Editor’s note: This is a repost of content lost in February.
By Donna Helen Crisp
I learned recently that Dr. Ronald Paulus, CEO of Mission Hospital in Asheville, has a five-point strategy to turn his hospital into the “Mayo Clinic of the mountains,” to make it “a shining star in the medical community across the nation.” Soon after, I heard a story on NPR’s All Things Considered byDaniel Zwerdling, who has been reporting a series of stories about injuries to nurses. Last week, Zwerdling’s report showed how Mission Hospital had refused to take responsibility to care for a nurse who worked there for two decades before hurting her back on the job. (His next story on Feb. 25 will feature a hospital that takes good care of its nurses, in contrast to Mission.)
Listening to NPR, I thought back to when I worked as a nurse at Mission from 2000 to 2005. It was the best job I had ever had. It was hard work and I loved it. We worked collaboratively to care for patients and to solve problems. I learned from other nurses and physicians, as well as my patients. My supervisor was wonderful. At times there was grumbling, yet turnover was low and I sensed no fear about being fired.
Since leaving Mission, I’ve heard many stories about how the hospital has changed, and not for better. Various people have told me Mission is no longer nurse-friendly, that it manufactures reasons to terminate experienced, well-paid, excellent nurses who are replaced with lower-paid hires. Several nurses have described their experiences to me about being fired and of having no support from HR when they explain that trumped up charges are untrue.
People have told me Mission is becoming a regional conglomerate, focused on profit at the expense of the quality of its employees. A Mission employee I met on the street last year said her department was carefully coached by the hospital about what to say outside work, if asked about Mission. Another person told me the lucky ones are given a forced retirement and then sworn to secrecy. She believed Mission, in its quest to take over all regional health care, sometimes emphasized superficiality over substance. Last week, a man said to me, “I was born and raised here. Mission used to be about the patients. Now they are all about the money.”
These testimonies have made me curious. I realize hospitals are complex environments, like little cities, each one with conflicts and issues. Mistakes happen. Yet, hearing Terry Cawthorn talk on NPR about how she was treated by Mission after she got hurt at work, made me sad and angry. She emphasized that nursing was not just something she did but that is was who she was, and that she had always believed she “mattered” to Mission Hospital, only to realize after her injury that she had not mattered at all.
I turned off the radio and thought back to March 29, 2000, when I attended a presentation at Mission St. Joseph’s Hospital, where Dr. Eric J. Cassell talked about Diagnosing Suffering. I had studied his classic book, The Nature of Suffering, in graduate school, learning that suffering involves an individual’s whole being, and that to recognize suffering, one must first believe it exists, and then, through compassion and living in the moment, recognize and ameliorate it. I believe Cawthorn’s suffering became her central distress, that her emotional and spiritual pain transcended the pain of her physical injuries in 2008.
How is Dr. Paulus going to transform Mission Hospital into the Mayo Clinic of the South? A great hospital treats its employees as well as its patients with respect, honesty, integrity, and transparency. To become an outstanding institution of excellence, Mission will need to review and re-pledge to honor its five Merit Values, excellence, respect, integrity, trust and teamwork, and, especially, mercy. (“We work to create a caring and compassionate environment responsive to the emotional, spiritual and physical needs of all persons.”)
To successfully mentor and influence his organization to apply core values to everyone, Dr. Paulus must be able to see the suffering in his organization, not just in patients, but in employees, from housekeepers to neurosurgeons, from unit secretaries to nurses. He must truly understand and live the words Dr. Cassell spoke 15 years ago, in the Heart Tower auditorium, when a young doctor asked, “How do you see the suffering?”
Dr. Cassell replied, “When you walk into a patient’s room, open your heart.”
Donna Helen Crisp lives in Asheville, where she works as a nurse and writer. From 2006 – 2012, she was a Clinical Assistant Professor at the UNC School of Nursing in Chapel Hill, where she taught the annual Nursing Ethics course each spring. Donna Helen Crisp, RN, MSN, PMHCNS-BC, JD.