Doctor Breaks His Neck, Appreciates the Work of Nurses More

Seeing this comment this morning in my post about our culture of being overworked reminded me of this piece I read last night in the New York Review of Books by Arnold Relman, a physician with six decades of experience who fell and broke his neck and saw a new perspective on what it’s like to be critically ill and cared for under the U.S. medical system:

Conversations with my physicians were infrequent, brief, and hardly ever reported. What personal care hospitalized patients now get is mostly from nurses. In the MGH ICU the nursing care was superb; at Spaulding it was inconsistent. I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.

Even in the best of hospitals, with the best of medical and nursing care, the ICU can be a devastating psychological experience for patients—as it was for me. Totally helpless, deprived of control over one’s body, ICU patients desperately need the comforting presence of family and loved ones. I was fortunate to have that support, but some others in the MGH ICU were not. I can only hope they received extra attention from their nurses.

Thank you, nurse! He also discusses the costs involved in his care, which was covered by Harvard’s faculty plan, and poses this question about the amount of medical attention he received as a person in his 90s: “Given the limited life expectancy of someone my age, is it justified to spend hundreds of thousands of dollars to extend a nonagenarian’s life a little longer?”

Photo: British Red Cross

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5 Comments / Post A Comment

andnowlights (#2,902)

I worked in a medical center for 11 months and there was no hiding the fact that the nurses kept that place running. They are the best and yet are the ones who constantly get put upon by doctors and executive staff- seriously, it is ridiculous how much they are not appreciated by the people they work with. When I offhandedly mention to someone that I missed my calling of going to bed school and the person responds by telling me that I should go to nursing school, I know they’ve never actually worked in a medical setting before. Love your nurses, let them know they’re appreciated and if you’re inpatient, have your family bring them cookies. They are so important to the medical system.

Kthompson (#1,858)

Nurses do work incredibly hard. They have long hours, they’re understaffed, they often have to do difficult/unpleasant jobs, and other hospital personnel (aka, doctors) often treat them like shit. It’s sad that a doctor would only realize their importance once he was a patient with a severe injury.

I work at a medical journal that specializes in neurosurgery. We once had an article that really struck me as mind boggling (and I’ve seen a lot of those). It was about creating surgical checklists to ensure that preventable human errors–like, say, operating in the wrong location or even on the wrong patient–were, well, prevented. The “illustrated case” was about a hospital up north, in Mass or NY I think, where the relationship between one doctor and the nurses was so bad, it resulted in a patient’s death. A man was brought in with a cranial hemorrhage, and the nurse tried to tell the doctor he was working on the wrong side, and the doctor basically told the nurse to go to hell because “nurses don’t know what they’re talking about.” And whoops, it was the wrong side, and the patient died. (Don’t worry. The doctor is still operating, and at that hospital! Hope you don’t get him.)

You won’t believe how often this happens. Seriously. I may never go to a hospital again. It’s really sad how much discussion goes on in the medical field about listening to the opinion of other members of the staff. Does that really have to be specifically stated? “Hey doctor, maybe you want to consult the nurse about that MRI?” Ridiculous.

Another note, more financially related, is this: the former editor-in-chief of my journal is a world famous neurosurgeon (who has worked on cases I guarantee you’ve read in the news). At his birthday celebration last year, he mentioned how downhill the local, famous hospital had gone. “They fired all the nurses!” he cried. “They fired them off and hired a couple foreign nurses” (yes he’s an old racist white man) “and the quality of care has gone down. The new CEO, the board said they would give him a bonus if he slashed a certain amount of the budget, and he did it by slicing the nursing staff in half. I would advise you all to go to [local competing hospital].” Scary.

qwer1234 (#4,140)

Nurses are great! Hurray nurses!

nutmeg (#1,383)

Oh how exciting! I loved this article- I’m actually going to be at MGH this semester, although I don’t know where yet, and I am so AMPED, it is the best clinical assignment I could have possibly hoped for. It kind of didn’t surprise me that a doctor, especially one who started practicing so long ago, would underestimate how much nurses do. Nursing has changed a LOT over the years! I had an English professor ask me, “Why would you want to be a nurse and get bossed around by doctors?” It made me laugh and laaaaauuugh

boringbunny (#3,260)

I was in the hospital for a couple of days over Christmas and yes, the nurses were the best. I sent them multiple gift baskets of thanks (the interwebs said to send one specifically to the night shift because they always get shafted). I didn’t understand why anyone would do what they do; my doctor friend informs me though that when nurses marry doctors, they never go back to work after they have children. So there’s that bonus.

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