“In the end we will remember, not the words of our enemies,
but the silence of our friends.” ~Martin Luther King Jr.
One of the tragedies of abuse is the secrets and lies. Children who are abused are sworn to secrecy by their abusers. They come to believe that harm will come, to them or other family members, if these secrets are exposed. The children grow up in shame, not knowing that they could have spoken up, told someone, and changed the story of their life. Many times when we hear the story of domestic violence we think, why didn’t she just leave? Why didn’t she tell someone? It is not that easy.
The recent dramatic news about Ebola in the US has stirred up a lot that is wrong within health care in this country. Although nurses make up the majority of health care workers, we act like an oppressed minority. This has its roots in the way that hospitals and the profession of medicine were set up over a hundred years ago. The business model was designed to create profits for hospital administrators/owners and the physicians. The nurses were (are) employees, an expense line (a very big one) in the budget. Profit still reigns supreme in the health care industry, and thus many big decisions that impact patient care revolve around the need to be profitable. Of course not all hospitals are ‘for-profit’ and there are many good and decent hospital administrators in the business, but the model remains and impacts us all.
Nurses are used to working in less than ideal circumstances. The economic downturn forced new realities, and despite the ‘nursing shortage’, often job vacancies are not filled. It is not unusual to ‘work short’, to make do with less. And since the patient always comes first, it is not surprising to think that short cuts may be taken, and protocols not followed to the T. Even when your own life may be at stake.
Why don’t nurses speak out? When Thomas Eric Duncan first visited the ER, why didn’t the nurse make sure the ER physician knew about his recent travel to West Africa? Ask any nurse what it is like to be that unheard person whistling in the wind. Ask any nurse what it is like to be asked to work longer, harder and with less help. Ask any nurse what it is like to ignore your bladder, your stomach, your kids, while you put patients first. And then you ask, why don’t they just leave?
Today’s students are graduating with more debt than ever. Many hospitals won’t hire newly graduated registered nurses. They want nurses with experience. So when you get your first job, and discover that it is less than ideal, you learn to adjust your expectations. You see things going on around you that don’t match what you learned in school, and you adjust. You see ‘seasoned’ nurses taking short cuts, and in a desire to be as efficient in your time management, you learn to cut corners too. At first you speak out, but your words fall on deaf ears. Like mothers of teenagers you learn to pick your battles.
It is striking to me that in the past few weeks we have heard the word ‘nurse’ in the news far more often than over the previous ten years. And it is associated with blame, finger pointing, and bad news. They don’t choose nurses to be on their panel of experts when they are discussing health matters. Yet, be honest, when you are feeling unwell do you make an appointment with your doctor or do you call your friend who is a nurse? When you were in the hospital, who was beside you, who tried to ease your pain? We are used to being overlooked and underappreciated. And unfortunately it has taken the Ebola virus to remind people that it is the nurses who are on the frontline, who take the risks.
Direct care nurses, who work long, tiring shifts, are often too exhausted to become involved in a struggle for better work environments. The American Nurses Association (and in Florida, the FNA) advocate tirelessly on the behalf of its nurses. But we know the power of money in politics. We know the power of the lobbyists on governmental decisions. National Nurses United, a nurses union, has been quick to mobilize in support of nurses everywhere. But most nurses do not belong to their professional organizations or a union. So who will fight for them? We need to use the strength of our numbers to overcome our tradition of silence, of being coconspirators in these less than ideal conditions. We need to advocate not only for our patients, but for ourselves also. We need to become involved and join the organizations that will go to battle for us.
It is unfortunate that it has taken death and disease to bring flaws in our health care system to the eye of the public, but I hope that we will use this discussion to change our unhealthy patterns of behavior. It is time to bring things into the open, to confront our mistakes, admit our faults and learn from them. We owe it to ourselves and our patients.
On this Friday morning I hope you are healthy, and that you do everything to stay healthy. I hope you take a moment to thank a nurse (and all the other healthcare workers who put others ahead of themselves every day) and appreciate the job they do. And if you are living with a secret that is holding you back, perhaps it is time to confront the pain and speak out.
Have a wonderful weekend Family! Love your life! It is a fragile thing, which may be over before you know it!