Wednesday, July 20, 2011

Drainage of Our Unsung Nursing Heroes

Being a hospitalized patient is one of the few moments in life where we sense our greatest vulnerability. Distracted by illness and not being in our home-comfort zone elevates fear and apprehension. At that moment, the most easing and reassuring words one can hear are “I’m your nurse.” The role of nurse has changed markedly since the time of Florence Nightingale. Not only do we see gender integration, but technology has hurtled nursing beyond the simple “fluff your pillow”. career.  It is a profession in the 21st century that must maintain knowledge of medication, alimentation, surgical procedures, and computerized monitoring.  Yet, nurses still must be empathetic and sympathetic as they sooth away our worries and distress.  Their skills are honed with time and are invaluable in the healing process.

Nursing is not stress-free, and requires not only continual interaction with patients, but also doctors, families, pharmacists, social workers, discharge planners, and Administrators.  Coordinating all of this is an expertise I know is not outrightly appreciated.

One of my  home-bound patients was hospitalized at Henry Mayo Newhall Memorial Hospital (HMNMH) with a complex medical problem requiring surgery and a stay in the Intensive Care Unit.  After “turning the corner”, she was transferred to a regular unit for her final recuperation before discharge.  Discussing her improving symptoms during “rounds”, she stopped me before leaving and said:  “I just want to let you know how ‘synchronized’ and wonderful the care has been by the two nurses on duty today”.  She had felt the care at HMNMH was good, but she wanted to emphasize that day how her nurses were especially “professional and outstanding”.

With that, I checked the nursing board for their names and asked the ward clerk to have them meet at the nursing station.  As I wrote my progress note, I peripherally saw them sit down tentatively near me.

One of the nurses has been at HMNMH for several years and has always done a great job.  The other was new.  As I looked up at them, there was clearly an unease to their body language.  I told them what my patient had said and commended them on their skills, at the end giving them my appreciation and thank you for their outstanding care.

I was taken aback for a moment as silence fell on the discussion, and then I noticed both had tears in their eyes as they excused themselves.  Later, one came back and thanked me, expressing how they had been guarded initially because they thought I was going to tell them something they did wrong.  I reiterated my thanks, but was saddened by the realization of how rare it must be for them to be complimented on their work.

In twenty three years at HMNMH, I have seen unskilled and uneducated individuals work their way from changing bed sheets, to become skilled and educated Registered Nurses.  For many, this was not an easy task as they balanced work with family and school.  Unfortunately, many of these professionals leave our hospital because of the same threats and intimidation embattled physicians now face (see WRB Henry Mayo Hospital Rant & Rave for previous articles).

Certainly, many people have trouble with their employer, but judging from the numerous nurses who leave our valley to practice at other hospitals, HMNMH has a problem.  As the “only bakery in town”, the Administration knows no one wants to trek on the crowded freeways to another job, but this flow is like a leaky bucket, which truly effects patient care.

It all comes back to the duty of the volunteer hospital Board of Directors to recognize this problem.  We have already seen the reckless money-draining rubber-stamp of million dollars projects (cardiac catherization lab, NICU, heart by-pass surgical suite) by this Board, so why would nurse’s tears be on their radar?

To be an effective Board, they must diligently work to find out what is really going on at our hospital instead of relying on a single source for information i.e. CEO Roger Seaver.  Not only do they have a fiduciary responsibility to this community, but they are demonstrating to the public they are “not in touch” with the true needs of Santa Clarita.  Draining this valley of it’s most precious professional resource, nurses, is a reflection of their irrational decisions without rational input. 

Statistically, the Board is being told there is no problem.  The best American companies rely on “exit interviews” to find out why people leave their organization, and I’ve demanded to see these interviews for years, without success.  Every former nurse and employee of our hospital I’ve encountered has informed me they were not given this interview when they left.  Can our reputable Board members possibly not understand the importance and necessity of this tool to improve HMNMH?      

The Board of Directors must not continue to ignore problems and be swayed by personal propaganda.  They should meet with the physician Medical Staff and Medical Executive Committee in open dialogue without influence from CEO Roger Seaver.  Improving patient care should be our focused goal.   

Hopefully, the common ground we find will allow us to give nurses the worthy “thank you” they deserve. 

Gene Dorio, M.D.- Guest Commentary
Gene Dorio, M.D., is a local physician. His commentary represents his own opinions and not necessarily the views of any organization he may be affiliated with including the Medical Executive Committee and Medical Staff of Henry Mayo Hospital, or those of the West Ranch Beacon.