Navigating the walls of white and grey

The double doors automatically folded open, beckoning me to enter. I fumbled for my white coat that I had absentmindedly stuffed into my backpack, as I needed the “prop” of my coat to help me navigate through the day. There I was, approaching Pt number 1. I thought to myself, please don’t ask me if I can take away your meal tray as you’re done and not hungry and hate hospital food anyway. 

I spoke with confidence, hello, how are you today Mr. Gray? I knew before he answered that the pain of the abdominal mass and swollen legs would not be a positive response. My gosh, I thought to myself, liver cancer lives and ravages him. I had seen the overnight events indicating his need for increasing doses of morphine. So, there I was, about to offer a service I knew nothing about … hospice.

As I look back upon my journey in medicine, I can now truly say that the excitement the walls of white provided me, those white-washed hospital walls, continue to weave a complexity that makes me realize I will always navigate in the gray through these walls. 

Decades have passed since my first introduction to caring for the dying patient, humbling me to the truth that medicine may attract sharp minds, but will be humbled by the even keener challenge of various patient personalities.  I have come to realize the interplay of the nursing staff, the nursing aides, and family members .. all critical and dynamic pieces with a common goal to treat each patient the best we can. 

You see, there is no cookie cutter manual for the care of the hospitalized pt. Comfort lies in knowing that we can listen to the spoken and yet recognize the unspoken. Knowing what standard treatments prevail as first-line and optimal is just 1 facet of what’s touted as quality excellent care. The other part resides in our willingness and ability to recognize the needs of all patients, from all walks of life, and remain comfortable in practicing in the gray. 

Special Treatment in Nursing

Another issue in hospitals across the country, “VIP” designations is addressing our workplace conditions. This practice places nurses in an impossible position of moral distress, and the rationales supporting the practice are ethically bankrupt.

VIP notifications ask us to treat patients differently, either explicitly or implicitly, based on factors including personal connections to employees, socioeconomic status, and whether or not they have donated money to the hospital.

These VIP requests ask nurses to violate our code of ethics, which explicitly forbids giving preferential treatment based on non-clinical factors.

Our patients are perceptive and question us when they see special treatment in practice. The unstated message to staff, and our community is that the hospitals use a 2 tier system to determine care. This is unacceptable, and we must do better.

Instead of fast tracking care for the wealthy and socially connected, let’s improve our service so that no one is forced to wait for necessary care. In the meantime, we are asking that all patients needing care are treated the same. We used to be able to tell our community that we will treat their loved ones as we would treat our own. As it stands today, we cannot back up this promise.

It is time to abolish the practice of “VIP” special.

How do you feel about corporate management bringing in VIP clients into the hospital?  Does your hospital deal with this issue too?…

Nursing shortage

Today we have a nursing shortage, but why?   This brings us to the question, did our needs increase?  Do we have fewer people going into the field?  Or is more people leaving this industry?  The answer is nurses are leaving.  In fact, as we speak 2/3 of all medical employees, from doctors to nurses are looking to leave the medical field.

So this brings us to retention.  What are we doing to retain the people that take care of us?  Check back at our new post on whats happening on the frontline.…