>Hailing one of health care's priceless resources -- nurses
>Commentary. By Michael Greenberg, MD, AMNews contributor. Jan. 28, 2002.
The U.S. Dept. of the Interior spends millions of dollars to protect our nation's endangered species. It writes long lists of plants and animals whose populations are dangerously low and hires scientists to figure out ways to increase their numbers. Too bad they haven't turned their attention to nurses.
In the fragile ecosystem of medical care, nurses are the ones who create the protective environment essential to the well-being of both doctors and patients. We cannot function without them. Their job is to provide knowledge, comfort, care and compassion. But, lest nurses be offended by my comparing them to the plant and animal life that are on the endangered species list, the metaphor stops here. My point is that it seems society expends greater resources and energy on the protection of birds and flowers than on protecting the viability of the nursing profession.
Throughout my training, it was as many nurses as doctors who turned me from a green medical student into a full-fledged physician. At times, nurses were my primary source of learning. Because the housestaff was overwhelmed, an operating room nurse took the time to teach me the fine points of suturing. When she saw I had mastered the technique, she put the needle holder into my hand during a procedure. "The student is ready
to close," she informed the surgeon.
My initial assignment during my first post-graduate year as a pediatric resident was the newborn nursery. Not yet a father, and uncomfortable in my awareness of how little I really knew despite the magical initials that had been recently appendaged to my name, I admitted my fears to the head nurse. Her smile put me at ease. "We're going to teach this young doctor how
not to drop babies," she announced to the other nurses in her unit. And by the end of the first week, I was a pro.
Even more frightening to me were the high-risk nursery and pediatric intensive care units. But by admitting my ignorance and asking for help from the nurses in each area through which I rotated, I felt myself respected and supported. And I believe the patients were better cared for because of the partnership I created with the nursing staff. At least they prevented me from killing anybody.
During my dermatology residency, nurses I met while moonlighting in attendings' private offices taught me medical techniques and also provided me with an education in business and practice promotion.
A significant part of the success of my more than 20 years in practice is directly attributable to the wonderful nurses who have worked with me. Along with my office staff, they maintain the "sacred space" in which patients and I interact. Nurses are full-fledged partners in the health care equation, offering not only their compassionate perspective but also their eyes, ears and hearts. I am indebted to them for the many times they have prevented me from doing or saying something foolish, or worse, harming a patient.
Hospitals and office practices have difficulty filling vacancies as
nurses discover they can earn higher salaries in other professions. But beyond the money, nurses are disappearing because as much misery as managed care has brought to doctors, they have been affected more than we have. Nurses traditionally have been the human interface between the
hospital and patient. While our time with patients was measured in minutes, nurses spent hours with patients. They were the ones who knew how patients were really doing and informed us at the first signs of trouble.
With the advent of managed care, many nurses have been relegated to shuffling papers and recording information. And as much as we didn't become doctors to argue with insurance companies, nurses didn't earn their degrees to push pencils.
Unfortunately, I don't have a solution for the problem. Raising
awareness of the crisis is a good start. Nurses are a priceless health care resource that is not being renewed or protected. And if we as doctors don't do something to reverse the situation, both our patients and our own profession will suffer. Let's not wait until nurses become extinct.
Dr. Greenberg is a dermatologist in Elk Grove Village, Ill. and author of the novel A Man of Sorrows (http://www.anovelvision.com/
). You can
contact him by e-mail (firstname.lastname@example.org).
Jan 27, '02
Hello. Thank you for posting this. I wrote and thanked Dr. Greenberg and received a response. I have Copy/pasted his response below. I also visited his website and read his other articles. I very much enjoyed them and agree with much of what he has to say. He wrote a brochure to help patients learn how to talk to their doctors. It is available for download, and I did so. I hope to get it to others who could benefit from it. Below is Dr Greenberg's response to my email. Tattoo
Thank you for your wonderful letter. I don't think, however, that even if all doctors changed their attitudes, nursing would flourish. The same problems that have hit doctors and dehumanized them are those that are forcing nursing into despair -- the intrusion of "big business" into medicine, of the attitude that what you do and what I do can be quantified like widgets made in a factory. These outside forces do not understand the healing force of a nurses touch, of time spent with patients instead of paperwork, of a nurse just being there with a patient. There is no provable return on investment to the insurance companies and hospitals. We need a paradigm shift in our society -- we need to remove the false belief that the bottom line is what makes us happy. Nurses have been givers of compassion and love since they were created (on the fifth day in Eden lol) and that concept just isn't what those outside our sacred professions want to hear or can hear.
I would invite you to visit my website, listed below. You'll find more columns, my personal story, and best of all, a sixteen page booklet that you and your patients can download for FREE (crazy, isn't it?) that will help them to "humanize" their doctors. If you like it and I hope you will, I need your help in getting the word out that this booklet exists. If you are willing, please tell your colleagues, e-mail list, and anyone else like your patients how to get the booklet. Thanks again for your wonderful letter.
Michael Greenberg, MD
850 Biesterfield Road Suite 3002
Elk Grove Village, IL 60007
Last edit by Tattoo on Jan 27, '02