The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital

by Alexandra Robbins

  more time to spend with patients and charge less for their services. “28 States Consider Expanding Nurse Practitioners’ Duties,” American Health Line, April 14, 2010.

  “essentially the same” health See, for example, Carla K. Johnson, The Virginian-Pilot (Norfolk, VA), April 18, 2010. See also “Research from Drs. Linda Aiken, Carole Estabrooks, and Others Have Established a Clear Link Between Higher Levels of Nursing Education and Better Patient Outcomes.” Doctor of Nursing Practice (DNP) Talking Points. American Association of Colleges of Nursing, October 2009.

  nineteen states and the District of Columbia Interview with AANP spokesperson. In these areas, NPs can “evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments—including prescribe medications—under the exclusive licensure authority of the state board of nursing,” according to the American Association of Nurse Practitioners. Other states require oversight of NPs.

  Nurse-owned practices . . . expected to grow. Peter McMenamin, “In 2011 in Every State Thousands of Medicare F-F-S Beneficiaries Were Treated by an APRN,” ANA NurseSpace, January 2, 2013.

  looming physician shortage in the United States by 2020 See, for example, Chen May Yee, “A Doctor and a Nurse, All in One Package,” Star Tribune (Minneapolis), April 27, 2008. See also Samuel Weigley et al. “Doctor shortage could take turn for the worse.” 24/7 Wall St. usatoday.com, October 20, 2012.

  “The medical profession . . . in the United States.” Interview.

  “code of conduct” . . . managing those behaviors. The Joint Commission Sentinel Event Alert 40.

  “moderate improvement” Alan H. Rosenstein and Michelle O’Daniel, “A Survey of the Impact . . .” See also Julia Edwards.

  In 2005 . . . quarter of these nurses. David Maxfield et al. “The Silent Treatment: Why Safety Tools and Checklists Aren’t Enough to Save Lives.” VitalSmarts, AORN Journal, and AACN.

  only 41 percent . . . “greatest negative impact.” Ibid.

  TJC continues to receive “Workplace Bullies Can Undermine Safety,” Occupational Health Management, March 1, 2010.

  “there are still large, disconcerting” Alan H. Rosenstein and Michelle O’Daniel, “A Survey of the Impact . . .”

  “Tempo!” “Workplace bullies can undermine safety.”

  red phones at each nurses station Interview.

  Nurses in a New Brunswick, Canada, hospital . . . in support. “Needed: Happy Endings in Workplace Bullying Cases,” The Times & Transcript (New Brunswick), May 13, 2010. Code Pink in many hospitals refers to infant or pediatric abduction.

  “Code White” to the same effect. “Workplace Bullies Can Undermine Safety.”

  “nurse-friendly” hospitals See, for example, Terry Simpson, “Transplant or Hospice,” Yourdoctorsorders.com, January 29, 2012. Emphasis in “doctor-unfriendly” is mine.

  “it affects my entire day.” Interview.

  “We train, hire. . . . They are pit crews.” Atul Gawande, “Commencement Address at Harvard Medical School,” May 26, 2011. Accessed at newyorker.com.

  “the issue boils down to . . . excellent patient care?” Guest blog by the anonymous nurse of Those Emergency Blues (blog), on KevinMD, February 25, 2012. This post was in reference to a specific case against a nurse who was allegedly fired after a confrontation with a doctor; however, the quote applies to the larger issue of disrespect between the professions. I did not discuss that specific case because there were some questions as to the credibility of the sources.

  of the top-ten media-generated See Jacinta Kelly, Gerard M. Fealy, and Roger Watson, “The Image of You: Constructing Nursing Identities in YouTube.” Journal of Advanced Nursing 68, no. 8 (August 2012). Also see, for example, “Study: YouTube Gives Mixed Messages About Nursing.” Nurse.com, July 17, 2012. Similarly, a “study of 280 films, produced between 1900 and 2007 from across the world, showed that 26 percent depicted nurses as sex objects,” in Nursing Times, October 2008.

  2010 Dr. Oz show See, for example, Staff and Wire Reports, “Dr. Oz’s Dancing ‘Nurses’ Draw Nurse Group’s Ire.” The Oklahoman (Oklahoma City), December 10, 2010.

  nurses protested Dr. Phil See, for example, Bob Groves, “An Image Problem, from TV to Silver Screen; Nurses Want Respect from Pop Culture,” The Record (Bergen County, NJ), May 6, 2007. See also, “Dr. Oz’s sexy ‘nurse’ backup dancers,” The Truth About Nursing, December 6, 2010. See also Susan Campbell, “Does Your Nurse Dance/Dress Provocatively?” Courant.com. December 8, 2010.

  waitresses dressed as sexy nurses See, for example, Larissa Liepins, “World’s Weirdest Restaurant Premieres Tonight on Food Network,” The Daily Gleaner, (New Brunswick) April 4, 2012.

  a sexy nurse costume with white fishnets See, for example, Sonya Padgett, “Hangover Heaven Doctor Treats the Buzz Kill on Strip,” Las Vegas Review-Journal, April 14, 2012.

  In England, a bus company advertised See, for example, Flora Drury, “Sexy Nurse Sparks Fury on the Wards,” Worcester News, March 16, 2010; “Sexy Nurse Ad On Bus Causes Uproar,” NSW Nurses’ Association, May 3, 2010; “British Nurses: We’re Not Sex Objects, Either,” Adweek, March 18, 2010.

  “You will be motivated . . . emergency department.” See, for example, “Hospital Advertises for ‘TV Series-Hot’ Nurses.” Asian News International, February 22, 2012. The Internet ad used the term “TV-series snygga” after a satisfied patient had praised the hospital with those words. Translated to English, “snygg” or “snygga” is the equivalent of “hot” or “good-looking.” See also “Swedish Hospital Seeks ‘Hot’ Nurses for Summer Employment,” The Digital Journal, February 22, 2012.

  largest Emergency Care Unit in the Nordic region Ibid.

  scrubs that might be stained with blood, urine Interviews.

  “We’re sweaty and smelly” Interviews.

  Certified nursing assistant Author correspondence with Erin Gloria Ryan.

  “Nothing sexier . . . bowel movements on a chart.” Comment following Margaret Hartmann, “BADVERTISING: Hospitals Are Obviously Full of Sexy Nurses!“ Jezebel.com, March 18, 2010.

  “Some nurses do fit . . .” Interview.

  “lecherous old perverts” Interview.

  “People are happy to sexualize . . . ” Claire Lomas, “Sexualising Nurses Could Lead to Attacks on Staff, Warns Unison,” Nursing Times, March 23, 2010.

  In 2010, a Dutch nurse union . . . sexually gratifying him. Ben Berkowitz, “Nurses’ Union: Care Does Not Include Sex.” Reuters, March 11, 2010.

  The man . . . nurses had done the same. News Staff. “Sex Is Not Healthcare, Union Says,” November, 3, 2010.

  When the student refused . . . unfit for the job. Ben Berkowitz, Reuters.

  “I’ve got to get myself a nurse in Holland.” Ronan McGreevy, “Nurse Stereotypes as Sex Objects Persist on Internet, Study Finds,” The Irish Times, July 24, 2012.

  union launched a campaign . . . front of her face Victoria Thompson, “Sexy Nurses: Tongue in Cheek or Demeaning and Gratuitous?” Nursing Times, March 19, 2010.

  patients “are free to ask. You are free to refuse.” Ibid.

  87 percent of them said yes. Interviews.

  “actually living Grey’s Anatomy” Interview.

  “Hospital life is . . . time to eat” Interview.

  “Some places . . . stressed-out people together.” Interview.

  Nurses have gotten intimate in on-call rooms Interviews.

  equipment lockers . . . patient rooms Interviews.

  offices Interviews.

  parking lots Interviews.

  “heady” feeling Interview.

  “Sexual exploits . . . call room at night Interview.

  “It’s like any kind of trauma” Interview.

  they hook up with Interviews.

  “I wanted to be” Interview.

  “residency was a
ll-consuming . . .” Interview.

  A camera captured a nurse giving oral sex Interview.

  “She became a joke” Interview.

  Louisiana oncology nurse accidentally Interview.

  “Usually it only causes issues . . . ” Interview.

  nurses caught having sex . . . The Herald (Glasgow), “Nurses in Sex Session Suspended,” January 30, 1997.

  When a resident and a nurse were caught Interview.

  “As Britons, we are obsessed . . .” Robert Gore-Langton, “Carry on Nursing our Saucy Fantasies.” The Express, March 4, 2008.

  When a group of nurses posed. . . .“practice into question.” “Sexy Nurse Calendar Causes Complaints to NMC,” Nursing Times, October 28, 2008.

  posed nude for a charity . . . Rob Harteveldt, “The NMC Should Focus on Things that Really Matter - Not Sexy Nurse Calendars,” Nursing Times, February 3, 2009.

  knowingly rented out a ward . . . “Big Budget” Porn Film Shot in London Hospital. BBC News, July 6, 2010.

  Lord Benjamin Mancroft . . . “promiscuous.” “Mancroft’s House of Lords Speech in Full.” Bath Chronicle, March 6, 2008. See also, for example, Morag Turner, “U.K. We’re No Angels,” The Express, March 8, 2008; Jenny McCartney, “Nurses: The Angels Who Fell from Grace?” Sunday Telegraph (London), March 2, 2008.

  His evidence was . . . “Mancroft’s House of Lords Speech . . .”

  “sexual boundaries” guidelines . . . dating patients. See, for example, “Guide to Patient Relationships,” The Times (London), January 22, 2008.

  One in six U.K. nurses . . . “Nurses Risk Breaking Rules on Relationships,” Nursing Times, February 25, 2008. See also, for example, Morag Turner.

  A British nurse received . . . they had sex. “Nurse Had Illicit Affair with Heart Op Patient.” Daily Mail (London), July 29, 2010.

  between 1999 and 2009 . . . “constitutes sexual misconduct.” “Practical Guidelines for Boards of Nursing on Sexual Misconduct Cases.” National Council of State Boards of Nursing, 2009.

  Oklahoma Nursing Board . . . broke up with him. Nolan Clay, “Nurse Loses License Over Patient Sex,” The Oklahoman, January 16, 2011.

  Mayo Clinic . . . relationship was consensual. Warren Wolfe, “Male Nurse’s Sex in Psych Ward Didn’t Break Rules,” Star Tribune, August 3, 2009.

  In Australia, a sixty-one-year-old . . . “ethical relationship.” Julia Medew, “Nurse Faces Disciplinary Action Over Relationship,” The Age (Melbourne), February 18, 2006.

  Nurse and Midwifery Council investigated “NMC to Investigate Nurse Accused of ‘Inappropriate Relationships,’” Nursing Times, March 11, 2010.

  “Cancer nurse bedded . . . ” John Kay and Alex Peake, “Cancer Nurse Bedded Three Victims’ Husbands,” The Sun, March 10, 2010.

  divorced mother of two . . . his wife passed away. See, for example, Andrew Levy, “Macmillan Nurse Sacked for Having ‘Affairs’ with Patients’ Widowers Reveals Her Love for Man Whose Wife Died Last Year,” Daily Mail, March 11, 2010.

  Some states, including Maine “Disciplinary Action and Violations of Law,” Department of Professional and Financial Regulation, State Board of Nursing, Chapter 4.

  Arizona R4-19-403, Unprofessional Conduct, “Laws & Rules,” Arizona State Board of Nursing.

  Washington State Washington Administrative Code, Title 246, Section 246-840-740.

  Three weeks . . . sided with the hospital. Ed Canning, “Employee-Client Relationships are Tricky,” Hamilton Spectator (Ontario, Canada), May 6, 2006.

  Lori Dupont tried to end . . . harassed her at work. See, for example, Doug Schmidt, “Daniel Turns to Blackmail,” Windsor Star (Ontario), November 9, 2006. Schmidt covered this story extensively.

  When several nurses complained . . . Doug Schmidt, “Daniel’s Return Unsettling,” Windsor Star, November 10, 2006.

  nurses took it upon . . . bent over to speak to him Ibid.

  broke a nurse’s finger Doug Schmidt, “Daniel Turns to Blackmail.”

  quiet weekend day . . . then killed himself. Doug Schmidt, “A Killing At Hôtel-Dieu: How a Workplace Romance Became a Deadly Obsession.” Windsor Star, November 4, 2006.

  “an unforeseen event” Doug Schmidt, “Why?: Family, Friends Ask: Could Nurse’s Death Have Been Prevented?” Windsor Star, November 11, 2006.

  Dupont’s family and coworkers . . . Colin Johnston observed. Ibid.

  when Daniel was pursuing Dupont . . . “problems.” Doug Schmidt, “Dupont ‘Relentlessly’ Pursued,” Windsor Star, November 7, 2006.

  Chapter 3

  “The nurse takes appropriate” “The ICN Code of Ethics for Nurses.” International Council of Nurses, Geneva, Switzerland, 2006.

  “Almost every single” Interview.

  “If I had a dollar for every horny . . . ” Interview.

  ER nurse in Sacramento . . . Interview with Dansby.

  Medics brought in . . . able to revive Interview with Dansby. See also Jessica Garrison and Molly Hennessy-Fiske, “Violence Afflicts ER Workers; Incidents Often Go Unreported, but Some Evidence Points to a Growing Problem,” The Los Angeles Times, July 31, 2011.

  Dansby left the patient . . . off of her. Interview with Dansby.

  Shaken and injured . . . assailant is still free. Ibid.

  When Dansby told her department Jessica Garrison and Molly Hennessy-Fiske; confirmed with Dansby.

  Afraid of losing her job . . . “that hospital door.” Interview with Dansby.

  “ward rage” See, for example Torri Minton, “Cry for Health: Poor Working Conditions Driving Nurses out of Hospitals,” San Francisco Chronicle, May 20, 2001.

  On the rise See, for example, Staff Report, “Not in a Day’s Work,” National Nurse, November 2010; “Preventing Violence in the Healthcare Setting.” Sentinel Event Alert 45, The Joint Commission, June 3, 2010.

  nine out of ten . . . “Emergency Department Violence Surveillance Study.” Emergency Nurses Association Institute for Emergency Nursing Research, November 2011. See also Jessica Gacki-Smith et al., “Violence Against Nurses Working in U.S. Emergency Departments,” Journal of Nursing Administration 39, no. 7/8 (July/August 2009); and Paula Zahn, “Nurses Under Attack,” Paula Zahn Now, CNN, July 11, 2007.

  a quarter of ER nurses . . . past three years. “Emergency Department Violence Surveillance Study”; see also Jessica Gacki-Smith et al.

  every nurse they know Interviews.

  Experts have attributed the rise . . . crime or accident scenes. Interviews; see also, for example, “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers.” U.S. Department of Labor: Occupational Safety and Health Administration; “Workplace Violence: Assessing Occupational Hazards . . .”; Jessica Gacki-Smith et al.

  third-most dangerous profession An examination of the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses reveals that nurses rank behind only police officers and correctional officers in the number of nonfatal assaults that resulted in days off from work due to illness or injury. A separate set of BLS data that more explicitly specifies professions shows that the assault incidence rates (again resulting in days off from work due to illness or injury) for RNs, LPNs, and licensed vocational nurses rank behind only health technicians and health aides.

  “nurses are nearly twice as likely . . .” Lois Berry and Paul Curry, “Nursing Workload and Patient Care,” Canadian Federation of Nurses Unions, 2012.

  “the actual number . . .” “Guidelines for Preventing Workplace Violence . . .”

  sixteen times more likely . . . See, for example, “Workplace Violence in Healthcare Settings,” Center for Personal Protection and Safety, August 2011; see also Alex Rose, “Protection Sought for Healthcare Workers,” Delaware County Daily Times, March 2, 2011.

  In 2012, Douglas Kennedy . . . See, for example, Ann Curry and Carl Quin
tanilla, “Douglas Kennedy Speaks out for First Time Since Confrontation with Two Nurses,” Today, April 13, 2012.

  hospital had not discharged . . . See, for example, “Statement on Northern Westchester Case Does Not Address Assault on Nurses,” Targeted News Service, April 4, 2012.

  concerned maternity nurses . . . “through the air.” Ibid.

  Kennedy went downstairs . . . welfare of a child. Ibid.

  superiors told them not to report . . . Interviews.

  Nurses who don’t keep . . . See, for example, Elizabeth Simpson, “Danger in the ER Health,” Virginian-Pilot (Norfolk), April 13, 2012; August Gribbin, “Hospital Health Hazard,” The Washington Times, February 10, 2002.

  Tammy Mathews . . . hospital fired her. Lauren Auty, “Nurses Face an Epidemic of Violence in Hospitals,” Philly.com, December 1, 2011.

  between 65 and 80 percent . . . “Workplace Violence in Healthcare Settings,” Center for Personal Protection and Safety, August 2011; Emergency Department Violence Surveillance Study, November 2011.

  “incidents of violence . . .” “Guidelines for Preventing Workplace Violence . . .”

  a Massachusetts judge . . . Elaine Thompson, “Hurt Healing Hands: Effort to Protect Health Workers,” Telegram & Gazette (Massachusetts), April 8, 2010.

  hospitals that encourage nurses . . . See, for example, Emergency Department Violence Surveillance Study, August 2010; “ED Nurses Seeking Protection from Violence,” Hospital Employee Health, July 1, 2010; Emergency Department Violence Surveillance Study, November 2011.

  “Victims are often untrained . . .” “Preventing Workplace Violence,” American Nurses Association Occupational Health and Safety Series, 2006.

  In 2007, a drug-seeking patient . . . “actually getting worse.” JoNel Aleccia, “Swearing, Spitting, Choking: ER Nurses Endure This and More.” Vitals, msnbc.com, November 9, 2011. Nurses’ tolerance is expected to be even higher than patients’ tension. A New York ER nurse said that a patient scratched her, bit her, spit on her, and hit her so hard that her jaw broke. The attacker later told her, “I’m sorry. I was tired of waiting.” “Workplace Violence in Healthcare Settings,” Center for Personal Protection and Safety, August 2011.