Thank you to Dr. Besser of Good Morning America for taking the time to fly himself out to the hot zone, ask the hard questions, investigate, and find out the real story instead of blaming nurses, I hope physicians follow your lead in the future….its the only way we will ever get to the root cause of medical errors and cut back on the 1,000 deaths a week….
There Is something that everyone needs to understand about private healthcare systems, ie: “Corporate.” If you didn’t already know, each healthcare system has developed a mission for its organization and a set of strategic goals to help them achieve that mission. Strategic goals change depending on the healthcare system’s climate, the ratings they receive from patients, the reimbursement rates they are getting from health insurance companies, and the need for more capital to remain competitive within the market, (seriously, how many of you are sick and tired of seeing every other commercial paid for by a healthcare system that claims it is the latest and greatest at whatever specialty and that everyone should go there. ) Here’s the thing. It doesn’t matter what the CDC says, or what the WHO says, what the American Medical Association says, what the American Nurses Association says, or what anyone else says for that matter. A private corporation DOES NOT HAVE TO IMPLEMENT IT. PERIOD. ESPECIALLY IF IT THREATENS THEIR REVENUE POTENTIAL OR CAUSES THEM TO SPEND MORE MONEY. Recall that Registered Nurses are already the single biggest expense that a hospital incurs. Healthcare systems today are NOT ABOUT THE NURSE OR THE PATIENT, they ARE about cost containment, tightly regulating resource utilization, and monitoring an insurance company’s reimbursement rates.
Spending all this time developing position papers and a list of demands for hospital administrations to fulfill in order to provide the “ideal work environment for nurses and healthcare providers” is really wasted paper and wasted brain power. You see, Corporate is corporate, and as long as that goes unchallenged or unchanged, there is only one thing that guides, and will continue to guide the captain of the ship—and that’s filling beds, scheduling as many tests and procedures as possible, staying competitive in the healthcare market by offering the latest technologies, and catering to those people who pay them the money–insurance companies. Hospital systems pay no mind to all this other stuff that has the potential to lead them astray from their real focus, and that’s on the organizations that do pay them. It’s the money, the revenue at the end of each fiscal year that keeps the ship afloat and up to par with all the rest. A hospital administration’s main goal IS NOT TO KEEP NURSES SAFE OR HAPPY, IT IS NOT TO DEFEND YOU IN COURT, NOR IS IT TO MAKE SURE THAT YOU ARE TRAINED PROPERLY TO HANDLE A DISEASE LIKE EBOLA. How do I know this? Read the news. Texas Presbyterian took forever to issue their apology for not being prepared and for making mistakes. One of those mistakes was putting their nurses in the direct line of fire by paying no mind to the seriousness of the situation and allowing those same nurses to take care of other patients. THAT IS AS CARING AS THEY WERE ABOUT THEIR STAFF AND THEIR PATIENTS. ….IS ANYONE OUT THERE AWARE THAT NURSING CARE IS “BUNDLED IN WITH THE ROOM CHARGE?” This is directly indicative of how highly we are regarded or respected in the hospital’s these days, and why it is so easy for them to throw out a nurse like dirty Kleenex. We are a dime a dozen, and when one is tossed out there are ten more they have to choose from.
Bottom line, unless the Feds step in and start coming down on these privatized corporate hospitals and finding a way to impact their bottom line by making them adhere to certain standards that not just protects its staff, but prepares them for deadly scenarios, incidents such as the ones involving the Ebola virus WILL KEEP HAPPENING.
Something else to consider…..is the potential for nurses to exit the profession en mass. You see, there are two kinds of nurses. There are the nurses who go into this profession because it is an internal calling, one they have known for a long time. Then there are the nurses who went into healthcare because of the huge amount of jobs available. It is a job. Not a career. For those who went into nursing and healthcare for a paycheck, for a job, the Ebola scare may just run them out of the profession early and unexpectedly. I don’t blame them. If my hypothesis proves to be true, We could end up losing a lot of nurses before we see a resolution to the Ebola scare in the United States, prompting another shortage.
The nation is bleeding. The band aid? Nurses. Every single time something goes wrong, or someone gets hurt, or someone dies, or some policy is not carried out, the nearest nurse is the first one to be thrown over the bleed. All I see is nurse after nurse being used as a band-aid for the massive systemic problems that have been plaguing the healthcare system for decades. The sacrificing of nurses has done nothing to stop the death rate of approximately 1,000 people per day from medical errors. The sacrificing of nurses has not fixed the major issues affecting patient safety in the nations hospitals. In fact, I think it took this Ebola outbreak to finally highlight the insanity of finding the nearest nurse and throwing him or her into the blaring lights of the media. I’m sure the Arizona Board of Nursing would disagree with me. After all, I was thrown over the coals for naming the facility who’s practices were placing patients in direct danger when I was fired.
This time, it didn’t take. Nurses all over the US wouldn’t allow it.
Sanjay Gupta tried to nail a nurse for “allowing Mr. Duncan to leave the hospital, or not communicating to the rest of the healthcare team”(gee ive heard that shit before) the travel history as reported to her by Mr. Duncan. I think many of us nurses rightly pointed out that a physician has the ability and duty to actually “read” the nurses notes. We also pointed out that it is out of the scope of a nurse to decide if a patient should be discharged or not. A triage nurse cannot be everywhere at once, nor can she discharge a patient, and the irresponsible remarks made by CNN correspondent Gupta were damaging, publicly calling into question the integrity and trustworthiness of the nurse and patient relationship. Texas Presbyterian Hospital joined Dr. Sanjay Gupta by repeating the same sentiments by making statements at their initial press conference that blamed the nurse for “not communicating to the rest of the healthcare team.” They later retracted their initial statements, and then did so once more in recent days by admitting they had fumbled the ball in this situation. Seriously? They get no atta boys from me.. Who knows what that triage nurse had to go through in those initial hours or days, or what he or she is going through now. I don’t buy into forced apologies to save face, and this is what hospital administrations do all the time to make themselves look good so as to preserve their census and consumer base.
Now, lets talk about the Centers for Disease Control. This is the top of the line. These are the big boys. The top of the food chain in healthcare (as close as you can get) and THEY TOO, BLAMED THE NURSE WHO TRAVELED by making statements that insinuated that the nurse TOOK IT UPON HERSELF to travel back home to Texas, even though she had spoken with officials, reported her low-grade fever, and received clearance to fly back home. They too, had to backtrack and apologize for their initial accounting of events that pinned the nurse as “the problem.” These big boys are the top of the medical food chain, and here they are setting the example of playing the blame game. I can only imagine how this will affect workplaces all over the country. I mean, if the big bad boys at the CDC can blame a nurse what’s to stop any other doctor from doing the same? Will the WHO follow suit?
Google “nurse whistleblower and you will likely pull up article upon article about nurses all over the United States who have PUT IT ALL ON THE LINE TO TRY AND ALERT THE MEDIA AND HEALTHCARE CONSUMERS ABOUT THE DANGERS THAT EXIST IN HOSPITALS EVERY MOMENT OF EVERY DAY. These pleas for help by the nursing profession have gone unheeded by the media and by state legislators. The message sent to nurses and to healthcare consumers is that patient safety and a nurse’s efforts to advocate for safer, better care simply doesn’t matter. We are the freaks, naysayers, the overly concerned, and the abnormal nurses that can’t just “go with the flow” like everyone else.
All us nurses concerned about the current state of the healthcare system have been talking for sometime now, about what it would take for people to wake up and realize that hospitals are not safe, that their confidence in the healthcare system is sorely misplaced, and that they are their own best advocates. We have spent hours talking on Facebook and Twitter trying to figure out how we can get the media to understand how big the problem is…..but so far the statistic of 1,000 people dying needlessly each day of unreported medical errors, and no answers about why they happen, doesn’t seem to interest investigative journalists or mainstream media.
But Ebola! Ebola gets the world’s attention…..
If you looked past the Ebola virus for a second and examined everything behind the curtain, you’d see that the problem wasn’t Thomas Eric Duncan, it wasn’t the Triage Nurse, it wasn’t Ebola. It was a lack of preparedness on the part of the CDC and hospital administrations across the country. It was a lack of caring and a blatant disregard on the part of a hospital administration for its frontline healthcare workers. Here are some statements made by nurses from Texas Presbyterian Hospital that provide perfect examples of how pennies and profits come before patient safety (these were taken from the official National Nurses United website ):
- There was no “policy” in place for them to follow. In fact, the “policies kept changing” and the nurses were confused. Nurse management advised them to just pick “whatever worked” for them.
- No one knew what the protocols were. Furthermore they were not able to verify what PPE’s to use.
- Mr Duncan was actually left in an open area around other patients for “several hours” before isolated.
- Nurses assigned to care for Mr. Duncan were told to carry on their usual nursing duties and care for other patients at the same time.
- When a nursing supervisor found out Mr. Duncan was not on an isolation unit she demanded he be moved, but hospital officials would not allow it.
- Lab specimens from Mr. Duncan were sent through the hospital’s tube system, rather than personally walked down to the lab, which likely contaminated the entire tube system. Again, there was no policy in place to deal with this.
- There was no advanced preparedness for how to care for Mr. Duncan prior to his arrival. No protocols, no system to deal with the dirty linens that were piled high to the ceiling on the day of his death.
- The infectious disease department advised nurses that they did not have clear policies to provide nurses to guide them.
- Nurses reported the most advanced preparation they received pertaining to caring for ebola patients was an email about attending an “optional lecture/seminar” about ebola that was deemed “optional.” To be effective these classes would have had to be mandatory and offered around the clock in order to accommodate the staff in this large hospital. ***Note, a hospital that is focused on resource utilization and cost containment will NOT pay for training like this that requires extra money for training and extra man hours.***
- Nurses inside the hospital also report that there was no hands on training on the proper use of PPE when caring for an ebola patient. There was no training on what symptoms to look for, or training on what to ask patients.
- There were no policies for cleaning or bleaching the premises in absence of the housekeeping personnel. There was no one to pick up the hazardous linens, so they piled high to the ceiling the entire time Mr. Duncan lay ill an dying.
- Nurses did not have access to proper supplies and observed the infectious disease personnel and members of the CDC themselves violate basic principles of infection control…including cross contamination between patients.
The bottom line: Nurses felt like they were left holding the ball to figure out how to deal with Ebola, how to care for Mr. Duncan, and how to protect themselves and their patients.
Members of government agencies, medical correspondents like Dr. Sanjay Gupta, hospital management and administrators or the CEO’s sitting up in their penthouse level offices with the cushy view CANNOT CONTINUE TO USE NURSES AS THE BANDAID THAT COVERS A BLEEDING NATION! Blaming nurses, firing nurses, ruining nurses does not solve the problems. The United States is still losing more than a thousand lives a day due to medical error/harm. It is still the THIRD LEADING CAUSE OF DEATH AMONG ALL PEOPLE IN THE U.S. Don’t believe me? The Senate Healthcare Committee thought is was alarming enough–they just recently met to figure out what to do about it.
I’m going to say it again: “firing does not fix” all the the things going very wrong right now in the healthcare system.
“Profits before Patient Safety.”
The situation at Texas Presbyterian Hospital highlights all that is wrong right now with “Corporate Nursing.” Nurses are being expected to do more with less, they are not given proper training to perform even the most basic of tasks to protect themselves and patients, the corporate entity is not investing in the safety of its workforce, the corporate entity will go to whatever length to cover its own tracks and reputation while focusing the attention on something or someone else in order to maintain the “status quo,” rather than accepting responsibility and being accountable for the course of events. Every attempt is made to do what needs to be done in order to maintain a good public image===in this case, the tried and true tactic of throwing a nurse out there in the public eye so that everyone publicly flogs him or her was the first line remedy. The proverbial band aid, if you will. Texas Presbyterian Hospital has also shown nurses how much they CANNOT TRUST their corporate employers.
This time, it backfired. Right up to the level of the CDC, blaming a nurse didn’t work. The real problems were revealed for a nation to see. Now, whether healthcare consumers pay attention to this and demand better, the status quo will continue. As long as mainstream media and investigative journalists continue to ignore the opportunity to make a huge difference in the lives of thousands of people and healthcare providers by shining a light on all that is wrong, and all that is unethical, and dirty, and deadly with the healthcare system…..we will see incidents such as the Ebola scare continue to happen over, and over, and over again.
Journalists—-you have the opportunity to take on the story of a lifetime, the chance to break it all wide open, the secrets that have been kept for decades, all the things weve never been able to talk about or reveal to the public…..you’ve got it in the palm of your hand to dig into and the chance to save thousands of lives by making healthcare consumers more aware of the TRUTH.
How much more do you need? The facts are all right there. Everything that happened surrounding Texas Presbyterian Hospital, the blame game as played by Dr. Sanjay Gupta and the CDC, the lack of regard for the safety of the nursing workforce, the threat to patient safety, a hospitals determination to do the wrong thing until it was FORCED to do the RIGHT thing, throwing nurses on the problems like band aids expecting that the problems endemic to a troubled healthcare system will be held together—these are all just the tip of the iceberg when it comes to some of the ugly things that take place away from the sight of patients and media. What will it take for you all to finally look at what has been the biggest story EVER staring you in the face for so long? Ebola has uncovered what is happening in virtually every hospital across the United States. The Healthcare system needs saving. It needs a Hero. Which one of you media outlets or journalists feels like being a hero and making history?
Think about it. If you don’t take a chance on opening up the Pandora’s box…. the next victim could be you.