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Since the debate is ongoing about healthcare, let’s think about what this is really going to affect: healthcare workers. I’m looking, specifically, at the nurses. Yes, doctors, we know that you are also over-worked, but with 10-15 minutes a patient, you can see more patients than nurses can. Given how much hands-on inpatient and outpatient care we provide, the stretch in healthcare is going to be felt most acutely by the nurses who will have to do more with less (always doing more with less).
If we are not going back to outright slavery, then we have to acknowledge that there are limits to service. We cannot make people work in healthcare. As things get worse, fewer and fewer people will choose this career. Why? It isn’t just the money. It’s about safety.
I know all of this because I face it daily. Beyond the care and concern for my patients, I have risked life and limb. I have had patients hit me, kick me, use telephones as a club, scratch me, and bite me. Luckily, it hasn’t usually broken the skin. I have also had HIV+ and Hepatitis + patients rip out IVs in my face and fling blood in my general direction.
I have never filed a report regarding a patient.
Why bother when it does nothing anyway? Nurses are to be superheroes. We are supposed to stand up to administration, doctors, other staff, and even family, all on behalf of our patients. We protect them to our own detriment, sometimes even failing our own physical and mental well-being.
I re-watched an episode of Gray’s Anatomy today. It seems counter-intuitive to bring to mind a show that is notorious for medical inconsistencies and stupid drama, but one episode always struck me as being entirely too true. Someone who assisted in this episode knew too much and it affects medical practitioners similarly. In the 11th Season, Episode 21, there is a car crash. Everyone in medicine knows these phrases: “He was trying to die on me.” “No. Not another one. We’re full and we’re not even trauma.” Everyone sees it coming. Doctors too full of themselves to answer the call. Supervising doctors uninterested in the priorities. Advocating (in futility!) for your patient’s best interests. “He needs a brain CT.” “No, his GCS is stable.” Trying to do the right thing over and over and hitting a wall. Over. And. Over.
The episode is nearly traumatic upon viewing if you have had these experiences yourself. Watching the anguish from the outside, the poor outcomes, and the sheer frustration, is almost too much. I cried when I saw this episode. Not because I had any particular love of the characters, but because everything was wrong and it was too familiar.
The worst part is that this is just TV. It attempts to reflect the basic truth of the reality.
In real life, in hospitals every single day, nurses struggle to do right by their patients. Even if these patients bit them, kick them, slap them, or pull a knife on them, the nurses still try to do their best and to get the best possible outcome. With universal healthcare, we will be forcing nurses to neglect themselves. Even more than now, we will have to encourage nurses to think of themselves as super human or somehow subhuman because only those can possibly endure that kind of daily degradation. Only people who are superhuman are able to smile and offer jello immediately after being spat on by a patient, yelled at by a doctor, and bullied by a fellow nurse.
Universal Healthcare is another word for indentured servitude.
As long as healthcare is a matter of service, we cannot force workers to provide. We simply cannot. We cannot force nurses to neglect their physical integrity, well-being, and frankly, sanity. A right cannot exist if it violates the natural right of self-determination of another.
Healthcare never has been and should never be a right. Nurses are not super-heroes. Eventually, they will break and there will be no one to care for the masses.