The reason why hospitals do not let doctors and nurses raise their voices about conditions in the fight against coronavirus

During the COVID-19 pandemic, doctors and nurses they are not only concerned about the risk of the disease. Across the country, thousands they fear that raising their voices about the shortage of employees and personal protective equipment will lead to disciplinary action and possibly dismissal for it. Many hospitals have instituted gag orders to make it clear that publicly advocating safer working conditions could lead to layoffs, and, as Nicholas Kristof and others have shown, dozens have already been punished.

I’m a nurse and although I’m not currently working on the front, I know how those nurses and doctors feel. I was one of them: I was fired from a job I loved because I refused to stop writing and raise my voice about problems in our healthcare system.

I have never related this anecdote in public and even now it is disturbing. I was naive when I started writing as a nurse for this newspaper. He believed that everyone involved in health care wanted all patients to receive the best possible care, and that emphasizing problems would allow them to be resolved. Instead, The administrators accused me of “making the hospital have a bad reputation.” And while I scrupulously adhered to federal privacy requirements, as I never named my hospital and tried not to identify staff members as much as possible, I finally received an ultimatum: if I wrote or spoke more, I would be fired.

The chief nurse at the hospital said what he wrote was affecting patient care and that several oncologists – who were never named and apparently did not want to meet with me – complained that they were unable to work as they wanted when I was in their flat. . This occurred after a series of intimidating meetings I had with the chief nurse and a corporate attorney. People who have not gone through a similar situation of corporate mistrust have no idea how stressful it is: I was a floor nurse who was repeatedly called to meetings, while my job was to care for very sick patients who were undergoing to bone marrow transplants. By the time I quit, I already had constant heart palpitations.

I kept this anecdote to myself because I did not believe that my individual problems with my employers mattered beyond my personal history. I was also concerned that I would be described as a “resentful former employee,” a label that could prevent me from going back to work as a nurse in Pittsburgh again. He simply had too much to lose.

However, the nurses and doctors who are being silenced now have too much to lose if they do not speak out. They do not want to infect their grandparents, partners, or children with coronavirus. They don’t want to infect their patients who don’t have COVID-19. They don’t want to lose their jobs, but they also don’t want to lose their lives.

The real question here is this: Why do they have to make a decision like that? Why are hospital systems issuing gag orders? And why, when complaints of lack of personal protective equipment or mismanagement of patients with COVID-19 arise, do hospital representatives so often deny everything, even when the evidence is overwhelming? Why are hospitals so willing to defend their own image, rather than their nurses, doctors, and patients?

An obvious explanation is money. Hospitals may be concerned that they are sued by patients or employees for negligence during the COVID-19 pandemic. There may also be regulatory issues that hospitals are concerned about violating, as that could lead to loss of revenue or threaten accreditation.

However, my experience suggests that restricting employee freedom of expression goes further and relates to the continued corporatization of American medicine. The gag orders and public relations-looking representatives who wage a political campaign are the product of corporate health care systems focused on their “brand”, on surpassing “competition” sales, and on generating as much money as possible. possible.

Controlling employees’ freedom of expression is the dark side of this marketing and that bias. The health system in which he worked was highly hierarchical, not only in the clinical setting, but also in how management related to staff. The information came in descending order. Questioning policies and practices was frowned upon, sometimes even when that questioning addressed patient safety. Not surprisingly, my former employer has issued gag orders for all staff during the pandemic. Clinicians who fear the virus and lack of sufficient protective equipment must now work in an environment where they also fear hospital administration.

The biggest problem with this Information tightness approach and focus on hospital brands is that maximizing healthcare income does not mean that patients receive the best possible care. The United States spends more on health care per person than any other industrialized country, but our patients generally do worse.

Silence is golden, they used to tell me when I was a child, which implied that not speaking has its own social value. In some situations that may be true, but not with the COVID-19 crisis. Patients, nurses, and doctors are dying. Bans on talking about your clinical needs can only increase the number of deaths, because those clinical needs are real. Frontline workers lack adequate supplies, lack testing for the virus, and continue to lose staff members who become ill.

But they do have courage and commitment and, in addition, they have their voices, full of compassion and indignation mixed. If the richest country in the world cannot care for its hospital workers, can we at least protect their freedom of expression? Their protest is a clear call for help in the midst of a dire emergency.

Theresa Brown is a member of the clinical faculty at the University of Pittsburgh School of Nursing and the author of The Shift: One Nurse, Twelve Hours, Four Patients ’Lives. (c) The New York Times 2020