Hey, What Happened to Florence Nightingale?

Saturday afternoon with Nurse Ratched

It was early Saturday afternoon in Scottsdale Memorial-North Hospital.

Saturdays are quiet times in hospitals. The operating rooms are closed down. The business office is shut. The doctors make brief morning visits. It's a time when the real power of the hospital shifts into the hands of minor bureaucrats and bean counters.

It's a time for them to cut costs by reducing services. Normally, they can do it without fear of criticism. After all, who is there to complain?

I was a patient because I'd undergone minor surgery at Scottsdale North the day before. It was the third time I had undergone the procedure at Scottsdale North so I'm not speaking from the standpoint of one panicked by a first exposure to a hospital.

By Saturday, the anesthesia had worn off and I was being lulled by painkillers. I was looking forward to a few quiet hours of watching the National Football League play-off games.

But all that suddenly changed.

Nurse Ratched entered the room swiftly. She was clearly in a state of high dudgeon. Nurse Ratched is not her real name. "Nurse Ratched" was Jack Nicholson's nurse in One Flew Over the Cuckoo's Nest, the one who pushed for him to be lobotomized because he wouldn't cooperate.

"You're moving out of this ward right now," the nurse ordered, her voice crackling with authority. "We're transferring all eight patients on this floor up to the third floor. We have just five minutes to get the job done."

"Nurse Ratched" turned on her heel and moved swiftly out of the room. A minute later, she returned with an attendant. The attendant, a tiny girl who seemed very nervous, was pushing a small metal wheelchair.

The two of them bundled me and all the tubes and metal stands together and we headed out the door and to the elevator.

"What about my clothes?" I asked.

"What clothes?" demanded Nurse Ratched.

"They're hanging in the closet," I said.

The nurse shrugged. She sped away for a minute. Quickly, she returned with a medium-sized plastic bag. She went to the closet, opened it, and with a few deft movements, had rolled my clothes into a solid ball and stuffed them into the bag.

Then, we were racing down the hallway to the elevator. There was so much haste that I felt something very important must be at stake. I felt like a hapless Phileas Fogg, being aided by a tribe of wild Indians to save a few seconds so he might still make it around the world in eighty days.

It wasn't easy to get my chair and the two pieces of apparatus into the elevator, but with much banging and pushing, the task was finally accomplished.

In almost record time, I was placed in another bed on the third floor of Scottsdale North. All around me I could hear the banging and the shouting as other nurses and attendants hauled their patients to new quarters.

Someone must have been holding a stopwatch on them to make sure they finished the transfer in the allotted five minutes.

I was placed on the bed and put my head on the pillow. Nurse Ratched was heading out the door. But then she realized something had been forgotten. She still had my clothes.

She carried the plastic bag over to the closet. She dumped it on the floor and walked out.

I have an idea for the management people at Scottsdale Memorial-North Hospital. The next time you prepare one of those slick four-color advertising brochures you might mention how patients are made to feel at home. Tell your future patients how homey things are and that there is no great ceremony employed.

Scottsdale North is a hospital that has benefited greatly in recent months because of an accident of geography.

The Mayo Clinic opened a few miles to the east and the Mayo doctors bring their patients who need operations to Scottsdale North.

John Eckstein is a world-class internist. Surgeons like Thane Larsen and Todd Chapman are among the best in the field.

What Scottsdale North hasn't come close to proving, however, is that it's capable of being a hospital that can match up with Mayo.

It is a small-time hospital not ready in many ways to perform sophisticated services. The only reason for closing down the ward to which I'd been assigned and shifted from so abruptly was strictly to cut down on the number of nurses who would work the next shift.

When I complained about the food, certainly the worst I've encountered in many trips to various institutions, I received a visit from a dietitian.

I tried to talk to her about food that reached my room absolutely devoid of any distinguishing taste.

She smiled.

"Perhaps you'd like me to give you some instructions about proper eating habits," she said.

"No," I said, "I've been avoiding instructions from people like you all my life. I won't change that policy now."

I also received a visit from a supervising nurse who listened politely to the account of the peremptory transfer.

She politely explained that those things were unfortunate.

Unfortunate? Why not try descriptions like callous and negligent, or incompetence, complacency, insensitivity and all-around stupidity?

Why, for example, is it necessary to wake patients from a deep sleep at 6 a.m. the day after surgery to demand they stand on a scale and be weighed and measured?

Why is it necessary to be asked the same questions about previous illnesses time and again? What happens to the list of questions you answered the day before or on your previous visit? What happens to all those computer records?

Who decreed that sleeping patients must be awakened in the middle of the night so that a thermometer can be stuck in their mouths and that they can have their blood pressure taken?

Intensive care is understandable for critically ill patients. The same kind of treatment for other patients is merely intentional harassment.

There are severe nursing problems. Some nurses are excellent. A few are head cases. A few more seem to be terminally stupid. But, overall, there is no esprit de corps.

Many nurses at Scottsdale North are merely day workers filling in for an extra day's pay. No wonder so few seem to care.

One thing's certain.

When I get the bill for my five days at Scottsdale North, it will be enormous.

There will be no deduction for the wild ride stemming from the cost-cutting transfer of patients that sent my blood pressure up sixty points.

There will be no refund because in five days there was not a single item of food that was edible.

This enormous hospital bill can be paid only because of two separate hospitalization policies carried by both my wife, Christina, and myself and both of our employers.

Something is wrong with the hospital system all right. Everyone keeps paying more and more for less and less.

We are left with a hospital system that has lost touch with its own soul.
Like Howard Beale in the film Network, I'm here to tell you to "go to your nearest window and yell as loud as you can, `I'm mad as hell and I'm not going to take it anymore!'"

Please don't think I'm complaining because I still don't feel well. The procedure performed by Dr. Larsen worked just fine. The recovery has been miraculous.

I feel better than I have in years.

Now, I can't wait to pick up the scent of those two legendary mountebanks, Dennis DeConcini and John McCain.

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