Calm Before the Storm

Unprecedented has to be my least favorite word these days. It feels like every news report (over)uses that word. Basically, what I’m hearing is that no one – not our government, the CDC, our hospital administrators – really knows what to do and is figuring it out on a day-by-day, hour-by-hour, minute-by-minute basis. I was hoping was that, at the very least, our elected officials had an emergency plan in place. Makes sense, right? There has been sufficient warning by epidemiologists in the past about possible global pandemics. When I am in a procedure, I have a plan for emergencies like a cardiac arrest, excessive loss of blood, etc. The likelihood in most cases is low, but I am always ready. Why aren’t our elected officials held to the same standard when their decisions affect the lives of many?

I am frustrated and frightened by the whole situation….but I press on.

Over the last week, I have tried to stay as updated as possible by trying to find reliable sources about the prevention, diagnosis, and treatment of COVID-19, the challenges shared by frontline healthcare workers all over the world, and the developing situation in my home city. Needless to say, it is difficult and completely overwhelming. And !@#$-ing scary.

The first time I heard about COVID-19 in a work e-mail was in late February. At that time, no alarms were going off. It felt more like a head’s up than a warning. Then information went from a slow trickle to a continuous flow. Currently, e-mails are packed with paragraph after paragraph of what the hospital is doing, what the city is doing, what we should do in various scenarios, what numbers to call, etc. All this makes my head spin. Ugh. How am I managing all this information? I created a COVID-19 folder in my work account just so that I could track the updates and make sure I know what’s what.

Needless to say, there has been confusion, anger, and anxiety among my fellow staff members in the OR. Totally understandable. We are accustomed to knowing what to do, even when a trauma comes in. We are used to seeing the worst of the worst. We are at a Level I Trauma and Research Center on the south side of Chicago, for Pete’s sake! Our preparation for COVID-19 was nothing like our Trauma Readiness Training two years ago. The hospital was all over it. But now? Why is this different?

Go ahead… Say it… UNPRECEDENTED.

So there have been a lot of What If discussions floating around the unit. Personally, I try not to participate. It is not helpful unless the What If’s are followed by a plan. I want to hear a plan.

Can someone PLEASE give us a plan???

Last Tuesday, St. Patrick’s Day, was the first day of the cancellation of elective surgeries. Our whole Ambulatory Surgery OR was shut down and the staff sent home on Low Census with a possible re-open date of April 15th. It was a shock that rippled through every OR (and we have 3 different OR units – Adult, Pediatrics, and Ambulatory). So many question followed… I still have questions.

The cancellation of elective surgeries also impacted the Adult OR (the Main OR) where I work. It has slowed down so much, that adjustments have been made to our schedules to low census some of us on different days. Still, we are “on reserve.” All of us in the OR know that it is just a matter of time before there is a need to float us to other areas of the hospital. Already some of our surgical techs have been asked to go to the units to monitor providers while they don and doff (put on and take off) Personal Protective Equipment (PPE).

Instead of sending us home, why don’t they set up training for other possible roles? Why aren’t they taking inventory of skills? They should be asking the OR Nurses who have experience in the ER, ICU, or MedSurg Floor. Unfortunately, I have no such skills, but I am willing to learn. How about organizational and management skills? Isn’t that good for crisis management? I’m just wondering…

A Heartfelt Letter

Recently, the nurses at the University of Chicago Medical Center (“UCMC”) have called for a one day strike for the second time this year.  This is the result of unsuccessful bargaining between the unionized nurses and hospital administration over safer staffing, safe working conditions, and benefits.  A hospital-wide e-mail was sent out by one of the administrators depicting the nurses as cold and heartless.

The message made its intended impact as UCMC nurses expressed hurt, upset, and outrage on social media.  One nurse posted a response on Facebook which activated overwhelming support from her fellow RNs.

Here is that eye-opening, heartfelt letter from the UCMC PICU Nurse….

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WRITTEN BY A PICU (PEDIATRIC INTENSIVE CARE UNIT) NURSE AT THE UNIVERSITY OF CHICAGO MEDICAL CENTER IN RESPONSE TO AN INSTITUTION-WIDE E-MAIL FROM A HOSPITAL ADMINISTRATOR.
Dr. Polonsky,

We’ve never met, but I recently heard you speak at the service awards in October. I was there celebrating my five year anniversary at UCMC. It was quite a celebration for me; I’ve worked at UCMC for five years, I’ve been a nurse for five years, I’ve lived in Chicago for five years. That night, I thought the University of Chicago did an incredible job of making me feel valued, appreciated, and immensely proud of the work I do, and the place where I do it.

Tonight, receiving your email has undone all those feelings. I am a dedicated employee of this organization; I am a natural rule-follower, I hate being in trouble, and I hate conflict. However, I feel compelled to write to you, someone I’ve never directly met, and someone who sits well above me in status (and pay) at our organization, in order to convey some sentiments and facts that I feel you have grossly misrepresented in your earlier email.

“Once again, rather than stay at the table and engage in the hard work of reaching the compromises that will produce a new contract, the Union is ordering nurses to walk out on their patients and their co-workers during a holiday.”

This is simply false. The union has called a strike on Tuesday, November 26th. Thanksgiving is Thursday, November 28th. While the union has called for a one-day strike, it is hospital administration that is choosing to lock the nursing staff out for the Thanksgiving holiday. Additionally, “walking out on their patients” is hyperbole, and spins a narrative that paints the nurses, the backbone of your organization as heartless and unprofessional. I can assure you that no patients were walked out on during the last strike. I can promise you, it broke every single RN’s heart to leave that building, knowing that unqualified, inferior and, at times, incompetent replacements were going to be attempting to deliver the unmatched quality care we provide at UCMC. As a PICU nurse, I didn’t have any patients to walk out on! I worked the night before the strike, completely alone in an empty unit, because the hospital administration had shipped out every last PICU child to a different hospital. So, you’ll understand if I take offense to this comment.

“This is not a strike against a nameless, faceless institution.”

This comment is quite ironic: You are correct; this strike is not against a nameless, faceless institution. However, I’ve been a nurse at UCMC for five years, and your email has made me feel like a nameless, faceless pawn in this organization’s bottom line. I know your name, I know Sharon O’Keefe’s name, and I know Deb Albert’s name, but I’m sure none of you know mine. The nameless and faceless members of society are not typically the ones whose paychecks end with seven 0s.

“This is a strike against our patients and their families. This is a strike against our community — one of the most vulnerable in Chicago where residents face high rates of serious conditions and life-threatening diseases. This is a strike against neighborhoods that rely on us for life-saving emergency and trauma care.”

Trust me, the people at UCMC who truly understand how vulnerable and critical our patients are are your nurses. If we didn’t care about our patients, we wouldn’t want more nurses, more IV pumps, more resources, and a safer work environment. The people who care the most about our patients are the ones who are willing to lose money to defend them. On September 20th, I walked out to picket line to find many former patients and their family members earnestly supporting their nurses at the strike. We are the face of this organization. We are what makes the care at UCMC excellent. Our patients and their families know that better than anyone.

What personal sacrifices have you made recently in service to the patient population at UCMC? When our PICU patients were shipped away to hospitals throughout the Chicagoland area, I went and visited one of our patients who didn’t have family members in the area. Each time I went, I stopped to pick up his favorite toys and coloring books and movies. I was out of work, not receiving a paycheck, but I didn’t care. In fact, my coworkers often bring clothes, food, and toys to work for their patients, using their own money. Can you honestly say you have a similar connection and responsibility to the patients we serve? If not, maybe you shouldn’t have included these comments in your email.

Finally, the heart of your email was read as an expression of frustration that you, as well as other hospital leaders and middle-managers, may now be forced to work more than you were planning around the holidays. Dr. Polonsky, I have worked 4 holidays at UCMC every year for five years. I am not from Chicago. It is an eight hour drive for me to get home to see my family. I have missed Thanksgivings. I have missed Christmases. I have missed funerals and birthdays. I have family members who are ill. I have family members that are elderly. And until now, I have never really complained or resented this aspect of my job. Nursing is a 24/7, 365 profession. I’m sorry you are now having to experience ¼ of what 2200 of your nurses experience every year in the rescheduling or cancelling of holiday plans. Maybe this will be beneficial to you and your colleagues; you may walk away with a greater appreciation of the sacrifices your nurses make for our patients and our organization, and a greater understanding of how valuable our profession is (and why we deserve to be valued and appreciated in the manner in which the Union is asking). The reality is that every holiday where you are home spending time with your family, thousands of employees are at UCMC away from theirs. Attempting to belittle my profession and my character by making me feel responsible for “robbing” you of one Thanksgiving with your family has opened my eyes to how out of touch you must be in your current role with the reality of your employees.

I understand that you are also in a difficult position. You are a leader at an organization that has to deal with a strong union that is pushing their agenda against yours. That can’t be easy. I imagine the past eight months have been stressful for you as well, trying to negotiate a fair contract for 2200 nurses. Well, take a moment and put yourself in my shoes. I work in the PICU; I do CPR on infants. I help police officers take pictures of beaten and battered babies. I sing Frozen songs to frightened 5 year-olds while trying to put in an IV. I hug parents after the doctors give them the devastating test results. I guess we both have tough jobs.

Dr. Polonsky, you have the privilege of earning a lot of money to make decisions that impact thousands of people’s livelihoods. The next time you find yourself at the bargaining table with NNU, I hope you can remember your own words. We are not nameless, faceless nurses. We have names, and faces, and families and friends and lives outside of work.

We do this for our patients. We do this for our patients’ families.

That’s why I come to work. Why do you?

Happy Thanksgiving.