrated ALOT.
I used to be angry about the biters and the yellers and the drug seekers. I understand those who are angry now.
But, you can only deal with YOUR patients TODAY. Otherwise, you will lose your mind.
My patients are grateful for my steady hand and good care. That is all I can do.
There is an answer to those terrified by this article and stories like it:
ALWAYS have an advocate in the hospital with you, even if you have to pay someone out-of-pocket to oversee your care needs while you are an inpatient.
Here in Japan, national health dispenses most medical care through private clinics. One benefit is the staff are generally friendly (1) because it’s a Japanese cultural trait and (2) because they want to keep you coming back to them and not a competitor. One detriment is that seeking medical care after 5-6pm and on weekends is hard, because small clinics are private businesses run by a doctor (and frequently relatives) who has to sleep at some point. Doctors’ and dentists’ groups assign late-night care on a rotating basis, but keeping track of who will see you at 11:30pm tonight isn’t easy, even for Japanese. Don’t expect the best equipment or latest techniques here, either.
Nov 11, 2008 - 9:13 pm 39. Doctor Tom:Whew, where to begin. As a physician who entered medical school in the early 80’s, I can relate to most of the comments. We are all doing the little game of fixing the blame rather than fixing the problem. The politicians and hospital administrators (and insurance companies, etc ad infinitum) have done exactly what we asked of them. It is a little disingenuous of us to criticize those we put in power for not divining the unintended consequences of what “We the People” have asked for.
It is unfortunate that there is no longer any vestigial remnant of a free market in health care, where people could take their business elsewhere and let a flawed enterprise fail. Rather than a system that lives or dies on the satisfaction of those utilizing the service, we have asked “those in power” (who we put in power in the first place and repeatedly) to regulate the system.
We now consider health care a “right”, and beyond that, it has to be “fair”. Let us consider something ABSOLUTELY critical for life, namely food. While we MAY die early without adequate health care, you most certainly WILL without adequate food. Our society has essentially abolished hunger with food assistance. We, however, do not mandate that everybody get filet mignon and arugula. By trying to regulate “fairness”, we have guaranteed ourselves a diet of hamburger helper and greens, and nothing more.
Those who can, are asked to pay more and more for a diet, which slowly deteriorates, so that everybody can “eat the same things”. Is it any wonder why people are complaining, when their filet mignon budget is only buying hamburger. The health care system is broken, so long as we try to deny human nature and impose “fairness”.
As a physician, it pains me greatly to see the current state of health care. It is no longer a field which attracts the best and brightest. Even though it will cost me dearly in later life, I have to honestly advise young promising students to steer away from health care as a profession. As a young graduate engineer, I made a decision to become a physician. The extra eight years of training and building debt rather than equity is far from being compensated for by a larger salary in later life, the laws of compounding (interest) are inescapable. I alone am responsible for my decision making. Hopefully, I can retire early, and I know that most of my colleagues are thinking the same thing.
Economics 101: In a free market economy, there will be no long term shortages because supply will equal demand. Shortages can only occur when we try to regulate a price which decreases supply while simultaneously increasing demand. Remember also that the “price” you are paying also has to “pay” for all the economic distortions created by your attempt to regulate price, so don’t expect a lower “price” in the end. How much of that (small estimate) $10,000.00 hospital bill do you think actually paid for nursing salaries, instead of administrators, billing coders, etc.?
Nov 11, 2008 - 9:34 pm 40. Louis Santacroce:I watched my ex-wife recieve rude, insensitive treatment during several hospitalizations. Because she suffered from Hep C, it was assumed she was either promiscuous or a drug abuser (as it happened, she got it from a blood transfusion in the days before they even knew what Hep C was), and was treated accordingly. We once made a trip to an ER when she was in tremendous pain. After waiting for over an hour, I went to the front desk to complain. The hospital’s response was to give my wife a questionare that asked whether she was about to become a victim, or was already a victim of domestic violence. She was finally seen after three hours of waiting, and the nurses tried to prevent me from accompanying her! As if, by this time, I would have trusted them alone with her, right? The result was that my wife, who had been kept waiting in an emergency room for three hours while literally screaming in pain, was found to be so ill that she required 10 days of hospitalization. I wonder how many days might have been knocked off that total if they had seen her right away? My complaints fell on deaf ears. On another occasion, at a different hospital, aid was finally rendered only after a nurse who attended my church happened to wander through the ER during her break, assessed the situation and DEMANDED that her fellow employees see to the situation RIGHT NOW THIS MINUTE (not for nothing did we call her “Sargent Debbie”).
But I’m sure that all of you can tell a story that’s just as bad, if not worse. Here’s an idea, albeit a farfetched one: every hospital has a “Patients’s Bill of Rights” posted everywhere. How about a class action suit claiming that those rights were denied? Hit ‘em where it hurts — in the bankbook — and watch those attitudes change!
Nov 11, 2008 - 9:50 pm 41. Jane:Please, Ms. Chesler, follow up with the hospital about the quality of care from the staff. The recovery room nurse should be fired immediately and the rest of them dealt with accordingly. There are GREAT nurses and nurses aides out there who should be rewarded for their hard work and compassion. The rest should be barred from ever working in the medical profession again. The heavy bureaucracy in modern hospitals certainly shoulders the blame for this shoddy care but unfortunately so do the unions that “protect” these jobs. The unions will protect the bad and punish the good ones because the good ones become frustrated, exhausted, and quit. The bad ones stick around because they never cared in the first place. Go after this “caregiver” in the recovery room. If she’s done it to you she’s done it to others!!
Nov 11, 2008 - 10:17 pm 42. Sylvie7:I am sorry to read about your stay in the hospital. I usually agree with everything you write, but I have to say this time I think you were in a very bad place, not all hospital staff behave in the ugly and unkind way you have described. I have had quite a number of hospitalizations in the past few years, and generally truly revere the nurses who have taken care of me. Of all the staff, doctors included they have been the people I have depended on and have not been disappointed in them. I can’t say that about Residents who seem to be around as decoration and displays of arrogance. This year for the first time after a knee replacement, I awoke in the ICU. The nurses there for some reason were not attentive and not kind. I wasn’t in the mood to philosophize about it, and it was a new experience. Maybe something is happening in the hospital system. I did find it difficult to communicate with some of the aids, who didn’t know how to listen before bestowing their opinions. They all come from different countries, and there are definitely cultural differences which exacerbate one’s already unpleasant misery. But I still find those people the exception. I had an African nurse and an African aid who were the kindest, nicest people, and both possessed a sense of humor. Africa is pretty far away in distance and culture. It was the nature of these two women to take their jobs seriously, and apparently to be good natured. I have had Filipino nurses, male and female, American born nurses, in the past and during this hospitalization. It was indeed the first time, I wasn’t happy with some. My experience has been excellent interacting with staff from the Philippines, but not this time. As always, some were very fine nurses, but this is the first time I have ever felt that I was not having even a simple conversation, that is exchange of ideas. I fortunately, have always been able to get out of bed, at least by the second day. Perhaps that’s why I have been satisfied with them until now. I wish you a speedy recovery. Sorry to hear your tale of woe, but I don’t think the situation is the overall catastrophe you describe.
Nov 11, 2008 - 11:17 pm 43. marymcl:God, what a demoralizing essay.
Amanda – Thank you for your response.
Nov 12, 2008 - 12:48 am 44. frank:mommydoc,
Nov 12, 2008 - 6:33 pm 45. Chesler Chronicles » Death By Hospital: Is it Avoidable? Part Two of a Series.:you are correct, but there us a multiplier effect at work as evidenced by most of these blogs. It’s the socialism/bureaucracy factor TIMES the Culture. I mean The Culture. Whatever your ethnicity, whatever ones income level, The Culture one is a part of dictates day to day normative behavior regards everything from spousal relations, to regard for authority, to your psychological relationship to work. I spent 24 hours at a city hospital last week. The receiving nurse in ER, with some decorum and maturity, shared a lewd sexual joke with me.And not because of her paygrade. That was where she “was coming from”. The nurse who checked my vitals all night spoke not a single wrd. She seemed afraid of everything. When she hurried me to remove the IV’s, I thought she had some special skills to spare my tentative eforts. She grabbed the IV, the tape as one and simply ripped if off my arm along with much armhair.I winced as she looked at me emotionless. The head nurse introduced herself without looking at me and spoke a short set speechof some type. Her difficulty with the language and gesturing made her seem slightly unglued. I was given 3
narcotics to go to sleep with. I hadn’t seen a doctor nor had I requested any of these “helpers”. That actually shook me up.I denied them and the aide appeared affronted. I dare say, none of this behavior had a thing to do with income or ethnicity per se. The Culture
is everything. There is a lack of psychological and emotional committment to the culture of work across wide swathes of the population. I see the same thing everwhere,it is cultural/moral rot. It would hit one hardest in a hospital evnvironment given the vulnerability of “customers” in this most sensitive of the institutions of any given society.
[...] November 11, 2008, I published an account here of my own recent experience in an American hospital titled: Every Hospital Patient Has a Story: The Decline of Compassionate [...]
Nov 13, 2008 - 10:21 am 46. Death By Hospital: Is it Avoidable? Part Two of a Series. | Ft. Hard Knox:[...] November 11, 2008, I published an account here of my own recent experience in an American hospital titled: Every Hospital Patient Has a Story: The Decline of Compassionate [...]
Nov 14, 2008 - 10:50 am 47. tanstaafl:I think it’s a sound idea (mentioned in the article) to avoid hospital stays, if possible.
In addition to (generally) the decline in patient care and the increase in attitude among caregivers that the patient is a pain in the ass and please leave us alone to our paperwork, gossip and computer games…(also, unfortunately, often seen in nursing homes), there is the delightful scourge of MRSA* roaming the surfaces and corridors of every hospital.
I personally know 2 people who almost died from MRSA infections acquired in hospitals. Individuals who had to undergo years of antibiotic therapy in an attempt to kill the hospital acquired bacteria, years that, ultimately, left their entire systems weakened and far more compromised than the original procedure or surgery for which they had been admitted.
European hospitals, reportedly, have had far more success going after MRSA than their American counterparts, insisting upon stringent cleanliness protocols.
A candid physician (they’re rare) told one friend when she was in the hospital…”get out of here, people get sick in hospitals.”
(*Methicillin-resistant Staphylococcus aureus)
Nov 15, 2008 - 10:54 am 48. Jenny Hatch:Thanks for sharing, this is the very reason that many mothers are opting for home childbirth. Nightmares during the birth process can lead to post partum depression and very toxic babies from too many drugs.
Socializing the whole mess will just make it that much more dangerous for families.
Jenny Hatch
Nov 15, 2008 - 7:47 pm 49. ate mely:Please watch this video from a mother who experienced “typical western medical care” during his first birth and then gave birth alone at home during her second birth. http://www.naturalfamilyblog.com/archives/000649.html
I am sorry for the minimal compassionate care you received in that hospital.
Nov 15, 2008 - 10:53 pm 50. Wil:I am an RN who quit nursing 15 years ago because the compassionate care I want to give in pediatric neuro ICU was not possible anymore to give with the health care changes in the ‘95. I can pinpoint the start of the decline of compassionate care in the big teaching hospital with a medical/dental school I worked – unionized nurses. Nurses salary went up a year after the union negotiated a new contract but the compassion part of nurses went down. With unions, mediocre and what I call ‘minimum care’ nurses have protection to keep their jobs. Unions treat patients as part of management and creates an adversarial attitude towards patients and patient care.
The problems of the nursing profession is a reflection on what is going on to the health care profession as a whole as well as the health care industry . To make the long story short , the quality of nursing healthcare is going down and not up because of the variety of reasons . Number 1) Nurses are becoming more chart centric than patient centric or in other words , CYA rather than see to your patients 2) Nurse – Patient Ratios and Acuity levels are just buzz words created to make non-floor nurses feel good . Hospital reality is this , with the exception of the critical care units , nurses will be obligated to take more patients and worse , much sicker patients in addition to what you already have in order to get the hospital off bypass . Try telling a nurse to help you go to the bathroom when his or her new admission is ready to throw a PE right before his or her very eyes in addition to the sad fact that his/her other patients needs the same kind of attention that this patient is getting right now will get you a quick , I’ll be right back and a long wait . 3) Too much chiefs and too few floor nurses and none of them will help with the floor nurses when called upon . Go check a hospital nursing organizational chart to those who have any doubts . 4) Mandatory Meetings about new regulations , new policies and new agenda that last for 1 hr after you just got your nursing report at the beginning of your shift 5) Medical orders that make no sense or contradictory to what the other consult or attending MD had recommended . What makes it fun is this , we nurses have to make sense out of everything and we have to call everybody involved in order to explain to each doctor why Dr X wants to do or give to patient A because Dr X is too lazy to communicate to his colleagues his plan of care . 6)Unrealistic expectations of the patient and their families . 7) Experienced nurses leaving because they don’t want the headache of dealing with inane regulations and policies and most of all an unrealistic workload that is expected of them . Experienced nurses are the backbone of a lot of health care facilities especially hospitals . They are the ones that will train and guide fellow nurses and provide a voice of reason within the units . Losing them is big blow because it’s very rare for a hospital to replace people with those kinds of experience.
To those people who think that we nurses need to be paid more , thank you . But honestly , being paid more would not keep me from leaving nursing if given the chance . Many nurses especially the good ones will stay if they are able to do the job they were hired to do which is this . To be a nurse , an honest to goodness nurse and not a nurse/pill pusher/secretary/mediator/punching bag/ scapegoat / messenger/personal maid among other things .
Nov 16, 2008 - 3:35 pm 51. tanstaafl:Unions treat patients as part of management and creates an adversarial attitude towards patients and patient care.
An interesting observation, so the patient can be seen in some circumstances (extremely stated) as the “enemy”.
When I accompanied a friend to a hospital emergency room last year (southern California), I remember being struck by the thought that the patient(s) seemed almost irrelevant to the life of the hospital.
Granted, it was the emergency room and things were slightly crazy, but the same feeling lingered after my friend was admitted.
The patient (condescendingly addressed as “honey” or “dear” or “sweetie”) seemed almost incidental and not really central or even important in the sundry goings on of hospital life.
Nov 17, 2008 - 9:46 am 52. Pam:The more heavily regulated any given business is, the worse its condition. Banking, airlines, and medicine come to mind. Every regulation adds to cost and decreases efficiency.
Had the hospital that Dr. Chesler had her knee surgery in not been regulated and hamstrung with all sorts of laws about diversity, the sadistic creep disguised as a recovery room nurse would have been fired the first time, and if not by the second time, she treated a patient in such a horrendous fashion. No doubt if this dreadful woman were fired there would be all sorts of weeping and wailing and gnashing of teeth about racism and Islamophobia. This woman’s race and religion have nothing to do with her sadistic behavior. This woman is dangerous to her patients and should never work in a hospital or doctor’s office again.
Hospital administrators bear the lion’s share of the blame for having a culture where management hates labor, labor hates management, the various labor groups hate each other, and all of them hate the patients. Each individual employee is responsible for his or her own attitude and behavior, but a pervasive negative culture will drive off the best employees leaving the patients at the mercy of anyone who happens to feel like working there and putting up with, or even contributing to, the garbage.
Airlines are often expert at having the above scenario and then wonder why the passengers would rather walk to Boston than ride on their airline and why there are so many labor problems and why everything is such a mess.
Also, we, in this country, have created a Cult of Victim-hood. As a result many people feel victimized because they have to work to support themselves. After all, royalty and career welfare recipients do not have to work, so why should they. They are victims of the world and spend a lot of time letting the world know about it. After all, in a hospital setting they are victims of their patients, and everyone should feel sorry for them. How dare the patients bother them! Can’t they see how hard their lives are!? Doesn’t everyone feel just so sorry for them because they do not have pay the size of a cardio-thoracic surgeon’s. Why should he wear a Rolex while she wears a Timex. And on and on and on. In the process of being fake victims they really do manage to make victims of their patients.
All of this, the endless government meddling, the victim-hood, the excusing horrendous behavior based on race or religion, must go.
Nov 17, 2008 - 11:25 am 53. Lauren:Phyllis, I could barely get through this entire post. As someone who works in healthcare but as an independent contractor and also someone who temps and has been sent to work for administrative positions in hospitals I concur with everything you are saying and speak about. The problem is that you and I are seen as the pain in the ass, the troublemaker for speaking out — or calling for a dialogue as you put it. It’s sadly way too systemic. One of the reason’s I work for myself is because of the very reasons you mention. I get to work directly for my clients, on my clients behave and I do not have to be beholdant to the politics of this profession that in itself is just sick sick sick. While I am helping only one woman at a time, I can go home knowing I did only what was right for that woman.
I am so sorry this happened to you. Perhaps with your clout you can do something amazing to change this.
Nov 17, 2008 - 1:21 pm 54. Carol Gould:I live under the socialised NHS system in the UK but I subscribe to ‘BUPA,’ which is the private health care plan. I had breats surgery for a small lump and the treatment at the exclusive private hospital was atrocious. My British friends told me I would have had a pleasant and compassionate experience had I gone to Charing Cross Hosptial under the NHS as the staff are permanent and csre about their patients from beginning to end. Like Phyllis I had horrible, cruel, uncaring and often sadistic nurses at the private hospital. More recently I have had darling nurses and doctors for various health issues in the NHS. In July fell in Trafalgar Square and the NHS amblulance staff were just wonderful and so, so caring. Maybe there is a future for universal health care in the USA.
Nov 18, 2008 - 5:26 am 55. Revolution of the Soul | The Doctor Is In:[...] 1: Phyllis Chesler’s recent piece, “Every hospital patient has a story“, at PajamasMedia. It is a piece to be read to completion, including its lengthy comment [...]
Nov 18, 2008 - 8:32 am 56. qwfwq:It’s too bad you didn’t go to a hospital like Northwestern Memorial, in Chicago. I was operated on there recently for a malignant melanoma, and I could not have been taken better care of if I owned the place. (I do not work there, and I’m just a regular person with a pretty good health plan.)
It runs like a Swiss clock and has a top-notch staff. I don’t know what their management is doing, but they are doing it right. I was absolutely astounded. It’s like a well-oiled machine. I’m sure from the staff’s point of view it’s not all beer and skittles, but from the patient’s point of view, it’s wonderful.
Nov 19, 2008 - 8:25 pm 57. Alice:Phyllis, I was in a hospital in Dallas earlier this year for hip replacement surgery, and had similar experiences to yours, but without rage being directly expressed by the staff. Most of the time I had no family with me, since my husband and I have no other relatives nearby, and I was not aware of the need for my own nurse going in (or how useless even that could be). I wound up actively afraid of most the staff in the acute care ward and risked further injury just to make the transfer to the inpatient physical therapy ward (minor risk: faulty wheelchair).
For a while I thought it was just one bad hospital, but when I was going to outpatient physical therapy I met a woman who had had surgery in another hospital in town, one with a good image (good advertising). She complained about her treatment by the nursing staff including the Patient Care Aides, and I was shocked and disappointed when she told me where she had had surgery. She in turn was shocked and disappointed when I told here where I had had my surgery.
We both realized we are ‘in for it’ when we have to go back to a hospital, because both of us are over 60 and it’s inevitable at some point.
I’m all for a national conversation on the subject of hospital care and will participate if it occurs. In the meantime, I will try to find a hospital with a caring, competent staff in the Dallas area, and the quality of hospital nursing care will be a factor in where my husband and I move after retirement.
Nov 20, 2008 - 4:17 pm 58. TheHeartoftheMatter:Ms.Chesler,
I’ve worked as a Registered Nurse for 28 years thus far,and am wholly proud of the compassionate and intelligent care I give to my patients. My heart truly does fill with joy as I go about my work caring for the sick and the suffering.
In that spirit,I was feeling sorry for you as I read of your trials and tribulations.All human beings have the right to receive compassionate care. Sadly,while it is true there exist many examples of substandard care in hospitals the world over,there also exist many stories of wonderful care – which you have chosen not to acknowledge.
In any regard,any person,entering a hospital for care, who would so smear an entire profession as you have done,very likely would never feel satisfied with ANY standard of care received. You even chose to denigrate a “really nice,kind” nurse as “not professionally smart”,and intimated that she deliberately,not accidentally,left your leg compressors on.
Registered Nurses are NOT the lapdogs of the pampered,lettered,entitlement-seeking rich.
Whatever sage points you thought you were making were dissolved by these acidic,myopic, & disparaging remarks:
“Hospital personnel are easy to criticize. Could I do the job of a nurse or a nurse’s aide? I doubt it. The work is as repetitive as housework, it is “dirty” work and no one really wants to do it, one’s job is never done, there are always new patients crying out for attention and help. And yet, the salary is reasonable for the education achieved and the work is neither isolating nor undignified. While everyone assures me that there is a serious shortage of nurses (hence, the outsourcing of the profession), I myself did not see nurses overworked. What I saw were civil servants on a permanent work slowdown.”
THESE are words of which to be proud?
Jan 10, 2009 - 1:40 pm 59. nurse:I have read some of these comments and suggest that some of you pray that one of their
Mar 19, 2009 - 4:33 pm 60. Mary:loved ones never becomes a Registered Professional Nurse and is subject to the disrespectful, clueless, bashing that we are, unfortunately subject to by some people
in society that think that we are glorified, paid “servants” to run, skip and jump
at the speed in which you feel is appropriate. I have been an RN for twenty years. I have worked in every area of the hospital setting and I can tell you that when I hear
a young person tell me they want to be a nurse now, I cringe for them. It truly is one of the most difficult jobs today. Management doesn’t give you enough staff,supplies,doctors avoid families and phone calls from us with your concerns,the bottom line is what’s important to the hospital. When we advocate for some patients,
we have problems with the doctor sometimes, but as patient advocate we are the ONLY
one who is their for you. The doctor writes a note to show he was there for the day so he can send a bill, we provide direct patient care, comfort the family, are responsible for contacting other disciplines necessary for you loved ones care, and you want us to
mop the stairs too? When most of the family doctors come to the intensive care unit where I work, they ask me how to treat their patient. We are not housekeepers, maids,
or babysitters. We are educated, trained, professionals and have worked hard, sacrificed
much, to get our education as well. The average age of the RN in this country is in their mid forties. It’s not a profession that people are running too. It’s a calling I
believe, and so do many that I know that I’ve worked beside. If you want respect, you must give respect. Most of us don’t have coffee breaks, lunch breaks, because we stay
where we are because we don’t want to leave our patients. We don’t need to be in the room to know what is going on. We have other responsibilities too. We must check orders, have endless charting and documentation to do, and so on.
No one that I’ve read about has mentioned the Veterans Hospitals. They act like we’re getting it for free. I was a Corpsman in the Navy, female, and am Service Connected of 40@ for cancer and Osteoporosis from an injury. Being a Corpsman, Medic, I know my rights. They don’t like that. Although I’m never rude or hateful, I have always been known to complain about the neglect and abuse, along with compliments of those who treat me well. After my last hospital stay, I’ve again gone to my patient advocate. To give a few compliments and tell him of the emotional abuse and neglect that I recieved while only pushing my call button three times within a week because I didn’t want to hear their crap or look into those eyes. I did tell him that the Nurses Aid gave better care than all the nurses put together. It could be that they’re used to old men who don’t know their rights. I’ve been forced to seek outside care for my other liver cancer, to avoid the stigma of also having HCV, which I got in the service, but didn’t file yet for it. Know your patient rights. Know the nurses and doctors responsibilities and your own. Then, when you get out of the hospital, go to you PA and get the paperwork to file a Tort complaint, if a Veterans Hospital, or get an attorney. I’m in the middle of filing a Tort Complaint. Yes, when it hits them in the belt, changes will be made, but with my SSD also, I’m never going back to the VA Hospital except for tests. I’m also getting 10% more disability. Was going to give up on it, but now, knowing my previous doctors caused it to get worse, my Osteoporosis from negligence. Don’t sit and do nothing. If you want something changed, YOU have to do it. Mary
Mar 23, 2009 - 4:12 pm