Yesterday I was told that the nurses on Unit 2-8, as a group, fear and hate me, and that I should
write letters of apology to them. So let’s take a look at the nurse group.
In the first place, they’re young. St. Joseph’s Hospital has an indentured servant plan whereby
(if I have my facts straight) their nursing school offers a tuition-free education on the condition
that once you’ve graduated then you will work for them for three years. That certainly
contributes to the pool of young nurses.
But it goes beyond that. On the night shift there are one or two nurses in their sixties. On the
day and evening shifts, I would estimate the average age to be around twenty-eight. Nurses,
once established in their profession, do not stay at St. Joseph’s Hospital. I don’t know how this
compares to other hospitals in the area. What I think is that hospitals are just as bad for nurses as
they are for patients.
Hospitals are enormous factories that do not work. I offer you two simple examples. Around
10:30 yesterday morning, I was seen by a physical therapist who brought me a walker (after the
previous night’s nurse told me I shouldn’t have one) and said she would order a heating pad only
to be used for about twenty-five minutes at a time.
Twelve hours later, I still had not gotten a heating pad. When I inquired, a nurse went and
checked and told me that the day nurse had done some stuff—including getting a doctor to sign
off on the order for a heating pad—but the nurse had not followed up by actually ordering a
The heating pad arrived after midnight when I was asleep. The nurse started to stuff it under
me (on the wrong side) without first waking me up. Do you know how scary it is to have
someone doing something to you without first giving you the courtesy of acknowledging your
conscious humanity? She could have been a murderer there to strangle me for all I knew in my
After positioning the heating pad, she started to leave the room—while I was trying to tell her to
come back in twenty minutes to turn it off (the controls were out of reach on the floor). She did
not stop to listen me, just kept walking. I woke up in a sweat some time later and had to call for
her to turn it off.
My point is simply this: children don’t know what they’re doing. They get an education and
then go work but they need adults around to show them the ropes. I am quite sure that nursing
school doesn’t teach students to remove a heating pad after twenty minutes. That’s the sort of
thing that you would learn on the floor from experienced nurses—and there are no experienced
The second example of the non-functional factory hospital occurred when my doctor changed me
from injections of morphine every three hours to a continuous morphine pump. Problem was,
somewhere in the bowels of the hospital there is a department that is responsible for producing
the pump and its associated parts, and they didn’t do it. The morphine wore off after two hours
and I didn’t get the pump for four hours. During the fourth hour, I yelled a lot. And what I was
told by the nurses, nurse coordinator and patient complaint center was that I should just wait—it
was on the way. Pain doesn’t wait.
Please note that these young women know nothing personal about pain. Six of the floor nurses
are currently pregnant and, to the best of my knowledge, they are all first pregnancies. What
should have happened was that the charge nurse assigned to me should have called the physician
and asked for an order for one more injection to give me some comfort until the pump arrived or,
alternatively, aggressively moved to track down the pump.
I like to think that a grownup nurse would have sense enough to have handled it that way, but
these aren’t grownup nurses: they are children who have not yet learned to stand up to authority.
If the doctor ordered a pump then they will stand firm until the pump arrives regardless of how
much pain the patient is in.
Hospitals keep getting bigger and bigger. All the hospitals in Syracuse currently are in the midst
of building plans. Here’s a suggestion for the improvement of the system: stop growing the
hospitals. Instead, build new little ones. I just reached out to a guy who is vice president of
a 1000-bed hospital. He never replied, of course—way too busy with that great big hospital.
How about a cap on how large hospitals can get? Two-hundred-fifty beds? Four hundred beds?
This hospital says on the Internet that it has 431 beds. The “hostess” from the kitchen says that
was before the new building and they now have more than six hundred beds. Let’s have small
specialty hospitals instead of trying to make all hospitals be everything to everybody.
A hospital lives and breathes by its nurses; they are the frontline care providers. Why are they
leaving? Find out and put a stop to it. Is it the money? Is it the working conditions? These
children who have never worked anywhere else—can they even articulate what the problem is?
There are no grownups here. There are old doctors giving orders and young nurses taking them
and no middle-aged women saying, “No, no, no. Here, let me show you how to get it done.”
‘Let me teach you how to prioritize; let me teach you which doctors you have to follow
aggressively and which ones you can trust to know what they’re doing; let me show you six
ways to get around a bad order, and seven ways to get what the patient needs. You are here to
take care of the patient, not the doctor. You have a brain; use it. Focus on the patient, and work
hard to get her what you and she think she needs. Don’t dutifully follow orders. If the patient is
uncomfortable, find out why and be her advocate.’
Nurses need to have experience and maturity. Until they get it, they need role models and
mentors. There are none here.
And I don’t apologize to children who have power over me, and abuse it.