My last post here painted a pretty rosy picture of hospital care, at least at some hospitals. And it’s true that there have been very significant improvements in many areas. But while I was there as a visitor (for many hours over several days) I also saw that the human factor is still a crapshoot.
Many of the nurses that we dealt with were excellent. In fact, I’d even say that most of them were very good at a minimum, but it seems that there are still a few in this profession that have a bad attitude toward his or her work and/or patients.
Of course, some nurses seem weighed down with paperwork (or computer work) and this is a matter of balance between patient care and possibly the kind of verification I wrote about last time. This might not be the fault of the nurse, but an unrealistic policy set by administrators. The result, however, is patient neglect. The obvious danger in this is that something serious could be happening and fail to get attention when needed. But patients don’t always know when something is serious so even when an issue is trivial they can experience severe anxiety when the nurse just won’t come.
But the worst thing I observed on this visit (and many other times) is the “Nurse Ratched” archetype.
Nurse Ratched knows what’s required and you don’t need to know – whether you’re a patient or a family member. She (sometimes he) speaks to her patients in an inappropriately loud voice and somewhat in the manner of a drill sargeant. She doesn’t ask, she tells. She manhandles her patients in order to accomplish her tasks efficiently, doing things like rolling her patients roughly from side to side of the bed like big sacks of potatoes so that she can change the sheets.
Nurse Ratched, however, is very experienced and doesn’t make big mistakes. She knows her job well. But she might up her patients’ dose of morphine just to make them go to sleep and stop complaining. Nurse Ratched is not easy to get rid of, especially in today’s situation where nurses are in somewhat short supply.
Because nurses are in demand, the employment situation for them is the opposite of that for almost everybody else. To generalize a little bit, I’ve noticed that when U.S. unemployment has been low, it seemed I was surrounded by incompetence – people not knowing how to do their jobs or just not caring. On the other hand, when unemployment is high, lots of good, able people are either without jobs or there are architects bagging groceries or something.
If given the choice, I would choose the former rather than the latter situation. I would put up with incompetence rather than high unemployment, which can be a self-reinforcing phenomenon as businesses fail that once supplied goods and services to employed people. I sure wish we could deal with both problems.
How about this? We pay people a decent wage that actually allows them to relax a little and not feel constantly under pressure. Then, we give people mandatory vacation time. With decent pay, he or she could plan for their time off and not go broke. When the employee is on the job, he or she might not resent the situation so much and just might take the job more seriously.
My bet is that each worker’s productivity would go up dramatically, as would job satisfaction. With their time off, workers would spend their money, and spread around the prosperity. Are government policies solely responsible for societal outcomes? Of course not. But policies can help to guide these situations in the right direction. That’s part of what governments are for.
Well, this is a decent idea for many kinds of jobs, but nurses are already paid pretty well. The fact is that nurse Ratched will probably never really go away no matter what we do.
Tom Rossi is a commentator on politics and social issues. He is a Ph.D. student in International Sustainable Development, concentrating in natural resource and economic policy. Tom greatly enjoys a hearty debate, especially over a hearty pint of Guinness.
Tom also posts on thrustblog.blogspot.com