Scatter my ashes here...

Scatter my ashes here...
scatter my ashes in the desert...

Monday, September 9, 2013

Vanderbilt Runs Amok

Two consecutive days of running now with no hamstring issues. I realize though, that I need to get with the program on the strengthening exercises so I can avoid backsliding.

So much for my plan to start rehabbing the hamstring at the beginning of September. I've just been slightly distracted...this coming week I am scheduled for four 12 hour shifts at work, what was I thinking? But that is my very last week from hell at work. After this, regardless of whether I quit altogether or do some per diem work, I will not be having any more weeks like that.

After this week, I will be able to recover from my fatigue, start the strength training and cross training and ease back into the running. I feel like I'm starting to rise out of the intense fog of what I can only describe as a persistent low grade depression, that's been dogging me for months.

I look forward to soon being able to share my training runs, races, and running anecdotes on this blog. And I will.

For now, I just cannot get off the topic of corporate health care, this is what I feel like writing about these days, since I don't have any races going on. Last night I saw an article about something that's happening at Vanderbilt University, with their nursing staff.

The administration there came up with the brilliant idea of cutting back on housekeeping staff and making nurses do some of the cleaning, though it's not specified how much. Nurses would be expected to take out the trash and linens, and mop up spot cleans on the floors, among other things.

What's interesting is reading the comments at the end of the article if you scroll down. Vanderbilt is going to suffer a huge backlash from this. First they mentioned Florence Nightingale doing this type of work. But good ole Flo didn't work these days when nurses do much more than light lamps, give baths and put warm compresses on people. She wasn't responsible for titrating IV medications, giving chemotherapy, or bringing someone back from cardiac arrest. And she didn't have to document everything she did on a computer either.

The thing that outraged me even more was the response of the administrator who told the nurses not to vent about it to the patients, to go to the administrators and vent.

First of all, that heavy handed approach always backfires. People are already talking about it in online nursing forums and other social media. No one trusts the higher ups, few people want to risk their job by speaking up. But the truth comes out in other ways, and makes it's way to the mass media.

Second, does the administration really believe patients live in a vacuum and are incapable of independent observation and thought? That they don't view and observe and think about what their caregivers are doing as they watch them work and see how stressed they are? Do you think it makes them feel good about their health care when they know their nurse is trying to juggle 5 or more patients at once and is being pulled in 3 different directions all at the same time she or he is giving the patient their medications?

I for one can vouch for the fact that my coworkers and I regularly remove trash, linens, and meal trays, clean chairs between patients, wipe down surfaces, keyboards, computer equipment, pumps, and so on throughout the day. I don't have a problem with that. We do it when we have time. But if we don't have time, we are paging housekeeping.

I can tell you something else. Spot mopping in a hospital isn't just mopping up spilled jello. It's more like drippy Clostridium difficile infected diarrhea, that is super contagious. Or Hepatitis infected blood that can carry transmissible virus from hours to days on a surface. Or any number of viruses, bacteria, or fungi that would like nothing better than to find their way to an immunocompromised host and have a feast, i.e. you or your family member in a hospital bed.

Housekeepers are trained in what cleaning solutions to use for different spills, how to properly dispose of things, and how long things need to be scrubbed, cleaned, and dried so they are infection-free. Nurses do not get that kind of training.

Nurses are trained in physical assessment, life-saving skills, applying both critical thinking and highly technical skills to our knowledge of physiology, disease processes, pharmacology, safety, and optimizing patient outcomes for quality of life.

Vanderbilt is a Magnet institution. This tells you what good Magnet status is. It's actually a detriment anymore. My brother, who is also a nurse, always says, Magnet status means it's a reverse polarity magnet- it shoots people out the door.

Magnet status at this point is just a bunch of academic and administrative types shilling for their own industries. It's a marketing ploy that doesn't even work as a recruiting tool anymore, nurses see right through it. Magnet means people spouting "Get a BSN" out one corner of their mouth, and talking out the other side, saying, clean rooms too. I'm sure they have a special course in the Bachelor of Science in Nursing programs for learning how to do basic housekeeping.

These Magnet proponents prop up higher education, so they can continue to crank out excuses for raising tuition for jobs that don't guarantee any upward mobility. Promotions are few and far between in nursing. There's almost unlimited lateral opportunity, if you're interested in getting a few cents a year pay increase for experience and no more influence over the way things are done in your workplace.

Do Magnet institutions back their claims of nurses needing BSNs with financial incentives? Often they offer just a pittance, with negligible or no increase in pay for the degree. It could take a working nurse 5 years or longer to complete a BSN program going one course at a time in order to be fully reimbursed.

Just some food for thought.

Oh, by the way, I was thoroughly delighted reading my junior high friend Carla's blogs yesterday, and I saw that she gets some flak about what she writes, as I do too. We write from our hearts, for ourselves, about what moves us, not to please anyone else.

If all we do is cower in the corner all the time, we might as well dig ourselves a shallow grave and tip over in it right now. Nurses, remember that apathy and fear are as good as death. And in the case of health care, might just be the equivalent thereof.


Andrew Lopez said...

Thank you for covering this issue Alene, I'm tagging everything I find on it here:

Alene Gone Bad said...

Thanks Andrew, I just submitted a version of this blogpost to a larger audience, we'll see if it flies. Thanks for your concern too, we need more nurses speaking up on this issue, and many others.