I Love Nurses

A nurse in Kentucky responded to my 9/22 post, in which I reference a case I reported to the North Carolina Medical Board in 2006 (a situation the Board has yet to definitively act on) . . . and sketchily relate a clinical experience that defines my worst night ever as a Pediatrician (in the wake of Asheboro, that's saying something).

It's amazing I don't need medication for PTSD.

I love nurses. Always have. They are the front line. Everywhere I go, I try very hard to be a doctor that a nurse can trust. I'm smart enough to understand that nurses can make or break you. There is a saying, that the best doctor on a hospital's staff is only as good as the worst nurse on the night shift. And the best nurse on the night shift can make even the worst doctor look good.

This is very true. And, in my time, I've known some way-stellar nurses. I've also encountered some pretty crappy doctors.

"LaborNurseLori's" comment made my heart sing. Now there was a real blogging connection. This lady KNOWS of what I speak.

The following is my response to Lori (with spelling and syntax corrections . . . and an added comment here and there). It speaks to the powerful sense of loss that I still feel when it comes to Asheboro. Sometimes, there is a big hole in your heart and soul, and you cannot just let it all go. Sometimes (Hoggard, Sue, Ed, Roch) that is really stupid, fundamentally clueless advice.

Well, if you know exactly what I'm talking about, Lori, then I don't know why your colleague could not believe what she was reading;)

Maybe what she could not believe is that someone is finally talking about this kind of BS.

Because it's total BS.

A Pediatrician who recently left Asheboro called it "the cult of personality".

After my hometown hospital in Asheboro did what they did to me (almost ten years ago), the VP of the hospital, Steven Eblin (trying to smooth it all over with the OB's who were upset about my sudden departure), told them that "good Pediatricians are a dime a dozen". Of course, time has proven that statement to be moronic (and him to be an idiot . . . not to mention a liar). But that's the attitude towards Pediatricians in most small towns.

We're the lowest docs on the totem pole . . . at the total mercy of the money-making operating room machine. We're just there to dry off the baby . . . until someone needs much more than that in the middle of the night. Then we're heroes for a day. But people forget quickly.

Before I was fired, I had a great relationship with the nursing staff at Randolph - both on the LDRP unit and the Pediatric floor. I stood up for these (mostly) ladies . . . fighting many small battles on their behalf . . . and called many of them friend. I valued their contribution to patient care, and always told them to NEVER BE AFRAID TO CALL ME when they needed help.

That's why a terrified charge nurse felt like she could call me that fateful night in 1998 . . . for a baby that was not my own patient. She reasoned that if a baby was dying (and this one was), Dr. Johnson would not yell at her, hang up the phone and roll over/go back to sleep.

Of course when the charge nurse called me, she did not have a clue about the threat I was was working under.

After "the incident" (which I reported to peer review the next day - defying the hospital/practice brass to do it), no one in administration had the good sense to de-escalate the situation by retracting their threat. But, by then it was all about power. Steven Eblin and Bob Morrison were going to prove they had it . . . and they were going to teach the troublesome/loud-mouthed bitchy doctor a lesson.

After I was fired, many nurses complained . . . several brave ones even wrote hospital administrators . . . knowing full well that the position they were taking could put their own jobs in the line of fire.

At one point, the CEO (Bob Morrison) called a meeting with the LDRP staff and tried to placate them . . . telling them that I had made wonderful contributions to the hospital, but that the decision (to terminate) was final. And OBTW (paraphrasing), "Dr. Johnson hired a lawyer - and you're not to speak to her because we'll call you as a witness if you do".

It was Draconian: the employment politic of fear. And it was very effective in terms of destroying relationships and friendships with many of my friends in nursing. I've keep in touch with a few close nurse-friends to this day (I took care of their children). But just a few.

The years went by . . . and I became more publicly critical of the place where these nurses worked. I'm sure there is some resentment now. These ladies (and some gents) work hard at what they do, and I know it.

But that does not change what happened. And I simply cannot let it go. Because what was done to me was wrong.

My "advocacy" and regulatory organizations, for years (like so many of my "friends" and medical colleagues in Asheboro), have just stood on the sidelines and watched. One doctor (of many) who ultimately left Asheboro said it was like watching a "slow-moving-train wreck". And as long as these doctors could collect their big/easy salaries and go home (or leave town) and not have their lives disrupted, they rationalized that all was well.

Who cares what happened to one doctor . . . whose life was destroyed for doing the right thing?

It's one of the reasons I am enjoying watching my (North Carolina) Medial Board squirm now . . . in the face of its past inadequacies (to effectively police) and slights. Where executions are concerned (one could argue just like the AMA and the beast that became managed care), the Board did not pay any attention to the ethical/practical side of the equation until it was far too late.

Now that battle too, is really about power. And trust me, in any battle with lawyers for power, doctors will loose.

Back on point, Randolph Hospital administrators circled the wagons and turned a deaf ear (to both nurses and angry patients). A small clique of people run Asheboro (and the hospital) and they are going have their way (and cover one another's messes) no matter what.

And to this day, I have NEVER been afforded a meeting with the hospital's Board of Directors. It's just the epitome of small town/good-ole-boy arrogance and bad management.

As for the hospital involved in the situation I cite in this post (located in yet another very small North Carolina town), yes, I actually do think they have tried to do the right thing . . . and have really done all they can do without some outside help from bigger medical sheriffs. I know the legal hoops are complex. But this particular doctor has had many chances to change his behavior . . . in my opinion, he has literally medically-terrorized the LDRP staff at this tiny rural hospital . . . because he thinks no one (for all of the reason$ you cite) can touch him. So far he's been right.

The nurses at this hospital said that I was one of only a few doctors who ever "had the balls" to stand up to him . . . and the only one really willing to go the extra mile to stop him from hurting another baby. Of course, it's easier when you're a temp doc and can walk away.

When this case when down, I literally suffered pangs of PTSD (given what I had already been through in Asheboro). But this hospital, when confronted with irrefutable evidence of bad care, really did step up to the plate in terms of a fair and balanced peer review process (which included outside review . . . to avoid to charge of conflicted interests).

But the Medical Board still sits in the ivory tower. A lot of nothing has happened. The staff (particularly the nurses) still cope and the public is in the dark. It's been well over a year since I reported the incident.

The irony remains that ten years ago, I was fired for saving a baby's life . . . and cannot get anyone to give me the time of day in terms of justice and fair restitution for a life completely disrupted (the NC Medical Board will not even discuss the situation in Asheboro with me . . . and, as I have blogged, would rather change the law than make a simple referral to the AG's office). But this OB is still practicing in his small town . . . and is being given every benefit of the doubt . . . despite having hurt many people in one fashion or another.

You see, hurting people is not just about the patients. It's about the doctors and nurses who step in to clean up the messes . . . and who have to cope with whatever they find.

I'd like to thank Lori for weighing in.

And I'd like to say this to all of my nursing friends (past and current) in Asheboro. If you're reading this, I've missed you terribly. And I'm sorry if anything I've said or done over the years to pursue "justice" (whatever that means) has ruffled feathers or hurt feelings.

But you know that what was done to me was BEYOND WRONG. And I will NOT apologize for waging the fight.