In The Face Of Crippling Shortages: The Voices Of Doctors And Nurses Matter

A few days ago, over at Joe's, Hugh suggested that, in lieu of Obama's planned community health centers, we should just staff Health Departments 24/7, 365 days a year.

I had some problems with the argument (apart from being one of those foolish types who believes that's what ER's are for) . . . the most obvious objection being related to staffing. You simply couldn't do it.

You see, when it comes to nurses, we're over 200,000 openings down, nationwide.

Obama called nurses "the front lines of the healthcare system," adding: "They don't get paid very well. Their working conditions aren't as good as they should be."

I love nurses. Respect them, treat them well and they'll take your back. When I got canned in Asheboro, several Nightingales complained to senior executives and board members . . . this despite the fact that they feared retaliation themselves.

For their trouble, these brave ladies were rewarded with a standard form letter . . . obviously carefully crafted by oily hospital lawyers - citing "confidentiality" and dodging personal responsibility for the decision . . . a letter full of factual inaccuracies about my status at both RMA and the hospital (for instance, for six months, I was not "free" to do anything that wasn't in RMA's best interests . . . and starting a competing private practice was not on the list) . . . closed with the mealy-mouthed platitude that it was hoped I would stay in Asheboro and practice.

It's kind of hard to do that when everything below the knees has been cut off.

Several years ago, after it became clear that neither he nor the hospital were going to move to correct the fraud they had perpetuated at settlement (Hi Roch, I hope someday you get it), I collected all of my legal files from Steve Schmidly's office.

In preparation for legal action at some point in the near future, I've been going through the files. It's gut-wrenching, PTSD-generating stuff.

Although side-tracked, I recently decided to tell the detailed story of what happened in the period between December 1997 - February 1998, the period immediately preceding my termination. This will involve a timeline . . . along with the actual text of complaints and warning and termination letters. Names will be named. I've debated about this for a long while. But a recent post at Kevin's regarding patients rating doctors online (what is good for the goose should be good for the gander) actually stirred me to move . . . along with recent chatter in the local blogosphere about the current media focus on healthcare reform giving little voice to the people (doctors & nurses) actually providing the care.

I was stuck in a black hole for a very long time.

Confidentiality and privilege are not the factors they once were . . . as in all instances I will post, they have been waived by the ("I'm gonna get her!") actions of the people involved - or breached already by the hospital, and I am tired of being on the wrong end of the "privacy" battering ram. It's fine (and part of the deal) for patients to complain. But I'm sorry. The "right" to privacy should END when you start maliciously attacking people's livelihoods or openly slandering them (i.e. what you're saying is false and you KNOW it's false, but you're all empowered by your sense of entitlement and your mis-placed anger) . . . and ESPECIALLY when what you do causes serious damage.

I sympathize with the doctor in Kevin's post because (after the wrecking ball started rollling and the damage was done) I was once placed in the incomprehensible position of seriously considering suing a parent (as well as another "colleague") for libel. I didn't. I trusted the system of checks and balances to work and for the truth to prevail. Of course, it didn't. And/so my life turned to crap. Since everybody is talking about reform now, it's time to put the facts out there . . . the very inconvenient truth that Randolph Hospital did not want reviewed/exposed in Court . . . and let the chips fall where they may.

These jerks negotiated a deal in bad faith and then did not completely honor the deal they made. And the government, which seems to be all about protecting the rights of everyone but me, has not lifted a damned finger to do anything about it. I don't owe ANY of these people anything.

Patients in one jam or another are getting all the media airplay. But doctors have been kicked to the curb. And oh, apart from the cluster-screw I endured at the hands of those who run my hometown hospital, I've been on the receiving end as a patient, but hey, I'm an "idiot".

The Randolph Hospital/RMA Board of Directors did not want to hear it way back then - as I was never afforded a forum or hearing to defend myself. They were important people, not involved in what they categorized as the "day-to-day" running of the practice (I've yet to understand how firing one of the founding physicians of your Pediatrics division ranks as a mere "day-to-day" decision), and could not be bothered.

They can read it now.

Another upcoming post will include excerpts from recommendation letters written by former colleagues on my behalf (not that the letters really mattered in the midst of a local blackball). Recent mean-spirited snark in the blogs pertaining to my medical competence will be put to rest for good.

There's post potential in another file - full of letters from parents who cared enough to strenuously object when I was fired. I'm pleased and comforted by the fact that it's a nice-sized file;)

As for nurses, I'd like to share the content of a letter sent to Bob Morrison on my behalf by one of the Med-Surg-Peds nurses I worked with at Randolph Hospital. I very much miss working with her. She was a gem. Reading her letter (dated February 10th, 1998) this morning made me cry. Here is the text. The only thing I am not printing is her name . . . as I do not want to embarrass her - or more importantly, endanger her job.

I am writing this letter in regards to the dismissal of Dr. Mary Johnson from the RMA practice. When I went to work today on Med-Surg-Pediatrics (MSP) and learned she had been dismissed from RMA, it was very upsetting to me. You may think this this is none of my concern, however, I want the leaders of this hospital to know what an outstanding doctor she is.

I initially met Dr. Johnson in my first PALS (Pediatric Advanced Life Support) class. I had no previous pediatric training, I have always been an adult med-surg nurse. In class, she was very knowledgeable and did not try to intimidate me or the other nurses in the class. We found out she would soon be finishing her residency and encouraged her to come to Randolph Hospital. We were even more surprised when she said she was from Asheboro. We were certainly hoping after our experience with her in class that she would be interested in coming here.

As I have said, I had no previous pediatric experience, and it was under Dr. Johnson's influence that we got our first monitors. She challenged my skills and my desire to learn more about Peds. She was always willing to help us and no question was ever treated lightly. She told us we could call her anytime, and she made herself available to the other doctors if needed whether she was on-call or not. You don't see this very often.

Dr. Johnson is the only doctor on staff that I'm aware of that has ever come on our unit and picked up the phone to call nursing administration to say we needed help. She saw we needed help at a time when no one else seemed to really care. She went to bat for us when we under-staffed and had only 2 or 3 nurses on the unit. We had no aide or secretary at the time. She cared that no one was at the desk to answer call lights or the telephone when there was not a nurse available.

Pediatric nursing is a speciality that no one understands until they do it. I know, because I have done adult nursing for the most part. Dr. Johnson, through her expertise and knowledge has helped make Pediatrics at Randolph Hospital the specialty that it is. She strives to help us give the best care we possibly can. The patient comes first!

I just can't say enough for Dr. Johnson. I had my first Pediatric code the other night and Dr. Johnson responded. She came from home and this was not even her patient. You don't know how that makes you feel until you have a child almost die on you and it's your responsibility. Book and pictures cannot tell the half! In this code, Dr. Johnson was very competent, calm and knowledgeable. She was instrumental in saving this child's life. She is a very special person, whom I will never forget. During the code, she reminded us to stay calm and that we were doing a good job. An hour or so after, the code she called me to check on a new nurse (graduate) to make sure the nurse was all right - and for me to encourage the new grad that she had done a good job. In all my years of nursing, no other doctor has ever done this.

Dr. Johnson has also treated my family. My niece was critical with RSV last winter and Dr. Johnson helped save her life before transferring her to Brenner's Hospital.

What I am trying to say is that Dr. Mary Johnson is one of the best doctors I know. I truly respect here as a person and a doctor. It is my opinion that she has made a large impact on the way our community views the Pediatric care that is now offered at Randolph Hospital. I feel this hospital, RMA and our community in general will suffer a great loss if Dr. Johnson is not longer here, and I wish things could be different.

If I had a sick child, I can think of no one else I would rather have care for it than Dr. Johnson. Until you are faced with looking after sick children, you cannot fully appreciate the doctor that Mary Johnson is.

Thank you for your time in reading this letter, and I hope you understand my concern.

Think about the courage it took to write this letter!

Of course, it speaks to the fact that I was indeed "disruptive". I took being a child advocate very seriously, and that caused headaches for bean-counters and pencil-pushers. They wanted me to shut up and "just go away".

And I wonder if Cone . . . or Roch . . . or any of their anonymous crap-flinging pals . . . have any questions . . . FOR *&^%$#@ BOB AND THE BOYS . . . now?

I've looked through the responses that executives & Board members sent out to people who complained on my behalf. The only response I can find to this beautiful, professionally-presented bit of writing was not from Robert Morrison . . . or even Steven Eblin . . . but the ever-effervescent Barbara Wolfe - and not on letterhead, but a cute notecard (very Barbara). At the time, Babs was Eblin's hospital gofer girl. I hear she's since gotten some kind of advanced business degree - more or less on the public's dime - along with a promotion/raise. I think I've said enough about the bloated administrative arm of medicine sucking the system dry this weekend, so I'll let it pass.

I think the response to the nurse - from a relative underling - speaks volumes about how Randolph Hospital regarded medical personnel . . . especially nurses . . . back in the day of Hillary's "village". From what I've heard, not much has changed.

The nurse - my colleague and my friend - might as well have been talking to empty air. No one was listening. She was not "right people".

Obama's "vision" is doomed to failure if that's the way it's going to be. Of course, his team uses the same playbook as Bob Morrison . . . only "yes" men & women need apply . . . we cannot say anything bad.

3/9 Update: The post has been "tweaked" some this morning.

3/9 Noon Update: Related.