A survey published in American Journal of Nursing in 2002, reported that 90 percent of hospital workers, including doctors and nurses, reported “yelling,” “abusive language” as well as “condescension” and “berating colleagues.” A quarter of the 1,200 people surveyed said they witnessed such behavior weekly.
Anyone with workplace experience can figure this out. Staff are being crushed by workloads and working conditions. The environmental pressures are hitting the fan, across the sector. The overstrained, overstretched and overworked health care front line is showing signs of massive fatigue.
The ramifications are less than sparklingly reassuring:
Verbal abuse is among the milder transgressions, according to (anger management therapist George Anderson) Anderson. “Throwing instruments, like scalpels, is not unusual,” he said. One surgeon flung a tool after being handed the wrong item twice. It struck the ceiling. Another launched a used instrument, hitting a nurse on the shoulder.
Dysfunctional sector pays the price of bad management
Flying scalpels? Certainly sounds healthy. These are not minor issues. The miracle is that nobody’s been seriously injured or killed. One incident would make a great class action. This is a powder keg, and it’s going to blow sooner or later.
Breakdown in working relationships means crack-ups at the operational level. Reasons for the crashing and burning aren’t exactly hard to find. I spent years covering the US health care sector’s various dysfunctions.
These are the basics, greatly simplified:
1. Endless pay disputes
2. A culture of “management vs. medicine”
3. Overwork on a colossal scale
4. Experienced people leaving the sector
5. Training issues
6. A truly lousy, cheapskate employment market
7. Obsolete management principles
8. Dismal allocation of resources
9. Importing foreign workers to cover shortfalls in the workforce
10. Double and inefficient standards on job design- Cheaper labor, more work
Add to these enchanting situations the realities of the work:
1. Sick and injured people in an endless stream
2. Farcically long waiting lists exacerbating medical conditions
3. Outpatient care blowouts through the supply chain of services
4. Constant clashes over things as basic as shifts and availability of staff
This is a sector that doesn’t know what it’s doing. Or doesn’t care. The figures for deaths and health care quality-related issues make the Vietnam War look like a comparatively safe place.
The health care sector needs to ask itself a few questions:
How long is this catastrophic failure expected to continue?
Is another generation of medical professionals expected to tolerate another 20 years of total failure on so many levels?
Is another generation of patients expected to risk their lives and their financial security in this quagmire?
This is a sector-wide Staph infection. It’s killing everything it touches. I know from my own experience that a lot of nurses are prepared to risk a career change after decades in the profession rather than tolerate it. Doctors can find easier ways of earning a living than working in a hell hole, too. Sooner or later, the sector will run out of willing participants. Imports won’t solve that problem.
Washington sleeps its way through another disaster
To say that Washington has been less than spectacular in its understanding and management of the health sector issues would perhaps be a bit polite. Politicians of all shades should take note of the fact that “anger management” is likely to be a big election issue. Health care is one of the biggest of America’s problems.
Denial is not an option. People do have a right to be angry when what used to be the global model for good health care turns into a war zone on so many levels. During the Civil War, the South, with almost no facilities, managed to care for its wounded to a degree of quality which matched Walter Reed. No minor achievement. In 2012, it’s a matter of opinion whether Congress could manage getting an affordable band aid from A to B in a four year period.
This is ineptitude on a colossal scale. There’s a lot to be angry about.