My wife and I once canoed across a glacial lake. There were twelve people in our 30-foot canoe. To reach the shore of the Mendenhall Glacier, we had to paddle two miles across a lake. All twelve of us had to paddle together to reach the shore. But what if we had different goals? What if the right side of the canoe wanted to paddle east and the left side wanted to paddle west? We would go nowhere, locked in an eternal struggle of right-side vs. left-side. Much like a canoe, an organization will go nowhere unless all aboard have the same objectives.
Ostensibly, those of us who work in health care all have the same goal: the wellness of the patients we serve. We are paddling the canoe of health care towards the glacial shores of patient wellness. The mantra is repeated, day after day, in every health care organization across the land: We are here to serve the patient. But while doctors, nurses, and other professionals are almost always paddling toward the glacial shores of patient wellness, there are others in the canoe who are not. Hospital administration, steering from the back of the canoe, likes to pontificate about the majestic beauty of the glacier while subtly steering us towards the gold mine on the opposite shore. We are not paddling in the same direction.
As a seasoned health care worker I know this to be true. I have been to countless meetings wherein lofty words are spoken about our mission and our values, and then the focus immediately shifts to maximizing the bottom dollar. I have worked in hospitals where nursing administration sends passionate emails about patient care and then slashes staffing to unsafe levels. I have seen hospital administrators with seven-digit salaries ask why we need a $10-an-hour tech in critical care. I have seen million-dollar ad campaigns where hospitals boast about their cutting-edge technology and their passion for patients, while less profitable wards of the hospital crumble into a ruin of dust and vermin. The passion, as it turns out, only applies to those with deep pockets. At the end of the day, talk is cheap, and medicine is not. Administrators will gladly cut any corner they can to bump profits a tenth of a percent. They’d steal organs from patients and sell them if they could get away with it.
The upshot of all this, of course, is that we have a fundamental split in health care. Front-line health care workers are focused on taking care of those in need. Hospital administrators are focused on performing radical cashectomies on all patients. Health care workers want appropriate staffing levels, functional equipment, well-stocked supply rooms, and fair wages. Administration wants to suck money out of everybody and inflate their own wages. Administrators see those of us who care for patients as a cost center, not an asset. They are rowing for the gold mine, not the glacier. And until someone takes their oars away health care is going nowhere.
Benjamin Davison is a respiratory therapist.
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