Saturday, February 7, 2009

The heartbreak of moral distress

This NY Times article speaks to the moral distress felt by doctors and nurses who feel trapped from doing the right thing for patients "by the competing demands of administrators, insurance companies, lawyers, patients’ families and even one another." It is a serious issue, because health care professionals drop out of settings where they are most needed, leaving behind those who become numbed in order to cope.

I worked in a hospital before I went to law school. My job was to do paperwork from noon to 3pm and then run the desk in the Operating Room wing on the 3 to 8pm shift. This meant that I did the Operating room billing, answered phone calls, ran errands for surgeries that ran past 3pm (getting blood, supplies, etc.) and also called staff in if there were emergency surgeries after 3pm (highway accidents, explosions, etc.) It was a job that ranged from being boring to overwhelming in a split second.

We often had pot luck dinners in the nurses' lounge where I got to know the OR nurses better. They were highly skilled, yet underpaid women with an extraordinary sense of commitment. Many times I saw them stay after work without pay, sacrificing their own lives to do so. I saw conflicts between doctors and nurses about patient care even back then, over twenty five years ago.

And I saw heartbreaking cases. I was in the hallway when a surgeon emerged from an OR, pulled off his or her mask and had tears in his/her eyes after losing a patient. When a patient was doing poorly, nurses came out to my desk to talk during their breaks or swept past grumbling about this or that. Grumpiness was a sign that things were not going well behind the swinging doors of the OR.

So if you add moral distress from insurance situations and other factors into this scenario, I can understand, even from limited experience in the OR wing of a major hospital, how health care professionals could just hit a limit. It's a tough gig to start with.

Anyway, check out the article if you have a chance. Because when health care professionals cry out that they cannot do the right thing for patients, those patients are you, me and our loved ones.

No comments: