All That Altruistic Stuff

Oh...back in the swim...slowly, slowly.

Went to work today, sort of.

Since I am now "management" I am now being trained how to do that.

This takes the form of management classes, and these are a little startling. For example, today our management coach told us that the reason we do everything we do is....The Bottom Line.

"If you want to get something done, and someone asks you why, the only reason you are doing anything is to address the bottom line. Harsh but true. The hospital is a business, and you are here to help that business prosper." To underscore this point, he had us all take a dollar bill out of our wallets and put it on the table in front of us and stare at it all through that section of the talk. "There are other reasons--serving your fellow man, altruistic stuff, whatever, but the basic reason you're here is to make money."

I pointed out that, since this was ostensibly a "university" hospital, there might be other motivators--like ummmm....service to others? Research? Advancing knowledge? That the university was comprised of professionals who have their own codes of ethics and their own governing and licensing boards and that my reasons for being a nurse only peripherally concerned money. I also said, very nicely, that, if he were going to be giving this talk to nurses, he might be more careful about being so dismissive about all that "altruistic stuff."

"If you're a patient," I said "and your life and your pain is in someone else's hands, you'd better hope your nurse is sincerely more interested in making stinky, pooping, out-of-it you comfortable and well than in the bottom line. Not to dismiss it, but maybe there's a better way to phrase that so you honor the reasons we're in this. I know health care isn't your background--so maybe you're used to a different crowd." I smiled.

The death smile, my children and my staff call it.

All that altruistic stuff.

Yeah, all that.

And here's what so great about the people I work with. Two of them were with me--Lois and Elizabeth. Elizabeth is my age, has 5 children, and a husband dying of leukemia. She's a sup on the night shift, Lois is her core. Elizabeth was the first person ever to treat me like I knew something. "You have a very good head on your shoulders," she said. No one had ever told me that. Acknowledgement and trust. Big gifts to receive so late. We didn't get along at first. Then one night she came over to me and said, "Ok Patton, I was driving home the other day and thinking about something you said and I was thinking 'what an idiot' but then all the sudden, I realized what you meant, and I just want you to know...I get you. I get it." And then everything was okay from then on.

So I sort of launch into this in class, and my two coworkers, instead of hiding their heads in their hands and pretending not to know me, nod and say, "yeah, that's right."

The only things that makes life worth living are the things that can't be measured in a bottom line. The only things that make my job worth doing aren't on the balance sheet. It's cliched but true.

No bottom line for sitting next to someone and holding their hand instead of restraining them, even though you could get more work done if you did. No bottom line for staying late and letting your staff vent--about patients, about other staff. No bottom line for being the one who sits with the parents after the docs have told them the news about their kid, no bottom line for doing the very basic work of loving your fellow man.

The rest of the class was good, so I guess it wasn't a total waste.

Oh, it's a tricky little swamp to navigate, this world, isn't it?

That's my 1/2 hour.