Tonight's picture was taken on October 20, 2007. Mattie spent the day at this school's Fall Festival and came home with his face painted, hands with kid tattoos and all smiles. I will never forget snapping this photo or the memories we made on the school field with his new found friends. It seemed like just the beginning for us. Never realizing that childhood cancer was going to be introduced to our lives 9 months later.
Quote of the day: Disappointments are to the soul what a thunderstorm is to the air. ~ Friedrich Schiller
Today I went to Mattie's hospital to push one of our Snack and Item Carts around the pediatric units. Since Mattie died, his medical home has undergone all sorts of changes. Starting with a change in leadership! If you think one person can't affect a whole system, you are wrong. I have witnessed this first hand, with the leadership of the pediatric oncology program changing at the hospital, there has been a mass exodus of talent and patients. So much so that it doesn't seem or feel like the same place we lived for 14 months. I view this as another addition to our LOSS column, as the institutional knowledge of who knew Mattie is practically all gone.
Certainly the families I met today are very grateful for the Cart. One mom, who has been in-patient with her child for a long period of time told me she has wanted to meet me, to thank me personally for the cart. The cart makes her happy. I know when parents look at me now, they view me as an outsider who can't possibly understand what life is like for them. But of course I get it all too well and I know how receiving food, snacks, and items while living in a hospital setting is like winning the lottery.
Switching gears, someone sent me the article below from the Washington Post Health Section. I think it should give you pause when reading it, as it is hard enough having to be a patient, but imagine if you are hospitalized and your doctor or nurse is burned out from the work? I would go a step further and say this article applies to everyone working in a hospital setting, as I remember administrative staff, radiology staff and countless others we met when Mattie was hospitalized who truly forgot WHY they entered the helping profession to begin with. The problem with this is patients are vulnerable and we rely on our providers to be fully on, fully engaged, and fully with it when making decisions about our care. I have no answers for medical burnout, but I do know that no one should enter a hospital system, regardless of age, without a family or friend advocate. If you doubt what I am saying, read the article below!
Health-care system causing rampant burnout among doctors, nurses. by William Wan
Imagine a health-care system in which doctors and nurses are so exhausted and beaten down that many of them work like zombies - error-prone, apathetic toward patients and at times trying to blunt their own pain with alcohol or even suicide attempts.
That is what America's broken health care system is doing to its health workers, according to a 312-page report released Tuesday by the National Academy of Medicine, one of the country's most prestigious medical institutions. The report found that as many as half of the country's doctors and nurses experience substantial symptoms of burnout, resulting in increased risks to patients, malpractice claims, worker absenteeism and turnover, as well as billions of dollars in losses to the medical industry each year.
"It's a moral issue, a patient-care issue and a financial issue," said Christine K. Cassel, professor of medicine at University of California at San Francisco, who co-chaired the committee of experts that wrote the report. It is alarming and tragic, she and other committee members noted, that the system is hurting the very people we have put in charge of healing us as a society.
In recent years, as the medical community has grown increasingly alarmed over the problems of burnout, the proposed solutions have focused on increasing the resilience of individual doctors and nurses. "What this report is saying is that this is a systemic problem that requires systemic solutions," said Cassel, a former president of the American Board of Internal Medicine. "You can't just teach doctors meditation, yoga and self-care. We need big, fundamental changes."
The committee's experts - which included doctors, nurses, health executives and leaders in bioethics, neurology and pharmacy - spent 18 months wading through mountains of research on clinician burnout. They found that between 35 and 54 percent of nurses and doctors experience burnout. Among medical students and residents, the percentage is as high as 60 percent.
Symptoms, they said, include emotional exhaustion, cynicism, loss of enthusiasm and joy in their work and increasing detachment from their patients and the patients' ailments. The problem has been linked to higher rates of depression, substance abuse and suicide. The suicide rate among physicians, for example, is twice that of the general population and one of the highest among all professions.
Health-care workers are especially prone to burnout, the report found, because of the workload, pressure and chaos that they deal with each day. As the country's health-care system has become increasingly dysfunctional, the bulk of that dysfunction has landed on them - resulting in long hours, mounting paperwork and bureaucratic hurdles, fear of malpractice lawsuits and insufficient resources.
The problem often starts with a well-intentioned, perfectly reasonable law, explained co-author Vindell Washington, chief medical officer at Blue Cross and Blue Shield of Louisiana. That is turned into a regulation, which is interpreted and made into a policy, often taking the most conservative path possible for legal protection. "At every step, the original intent gets a little misinterpreted or picks up an unexpected effect," Washington said.
A law about patient privacy, for example, becomes a quirk on a doctor's terminal that ends their sessions every few minutes, requiring them to repeatedly log in throughout the day - adding frustration and burden to their days. Complex regulations on hospital reimbursement gives rise to a long list doctors must tic through in physical exams, even as they try to figure out what's ailing a patient, so hospitals can charge more or less based on the exam's complexity. "The problem is we're not workers in a factory making widgets," Washington said.
"It's incredibly inefficient, and the workload is unsustainable," said Liselotte Dyrbye, a doctor and researcher at the Mayo Clinic. "The system is built for billing and not taking care of patients."
Burnout is also expensive. One study cited by Wednesday's report, for example found it costs the medical system $4.6 billion a year. Some of that cost comes from doctors reducing their hours, quitting their jobs or leaving medicine altogether. With each doctor affected by burnout, the estimated average cost to the medical industry in America is roughly $7,600. Those numbers did not include the costs of increased medical errors, malpractice lawsuits and other doctors' having to pick up their burned-out colleagues' work.
That financial incentive is imperative, because alleviating burnout will require significant buy-in from federal regulators, insurance companies, medical schools and the country's health-care systems.
Wednesday's report outlined a hefty list of needed changes:
- Health-care organizations should create executive-level chief wellness officers to monitor and protect clinicians' well-being and develop IT programs to reduce repetitive and redundant paperwork.
- Medical and nursing schools should train students to deal with burnout. Federal and state regulators should identify and eliminate overlapping regulations.
- Medical licensure agencies should find ways for doctors to seek help without having it used against them, such as in malpractice litigation.
- Federal officials should develop a coordinated research agenda to understand the problem and how to alleviate it.
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