Nurses Need To Be Listened To, Not Blamed
By Suzanne Gordon, McClatchy-Tribune News Service (MCT)
Stop blaming nurses for the potential spread of Ebola.
In the nationwide hysteria over the Ebola virus, many people are pointing fingers at two of the nurses who risked their lives to take care of Thomas Eric Duncan at Texas Health Resources Presbyterian Hospital in Dallas.
But this scapegoating does not help us focus on the systemic obstacles that make it difficult for nurses to protect their patients, the public and themselves — whether against Ebola or any other dangerous virus or bacteria.
As the caregivers who are with patients 24/7, bedside nurses are the ones who spot critical changes in a patient’s condition. But rather than seeking nurses out to solicit information about a patient’s situation, too many physicians ignore them.
In fact, many don’t even read the nurses’ notes section of patients’ charts, which some consider to be full of extraneous information or, as one doctor put it, “ridiculous nursing jargon.”
When I recently talked to a prominent patient safety physician at a major teaching hospital, he told me that attending physicians and residents in his institution refuse to use a nationally recommended communication protocol known as SBAR (Situation, Background, Assessment, Recommendation), which is designed to facilitate the sharing of information between physicians and nurses.
Because that’s a protocol nurses use, and doctors don’t want to use “nursing language,” he said.
Nurses are often silenced or even disciplined when they try to draw attention to major safety problems or mistakes — particularly those made by medical higher-ups.
In 2010 in Texas, for example, two nurses were fired — and one was actually prosecuted — when they reported that a physician in their hospital was engaging in serious breaches of safety. This case sent a message to nurses everywhere: Act assertively to protect your patients and you put your job at risk.
Then there’s the issue of protective equipment. During the SARS scare more than 10 years ago, nurses’ organizations warned that hospitals weren’t providing nurses with the kind of equipment (and training to use it) that would actually protect them, as well as their patients and the public.
Another contagious disease and a decade later, and nurses have not been given either adequate gear or training in how to use it, as the National Nurses United union recently noted.
Creating a safe workplace for nurses — and other health-care staff — is a nonnegotiable condition of asking them to risk their lives to care for patients.
This means not only providing them with protective equipment and the training to use it, but also soliciting and welcoming their input.
It will be instructive to see how Texas Health Presbyterian Hospital responds to the fact that nurse Briana Aguirre spoke to the press about her concerns about safety in the hospital.
Will she be supported — and even rewarded — for her courage, or will she be reprimanded or even fired?
This is a real test of whether hospitals are serious about creating a culture of safety.
Health care journalist Suzanne Gordon is the co-author of Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety (Cornell University Press).
She wrote this for Progressive Media Project, a source of liberal commentary on domestic and international issues; it is affiliated with The Progressive magazine. Readers may write to the author at: Progressive Media Project, 409 East Main Street, Madison, Wis. 53703; email: firstname.lastname@example.org; Web site: www.progressive.org. For information on PMP’s funding, please visit http://www.progressive.org/pmpabout.html#anchorsupport.
AFP Photo/Mike Stone