Healthcare Hero Quotes

By treating patients like customers, as nurse Amy Bozeman pointed out in a Scrubs magazine article, hospitals succumb to the ingrained cultural notion that the customer is always right. “Now we are told as nurses that our patients are customers, and that we need to provide excellent service so they will maintain loyalty to our hospitals,” Bozeman wrote. “The patient is NOT always right. They just don’t have the knowledge and training.” Some hospitals have hired “customer service representatives,” but empowering these nonmedical employees to pander to patients’ whims can backfire. Comfort is not always the same thing as healthcare. As Bozeman suggested, when representatives give warm blankets to feverish patients or complimentary milk shakes to patients who are not supposed to eat, and nurses take them away, patients are not going to give high marks to the nurses.

This was clear less than thirty minutes into the speech, when—as I debunked the phony claim that the bill would insure undocumented immigrants—a relatively obscure five-term Republican congressman from South Carolina named Joe Wilson leaned forward in his seat, pointed in my direction, and shouted, his face flushed with fury, “You lie!” For the briefest second, a stunned silence fell over the chamber. I turned to look for the heckler (as did Speaker Pelosi and Joe Biden, Nancy aghast and Joe shaking his head). I was tempted to exit my perch, make my way down the aisle, and smack the guy in the head. Instead, I simply responded by saying “It’s not true” and then carried on with my speech as Democrats hurled boos in Wilson’s direction. As far as anyone could remember, nothing like that had ever happened before a joint session address—at least not in modern times. Congressional criticism was swift and bipartisan, and by the next morning Wilson had apologized publicly for the breach of decorum, calling Rahm and asking that his regrets get passed on to me as well. I downplayed the matter, telling a reporter that I appreciated the apology and was a big believer that we all make mistakes. And yet I couldn’t help noticing the news reports saying that online contributions to Wilson’s reelection campaign spiked sharply in the week following his outburst. Apparently, for a lot of Republican voters out there, he was a hero, speaking truth to power. It was an indication that the Tea Party and its media allies had accomplished more than just their goal of demonizing the healthcare bill. They had demonized me and, in doing so, had delivered a message to all Republican officeholders: When it came to opposing my administration, the old rules no longer applied. —

My Struggle (Sonnet 1500) My struggle is to build a world, where gestapo, mi6, cia, raw, all are history; where thieves aren't glorified as heroes, invasion isn't sugarcoated as security; military is found only in books of history, where guns are displayed in museum as relics; nukes are just defense against celestial threat, where green sources power all things electric; where it's illegal to amass limitless wealth - food, housing, education, healthcare, are free; where no one can be politician without license, where citizens listen to experts, not celebrity. My struggle is to build a world, where human rights is a human issue, not legal one; where equality is not a belief, but the norm - where human is neither ape nor robot, but human.

The kinds of change that come from rapid process improvements are essential but are only the first steps of a lean journey. The core work of the transformation is changing the culture—changing how we respond to problems, how we think about patients, how we interact with each other. This is an issue not only in healthcare organizations; we have also seen manufacturing, service companies, retailers, and government agencies all struggle with the same issues. When lean thinking goes only skin deep and management does not change, improvements cannot be sustained, and savings never quite hit the bottom line.

Knowing this, I have watched with great interest as Kim Barnas and her team at ThedaCare hospitals in Wisconsin worked at transforming their culture by redesigning the system of daily management. After two years of experimentation, discussion, and study, they found a more deliberative approach to leading a lean healthcare system. By changing the expectations of what managers and frontline supervisors actually do each day, Kim and her team pushed the roots of lean deeper into the organization. This encouraged new ways of thinking, which led to new behaviors. Instead of adding continuous improvement to the list of manager’s duties, improvement became the organizing principle of their work. Thus, a new management system emerged and it was clear that this was the secret sauce that so many had been seeking. Kim discovered that changing a leader’s work content changed the leader as well. From frontline supervisors to top executives, new management duties encouraged everyone to become more respectful, improvement focused, and process orientated. Instead of managing by exception—running after today’s unique emergency—they fixed processes. They standardized processes. In doing so, more improvements to clinical processes remained in place. Projects initiated by frontline caregivers were aligned with the hospital’s major initiatives and relevant to the unit or clinic. Continuous improvement became the working method instead of the extra task.

Figure 7. New Improvement Opportunity form

A solution to many of the issues in this book, and one that would go a long way toward fixing American healthcare, is relatively clear: Treasure nurses. Hire more. Nurses are perennially the number-one most trusted profession in America, according to an annual Gallup poll rating honesty and ethical standards. They are called to an exhausting commitment in which mortals must sustain an unwavering grace at the edge of life and death, almost divinely slowing heartbeats, hurrying them along, or pounding them back into existence. Nurses are exceptional. So why aren’t they treated accordingly?

A lack of COVID-19 personal protective equipment (PPE) is burying our healthcare heroes.

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