Sunday's episode of 60 Minutes included an interview with nurses who directly cared for the first U.S. Ebola patient, Thomas Eric Duncan, in the emergency department or ICU at Texas Health Resources Presbyterian Hospital.
Say what you will about the insufficient standards originally laid out by the CDC or criticize hospital leaders for not following up on the concerns of nurses… it's easy to see that the problem is NOT the nurses (I never thought it was).
Nurses are wonderfully caring and compassionate. They occasionally find themselves in the situation to be very brave. So often in healthcare we have great people working in a bad system.
Watch the piece below, if you can (or read a transcript).
The story throws the CDC under the bus (pointing out how the protective gear standards were not appropriate… and later changed) and they don't delve into the role of hospital leadership, communication, or training.
Host and reporter Scott Pelley says:
Contrary to reports that the hospital bungled the response, the story the nurses tell sounds more like a heroic effort to stop an outbreak.
Bravery and bungling can co-exist. The focus, here, is on the nurses. We can celebrate the nurses, yet still ask questions about “the system.”
Nurses were understandably concerned about a case of Ebola. They realized they were risking their lives. But they stepped up anyway.
Richard Townsend: People were allowed to request not to be tasked with his care.
Krista Schaefer: We asked for volunteers. Everyone volunteered.
Scott Pelley: Everyone was a volunteer, everyone that was there wanted to be there?
Krista Schaefer: Every person, housekeeping, respiratory, physicians, nurses.
Nurse John Mulligan described the scene:
John Mulligan: And we held his hand and talked to him and comforted him because his family couldn't be there.
Scott Pelley: You held his hand through the spacesuit?
John Mulligan: I did. He was glad someone wasn't afraid to take care of him. And we weren't.
Mulligan added:
[Duncan] was heavily sedated and he had tears running down his eyes, rolling down his face, not just normal watering from a sedated person. This was in the form of tears. And I grabbed a tissue and I wiped his eyes and I said, “You're going to be okay. You just get the rest that you need. Let us do the rest for you.” And it wasn't 15 minutes later I couldn't find a pulse. And I lost him. And it was the worst day of my life. This man that we cared for, that fought just as hard with us, lost his fight. And his family couldn't be there. And we were the last three people to see him alive. And I was the last one to leave the room. And I held him in my arms. He was alone.
That's incredibly loving and compassionate. It's hard not to get choked up about that.
Moments like that are why my Dutch friends have referred to their Lean program at St. Elisabeth Hospital as “Loving Care.” It's not just a slogan. It's about using Lean methods to free up staff time. Eliminating waste isn't a matter of cost cutting… time spent not searching for supplies or equipment means time that can be used to be with the patients… to answer their questions… to be compassionate.
Lean isn't about cold, ruthless efficiency. We can use Lean to create a more loving environment. It's a beautiful thing.
It's not about “treating Ebola” — it's about “treating the patient.”
Thanks to the wonderful nurses at Presbyterian… and hospitals everywhere for what they do. I'm driven to make the workplace safer, more engaging, and less frustrating for all of you… so you can be freed up to provide the best possible patient care and to be involved in improving how that care is provided, through Kaizen.
There's also this “bonus video”:
Unlike Briana Aguirre, the nurse who complained that leaders didn't quickly address her questions and concerns about skin being exposed, the nurses here say leaders ordered whatever they needed as soon as they asked for it “despite what the recommendations were.” One nurse says they developed new, better standards “with the CDC.” Maybe it was in spite of the CDC…
Emory University Hospital sent two nurses there to help, which I hadn't seen reported previously.
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