Emotional and intellectual revelations in Patient Safety Advocacy
Every single day, I learn. I am learning more now than I have in 43 years as an RN, about being a patient. I have learned how to be a safe. engaged patient, from other patients and from patient safety activists and advocates. A rare few professional doctor and nurse advocates are stepping forward too, and talking about important patient issues, like safety and good practices. They discuss the necessary steps to avoid medical harm or infections in healthcare settings. They talk about how unsafe staffing levels in hospitals and long term care facilities is a contributing factor to patient harm and complications. Some of my colleagues are engaged more in the issues of healthcare transparency and accountability of both quality and costs. They fight for affordable healthcare and reporting of all medical harm. Some even work toward meaningful apologies by professionals and hospitals if harm has occurred.
I have come to realize that I worked for a dysfunctional industry and I was complicit in it. That makes me feel sad and guilty. I got coopted by my employers because I needed the paycheck. I know, that is no excuse, but I was part of things that I am ashamed of.
Example#1
When I was called “into the office” once and told about a woman who had been harmed when I was a triage nurse one day, I felt absolutely awful. I remembered her in detail. I remembered that she was in excruciating pain, and that her primary nurse was snotty to her and made derogatory remarks about her. I remembered her very concerned and dedicated husband. I remembered everything, and my first reaction was that I really wanted to talk to that patient. My instructions were “you do not talk to anybody about this except the legal team. you do not even talk to your coworkers about this”. This patient had been harmed during surgery prior to her ER visit and then she was RE harmed in our ER that day. She nearly died as a result. A lot of years have passed, but someday I am going to call her and try to talk to her.
Example #2
When I worked in a Hospital employee health department, I got a call one day from the Loss Prevention Director. He asked me about a SOAP nurses note I had written. He wanted me to change it. I believe he wanted that because it would help the Hospital’s case against that employee in a Workman’s Compensation hearing. I was very proud of myself that day for not cow towing to that man. I absolutely refused to compromise my professional integrity to “do good” for our employer. The entire experience disgusted me, but that time I did stand by my patient and my convictions.
Example #3
Way back in my very early days of RN practice, a nurse always assisted the doctor. If Dr. said jump the nurse asked “how high?” One doctor I knew was a mean red faced bastard. He was mean to me, and mean to patients. He refused to allow any parents into the room when he sutured their children. One child cried uncontrollably, even with my attempts to comfort him. The doctor stuffed a wad of gauze sponges into the child’s mouth to silence him. I was horrified….and I reported him to his superior. But, I never told the parents. I was complicit in that abuse, because I was scared out of my mind of this horribly mean doctor. My fear overcame my moral responsibility to the patient and family. It is the legal responsibility of all healthcare professionals to report known child abuse. I was very young, stupid and scared.
I hate that all of this and a whole lot more, happened during my practice as a nurse. I have come to know that not all doctors and Hospital leaders are evil, but some are, and many, if not most see evil every day and they turn away and ignore it. I did to, and I live every day with that guilt. The entire practice of nursing and medicine needs to be revamped if patients are ever going to become the priority. Professional schooling needs to teach ethics, humanity, caring and compassion, instead of elitism and protectionism.
What can I do about it? I can work my tail off in retirement to make things different for patients….ALL patients. I can share my professional and personal stories in my writing, my presentations, amongst my friends and colleagues to make a difference. I feel a burning need to do this…..something like breathing. If I don’t, how can I ever say that I was/am a nurse? How can hold my head up and be proud that I helped thousands of sick vulnerable patients. Sadly, not all of my patients’ needs were met, and some were even harmed. I am proud of the good I did for patients, but now it’s time to see about the ones I (and others) have failed……
