The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital (51 page)

ri • Julie Willems Van Dijk, Wisconsin • Vanessa Williamson, Texas • Katie Wooten-Bielski, Pennsylvania • Barbara Van Horn, New Jersey • Linda Vann, Maryland • Elenita Velasco, California • Karen Vincent, Maryland • Leah Viogolo, New York • Gretchen Virkler, New York • Maria DeCleene Vlach, Wisconsin • Julia Volcjak, Washington, DC • Taylor Vozza, New Jersey • Maria Wagner, New Jersey • Ashlyn Wallace, Washington, DC • Katy Russell Walpole, Connecticut • Beth Metzger Walsh, California • Kara Warner, Massachusetts • Ashley Nicole Warren, New Jersey • Elizabeth Weber, Texas • Sarah Weber, Canada • Jean S. Welch, Kentucky • Kathy Wertz, Washington, DC • Laurel M. West, Virginia • Geri Westad, California • Mara Casarez Weston, Michigan • Amber Whaley, Pennsylvania • Gwen Wheeler, Tennessee • Natacha Yanick Wheeler, Maryland • Erica Emig White, Minnesota • Lucie White, Washington, DC • Maggie White, Washington, DC • Therese White, Maryland • Dale Whiting, Kentucky • Maryann Duffy Whittaker, Florida • Elizabeth Bartz Wiener, Hawaii • Carisa Wilburn, Mississippi • Sharon Wild, Colorado • Cheryl Wille, New York • Linda Williams-Patterson, Mississippi • Nadia Wilson, Mississippi • Anne Wiltshire, Maryland • Leticia Williams, Mississippi • Meghan Williams, West Virginia • Katelyn Willis, New York • Cristina Withmory, California • Natalie Yao, Georgia • Shannon Roberts Yeardley, Colorado • Kristina Thompson Yocum, New Jersey • Diane Yorke, North Carolina • DeAlice Young, Mississippi • Josh Young, Washington, DC • Elizabeth Zagar, Washington, DC • Meri Zaumseil, California • Eve S. Zeff, California • Ann Zelenak, Virginia • Vicki Zimmerman, New York • Inarose Ries Zuelke, Oregon • Susie Zuelke, Washington • Rebecca Zylber, New York

Reuniting with Mary Ellen O’Neill—wise, funny, and irresistible—felt like coming home. I could rhapsodize for pages about this remarkable woman, but she told me to keep the word count no longer than the last book we did together. I also was lured to Workman by the prospect of pairing again with amazingly talented marketing guru Jessica Wiener. I wish Peter Workman, who gamely agreed to open his magical publishing doors to narrative nonfiction, were alive to see this through. On some level, he must have intuited that, for me, a publishing house adorned with Star Wars paraphernalia, Cookie Monster bookmarks, in-progress robot prototypes, and a giant stuffed chicken is the publishing house of my dreams. I thank dynamo Carolan Workman, who plays a mean kazoo, for the warm welcome.

I have been fortunate to be on the same team as the smart, wonderful Suzie Bolotin, and the fun, creative publicity duo of Selina Meere and Noreen Herits. I’m also thankful to Page Edmunds, Michael Rockliff, Claire McKean, Beth Levy, Vaughn Andrews, Becky Terhune, and Heather Schwedel. I’m indebted to the hardworking booksellers and sales reps, many of whom told me personal stories about nurses, and to Michael Prevett, Gail Ross, Howard Yoon, and Anna Sproul-Latimer for their tireless efforts.

I am so grateful to my manuscript readers, who generously spent countless hours poring over unedited text: my Mom, my husband, my sister, and my friend Laura (all errors are mine). My Dad and brother are unwavering in their support and humor, which both are crucial to my writing and well-being.

Researcher Ali Eaves, who spent a summer assisting with research and reporting, was the best right-hand woman an author could ask for; her work was vital to this book. Semester interns Shaina Cavazos and Steffi Lee cheerfully tracked down stats and sources. Dave Holbrook and Krissy Hudgins offered sharp, helpful critiques of the essay on patient satisfaction.

I am lucky to know Denise Wills, for her friendship and for teaching me to be a better reporter and writer each time we collaborate, and the G.N.O. girls: Chrissy, Charlotte, Eliza, Jesse, Laura, Yvonne, Gwen, Danielle, and always Amy L. from afar. And I send an appreciative salute to Eva, my own nurse in shining armor.

Molly, Juliette, Lara, and Sam were generous with their time, stories, and patience, particularly when we reached the fact-checking stage. I hope they are as proud of this finished work as I am to know these incredible nurses.

My Facebook readers are awesome. They are supportive, thoughtful, interactive, and interesting. I particularly want to call out Andrew P.D.G. Everett for locating an elusive article and for helping to fact-check statistical analyses, Melinda Lundquist Denton (statistical analysis), Alexandra Markus (sourcing assistance), Andrew Eppstein, and Chip Decker (medical fact-checking). You, too, can join our fun at
www.facebook.com/AuthorAlexandraRobbins
or follow me on Twitter
@AlexndraRobbins
.

Thank you to my family with all of my heart. You know how I feel. And my eternal gratitude and devotion go to my husband: my rock, my best friend, and the love of my life.

“Emergency nurses practice . . . ”
Emergency Nurses Association, Award Recognition Program.
www.ena.org/about/annualawards/Pages/ENAAward.aspx
.

“ER nurses have the raunchiest jokes . . .”
Interview with author (henceforth designated as “Interview”).

“It’s like high school, except for the dying people.”
Interview.

Dilaudid, a narcotic five to ten times
See, for example, L. Felden et al., “Comparative Clinical Effects of Hydromorphone and Morphine,”
British Journal of Anaesthesia
107, no. 3 (2011).

injecting up to 8 milligrams of Dilaudid at a time, an enormous dose, but, for Lara, just enough to keep her alert
. Lara’s recollection, interview.

Medical Drug Intervention program
MDI is a pseudonym. To find a rehabilitation program in your state, visit
http://webapps.aana.com/Peer/directory.asp
. While Peer Advisors are for CRNAs and student nurse anesthetists only, many of the programs are for all nurses.

At 3.5 million strong in the United States
See U.S. Census Bureau, “Men in Nursing Occupations,” February 2013.

and more than 20 million worldwide
Correspondence from World Health Organization spokesperson to author.

nurses comprise the largest group of healthcare providers
See, for example, “Nursing Fact Sheet,” American Association of Colleges of Nursing,
http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-fact-sheet
.

women who comprise 90 percent of the workforce
Interview, Office of Occupational Statistics and Employment Projections, U.S. Census Bureau. See also “Men in Nursing Occupations.”

“like a secret club . . . ”
Interview.

“We are not just the bed-making . . . ”
Interview.

They are, for example, frontline reporters
. Thank you to nurse Meghan Yowell for inspiring the structure and content of this paragraph.

“Nursing is not a job.”
Interview.

“Doctors breeze in and out . . .”
Email from this nurse to author.

an “I’m-going-to-eat-my-hair-in-a-corner person.”
Sam’s words, interview.

“I will not be ashamed to say ‘I know not’ . . .”
From the Modern Version of the Hippocratic Oath. See Peter Tyson, “The Hippocratic Oath Today.”
NOVA
. March 27, 2001. Accessed at
pbs.org
.

“The intimate nature of nursing care . . .”
The American Nurses Association’s
Code of Ethics For Nurses
page at
http://nursingworld.org
.

“Lots of hot residents . . .”
Interview.

I-STAT
A portable device that can perform diagnostic tests at a patient’s bedside.

“ . . . shadowy, dark corners of our profession.”
Barry Silbaugh, “ACPE Foreword.” In Owen MacDonald, “Disruptive Physician Behavior,”
American College of Physician Executives
, May 15, 2011.

bloody handprint on her scrubs.
Abigail Zuger, “Nurses Speak Out, About Doctors,”
The New York Times
, October 28, 2008.

shoving matches in the operating room
Interviews. Also see, for example, Richard Knox, “Doctors Behaving Badly? They Say It Happens All the Time,” NPR, May 25, 2011.

physicians throwing stethoscopes, pens, or surgical instruments
Interviews. See also, for example, Harold Levy, “Heal Behaviour, MDs Urged,”
Toronto Star
, September 15, 2004.

scissors
See, for example, Liz Kowalczyk, “Hospitals Try to Calm Doctors’ Outbursts; Medical Road Rage Affecting Patient Safety, Group Says,”
The Boston Globe
, August 10, 2008.

Physical abuse by physicians is on the rise
. “Unresolved Disrespectful Behavior in Healthcare,”
ISMP Medication Safety Alert
, October 3, 2013.

“Are you stupid or something?”
Interview.

A Texas doctor threw a metal clipboard . . .
Interview.

A surgeon threw a scalpel at a Virginia nurse . . .
Interview.

“. . . He-Who-Must-Not-Be-Named”
Interview.

The Institute for Safe Medication Practices (ISMP) . . . has reported rampant bullying in healthcare
ISMP’s Survey on Workplace Intimidation, 2013; ISMP’s Survey on Workplace Intimidation, 2003.

87 percent of nurses encountered
Ibid.

“Every single nurse I know . . .
” Interview.

in countries such as Australia . . .
“Workplace bullying is a serious health and safety hazard affecting nurses and midwives.” See “Bullying in the Workplace,” policy paper, The Australian Nursing Federation. Reviewed and re-endorsed November 2011. See also Amanda Place, “Dealing with the Bullies in our Midst,”
The Age
, Melbourne, Australia, June 22, 2002.

prevalent in South Africa
Simone Honikman and Ingrid Meintjes, “Nurses are Stressed, Ill-Treated, Burdened,”
Cape Times
, September 9, 2011.

Hong Kong
R.P.W. Kwok, “Prevalence of Workplace Violence Against Nurses in Hong Kong,”
Hong Kong Medical Journal
, February 2006.

Canada
Lucie Lemelin, Jean-Pierre Bonin and Andre Duquette, “Workplace Violence Reported by Canadian Nurses,”
Canadian Journal of Nursing Research
, September 2009.

In 2010, a nurse in India committed suicide
“Mamata Suicide Case: Nurses Set Deadline to Nab Doc,”
The Times of India
, February 16, 2010.

In Korea, a 2013 survey . . .
“Half the Nurses Suffer from Sexual Harassment.”
Korea Times
, February 26, 2013.

the more abuse that nurses experience . . .
Laurie Scudder, “Physician Abuse as Reported by Early Career Nurses,” Viewpoints,
Medscape Nurses
, September 20, 2013.

a link between doctors’ intimidation and poor nurse satisfaction
See The Joint Commission. “Behaviors that Undermine a Culture of Safety,”
Sentinel Event Alert
40, July 9, 2008.

most nurses don’t speak out
See, for example, David Maxfield et al. “The Silent Treatment: Why Safety Tools and Checklist Aren’t Enough to Save Lives.” VitalSmarts, AORN, and AACN.

Nurses are afraid to report doctors . . .
“Workplace Violence: Assessing Occupational Hazards and Identifying Strategies for Prevention, Part 1,” a CE Home Study Course by
National Nurse
, January-February 2012.

a male travel nurse . . . saw cardiologist Abdul Shadani . . .
Reed Abelson and Julie Creswell, “Hospital Chain Inquiry Cited Unnecessary Cardiac Work,”
The New York Times
, August 6, 2012.

“Sir, what are we going to fix?” . . . inserted the stent
. Ibid.

Soon after Tomlinson reported . . . including several other unnecessary procedures
. Ibid.

Shadani still works at Lawnwood
. Author’s 2014 phone call to Lawnwood Regional Medical Center and Heart Institute.

In 2009, two Texas nurses filed . . . that risked patient health
See, for example, “New State Law Bans Anonymous Complaints Against Physicians,”
FierceHealthcare
, September 20, 2011.

taking hospital supplies to perform at-home procedures
See, for example, Betsy Blaney, “APNewsBreak: Ex-County Lawyer’s License Suspended,” February 2, 2012.

pushing patients to purchase herbal supplements that he conveniently sold on the side
. See, for example, “Editorial,”
The New York Times
, February 10, 2010.

sewing a rubber scissor tip to a patient’s thumb
See “Justice Doesn’t Always Have Happy Ending,”
Austin American-Statesman
, October 7, 2011.

using an unapproved olive oil solution on a patient . . . failing to diagnose a case of appendicitis
See, for example, Kevin Sack, “Doctor Arrested in Whistle-Blowing Case,”
The New York Times
, December 23, 2010.

performing a skin graft without surgical privileges
Ibid.

When the board informed Arafiles . . . his supplement business
. “Medical Justice, West Texas–Style,”
The New York Times
, February 10, 2010.

Arafiles tracked down contact information for the patients listed in the complaint
See, for example, “Former Winkler County Memorial Hospital Physician Sentenced for Scheme to Fire Nurses in 2009.” States News Service, November 7, 2011.

and gave it to the sheriff, who got hold of them
Kevin Sack, “Sheriff Charged in Texas Whistle-Blowing Case,”
The New York Times
, January 15, 2011.

to determine the nurses’ identities . . . found the letter.
Ibid.

A hospital administrator fired both nurses
Ibid.

who had not signed their letter because they feared . . . retaliation
. Rick Casey, “Justice, Injustice are Served,”
Houston Chronicle
, August 13, 2010.

after months of unsuccessful attempts . . .
Betsy Blaney, “Nurse Testifies Talks on Doc’s Cases Delayed Often,” the Associated Press State and Local Wire, June 8, 2011.