Friday, December 7, 2012

The Appearance Of Callousness


Have you ever seen the short film It’s a Dog’s World? (The “new” edition can be seen here).  This is a short film that makes the comparison of how a dog is treated with empathy, dignity and respect after an injury, while his master, also injured, does not get the same. The owner of the dog has to deal with among other things, people who don’t really seem to care about him.

I am very fortunate to be the CEO of the GBMC HealthCare system. I get so many wonderful letters about members of the GBMC family who do marvelous things for our patients. But I also get letters where we did not treat people the way we want our loved ones to be treated. When I read these letters, I most often believe that our people did care but they gave the impression that they didn’t.  I have come to call this the appearance of callousness. We often give the impression that we don’t care when we are overwhelmed or when we are busy trying to protect our teammates from being overwhelmed.

Here is an excerpt from a letter that I received this week:

“I am writing you about my recent inpatient stays at GBMC. I was admitted to GBMC for 4 days, went home for 2 days, but needed a readmission for another 3 days. My two stays couldn't have been more dissimilar. So I am writing about my observations, those who did a great job, and the few problems I found.

First, I think in general I got very good care. In the ED, I actually thought that the waiting was reasonable, they gave me a reasonable expectation of time delays etc. I found the ED nurses and techs very good- both in doing their job and giving the personal attention. One is struck by how busy they are and how they have to juggle many duties. Despite that, I didn't find it detracting from my care. Transport was fine, CT and sonogram people were pleasant, capable, and helpful.

I was admitted to an inpatient unit. My hospitalist was Dr. Renu Thomas, whom I found to be excellent. She was very thorough, had good insight into my care, was prompt about writing orders, and showed compassion and concern. Medically I thought she was excellent.  I was in a typical GBMC room- very small, but it was quiet.  I didn't really require a lot- mainly IV antibiotics etc. The nurses were all excellent, caring. One is struck by how busy they are, how they have to juggle many things. I liked that they wrote their names down each shift and left the direct number to the nurse. Once I used the call button, didn't get a response, but just waited since it wasn't that urgent. Later, I just called the nurse. Once a tech forgot something I asked for, and she was so apologetic. It really was fine. I had one aide who could have been a little quicker to help, but in general I found the staff great. The phlebotomists at 5:30 am were incredibly quick, quiet, and excellent at getting the blood work done. A night nurse, who clearly has many years of experience, was particularly helpful with her suggestions.

I was discharged home but the symptoms returned, so I came back for more intravenous medication. On my second visit my ED stay was again appropriate, not too long a wait, good staff. Then I was readmitted back to an inpatient unit. However I was put by the nurses’ station, in between a demented woman, and a hard of hearing man. And I was down from the ice machine- which is very noisy. So the room was very noisy and not ideal. This time I had a different doctor, whom I was not very impressed with. I found her manner not very caring. She made a mistake ordering me a medicine. When I mentioned it the next day- next time I saw her- she didn't even apologize. She just said that the computer wouldn't accept her code etc. When it was time to be discharged, she said I would have to wait at least 3 hours because she had sick patients she had to care for. I am sure that this was true but not what I needed or wanted to hear.

However my worst experience was from the unit coordinator. During my second stay, I developed a headache (my headaches often progress to severe migraines), and at 7:10 am hit the call button to ask for Tylenol. I was answered right away and told that it was change of shift so that it would be awhile for the medicine. At 8am when I still hadn't received the Tylenol, I called again. No answer. So I tried 2 more times over 5 minutes. No one even answered the button. So I got out of bed, and with my IV pole in tow, went out to the desk. As I approached, the unit coordinator said she told me the nurse would be coming. I said that no one answered the call button. She then, in front of many people at the desk, said that she had talked to me several times and told me that the nurse would be coming. At that point, I told her that she had only told me once at 7:10 and I wasn't sure that the bell had even worked the next time since no one even answered me. The nurse then came and gave me the Tylenol.

Later that day I spoke with the charge nurse, who was extremely polite, apologetic and helpful. She arranged for my room to be changed to one away from the nurses’ station. I did mention that I thought it was a problem that someone couldn't even get a Tylenol for an hour due to change of shift.

I will probably be returning again to GBMC as an inpatient because of my chronic medical problems. I am hopeful that I will have a better experience than my second stay. But in general the nurses are all excellent, caring, and very busy. You really get a sense of all they are taking care of with their patients. So many things go well at GBMC, but there is always room for improvement.

I am very grateful for the work of our people at GBMC, especially all of the nurses and technicians that this patient thanked and Dr. Renu Thomas.  But, as the patient said:  “There is always room for improvement”.  I called the patient and apologized for the appearance of callousness by that unit coordinator.  I told the patient that our unit coordinators do an excellent job but sometimes people slip and make it appear that they don’t care when they do, and sometimes they say the wrong thing when they are trying to prevent their nurse teammates from being overwhelmed. The patient accepted this and she told me that GBMC is still her preferred hospital. I thanked her for her trust in us.

I know that there was a discussion between that unit coordinator and her supervisor, to get her to reflect on her behavior and change it. I should also mention that our nurses are working to redesign our approach to answering the call light and they have embraced bedside handoffs and hourly rounding to reduce the frequency of patients needing to call them.

But in addition we all need to work to eliminate the appearance of callousness.  I look forward to your thoughts on this.

55 comments:

  1. I am a very proud employee of GBMC.I have also been a patient and was treated with utmost care and respect. Yes, there is always room for improvement and continued feedback from our patients assists at identifying bottlenecks. I too, am thanking this patient for expressing there constructive critisism and hope that GBMC continues to improve on patient satisfaction.

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  2. Thank you for calling the patient and apologizing.
    I am wondering if the second physician (mentioned in paragraph four) was approached and asked to reflect on her behavior and responses to this patient?

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  3. Thanks to both of you for your comments. Yes, the supervisor of the second physician reviewed this letter with the physician to get the physician to learn from it and make the appropriate changes to the physician's behavior. Sorry that I left this out of the story.

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  4. Great reminders! Being both an employee and a former patient though, I fear that your suggestions may fall on deaf ears with some of our caregivers. I would urge managers (even non-clinical ones) to observe the interaction of our employees with patients and visitors and report both exceptionally good and "could be better" incidents to the managers of those departments. This goes a long way to help.

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  5. I am a manager. It is NEVER ok for a patient to wait for pain medicine during change of shift. We have double the amount of staff at that time so there's no excuse for not meeting a patient's needs. When you're in pain, every minute feels like an hour. Then, to quote the patient, "So I got out of bed, and with my IV pole in tow, went out to the desk. As I approached, the unit coordinator said she told me the nurse would be coming. I said that no one answered the call button. She then, in front of many people at the desk, said that she had talked to me several times and told me that the nurse would be coming." Would the unit coordinator have accepted someone speaking to her own mother or father that way? It's demeaning and unprofessional. And in the time it took the UC to have this discussion with the patient, she could have gotten the Tylenol for him/her. Until we truly hold people accountable for the Greater Behaviors, employees will continue acting this way, unfortunately. The consequences for poor attitudes are too minimal to be effective. I vote for three strikes, you're out!

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    1. well said and boy I couldn't agree more. As an employee I find it very difficult at times to have to keep putting up with the same individuals time and time again who have very bad attitudes. I know if it makes me not even want to come to work sometimes then I can certainly understand patients that become "put off" by their stay here. I love gbmc, but sadly I feel the workers here are very in apropriate and un proffesional more times than not.

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    2. What unit do you work on? Not the same one that I work on.

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  6. This would be great for Schwartz Center Rounds!

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  7. The GBMC acceptance of continuous improvement makes it possible for "the appearance of callousness" to be addressed in a constructive matter of process rather than as an attack on an individual. This positive environment fosters self reporting and the sense of ownership and being invested in continuous improvement at all staff levels. Kudos on this to everyone, and to leadership which sets this priority in the organization!

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  8. First Of all all employee treat thier PT with respect.And sometimes PT'S in an hurry. In shift change the RN has to give report about his/her PT and can not give meds without knowning the PT information. So in some case the PT has to wait until report is do to get thier meds. Some PT's want things done quick and fast and we can not do things in that order.Sometimes i have answer the call bell and i let the PT know the RN's are in report and someone will be with you in a few. This letter is one sided and is not far for the people who are mention.We are here for patient care and try our best to do so with many duties on hand. We try our best to give good care to everyone and some may not see it that way.

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    1. I've been a staff nurse at other hospitals and was always told that if you have not given report on that pt then that pt still belongs to you. So you need to medicate that pt. If you need to stop your report to do it just send your manager an email to let them know that during your report that pt (xyz) asked for pain medication while you were in report. Or maybe if you made final rounds and ask your pt if they need anything prior to the end of your shift that all of this could just be avoided.

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  9. Funny how you take the time to call this patient and apologize for the behavior yet when your own staff is subjected to abusive behavior from a manager and you are made aware you could not be bothered. Know where we stand.

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  10. When the nurses are in report, to say that the oncoming nurse "doesn't know anything about the patient" is an excuse. The offgoing nurse who was caring for the patient knows everything about the patient and can medicate him or her. Report can wait. Patients can't.

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  11. This blog as well as several comments come across as one-sided and as an unfair attack on the Unit Coordinator. We as readers don't know what else was occurring at the time that patient asked for Tylenol. Nurses are constantly pulled in many different directions. While this patient needed Tylenol for a headache, what else was occurring on the unit? How many other patients had just pushed the call bell needing to use the bathroom? How many falls were prevented by nurses assisting those patients? How many patients had an unstable blood pressure or other more emergent issues regarding their vital signs that needed to be dealt with? How many admissions or transfers were happening on the unit at this time? While it is unfortunate that this patient was in pain, when the bigger picture is looked at it is not always so simple. That Tylenol request unfortunately may fall to the bottom of the priority list when many things are occurring at once on the unit. When the unit nurses are often forced to "flex up" above the established nurse/patient ratios, we are stretched thin and the more urgent situations are addressed first. Unfortunately "flexing up" seems to be occurring more and more over the past several months. The Unit Coordinators are ideally to be out of staffing (so they can assist the other nurses with situations just like this Tylenol example). This is frequently not the case - due to short staffing these people often have assignments themselves, so it is not possible for them to act as "helping hands". When multiple people are ringing the call bell, someone has to wait - we can't be everywhere at once. There are many days we are short a tech and forced to play both roles. Due to unit secretaries being eliminated at night, the phone and call bell sometimes ring for some time because all other staff members are with other patients trying to do right by them. This is the reality of the staffing on the units and many of these staffing decisions come from you Dr. Chessare. The theme of many of your blogs is to treat every patient as you would your own family member. I would argue that the bare bones staffing on the unit does not follow this model and you should be asking yourself these same questions that you are asking us. We can only work with what the administration gives us.

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    1. I TOTALLY AGREE. COULDN'T HAVE SAID IT BETTER

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  12. For the manager that responded- Wy don't you come out of your office and help your staff? Three strikes and your out. I know quite a few of upper management who with this type of system would be out. Does that include you. NEVER is a very strong word so by using that word you place yourself in the situation. That means you need to get up and help the patient also or don't judge those of us who are running around trying to do our best.

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  13. This comment has been removed by a blog administrator.

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  14. I think that a good edition to this story would be the GBMC employee(s) involoved in this situation telling the story as they remember it happening; anonymously of course.
    It seems Dr Chessare, that you are attempting to show us that they way a situation is perceived by a patient may be different from the way the staff was perceives their delivery of care. However, the way it is displayed looks more like a not-so-anonymous attack on the employees involved without their consent or ability to tell their side.
    I would be interested to know how the staff on the unit felt their interaction with the patient went.

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  15. This comment has been removed by the author.

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  16. Gbmc has a great nursing staff, of course we are never told how well we our job or given kudos for all we do.
    Is it really nessary or proper to use an open forum to adress this issue? And it seems always so one sided when it comes to complaints from patients. Have you ever worked the floor?When wasthe last time you ever took the time to talk to your nursing staff and listen to thier side of patient care?
    We as nurses give the best care we can.For you to compare the care of the care of the ER nursing staff to the floor staff is unfair. The patient 9 out of 10 times comes to the floor with catscans undone Doctor orders not done and an urgency for the the nurse to take report so they can send the patient to the unit.
    Yet we we just do our jobs and give the paitents the best care we can. Because we know how one sided things can be in nursing. It would be nice if more time would be given to the nursing staff complaints. And if we were made to feel like our concerns mean something.
    Have you ever heard of the phrase there is 2 sides to every story? Yes there is always need for some improvement in everything. But how would you like if we used an open forum to be make you look like your inadequate in filling your postions duties? How would you feel if you had to see constantly that you need to improve on what you do?
    We take patient care seriously and we do our job well.
    Do anyone ever notice when we are cursed at? hit? spit on? screamed at? family members insulting us? threatened?
    Do we ever geta blog about how we work through our lunches and breaks? or how we save lifes or consoles families? or how we spend time with the patient and go out our way to make them feel safe and secure? How about seeing Kudos for the nursing staff who spend time calling through the hospital to findthatone thing that will make a patient stay a little better. Or taking the time to just make them feel like they are the only patient we have.
    Or how about the staff that takes their breaks to do something nice for a patient.
    If we all counted the times we were hit, kicked, scratched cursed , abused and blogged on it . We would never get nothing done
    Unfortunately i can personally tell you that we can not always please the patients even if we do everything they ask in a timely manner. I have spent a whole shift addresing a patient feel good atthe end of my shift to ony come back to work to hear complaints from the nurse that relieved me that the patient complained about me
    I want to take the time to say all the Nurses and Techs and nursing staff remember why your a nurse and in health care. Because no one obviously remembers or even have a clue!
    And kudos to Doctor Thomas for being a hero ! and to ER for doing there job!
    I just wish someone would take the time to appauld us instead of always telling us how we need to improve and to get a lecture.

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    1. Please excuse the errors ...long night will do that

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    2. Of course there are two sides to every story. No one is attacking an employee for anything. The post is just an example of how someone's actions/statements were interpreted by a patient and a request for all to be mindful of it going forward.

      Also, I'm not sure how you can say "we are never told how well we our job or given kudos for all we do" and "I just wish someone would take the time to applaud us." Nurses get a heck of a lot more thanks and recognition than many other employees!!! There's a whole week every spring dedicated to honoring nurses! There's a whole department dedicated to nursing education! Meanwhile, there is only one day per year in honor of doctors and nothing for anyone else. Providing indirect care by running the business of the hospital matters, too.

      Please remember that those who support the hospital in administrative capacities have frustrations of their own, which are also paired with large workloads (nurses aren't the only ones who work through lunch on a regular basis either!). How often is there a week or even a blog post to celebrate payroll staff, the purchasing department, marketing, human resources, IT, environmental services or medical records personnel?

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  17. I as a Leader in this organization I am not quite sure what this "blog" accomplished but to anger our most prized commodity and that is people working and trying their best to provide great care under stressful conditions. Let's also try to get the terminology correct of our positions- we have "Unit Clerks/Secretary" and "Clinical Unit Coordinators" none of which I have ever known to be "callous" with their interaction.

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  18. It is very sad to be called "callous" by many of those who have never worked as a nurse at the bedside. I can't speak for all nurses but most of us choose this profession because we do care. It is extremely difficult these days to always express how much we do care due to the work load that we are subject to. I know this is present in most bedside nursing facilities but the difference with GBMC is that we care about pt satisfaction. Upper management needs to understand they "can't have their cake and eat it too." We are only human and can only do what is humanly possible. As nurses we want to give exceptional care but it isn't always possible. So please don't call us "callous."

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    1. The care I would want for my family member is not how we currently work - short staffed to save money - lets look at the real reasons patients aren't being seen on time.

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  19. This blog is a disgrace to our staff that work so hard everyday. The president of this hospital should be ashamed of himself. What always needs to be remembered is if you don't care and consider your employess, you will have no one to care for these patients you always want to put first. Think about it.

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  20. As a nurse with over 25 years of experience at the bedside in a variety of institutions, I can condfidently state that GBMC has kind and competent caregivers. (A patient has to wait longer than expected for a tylenol- let's all get perspective) Nurses, please don't allow administrative decisions, such as the inferences made in this "Healthy Dialogue", devalue you or your profession.

    As to the "appearance of callousness", I believe that our administrative leadership should reflect on this statement with regard to their job performance. Contemplate not only the above message, but also the recent policies and initiatives that serve to abuse, threaten and devalue the hospital's caregivers.

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    1. If one wants to know how executive management values nursing, they need only look at recent decisions. One of the top three concerns on the employee satisfaction survey was that employees did not feel valued, did not see opportunities for advancement, and did not see a stable future for their career here. It is no wonder with the recent lay offs of several employees who spent decades of their lives making GBMC what it is today. They invested their time, talent, and heart only to be disposed of. Unfortunately GBMC views its nursing staff as just another piece or equipment.

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  21. The title of the blog is the "appearance of callousness" not "staff that was callous" - geez. Again remember that this was written by a patient. When will we learn to accept feedback as a gift and stop being so hyper-sensititive.

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  22. Hi, Nice post thanks for sharing. Would you please consider adding a link to my website on your page. Please email me back.

    Thanks!

    Joel
    JHouston791@gmail.com

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  23. Dear CEO of GBMC regarding your latest e-mail to all nurses: Is this not the pot calling the kettle black? You seem to cater to the more educated more high-brow patients. Who does this patient think she is? Have you seen Downton Abby or Upstairs Downstairs series? If not, you need to. We working class nurses have managed to raise ourselves out of the downstairs group of people by going to community colleges "all we could afford" or hospital schools of nursing - a compassionate "not callous" caring group of people, who take all kinds of insults from patients. We know what it is to serve. I have many stories from my 40 years experience but have no platform for my complaints. We nurses do as we're told. The patient you wrote about reminds me of "My Lady" in Downton Abby. Born with a silver spoon, well educated, thus writes a grammatically correct complaint and YOU (in effect) chastised the entire staff of good, hardworking nurses. Definition of "Callous" -- feeling or showing no emotion for others". I prefer to think of my co-workers as angels. Occassionally we get our wings broken - but we go on, and on and on because this is what we do best. And you infer or rather outright tell us "we are callous." How insulting!

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  24. To previous response......AGAIN.....

    The title of the blog is the "appearance of callousness" not "staff that was callous" - geez. Again remember that this was written by a patient. When will we learn to accept feedback as a gift and stop being so hyper-sensititive.

    If you can't take criticism from patients then you are in the wrong line of work. Patients complain ALL THE TIME, whether they are right or wrong. Why are you attacking the messenger???!!!! Take the feedback and move on.

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    1. You're absolutely correct! The blog post does not call nurses (or any other employees) callous. The point I believe Dr. Chessare is trying to get across is that we all need to be aware of how our actions may be perceived by others. I didn't see anything in the post that suggested nurses don't do a good job.

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  25. I am currently a Clinical Unit Coordinator on the unit that the letter was referencing. I was not working that day and was not involved with this incident. I will say that in nursing care, there is always room for improvement to better ensure patient care and patient safety. However, I cannot fathom that my coworkers would act or even appear as callous. I actually cannot imagine this occuring on any unit, as the people of this hospital are just plain nice and caring and that is why I chose to work here. Do I believe that we should follow up on patient complaints to improve our process and hold each other accountable? Of course we should. This is necessary to better our practice. What this blog is though, is poorly timed. Our unit has just gone through major changes, with an expansion and increases to our nurse: patient ratio. What we need right now is support and unit based discussions to better our processes through this difficult time. Our doors are always open and I know that our staff would be open and appreciative of the chance to sit down with Dr. Chessare and discuss patient feedback, both positive and negative.
    Carrie

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    1. I agree with you Carrie we need to be supported during this time. I was there when this occurred and there are two sides to this story. I feel that this blog has gotten out of hand and needs to be stopped by uppermanagement. With all of this negative talk We are only hurting our hospital that we all love so much. Dr. Chessare come talk to us and put an end to this public embarrassment. People out in the public can see this blog which I am totally embarrassed by.

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    2. I am happy to meet with the staff on the Unit. Please find some times that work for you and I will make one of them work on my schedule.

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  26. Nursing is not always a pleasant job and that is just the nature of the profession. There is not much anyone can do about that given the job we are called to do. What executive management does have control over, however, is the resources with which we are given to do it. The management at GBMC want their nurses to do more with less, delivering complex and intricate patient care to many patients with many comorbidities, without the proper equipment or support staff, and all while maintaining a smile. If leadership wants this caliber of care given to their patients, perhaps they need to deliver the same caliber of support. Nurses are thrown to the wolves, abused, degraded and pulled in every direction without any thought given to their personal needs or their abilities. Nurses can not sip a cup of coffee, use the restroom, or take a thirty minute lunch break without being pulled away. It is physically and logistically impossible to deliver the amount and quality of care expected. Nurses can not be in more than one room at once or more than one unit at once. Nurses on surgical units are caring for six patients and discharging their patients home with new equipment, drains, tubes and mobility limitations without the proper teaching because nurses do not have the time or resources to provide the education. Nurses on medical floors caring for 4-6 patients need to make the decision to cater to the abusive, demanding family member, or to answer the bed alarm of the patient who is likely falling. Nurses in the intensive care unit are leaving a unit full of unstable patients to respond to codes and rapid responses all over the hospital. When they do this, they are leaving their own patient assignment (of 2-3 patients) abandoned because they are working with a charge RN in the numbers and no support staff. During all of this, nurses are expected to document perfectly and complete every task and administer every medication on time. Most nurses finish a shift mentally, physically and emotionally exhausted, defeated, and unappreciated, only to find a plethora of emails and notes criticizing everything they did not do "right." These criticisms are coming from people who have not seen a bedside in quite some time, if not ever. Human nature dictates that when someone is told repeatedly they can't do anything right, they stop trying. After experiencing this day in and day out for months, years, or even decades, many of your nurses may not be willing to do the extra mile or fake that extra smile. Recent turnover rates should be proof of that. GBMC is currently using more agency staff than they have in years. If GBMC wants their care given like its being given to their own family member, perhaps they should ensure their employees are being treated like a family member should be treated. The key to customer satisfaction is employee satisfaction. Employees would smile more and would be more willing to go the extra mile if they were happy. Executive management needs to work toward building self-actualized, appreciated employees. Go back to the basics and the "numbers" will certainly follow. Staff are doing the best they can with what they are given.

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  27. What "appears callous" is that Dr. Chessare has not further commented on this blog.

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    1. Yes, I've noticed that he only deigns to reply to comments made in the first day or two after an entry. Way to support open communication with the employees, Dr. Chessare.

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  28. I am appalled by the tone and disrespect shown by GBMC employees in replying to Dr. Chessare's blog... all under the "protection" of anonymity. I think it is so harsh that I cannot "sign" this entry for fear of further insults and slurs sent MY way, too. Like a previous writer, I am embarrassed that this blog is able to be viewed by "the public." What must they think of GBMC? Please consider that Dr. Chessare's comments are not nearly as harsh as those in the replies section here. If ill-timed or poorly stated (in some folks' opinion), they don't deserve the diatribes written here.

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  29. I do not believe this incident should have been posted in a blog for everyone to read. I think the patients' complaints should have been discussed privately with both the nurses and doctor involved, discussing all aspects of the situation. I believe to interpret the nurses and doctors' action as callouse, may be extreme, because it appears they were trying to explain to the patinet why there was a delay in her receiving her tylenol and did not intend to appear calloused.
    But that should have been discussed privately. Dr. Chessare decided to judge and convict the involved individuals in the elctronic press. Maybe Dr. Chessare should rethink that venue for sharing negative comments towards staff members and how he deals with patient complaints.

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    1. Yet again, no one judged and convicted anyone! He said we all need to work to eliminate the APPEARANCE of callousness in the patients' eyes. Remember that the italicized text is directly from a patient. That's his/her side of the story, not Dr. Chessare's.

      In fact, Dr. Chessare stated how grateful he is for the work that our nurses do. And he went on to say that nurses "are working to redesign our approach to answering the call light and they have embraced bedside handoffs and hourly rounding to reduce the frequency of patients needing to call them." That's a positive thing! Nurses are working hard to make changes that benefit our patients...that's great!

      I may not necessarily agree with everything that GBMC does as an employer, but I believe we're ALL (upper management included) doing the very best that we can. And it seems to me that regularly having to deal with mountains being made out of molehills probably doesn't allow leadership to focus on doing its job effectively.

      Perhaps we all need a refresher in our value of accountability? Accept responsibility for ourselves, acknowledge that our actions *MAY* come across as callous to some and learn from it so we can stop this finger-pointing blame game and move on with the business of improving care.

      To quote a previous reply: "When will we learn to accept feedback as a gift and stop being so hyper-sensititive?"

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  30. To the December 7 commenter: I and many other managers come to work in scrubs so we can give a hand when needed - especially during change of shift. In spite of your snide comments, I would even medicate you, too - and not make you wait.

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  31. recently resigned employee:

    This blog goes to show how dissatisfied employees are at gbmc. The major reason I left is because of management and how they treated their employees. There is no appreciation for employees or a since of job security at all. I think that the issues expressed on this blog go beyond this situation. It gets to the root of how things are operating at GBMC. I think it is only a matter of time before the hospital crumbles. Sure the patients are important because they bring in the revenue, however the employees are just as important because they keep the place running. Upper management needs to get a grip. GOOD LUCK TO YOU ALL WHO REMAIN AT GBMC.

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  32. Regarding the manager who responded Dec 12 th.: your post would have been better received if you had left out "in spite of your snide comment." You are doing the same thing, expressing a "snide comment" and this is no way for a leader to lead. You lead by example and you are setting an angry defensive tone. You are called to be a role model for your staff and this post demonstrates what the staff is complaining about, the "callouseness" of people who make uncaring and even "snide " comments to their own staff.

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  33. The December 7 post was snide. And it was uninformed. I am not an angry person and I love my job and my staff. None of us would embarrass a patient in front of others. I think that's what everyone's missed here - the fact that the UC spoke unkindly to the patient where others could hear. Was the UC stressed? Probably yes, and her colleagues probably were, too. But from my interpretation of the patient's letter, she was basically scolded by the UC with an audience. That wasn't nice.

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  34. In a nut shell, it seems most mangers are calling the staff names either directly or by inference, in defense of Dr. Chessare, inferring the staff was calloused. The patient who wrote the complaint never called the staff "calloused " nor did she infer it. Dr Chessare inferred the staff was calloused by stating that the comments made by the nursing staff gave the "appearance of callousness" to the patient, which she never really said. Only Dr Chessare said it. The staff is becoming bitter and resentful because this isn't a learning opportunity to improve communication. Instead the "attitude" of upper management that the staff should just accept the criticism without looking at all sides of the story, packaged as constructive criticism, is defeating. The management who write kind responses are listened to more than the upper mangement who continue to write defensive posts about how the staff needs to not be hypersensitive. Remember it 's all "perception" and many of the staff seem to perceive that management is not sensitive to their work environment and the difficulties they face every day. They do not feel supported and they are voicing their opinion on this blog and shouldn't be criticized for doing so. After all Dr. Chessare decided to air this patient complaint for everyone to read and comment on. When the feedback is negative upper mangement starts calling the staff names "hypersensitive", "snide", "rude" ,"disrespectful". Management needs to lead by example,and if you want to staff to accept criticism, then management needs to be able to accept it as well without resorting to retaliatory comments.
    Why don't we just end this blog. The whole thing is inappropriate, from the mangers and staffs comments, to why it was ever aired on a blog in the first place by Dr. Chessare. Probably not the best decision of how to disseminate private information about patient complaints and involved staff.Going forward lets learn from this

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  35. DITTO.AGREE. END IT. AMEN

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  36. Seems like there is a need for an anger management class for all involved. Wow. Being called names by managers in a public forum. Time to stop this and remove all comments completely. This is nonproductive, harmful and just plain degrading to GBMC as an institution.

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  37. Rather than "end" the blog, which is often a useful and insightful means of communicating news inside and outside of the organization, perhaps staff members ought to be a little more professional in the comments they post here. In reading Dr Chessare's entry again, he never insults nurses, or suggests that they are not professional & caring, but simply highlights one patient's story as a real-life example to demonstrate how staff members' appearance and actions MAY at times be perceived as being callous (defined as "insensitive; indifferent; unsympathetic") simply because of their actions, or non-actions. And we all know that often times "perception is reality."

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  38. This entire event should be taken as a learning experience to everyone involved. Dr. Chessare, maybe next time you choose to blog about an incident or complaint, it might save some heartache if it is done without the people involved knowing it is about them and a patient they cared for.
    As for the patient who wrote this letter, she obviously did not have that bad of an experience on the unit b/c she has requested to come back to the unit on subsequent admissions. Some people just like to complain and voice their opinions.
    It is easy to tell others to take criticism "like a grain of salt", but it is difficult to act on such an expression when nurses here put their heart and souls into their job and are nurses because they want to help people. Afterall, that is what makes GBMC employees special. It is only natural to be slightly offended when someone critques what you do, especially when you are giving your all everyday.
    These nurses are taking care of many patients, probably too many to even be considered safe. It is unfortunate, but some patient has to be first and some patient has to be last. Nurses can't be everywhere at once. We live in a society which has become accustomed to "instant gratification". It is unfortunate, when providing medical care, instant gratification, in a non emergent situation, is not always possible.

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  39. To the manager who called staff "uninformed"- you are almost laughable if you weren't serious. "I would even medicate you" isn't snide or rude? The only thing you were asked was to get up and help. Three strikes and your out. I have been here a long time and have seen many managers who would lose their job with that description. I feel sorry for your staff and happy that I am not one of them. You need to reevaluate your feelings as a manager. I am not so uninformed as I have been a manager and have run a unit. I find most of the meetings I had to attend nothing more than a way to degrade one person per meeting and you all enjoyed it. This trickles down from the top and the top needs some serious help. I feel sorry for all the managers who feel the way you obviously do about your staff. It is too late to go back and say how much you love your staff when you have already said some degrading things about them. You need help.

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Thank you for taking time to read "A Healthy Dialogue" and for commenting on the blog. Comments are an important part of the public dialogue and help facilitate conversation. All comments are reviewed before posting to ensure posts are not off-topic, do not violate patient confidentiality, and are civil. Differing opinions are welcome as long as the tone is respectful.