Nurses Say Stress Interferes With Caring For Their Patients [NPR.org]

Stress? Or Workplace Bullying/mobbing? When I began researching workplace bullying in education (a personal journey, not merely curiousity) I was surprised to learn that nursing is at the top of the list when it came to workplace bullying. While "stress" is an unfortunate, imperfect reality of life, workplace bullying is a deliberate, even calculated means to make someone else's Worklife 'hell'.

I've read of nurses whose colleagues/supervisors deliberately saboutaged their work with actions that compromised patients' health/safety. Here's just one article. https://www.amsn.org/sites/def...SNJ_Murray_18_05.pdf

i suspect nurses, like teachers, know when articles benignly may miss the mark on what is hardest to deal with at work. They know the difference between stress from being short staffed from stress from saboutage. 

If we want to do more than repair the wounds from ACEs, we need to identify ways in which interpersonal trauma continues unchecked here in America. One HUGE way is via workplace bullying. We have no laws. We don't even know what healthy workplaces should look like. 

During my career as the CEO to 2 Alaska rural health care organizations, I learned about, and implemented, the health management system referred to as "Lean Healthcare." If you Google the term, you will find both successful and unsuccessful implementations of Lean Healthcare. Mine was successful. My staff was valued, and did things that no other Alaska rural health care provider did. When you read about a lack of success, it's because the CEO didn't appropriately value the employee enough to coach and mentor them about the processes of improvement. I am happy to communicate with anyone who would like to learn more.

My favorite example of success in a major medical center is the story of Virginia Mason in Seattle. In 2002, they had a negative fund balance of about $2 million. In 2008, they had a positive fund balance of over $70 million. They attribute their success to Lean Healthcare. But it's not about money. Patients are happier, institutional customers are happier, and staff has bought in and during my visit, appeared to be happy. My colleague, Mark Graban, has an excellent blog where he discusses Lean Healthcare at www.leanblog.org. 

Years ago, I wrote a paper with a hypothesis that saw a potential for reducing our health care costs by over half in the United States. It involved both addressing ACE's (Toxic Stress) and implementing Lean Healthcare. I am happy to share that very old paper with anyone who is interested.

In 1973, the House Staff/Residency brochure for Lincoln Hospital, in the Southeast Bronx, noted that their Emergency Room had an annual use by 186,000 persons. That's about 22 per hour-if they come in at an even pace. There were 100,000 Heroin addicts in that community at the time-in spite of Pediatric and Internal Medicine Residents who made "House Calls" in that neighborhood. Lincoln was a 400 bed hospital with an average In-Bed Daily Census of 1,100 patients--sitting in chairs in hallways, etc. I remember an Internal Medicine resident telling me about an 8 year old gang member, who came to the ER with a gunshot wound to his thigh, accompanied by two older fellow gang members, to make sure he didn't cry when the bullet was removed in the OR. When I read "Caregiver, CareTaker: From Dysfunctional to Authentic Nursing Service", the preface noted that ALL the Bachelor degreed nurses in California had participated in a survey: 85% acknowledged growing up in Alcoholic households. I suspect that ACEs may "pre-dispose" people to .....later-life PTSD. I suspect that Nursing isn't the only "profession" to experience this.