he heard from a few NURSES here & that caused him to do his homework. Heres his latest article - responding to nurses response to the first one:
Healthcare Executives Are From Mars, Patient Caregivers Are From Venus: A New Understanding Is Needed
by Jan Jennings
In recent months I have written several articles that peek into the world where physicians, nurses and other patient care professionals live and work. I have been stupefied by much of the reaction. The angry e-mail and letters from patient caregivers all across the country go something like this:
"The audacity of a hospital CEO to opine on anything directly related to patient care.
Who does he think he is and what makes him think he would have a clue about the conditions under which we work?
Has he ever held the hand of a dying patient?
Does he know what its like to work short staffed?
Has he ever faced the anger of a family member after their loved one has waited four hours to be seen in the emergency department? Has he ever lifted a patient from a gurney onto a hospital bed and hurt his back? Does he know what it is like to have a physician scream at him with impunity? Does he have any sense for what it is like to practice medicine, worried that the next patient might be a future litigant or an accuser of personal misconduct?"
The concerns go on and on. For me, this has provoked a lot of soul searching. What am I missing? So, I reached deep within and wrote a "DRAFT" response to these concerns and sent it to a number of patient care providers I admire and respect. Wow! The reaction was even angrier!
What am I missing?
As it would happen, and at my lowest moment, I went to my computer and opened an e-mail message from a nursing executive who recently retired. She unlocked my mind and heart and took me to an understanding I have never had in more than thirty years of service to patient care providers. In part, here is what I learned:
Patient Care Givers And The Nature Of Their Work
: Physicians, nurses and other patient care givers have many tugs and pulls within their professional lives. What motivates them to continue giving of themselves unselfishly each day to their patients? When a nurse relieves or prevents a pressure sore, there is an emotional bond that forms between her and the patient. When a physician discovers, upon examination, that a patient is a treatable hypertensive, he provides advice, counsel and, frequently, medication. In so doing an emotional connection is formed between the patient and the physician. When a physical therapist helps a stroke victim attain levels of functionality to resume activities of daily living, something very special occurs between the physical therapist and the patient. And, whatever "warm noises" healthcare executives might express, hands on patient care providers know this in their heart of hearts: healthcare executives do not engage in patient care services, do not make these emotional connections and, therefore, could never fully understand the world of the direct patient caregiver.
Further, patient caregivers, from all areas of the hospital, see healthcare executives as pampered, overpaid dilettantes - working in "carpeted caves." If the "suits" really cared about us . . . where are they and why don't they show us they care?
There is a strong belief that healthcare executives are detached, literally and figuratively, from the "real" work of a hospital; some of this belief might be true. If only a small fraction of the anecdotes related to me about healthcare executives are true, some people do not deserve to be serving in their executive positions. Some of the examples of executive indifference and insensitivity are so outrageous, I am hesitant to share them for fear the reader would doubt my credibility.
Healthcare Executives And The Nature Of Their Work
It is impossible for me to be "preachy" about this for I am a "sinner." All these years I have held "managers meetings" and "employee meetings" and sent out letters and walked the halls and made it a point to talk to employees, patients and family members. Notwithstanding these efforts, I have clearly missed the mark. Never once have I said, "You do something I cannot . . . and I appreciate that you do. I fully trust you and your judgment." I just assumed everyone knew I felt that way.
Most healthcare executives came into the field with the same or similar eleemosynary, caring and giving impulses as other healthcare professionals. Most healthcare executives do what they do because they "care." They truly care and give of their talents for the benefit of caregivers who touch and heal patients. They care about patients and their families more than they know how to express in words.
It never crossed my mind that the physicians, nurses and other caregivers did not know why most of us devote our lives to healthcare administration! The patient caregivers do not see us behind closed doors fighting for the funds to hire additional staff, purchase new technology and other tools to help caregivers do their job. Why would they know? Here is an insight about being appreciated. Most healthcare executives have spent six to seven years of their lives studying management on a fulltime basis and an entire career of trying to stay current. One thing we learn early on is not to expect a "pat on the back." Most executives have to look deep within their soul to find satisfaction in what they do. We spend precious little time being thankful for things that go well. We focus most of our time looking for and solving problems.
As a consequence, our work culture is counter-intuitive to a patient caregiver. Is there any potential for healing between patient caregivers and healthcare executives? Yes!
Here is my New Year's Resolution. I hope to stop assuming that other people know the content of the innermost recesses of my heart.
In 2003, when I make rounds, I am going to stop nurses and tell them I appreciate what they do and I trust them. At the next Medical Staff meeting, it is my intention to thank the physicians for all they do in taking care of our patients and families. When I meet with our managers, I am going to discuss this subject and ask for suggestions on how I might better show my appreciation to their staff. These are small steps, to be sure, but I believe if we all make an effort, we can begin to diffuse the tension between patient caregivers and healthcare executives. Dare we not try?
Here is wishing a health and happy New Year to you all.
Jan Jennings is CEO and President of Jefferson Regional Medical Center. You can reach Jan Jennings at firstname.lastname@example.org