Текст книги "The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital"

Автор книги: Alexandra Robbins

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“who enjoy a high degree” http://www.aana.com/ceandeducation/becomeacrna/pages/default.aspx.

may be even more vulnerable . . . at more than 15 percent. Jane Hedrick and Stephanie Luck.

“they’re playing with rocket fuel . . .” Interview with Art Zwerling by Eaves. Some researchers have suggested that “exposure to trace quantities of these agents in the workplace sensitizes the reward pathways in the brain and promotes substance abuse.” Heather Hamza and E. O. Bryson, “The Drug Seeking Anesthesia Care Provider,” International Anesthesiology Clinics 49, no. 1 (2011).

Jan Stewart, a CRNA . . . a friend to all.” http://www.aana.com/resources2/health-wellness/Pages/Jan-Stewart-In-Memoriam.aspx.

back pain so intense . . . Sarah Ruth Gomes, Foreword, in Paula Davies Scimeca, Unbecoming a Nurse: Bypassing the Hidden Chemical Dependency Trap. Sea Meca, 2008.

died at age 50 . . . www.aana.com/resources2/health-wellness/Pages/Jan-Stewart-In-Memoriam.aspx.

opioid hundreds of times . . . See, for example, M. A. Clotz and M. C. Nahata, “Clinical Uses of Fentanyl, Sufentanil, and Alfentanil,” Clinical Pharmacology (August 1991).

That’s how many nurses . . . See, for example, Blythe Bernhard, “On Drugs, on Duty: Doctors, Nurses with Easy Access Can Be Vulnerable to Addiction.” St. Louis Post-Dispatch, March 26, 2008.

. . . get most easily See, for example, Jane Hedrick and Stephanie Luck. See also “Substance Use Disorder in Nursing.”

. . . abuse them more often See, for example, A. M. Trinkoff et al., “Workplace Access, Negative Proscriptions, Job Strain, and Substance Use in Registered Nurses,” Journal of Nursing Research (March–April 2000).

Doctors’ substance abuse . . . Ibid.

the nurses’ familiarity . . . the general population. See, for example, A. M. Trinkoff et al.

tend to get sicker . . . See, for example, Blythe Bernhard.

take patients’ doses . . . gave only one. See, for example, Brandi Watters, “Prescription Pill Abuse Surpasses Street Drugs,” Herald Bulletin (Anderson, IN), January 26, 2010; Debra Dunn.

might sign out drugs See, for example, Anne Geggis, “2 Lose Nursing Licenses Over Missing Drugs,” News-Journal (Daytona Beach, FL), April 1, 2006; Debra Dunn,

can steal prescription pads . . . didn’t actually give See, for example, Blythe Bernhard.

or otherwise falsify hospital records See, for example, “Seattle Nurse Pleads Guilty to Unlawful Theft, Diversion of Controlled Substances,” US Fed News, May 19, 2009.

take advantage when coworkers . . . Interviews; See, for example, David C. Shampine, “Nurse Charged with Supporting Her Vicodin Addiction with Forged Electronic Prescriptions,” Watertown Daily Times (NY), June 8, 2012.

ate the gel . . . placebos Robin Stein, “Did Nurse Take Patients’ Painkillers?” St. Petersburg Times (FL) South Pinellas Edition, December 3, 2005.

“Often, it’s our best people” . . . “What to Do When Confronting . . .”

don’t necessarily act immediately See, for example, Jason Blevins, “Addicts in Health Professions Flock to Get Peers’ Help,” Denver Post, July 23, 2009.

“should incorporate prevention . . .” Interview with AACN spokesman.

AACN doesn’t monitor whether schools comply. Interview with AACN spokesman, who said there is too much variability between nursing programs to comment further.

“enables an abusing nurse . . . there was a problem.” Debra Dunn.

license suspension . . . penalties are possible. See, for example, S. Trossman, “Nurses’ Addictions: Finding Alternatives to Discipline,” American Journal of Nursing 103 (September 2003).

again work in healthcare See, for example, “Nurse Gets 3 Years for Drug Tampering.”

Nursing boards are . . . out of the field. Debra Dunn.

“The good news is . . . problem it becomes.” Interview, Al Rundio.

Los Angeles Times and Pro Publica investigation . . . “impose discipline.” Tracy Weber, Charles Ornstein, and Maloy Moore, “Loose Reins on Nurses in Drug Abuse Program,” ProPublica and Los Angeles Times, July 25, 2009.

California eventually imposed stricter rules Tracy Weber, Charles Ornstein, and Maloy Moore, “California Adopts Stricter Rules for Drug Abusers in the Health Industry,” ProPublica, November 20, 2009.

ended an anonymous . . . surgeries. See, for example, Blythe Bernhard.

forty-one have non-disciplinary . . . “Discipline/Continued Competency/Assistive Personnel Practice,” National Council of State Boards of Nursing.

fewer resources than doctors . . . severe professional sanctions. See, for example, M. F. Shaw et al., “Physicians and Nurses with Substance Use Disorders,” Journal of Advanced Nursing 47, no. 5 (2004). Despite the discrepancies between services for nurses and physicians, by focusing on treating a healthcare professional and getting her back to work, these programs at least encourage more people to seek help, rather than to continue to cover up their abuse and put patients at risk by working while under the influence.

“The rate at which nurses . . . representation.” Ibid.

fewer than 1.5 percent of nurses See Cynthia Clark.

140,000 nurses . . . what they’re doing. Interview with Douglas McLellan by Eaves.

compassionately mentioning the topic See, for example, “What to Do When Confronting . . .”

“The best recommendation is . . .” Interview with Julie Rice by Eaves.

“It is every nurse’s responsibility . . .” “ANA Unveils Bill of Rights for RNs,” American Nurses Association, cited in Debra Dunn.

legally responsible to turn in . . . See, for example, Jane Hedrick and Stephanie Luck.

“the nurse becomes [the] nursed.” See Patricia Welch Dittman.

Chapter 8

“Nurses are frequently put” The American Nurses Association’s Code of Ethics For Nurses.

“Somewhere along the line” Interview.

“So many things are just simply . . .” Interview.

“on day one new interns . . .” Robert S. Huckman and Jason R. Barro, “Cohort Turnover and Productivity: The July Phenomenon in Teaching Hospitals.” NBER Working Paper Series 11182, National Bureau of Economic Research.

“The July Effect” . . . in August. See, for example, John Q. Young et al., “‘July Effect’: Impact of the Academic Year-End Changeover on Patient Outcomes: A Systematic Review,” Annals of Internal Medicine, September 6, 2011.

harms patient care . . . hospital stay. Ibid.; See also Robert S. Huckman.

U.S. death rates . . . 2,750 deaths. Robert S. Huckman.

“spike by 10 percent in July” David P. Phillips and Gwendolyn E. C. Barker, “A July Spike in Fatal Medication Errors: A Possible Effect of New Medical Residents,” Journal of General Internal Medicine (August 2010).

August mortality rates See, for example, Simon Rogers, “Will Patients Really Die This Week Because of New NHS Hospital Doctors?” The Guardian (London), August 1, 2012.

“beyond their capabilities.” Rebecca Smith, “Thousands of Juniors Start Jobs in NHS ‘Killing Season,’” Telegraph (London), August 1, 2012.

in English hospitals . . . previous Wednesday. M. H. Jen et al., “Early In-Hospital Mortality Following Trainee Doctors’ First Day at Work,” PlosOne.org, September 23, 2009.

“Nurses are correcting . . .” Interview.

not the problem here Interviews.

“I have had doctors . . .” Interviews.

25 percent of the hospitals Author correspondence with American Hospital Association spokesperson.

checking the “About Us” page Author correspondence with Association of American Medical Colleges spokesperson.

“My reflex was as if . . .” Interview.

“box shape . . .” Interview.

“tell you the truth.” Interview.

“Sometimes physicians practice . . . but staff knew.” Interviews.

. . . wagered on patients . . . arriving via ambulance. Interviews.

“games of chance . . .” See, for example, R. T. Penson et al.

Different “codes” mean . . . Interviews.

Some hospitals further . . . Interviews.

Mr. Firestone . . . unresponsive patient Interviews.

Ohio’s Cleveland Clinic . . . take it easy. Interview, Rev. Amy Greene. See also, for example, Carolyn Gregoire, “The Amazing Way This Hospital Is Fighting Physician Burnout,” Huffington Post, December 2, 2013; Katie Sullivan, “Hospitals Try Holistic Approach to Treat Docs’ Stress, Burnout,” FierceHealthcare.com, December 3, 2013.

Cleveland Clinic’s healing . . . in times past. Ibid.

Code Brown . . . a break to eat. Interviews.

“Parents call to ask . . .” Interview.

several props . . . down hospital hallways. Interviews.

Plenty of nurses admit . . . “something with poop.” Interviews.

occasionally use larger needles . . . Interviews.

If breaking a rule . . . Interviews.

“. . . few rings is a mistake.” Interview.

personal interaction is against policy Interview.

“We are working fourteen to sixteen hours” Lois Berry.

without a strong support system. Interview.

Even if I haven’t. See Michelle Crouch, “50 Secrets Your Nurse Won’t Tell You,” Reader’s Digest, November 2011.

“We usually know the results . . .” Interview.

toilet humor . . . Interviews.

“Nurses are gross.” Interview.

“happens all the time.” Interviews.

The most common . . . plan of care. Interviews.

“. . . lose-lose scenario.” Interview.

“and not really. . . . counts the same.” Interview with Arthur Caplan.

If there is time . . . choose differently. Interviews.

slow codes Interviews.

“There are lots of unsavory . . .” Interview.

“Code 55” Interview.

Some physicians will unofficially call . . . Interviews.

“Responders literally walk” Interview.

“It’s often for the sake . . .” Interview.

“not ethically appropriate” Interview.

“. . . as comfortable as possible.” Interview.

Respectful patients might get . . . Interviews.

“I’m always happy . . .” Interview.

“rest assured that every single . . .” Interview.

Many hospitals also treat VIPs . . . Interviews.

John’s Hopkins Marburg Pavilion. www.hopkinsmedicine.org/the_johns_hopkins_hospital/planning_visit/room/marburg_enhanced_amenities_program.html.

Nurses described accommodations . . . “because they aren’t famous.” Interviews.

“The doctor is at your bedside . . .” Interview.

“Half of the hospital is unavailable . . .” Interviews.

If a hospital’s technicians . . . “it can be bad.” Interviews.

Nurses have strong opinions . . . Interviews.

“Studies show that patients . . .” Interview.

patient with a history Interviews

If you say something . . . “getting better service.” Interviews.

“Sadly, doctors and doctors’ offices . . .” Interview.

“If I could talk to” Interview.

nurses do cry . . .“home from work.” Interviews.

don’t portray hospital . . . “make orders, and leave.” Interviews.

“make their rounds in the morning.” Interview.

patients who survive . . . “Even in a hospital.” Interviews.

“Doctors and nurses”. . . she has insurance. Interviews.

“After that talk . . .” Interview.

appreciate the fragility . . . “holy profession.” Interviews.

California nurse Jared Axen Interview.

transplant nurse Allison Batson Alicia Tejada, “Atlanta Nurse Donates Kidney to Hospital Patient,” ABCNews.com, January 17, 2012; Helena Oliviero, “Nurse Donates Kidney to Patient,” Atlanta Journal-Constitution, January 29, 2012.

Batson saved his life . . . to help people. Interview with Clay Taber.

Chapter 9

“Nursing is a calling” See, for example. www.hhsnalumnae.org/TheNightingaleTribute.pdf.

“Nurses are the glue” Interview.

At six feet two inches . . . “sisterhood without any issues.” Interviews with Dean Visk.

330,000 are male U.S. Census Bureau, “Men in Nursing Occupations: American Community Survey Highlight Report,” February 2013.

41 percent of CRNAs are male Ibid.

lingering public stereotypes Interviews. See also Eve Tahmincioglu, “Men Are Much in the Sights of Recruiters in Nursing,” The New York Times, April 13, 2003.

“hold a high degree of masculinity.” Kenny Thompson, L. Lee Glenn, and Daren Vertein, “Comparison of Masculine and Feminine Traits in a National Sample of Male and Female Nursing Students,” American Journal of Men’s Health (May 2011).

gay, feminine or “not man enough” Interview.

stereotypes don’t bother them Interviews.

“I realized after seeing” Interview.

“It insults my profession . . . proud to be a nurse.” Interview.

disproportionately assigned Interviews.

“glass escalator” . . . across other fields. “Men in Nursing Occupations.”

“Yes, I’m in a job . . . end of the day.” Interview.

“It is incredibly fulfilling.” Interview.

Chapter 10

“Nurses can work individually . . .” American Nurses Association’s Code of Ethics For Nurses.

“Our clinical skills are essential . . .” Interview.

“Hospital finance people . . . expected to retire.” Interview with Peter McMenamin. The Bureau of Labor Statistics estimates that 555,000 RNs and APRNs will retire over the next several years, but the occupational projections do not specify how many of those nurses are working specifically at hospitals.

“A hospital that now . . . sound long-term strategy.” Ibid.

patient-to-nurse ratios . . . and patient satisfaction. See, for example, “Workplace Violence: Assessing Occupational Hazards . . .”; Lois Berry and Paul Curry. For length of stay, infections, upper gastrointestinal bleeding, pneumonia, and failure to rescue rates, see also Jack Needleman et al.,“Nurse-Staffing Levels and the Quality of Care in Hospitals,” New England Journal of Medicine 346, no. 22, May 30, 2002.

Most trusted profession. http://www.gallup.com/poll/1654/honesty-ethics-professions.aspx

Directly involving nurses . . . these strategic meetings. See, for example, Robert Wood Johnson Foundation, “Nurses Are Key to Improving Safety,” April 28, 2011.

One strategy to curb bullying . . . C. Rocker, “Addressing Nurse-to-Nurse Bullying to Promote Nurse Retention,” Online Journal of Issues in Nursing, August 29, 2008. Steering committee: see, for example, ISMP Medication Safety Alert, March 25, 2004.

“no retribution” policy See, for example, ISMP Medication Safety Alert, April 24, 2014.

Some hospitals have trained Interviews.

a quiet room . . . B. Lombardo and C. Eyre.

soothingly colored walls . . . Ibid.

Advocate Lutheran General Hospital . . . “Three-Tiered Emotional Support System Generates Positive Feedback From Providers Who Become ‘Second Victims’ of an Unanticipated Clinical Event,” Agency for Healthcare Research and Quality (March 2009).

“Using a colleague’s first name . . .” See ISMP Medication Safety Alert, March 25, 2004.

Hospitals have had success See, for example, Emergency Department Management, “Take Steps to Curb Violence, Improve Safety for ED Personnel,” October 1, 2011.

. . . or conducting bag checks. “Preventing Violence in the Healthcare Setting,” Sentinel Event Alert, The Joint Commission 45, June 3, 2010.

consider installing metal detectors. See, for example, “OSHA Guidelines for Preventing Workplace Violence for Healthcare and Social Workers,” 2004.

Within six months after . . . “Workplace Violence in Healthcare Settings,” Center for Personal Protection and Safety, August 2011.

By requiring staff to report See, for example, Jessica Gacki-Smith et al., “Violence Against Nurses Working in U.S. Emergency Departments,” Journal of Nursing Administration (July–August 2009).

“The program helped reduce . . .” “Occupational Hazards in Hospitals,” CDC Workplace Safety and Health, National Institute for Occupational Safety and Health, April 2002.

“at a minimum, workplaces should” OSHA Guidelines for Preventing Workplace Violence for Healthcare and Social Workers (2004).

The most important step . . . getting harmed.” Interview with Douglas McLellan by Eaves.

illness, not willful misconduct See, for example, Debra Dunn and T. Monroe.

nurses with chemical dependency issues Some helpful links can be found at http://www.peerassistance.com/links.htm. For resources searchable by state, visit http://webapps.aana.com/Peer/directory.asp. (While the AANA’s directory is intended for nurse anesthetists, many of the resources and state assistance programs are for all nurses. Peer advisors volunteer only for CRNAs and student nurse anesthetists.) The ANA’s Impaired Nurse Resource Center also includes some links to organizations specializing in addiction: http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Work-Environment/Work-Environment/ImpairedNurse/Impaired-Nurse-Resources.html.

administrators could tap them . . . See, for example, Kevin Pho, “Should Nurses Be Fired for Fatal Medication Errors?” KevinMD.com, May 2, 2011.

“A mistake does not mean . . .” David Maxfield et al., “The Silent Treatment: Why Safety Tools and Checklists Aren’t Enough to Save Lives.”

Montreal’s Jewish General Hospital . . . See, for example, Aaron Derfel, “Jewish General Dramatically Cuts Bed-Sore Cases,” Gazette (Montreal), July 20, 2012.

Designate one family member . . . Interviews. See also “Total Disregard for Visiting Hours,” allnurses.com, comment, September 19, 2012.

“Even if you’re worried about annoying . . .” Interview.

maintain a written medical history . . . pain or complaint. Interviews.

Your hospital is not as clean . . . Interviews.

“It is really important . . .” Interview.

at least sixteen hours per day. Interview.

Not all doctors and nurses remember . . . Interviews.

Bring or find your own . . . love them most? Interviews.

Even if your hospital medications . . . “abused by a drunk,” Interviews.

“Most nurses bust their ass . . . deal with them.” Interview.

fastest-growing occupation Bureau of Labor Statistics’ Employment Projections 2012–2022, released in December 2013. See also Bureau of Labor Statistics. Occupations Projected to Add Most New Jobs, 2012 to 2022 (January 27, 2014).

“The profession is exciting . . .” Interview, Terri Weaver.

“Campaign for Nursing’s Future.” Interview with spokesman; see also www.discovernursing.com.

“Choosing nursing as a profession . . .” Author correspondence with Joan Shaver.

scientists, engineers . . . Interviews with several deans of nursing schools.

“gives you a chance . . .” Interview.

“consider no less . . .” Kathleen Potempa.

“They have the same . . .” Interview, Bobbie Berkowitz.

lifelong goal. Interview, Mary Kerr.

“Be avid readers . . .” Interview, Linda Norman.

“We’ve got to get away . . .” Ibid.

“Never give advice . . .” Interview, Judith Karshmer.

“The best coping resource . . .” Interview.

“It’s a platform for nurses . . .” Interview, Brian Short.

“The point of the profession is to provide patient care . . .” Interview, Terri Weaver.

“To be a good nurse . . .” Interview.

“Many times patients wanted . . .” Interview.

Nurses nationwide told me . . . “identify the possible options.” Interviews.

“After a bad day . . .” Interview.

“I am not asking you to confirm . . .” Impaired Practice in Nursing: A Guidebook for Interventions and Resources, Massachusetts Nurses Association. National Nurses United, 2011.

“. . . positive effect on the nurse as well.” Author correspondence with Beth Perry. See also Beth Perry, “Why Exemplary Oncology Nurses Avoid Compassion Fatigue,” Canadian Oncology Nursing Journal 18, no. 2 (2008).

taught a group of new nurses . . . bullying by peers. Martha Griffin.

“Experienced nurses do feel threatened . . . ” Interview.

exercise in which participants share . . . Interview with Patricia Potter, Barnes-Jewish director of research for patient-care services. See also States News Service, “Compassion Fatigue Program Gives Staff Skills To Be Resilient Against the Cost of Caring,” January 3, 2012.

“I absolutely” . . . “who love what they do.” Interviews.

About the Author

Photo Credit: David Robbins

ALEXANDRA ROBBINS, winner of the 2014 John Bartlow Martin Award for Public Interest Magazine Journalism, is the author of four New York Times bestsellers. Her previous book was voted the Goodreads Best Nonfiction Book of the Year. She has written for The New Yorker, Vanity Fair, The New York Times, and other publications, and has appeared on numerous television shows, from 60 Minutes to The Colbert Report.

For lectures: alexandrarobbins.com

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