January 11, 2022 • 46 mins
Nurses have been on the front lines throughout the pandemic, often overworked, underpaid, and without resources to address the mental health challenges that have come from two years on the front lines. In this episode, host Roy Wood Jr. sits down with Daily Show associate producer Madeleine Kuhns and doctor of nursing, Dr. Christopher Friese to discuss why nurses are so burnt out, how hospital administrators can help, and why the solutions need to be better than pizza parties and banging on pans at 7 p.m.
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Episode Transcript
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Speaker 1 (00:07):
Hey, welcome to Beyond the Scenes. Look, this is the
podcast that's like, you know, you know, you know what
this podcast is. Like. This podcast is that big gas
bag of Eminem's that you dump into your popcorn right
as the movie starting. So did you get a little
bit of sweet along with that butter re salty savory? Right?
It's that contrast, you know, That's what this podcast is.
(00:29):
You know, it's the goodness that you didn't even know
you needed until that weird kid Marcella's did it that
one time and now you can never go back. There
was a kid one time he put he put his
French fries in his ice cream and I was like,
that is disgusting, And then I tasted it. I was like,
that is brilliant. I need to figure out where the
kid is these days. Anyway, speaking of my failing health
(00:49):
due to an unsustainable diet of ice cream and French fries.
Today we are diving into the latest debacle to hit
the American health care system, the nursing crisis. Give him
a clip, nurses understanding me pistol right now. And no
matter how dedicated you want to a profession, everyone has
a breaking point. And nearly two years into serving on
the front lines of this war, a lot of them
(01:11):
are starting to update their LinkedIn's. Some hospitals experiencing critical
staffing shortages, as frontline workers say they feel like they're underwater.
Survey during the pandemic found that six of intensive care
nurses are burned out burnout, stress grueling hours. There are
multiple reasons career nurses are choosing to leave. Mississippi has
(01:34):
at least two thousand fewer nurses than it did at
the beginning of the year. In Kentucky, more than twenty
hospitals report critical staffing shortages. In hard hit New York,
there was a four increase in nurses looking for new jobs.
We are joined today to break down this Daily Show
segment with number one Daily Show associate producer. You've heard
(01:55):
on this wonderful program before, Madeline. Coon's Madeline. How are
you doing today? I'm good, Roy, It's good to be back.
Always a pleasure. What is this third? Fourth time? I
think it's third. I think I'm tied with CJ. Now
I don't know. It's it's all a blur. I'm just heady.
Also joining us on the program today is a longtime
(02:17):
nurse and nurse educator, a doctor of nursing, a doctor
of nursing, you know, just to show those physicians what's
what Dr Christopher Freeze. Dr Freeze, welcome aboard beyond the scenes.
It's great to be with you. Thanks so much for
having me. Thank you. And I know that the people
um listening cannot see this, but I want to acknowledge
(02:37):
how color coordinated your couches with the background in the
the your living space. There's a color um what's what's
the word, like a palette? The color story. That's yeah,
my girlfriend is the color story. Everybody's worried about books
in the background trying to impress people, but not you don't.
You got the turquoise contrasted with a little bit of
a brown. It's very it's very nice, very nice. Thank you.
(03:00):
We're going for a ten out of ten, so thank you. Well,
we'll see Room Raiders a bunch of assholes. They gave
me a six. They can kiss my sorry about that.
We're here to talk about things that are much more
upright and appropriate, Madeline. This segment that we did on
the Daily Show, we just played a little bit of
a piece of the original segment, but for folks that
that mystic give us a little bit of an overview
(03:21):
of what the segment covered up and how it came
to your attention to Yeah, so the pieces essentially, uh,
it's about how the crux of how we have a
critical national nursing shortage which is only getting worse. By
the way. It's not magically solved since we did this piece,
and a lot of that is due to nurses burning
(03:42):
out on the job. And this particularly why we did
it when we did earlier this year, is because it's
you know, after after I feel like the vaccines came
in and we were all, yeah, we have a vaccine,
the pandemic is over. Except well, we were going dining
nurses and all the healthcare workers were being thrown into
(04:05):
another pandemic, and that was the pandemic of the unvaccinated.
And the ridiculous and really like truly awful fact of
that is that unlike the first wave, when we were
all kind of dealing with something we couldn't control, this
one was completely preventable and it did not have to happen.
So then, as you were piecing this together for the show,
the thing we've talked about on this podcast in the
past about is how we can find an issue and
(04:28):
then you can find eight different aspects of this issue
to address. What were the ones that you all decided
to dial it in on and why I know that
on the one hand, we could talk about the mental
health part of it, but then you can also talk
about the staffing part of it, but then you can
also talk about the public negligence part of it. So
just how did you all, as you all were producing
(04:50):
and putting this piece together, how did you all decide
the hierarchy of important things to make sure it stayed
in the piece and didn't get edited out part of it?
I will say, I think the heart of the piece
that I really wanted to try to address in some way.
I'm not a nurse, but I've had some I've had
more interaction with the hospital system, I think than the
average Americans. So like when I was young, I was
(05:10):
in the hospital, I was hospitalized a lot for pneumonia.
And I'm definitely a product of my parents health insurance
and modern medicine and I am fine. But the you know,
one of the reasons I'm still here is because of
the you know, I mean fantastic doctors, but fantastic nurses.
So a lot of my earliest memories are of just
like nurses in that care and just like experiencing firsthand
(05:32):
what a difference like that level of like human care
makes like. Okay, So for example, um, I'm gonna go
off on an anecdote now that I thought of, But
when I was so, I was a young kid in
the hospital and they would always put these i vs
in my hands all the time, And as a kid,
I hated that because I wanted to play with my hands,
because you're when you're in the hospital for long time,
is actually kind of boring because you just not much
(05:52):
to do as a patient, not as a hospital worker,
as a patient, as a kid. Um, And when they
listened and they put the ivy in my foot, and
what you think would be hard because I wouldn't be
able to walk around, But what the nurses did is
they let me ride you like those long, big i
V polls. They would let me ride around the hospital
on those like the silver Surfer or something. And so
(06:15):
I think, when when I think back to that time,
I think it's something that could have been a very
scary memory is actually very warm, and that all of
that had to do with the level of care I received,
and so when I was looking for pieces and seeing
how nurses are being affected by COVID, there was a
part of me that remembered the level of care that
(06:37):
you can get wh nurses are able to do their
job versus what we're seeing happening now. And that's what
I started looking at, saying like, how can how how
can we tell that story? How can we show what
should be? And how can we show it is? Because
Dr Freeze, you know, when you look at healthcare in
the modern era in this country now, like it's not
just about knowing your job from a ticky technical I
(06:59):
v find the main standpoint you also, it seems that
the job of nurse is a little bit part sociologists
as well, where you have to be able to relate
to people. And I would even argue that there might
be a little small element of social work and trying
to just connect with people on a normal human basis,
But you have a lot of different confluences happening. What
(07:22):
do you believe are the primary challenges for nurses and
the health care system right now? Well, how much time
do we have right now? So first I want to
say that each and every day, nurses are delivering exceptional
care across the country. They are they are getting it
done for their patients technically, socially, physically. They are problem
(07:45):
solving behind the scenes there you know, I call it,
you know, part technical, part psychology, part air traffic controller,
and and that's the part that a lot of people
don't see. So a lot of excellent nursing care is
still happening. But we're on the brink, and we've been
on the brink for about almost two years now. So
when we think about the priorities, what I'm really worried
(08:05):
about is at some point our public health officials will
have a lower level of concern for COVID than they
do right now. They will say, we're in a phase
that we can quote manage this. We we have an ability.
You know, the case counts are very very low. We're
not seeing these big white spikes that we're still seeing.
And everybody's gonna say, oh, great, problems solving. They're gonna
(08:28):
walk away and they're gonna leave nurses in the lurch
without solving the underlying structural things that are happening to
nurses every day and have been happening for a decade.
So my team has been studying nursing work places for
two decades now. A couple of things that I'm very
worried about. One is executives are not spending enough time
(08:48):
on understanding the working conditions of nurses and how they
need to fix them. They're not listening to nurses and
solving their problems within the health care system. Exactly right, okay,
Executives in the health care system are not listening carefully
to nurses concerns and acting upon those concerns. When nurses
tell you they have a problem, they have a problem.
(09:09):
They're not making it up. And when nurses have problems
in their workplaces, we've known that patients are more likely
to die, patients are more likely to have complications, patients
are more likely to have to stay longer in the hospital.
None of us want any of that. So firstus, we
have to have our health care executives listen deeply and
carefully to nurses and work very strategically on those problems.
(09:31):
Then we have a couple of structural things, not very sexy,
but we still allow many nurses, as you point out,
to work mandatory over time, their boss can come to them,
they've worked a twelve hours shift. It's five o'clock at night.
They've worked ten hours NonStop, and their boss can come
to them at five pm and say, guess what, you're
staying in another four hours. And we don't do that
(09:51):
to pilots. Your pilot flies you from New York to
l A. They get off the plane and they go
home and rest drivers and they drivers to make sure
they're not even cheating exactly right. So so we've got
a couple of structural things like that. We also have well,
guess what, we're running short on a nurse, so you're
gonna take another one to three patients. And right now
(10:14):
in the COVID area, we're seeing that in the I
c U. I've never heard of that in the I
c U and twenty five years of nursing. So executives
have decided to put the labor problems on the backs
of nurses rather than solving the underlying problem. And I
think that problem predated COVID and it's only gotten worse
during COVID. So if we really focus on those issues,
(10:37):
we're going to have a healthy, safe nursing workforce that
can care for us during COVID and after COVID and
if we don't pay attention to that stuff, we're going
to be in a whole world of hurt and we're
going to see more of the stuff that we're seeing now,
Nurses leaving in droves, too many, too many patients to
care for, unsafe staffing, etcetera. It's a vicious cycle. If
(10:58):
we don't break the change, I'm gonna ask a question,
it's gonna seem more of it. But it's from a
fiscal place. Why would the executives by break the backs
of the employees whose job it is is to help
keep the customer a lot? Like if we're just going
base level making money in health care, if people die
(11:22):
that it's not good fiscally for business. So why would
we create a place where the workers cannot do their
job the right What what is the advantage in an
executive doing that? Like if we said they're not a sponsor,
let's just use Amazon for example. Okay, yeah, Amazon is
(11:46):
gonna pay you as little as possible and not put
you in the union because it makes them more money.
Overworking nurses doesn't make you more money. The patient is
the patient. The cost just the cost, So why would
you want the patient to die like, what are the
advantages in the executive infrastructure of a hospital in being
(12:07):
assholes like this? Well, I have a lot of friends
who are executives, so let me put that on there,
and I think a lot of that. Then they're cool,
you know what I mean? Those other people right, So
you know I think that first of all, a lot
of the executives are trying to do the right thing,
but we don't have the incentives lined up. And I
spoke about this earlier. So Number one, when you, unfortunately
(12:30):
are in the hospital and you get a bill when
you go home, do me a favor and look at
your bill and you tell me. This is a quiz
for everybody listening. Go take a look at that bill
and tell me where the bill for nursing services is.
You know where it is. Room and board nurses are
part of the room and board part of a hospital bill.
(12:51):
So if you have cancer and I'm on college nurse
and I am giving you expert care for you, Lukenia,
and I'm in your room every hour drawing blood and
checking your giving you blood products to save your life,
and giving you antibiotics and all that stuff, and and
the person next to you or the room down the
hall has an appendix removed, and they're there for twelve hours,
(13:14):
and I give them to tile and all and send
them on their way. The bill for the day is
the same. So right now, nurses are widgets in the
hospital and they are the largest part of the hospital budget.
And so when times get tough, guess where they're gonna cut.
Guess where they're gonna cut the corner without nurses stepping
(13:35):
up and saying this is no longer safe, this is
no longer acceptable. We need a different structure. And so
it's a it's a tricky thing. It's gonna be hard
to solve. But what I'm what executives can do right
now is really listen carefully to what their nurses are
telling them and act on it. And what they can
do tomorrow is eliminate mandatory over time because that's unsafe,
(13:55):
and we know it's unsafe, and they can work carefully
to get those numbers right so that we have an
adequate number of nurses to care for the patients because
it's unsustainable. But the primary problem is we do not value,
either numerically or monetarily, the kind of nursing care that
patients in the US need in hospitals. One of the
things that I found researching that you really struck me
(14:17):
was just, you know, not just the level of care,
but just all of the different types of care that
nurses do that I don't think we really think of that.
You know, it's not it is drying blood and it
is giving medicine, but you're also you're helping patients shave,
you know. The nurses are the ones holding the phones
that people can talk to patients. Like. There's a lot
of things that if you did put them on a
hospital bill, it would probably look like a CBS receipt,
(14:38):
you know, because it's like, all right, that's like, you know,
maybe maybe we should start, you know, putting those on
so people can actually understand that that type of care
because or talking to the doctor and the pharmacist when
you're not even the room to say you just ordered
an errant medication that's going to put this patient at risk.
Do you really want to do that? Yeah? Are? You know?
(15:01):
So there's all this work happening behind the scenes, this
air traffic control function. Nobody sees it and nobody's paying
for it. It's just happening, and it's part of my work.
And so you can either have me overloaded where I'm
trying to do that for too many planes, too many
patients in this example, or we can do it in
a way where I have the time and space to
really care for patients or teach them about their new
(15:23):
leukemia diagnosis or their new surgery whatever they just had done.
So you get what you pay for. And right now
we're lumping this into room and board. It's basically a
Hyatt bill. Sorry if they're a sponsor of yours, but
you know we don't. I love this idea of the
scene because if we did that for a nurse, what
did you do for this patient for twelve hours? It
would be a sicker tape parade because that's the thing
(15:47):
that I think is interesting as well, because it's all
hidden under room and board. I don't even think Americans
even know what. We don't know everything that a nurse
to do. Like, all you know is that the nurse
is the person who is in charge of apparently from
what you're saying, Dr Freeze everything from medicine and the
right dosage to batteries for my TV remote, which is
(16:07):
always my concern when I'm visiting someone in the hospital.
Is that the television has an inadequate amount of channels.
But um, what I'm gathering is that that's probably not
a bigger issue in the eyes of the administration right now. Well,
you know, if you're visiting, you shouldn't be inconvenience if
you can't access cable. So what is the point of
visiting you in the hospital if I can't watch Comedy Central?
(16:30):
Wink wink, shameless plug. So then, with all of that happening, Madeline,
how do you all It seems like and I could
be wrong, Dr Freeze jumping in if I am, but
it would seem like the issue of the stress of
this job and what the pandemic did um to morale.
(16:50):
It's also somewhat of a, if not a newer issue,
definitely more prominent and more prevalent now, So how did
you all decide on how to sparse that into the story?
I think the challenge with trying to put together a
piece like this is that you have to figure out
when you're going to make jokes, but also when you're
going to take it seriously. I would say the best
(17:13):
asset that we have, I mean, and you know this
at the Daily Show, Roy, is that like, we just
have a lot of I mean, there's a lot of
hands on these pieces. There's a lot of people working
on them. It's a really collaborative effort. And so one
of the people I mentioned above, the very talented people,
is one of our producers, Allison, who did a lot
of work on this piece. And when we were talking
about burnout specifically for nurses, which again is not a
(17:33):
funny topic, it's very serious, it's very depressing. But she
found a clip of a nurse speaking about how you know,
when they're talking about their burnout, and the solution by there,
you know, I guess the hospital executives was to kind
of throw a pizza party. People just still, honestly do
not understand how severe this is, how bad staffing for
(17:56):
nursing is. When tom's are tough and things are getting rough,
still have a pizza party. You know, you guys are
spread really really thin, and we can't get new nurses,
but here's pizza. Okay. No, people, No, you cannot solve
a nurse shortage with a pizza party. In fact, it's
probably gonna make the problem worse because it's the lost
(18:19):
food you want to feed someone who needs to stay
awake for a double shift, you know. So it's it's
finding things like that to still be able to talk
about an issue. Pizza is probably a good problem solving
until about the eighth grade. After that, you gotta be
taken us at minimum the cheesecake factory after the break.
Dr Freeze, I want to throw that same question at you,
because I know that you have a lot of colleagues
(18:40):
that are still in a lot of these you know, hotspots,
and are dealing with all of the problems that you're
talking about. And I'm very curious not only about the
mental health issues that are happening right now within our
within our hospital system with nurses, but also what are
y'all telling the new nurses that are coming. How do
you convinced to take this job? What did the nursing
(19:04):
recruitment post to look like? This is beyond the scenes.
We'll be right back. I have a lot of questions
for you. I'm sorry, Dr Freeze. You've spoken about the
mental health challenges that are faced by nurses. What makes
these challenges so acute? You know, what is it about
the job that is creating all of this stress and
(19:27):
how is that affecting the nursing population, you know, even
by gender. So it's a really important topic because I
think the take home message for your readers, we're all
spending a lot of time worrying about nurses right now,
and probably everyone listening has a family member, a friend
who's a nurse just because of the numbers. Are four
million of us out there in the US, right But
(19:47):
but the big take home message for everybody to know
is nurses were in trouble before the pandemic. So our
team at the University of Michigan had done some work
to understand and I'm gonna just give folks mentioned we're
gonna talk about some unpleasant topics like suicide, just to
prepare people. We actually did some work to show that
um deaths by suicide were two times higher among female
(20:11):
nurses than the rest of the US population. And that
data went through before the pandemic, and the curve was
like this for the last eleven years that we studied it.
It was a steady increase over time. The all time
peak was the when we have the latest data that
to our group. Another group, now you could say that's
still very rare, you know, but I mean I would
(20:32):
say every nurse we lose is you know, a tragedy,
and the numbers are still rising, rising numbers, rising numbers, right,
So it's a it's alarming finding. But the other point
is a survey by the Mayo Clinic just showed that
even thinking about suicide and self harm was on the
rise during the same period. So, you know, not thankfully,
not everyone is going to have a tragic event, but
(20:55):
nurses have had behavioral and mental health challenges before the pandemic.
I think there's a couple of things going on. Number
one is the work is stressful. We've talked about mandatory
over time and shifts and workload. The other thing we
haven't talked a lot about is violence, verbal and physical
violence against nurses is continuing to rise, was rising before
the pandemic, and we do not have a strategy in
(21:17):
the US to control that. So nurses are in an
in an unsafe, hostile environment for their work and then
think about what's going on around them. Plus of the
US nurse population is female. They're often caregivers at work
and their caregivers at home for family members, for kids,
for etcetera. So you put all that together in a
(21:40):
tough work environment, and you you can imagine why people
are having stress. The other piece we know about nurses
and other healthcare workers is it's very hard for them
to seek health care services for mental health because of
the stigma involved. They don't want to be seen that
they can't handle their work. They don't want to be
seen as a patient for that problem. And the police
(22:01):
and pride that comes with the position that white wall is.
You know, we'll call it a white wall of silence
instead of the blue line. You know, there's we don't
want to talk about this stuff because we want to
be seen as professionals. We can handle our stuff. But
you know, it's like diabetes. You can't just wash this away.
If you have a mental health condition, or you have
(22:23):
a substance use issue or whatever you have, there's no
thinking that a healthcare worker is is less immune to
that problem. And they need as much help, if not
different kind of help than anyone else. And they repeatedly
say in surveys it is hard for them to find
services that understand their needs. They feel they can't do
it confidentially. They're they're worried about retribution, they're worried about
(22:44):
getting fired, they're worried about losing their license. So until
we solve that problem, we're not going to solve the
mental health crisis among nurses. The final point I want
to add on this is some of my colleagues work.
Dr Christian chow at U c l A. Has shown
in a survey that nurses have a lot. In a
large survey of nurses and the Nurses Health Study, a
substantial proportion of them had childhood trauma, physical, verbal, sexual
(23:09):
trauma in their past, far higher than the US population.
So we're trying to put all of this together, but
we're flying blind because we really don't have good understanding
of what the exact issues are. We know what the
clumps of things are, but we don't know really how
they fit together to create a problem where a nurse
is really in trouble. So then you we're dealing with
(23:32):
a workforce that themselves may be broken and unhealed from
their own traumas while also working in a stressful situation
to heal everybody else. Now, then when we talk about
just the workforce in general, why has it been so difficult?
And this is just me, a layman. This is a
guy who I've gone to the hospital a couple of times,
(23:56):
really good blankets at the hospital. If you could steal one,
please do yourself a favor and get you one of
those nice hospitals. UM, as a layman, why can't we
just hire more nurses? That's just part of the issue,
Like that's always been the approach to if we want
to use policing. Isn't a one to one, but that's
(24:18):
always been something where that's a job with decent pay,
decent over time, decent retirement. So you don't really have
the bigger issue in recruiting over there. Why why can't
we just add more nurses to the workforce, And why
hasn't that been um a solution. Yeah, so a couple
of things. So we need special training, right for nurses.
You can't just kind of walk in from another sector
(24:40):
and become a nurse. There's there's you know, at least
two up to four years of training and then you
need extensive on the job training. And the problem is
we have a pipeline problem. So you we joked earlier,
you know, how do you get people into the field.
We turn away eight to ten qualify people for nurse,
every nursing school position, every student position. There are eight
(25:01):
to tend people behind them that we turn away because
we don't have enough capacity. Why don't we have enough capacity.
We don't have enough faculty. We don't have enough people
to teach both in the school of nursing and in
the hospital. Those expert nurses who are leaving, we need
those folks to help teach our students. So when we
have experts leave, we don't have enough people to teach
(25:23):
our students, and we don't have enough faculty, we can't
teach our students. And nurses make more money practicing than
they do teaching. We have an aligned the incentive to say,
if you want to be if you're an expert nurse,
we want you to be an expert teacher, and we're
going to reward you for that. Instead we say, oh,
you're gonna take a pay cut. So how's that going
(25:45):
to work. Also, I'm wondering dr freeze if there's something
like with a I mean, obviously there's a there's a shortage,
which is a critical issue, but in terms of like
a distribution, because I mean, I think one of the
things about being in New York is that I kind
of take it for granted, like we do, like we
have a lot of hospitals here, you know, like you
can you can uber to a hospital, but there's a
lot of more rural parts of the country that a
(26:09):
lot you know, a lot of nurses have been lured
away to be traveling nurses, right because it pays more money,
and you know, we don't hold that against them, obviously,
but those shortages are so much different than here where
I don't think we would feel it. What is the
difference between what a traveler nurse is just someone who
comes in and they're higher privately by a particular hospital. Hey,
come be a nurse here for a little while, contract
(26:29):
for higher bouts. Usually if it's like six to thirteen
week contracts, and so you pay a print, they pay,
they get a premium pay. They get paid to relocate
and they're there for six to thirteen weeks, and they
typically are placed in the shortest staffed units. You know,
they're filled, they're filling holes. And so people will say,
I'll go in, I'll do this. I would call it jokingly,
(26:53):
hazard pay. I'm gonna do this for for six to
thirteen weeks and then I'm gonna leave and then I'm
gonna go on to somewhere else. Some people stay um,
but it's really to fill that critical whole um. So
that's the that's the travel nursing thing, and what we're
seeing right now, the big kerfuffle is we've got expert
nurses who have been in the same unit with a
lot of expertise for ten twelve years caring for these patients,
(27:16):
and then an a travel nurse comes in and is
making twice the salary for that that blitz of time,
and so the ten twelve year veterans looking around saying,
why am I staying here? What's this about? So that's
the newer phenomena that we're seeing. You know, you're you're
you're putting me through the ringer, you're giving me lukewarm
pepperoni pizza. The one today I heard is coloring books.
(27:40):
So congratulations, you're getting a coloring book. So, you know,
the list goes on and then I look around and
there's this curse. There's this person from a travel agency
who's gonna be here for six to thirteen weeks making
double sometimes triple my pay. Why would I stay? And
I don't have a good answer for them. I don't
(28:01):
have a good answer. So then you look at that's
like private sector security who gets sent over to the
Middle East and fight alongside our troops, and the troops
are like what like, yeah, dude, and my equipment is
better than yours. So that's that's wild. So when we
when we look at this madeline and we haven't even
had time to even unpack what all of these stresses
(28:23):
on the nurses and taking on too many patients, what
that means for the patients who are actually the ones
at the center of all this and the ones who
need to care. How do you and the writers, how
are you bringing levit? Look, I'm just be honest. This
ship is sad. It's very sad because it's very real.
(28:44):
How do you all balance the jokes what we want,
which when you want? How you balance deciding when to
make someone laugh versus when to make them feel This
definitely felt more like a feeling peace to me. But
I'd lean heavily on the writers for that. I think
they have more of a burden to, you know, write
the script around the story that we're trying to tell.
(29:06):
But it's difficult. I mean it's difficult. You know, sometimes
things just you know, they're not funny, but at the
same time find you know, finding pockets where we can
actually laugh about something is really important. Because I was
thinking about Dr Freees what you're saying earlier about the
mental health challenges. And you know, one of the things
that I hope pieces like this do is, you know,
(29:29):
show the show the human side of somebody. Because if
if you can relate to someone and see that they're human,
then there is room for a comedy and there's also
room for you know, having other feelings. But I think,
you know, thinking about how we talk about nurses and
how we kind of put them as heroes and maybe
how that actually isn't that helpful for people who are
trying to seek mental health services because that might just
(29:51):
be a bigger burden on somebody. Yeah, one of the
senior nursing assistance I learned my craft from twenty five
years ago. Early on, she said to me, if you're
not laughing, you're crying. So having a bit of lightness
about and we see the pizza rolled in and we
all just kind of roll our eyes and oh, well,
isn't that nice? And thank you? Or you know, so
we understand that, and I think we appreciate when people
(30:13):
are really supportive. You know, my heart went out we
saw signs in the parking lot at Michigan when people
came and you know, supported us, and you know, as
I was driving and I'm like, okay, now, is everybody
going to sign up for the vaccine? Is everybody going
to do their part and stay safe and stay home
and stay out of trouble while they're clanging their pots
and pans and while they're putting signs out. And that's
the piece that I think a lot of nurses are
(30:35):
still struggling with, like, thanks for that, but we're asking
you to do these two or three other things that
are really a pain in the butt. We get it,
but they're gonna keep you safe. And I think that's
where a lot of nurses are kind of, you know,
looking up up at the sky wondering what's going on here.
I think that's the mystery. You are a hero and
I can't wait to see in two weeks when I
(30:57):
catch COVID with my untroxolated bunks. And that's how badly
I want to meet you. And you've just touched on
something as well, Dr Freeze. I want to talk about
it after the break here, because when we talk about
people refusing the vaccine, there's people on both sides of
that issue. And I want to get your opinion on
people in the healthcare industry who are refusing the vaccination
and these higher ups, some of whom that are your
(31:19):
friends and very cool, whether or not these vaccine mandates
are the right thing to do in a time where
you're short staffed. Uh, this is beyond the scenes, and uh,
we'll be right back. I'm gonna claim a pot for you,
Dr Freeze. Let me go get a pot, right, where's
my pizza? Beyond the scenes, we are discussing the crisis
(31:46):
that has struck our health care systems. Specifically are men
and women that are nurses and apparently, unbeknownst to me, Madeline, Uh,
pizza has been one of the biggest solutions now since
clearly pizza has been a bridge and boosting morale. Dr Freeze,
(32:08):
do we have to go to meet lover's pizza to
get our healthcare workers to accept the vaccine? Uh? Stuff, chriss?
What do we need to do? Set up to go fund?
See pepperonis that have the oil in it? Like, what
is it? Little? You know? I'm a scientist, so uh
(32:29):
you know, I'm a scientist, So I'd like to do
a randomized trial of you know, different pizza compared to
coloring books compared to massage chairs, you know, and kind
of just see which one of those. Uh, when we
can throw in pot clanging at the same time, maybe
we'll maybe we'll hit bingo. I don't know. The dwindling
number of nurses means that their job is only getting harder,
(32:52):
and as an extra insult, some of their colleagues are
abandonship for a much stupider reason at a time when
they're already staffing shortages. Some nurses are threatening to quit
your forced to get the COVID vaccine. One hospital in
upstate New York will stop delivering babies after workers resigned
over vaccine mandates. Houston Hospital System has fired or accepted
(33:15):
the resignations of more than one hundred and fifty nurses
and other staff members who refused mandatory COVID vaccinations. Show
of hands, how many of you have gotten a COVID vaccine?
These are four healthcare workers from different hospitals in North Carolina.
Why not? We don't know what the long term side
effects are. It also hasn't been proven to be effective.
(33:38):
The CDC and many public health experts say that it's
more than effective. I have the right to question anybody
in this country. I want to question. You're entitled to
an opinion. But these are facts, are they though? Are
they fact? Wow? You know this nurse is a genius. Yo.
She knows in order to stop an unvaccinated person, you
(33:59):
must think like an unvaccinated person. In order to kill COVID,
you must first die of COVID. It's so obvious. Now,
what do you make of healthcare workers who have decided
to decline the vaccine? Do you think that reflects poorly
on the healthcare system? I guess there are a hypocrisy
in that, and that you, being one who cares about
everyone's health, not doing the thing that the healthcare system
(34:22):
says is healthy. So I've spent a decent amount of
time first understanding the science behind these vaccines. They they have.
The science behind these vaccines has been around for two
decades um, but it hasn't been very publicly shared and
hasn't been really well understood, right, And so the entire
US population is trying to get up to speed with
(34:43):
with what we understand about these vaccines and why they
are safe and clearly why they're effective and just like
the US population, there is a subgroup within the health
care sector who have questions and concerns. I don't like
to use the term anti vacts or vaccining hesitant. What
the way I like to frame it is people have
unanswered questions. And the way I like to approach that
(35:07):
is come to people and have open conversations where I'm
not their boss, I am their peer, I am their
colleague trying to answer questions. And you know, when I staff,
I usually come in a little bit early and spend
some time with the nurses and just have informal conversations
about what's going on and answer to their questions because
there's a lot of uncertainty out there, even if you're
(35:28):
a healthcare provider. It's literally changing every day for a
lot of the recommendations. So what I've come across are
some very common questions about long term safety, about nursing
or childbearing issues. And the way I've tried to tackle
that is get the experts to those colleagues who have questions.
Rather than command and control, rather than bosses, rather than
(35:52):
punitive strategies, is to have a conversation and for folks
to do that, and you know, I remember a particular
own nurse, not that I worked directly with this person,
but someone I know pretty well and new baby and
a lot of questions and said, you know, I'm just
not ready yet. And so I could turn that conversation
off and say alright, good luck, you're on your own
(36:13):
or whatever. But we've kept the dialogue open, and I
think that's the strategy, is to continue to have a
dialogue and answer questions. The final thing I'll say about
this is I think in some ways the media got
this a bit wrong. They looked at the same statistics
I did, and they came out with one out of
however many nurses, nine or ten nurses is decline. It
(36:36):
will say they'll leave their job or decline the vaccine.
I saw an overwhelming majority or more of healthcare workers
are ready to sign up and get the vaccine. And
then we fast forward that story a few weeks later,
and what we see is very few people actually leaving
their jobs because of this. So I we were in
a unique snapshot in time. It was a highly emotional,
(36:59):
um challenging period. There's still a lot of unanswered questions,
and I felt like as we were watching that story
unfold and time, we got a little ahead of ourselves
and not really stressing the positives and then following up
to say, well, actually, how many people really are gonaic journalism?
The NYPD was having was going to have all of
(37:21):
these officers and ended up being like thirty, it's going
to be thousands and murder will Reigne Supreme isn't like
there are tens of us? Yeah. Uh, I did have
a question for you, Dr Freeze. You know, one of
the things that we touched on in the piece was
I guess how burned out nurses affect patients? Uh? You know,
(37:44):
cancers don't stop just because there's a pandemic. Other things.
You know, you don't stop breaking bones, you know, everything
else doesn't stop, Like the hospital system doesn't stop, and
people don't stop getting sick. So like, how is that?
I guess how how have you seen the knock on
effects of all of this happening? Yeah? So two things
on that. One is that even if you're not caring
for COVID patients, you saw a dramatic change in your
(38:07):
work during this period. That continues because your patients are
coming to you with more complicated problems because they couldn't
get their cancer screening, and so now they present with
a cancer at a later stage, or they have a
complication that we couldn't manage before they got diagnosed. Number one.
Number two, we had a lot of visitor restrictions, and
(38:28):
so we didn't have family members and loved ones who
could provide that extra emotional support for patients in the hospital.
And as you said, we had nurses with face times
and yeah, no, no one's checking the batteries. Uh, no
one's making sure the channels on the right channel at
you know, nine tenths t nine cents or whatever. Uh
(38:48):
So those pieces add up. I mean, I don't want
to trivialize that. You know, when you are alone and
scared in a hospital or you know, in my in
my family member's case, you know, they had to go
a very complicated diabetes. They had to go to the
office by themselves. Their loved one couldn't come with them
to make sure everything was being monitored properly and carefully,
and they follow up with questions, so everything got more
(39:09):
complicated and and and much of that stays to this day.
And then for the patients, as we said, cancer doesn't wait,
and heart attacks still happen, and in my case, broken
ankles still happen, and so I needed to seek care
in this pandemic. And you you are worried that are
am I going to get the care that I need?
(39:30):
Is everything going to work out? In my case, it
worked out beautifully. I couldn't have been more comfortable or
treated better. But but we have seen very clearly that
some care is falling through the cracks and continues to
do so. So that's bad for patients, and then it's
also bad for healthcare workers because they can't give their
very best, and so it continues to pour salt on
(39:51):
that wound that we're in this vicious cycle that we
can't seem to quite get out of. And I'm not
able to give my very best to my patients for
re sasons that are really outside of my control. And
I think that's always been hard for me as a nurse.
When I know something could have gone better but it
couldn't because of something beyond my control. That's very hard
to live with day in and day out. So then
(40:13):
do you think things right now, Dr Freeze are trending
the right way? Are we still kind of in a
bit of a holding pattern where it could still go
either way right now, So I think we have a
mixed picture. The one thing that I'm amazed at um
you know, a few weeks ago to transfer patient to
the intensive care unit for management of their their cancer.
(40:34):
They had a problem with their cancer complication, but there
were COVID patients in a separate part of that ward.
And the amount of intensive, unbelievable care that nurses and
doctors and respiratory therapists and pharmacists are giving you these patients.
We know far much more on how to treat patients
with COVID, and we are we are doing a better
(40:56):
job of managing COVID because we've learned a lot in
the last two years and that's a tribute to the
folks on the front line and the researchers who have
helped do that. So that's a positive. We have very
safe and effective vaccines and we now basically you can
walk in almost anywhere you want and you can get them.
So those are triumphs and we should celebrate them. And
at the same time, our nurses, doctors, pharmacists, respiratory therapists,
(41:19):
other folks have kept America's heartbeat going for all their
non COVID stuff. For the most part. But but, but
the net is fraid, the net is very fraid. And
I'm very worried that there is probably a group of
folks who are falling through the cracks, either because they
can't get in for care or the care that they
get is suboptimal because we'restrained so hard. And what I
(41:43):
really worry about is we're not going to fix this problem.
As COVID eases, We're gonna say, well, back to normal,
no problem. We have to learn from this and we
have to start making the changes now so that patients
today are safer and patients six nine months, nine months
a year from now, regardless of COVID or otherwise, they're safer.
(42:04):
And I feel like we're going to forget that. Is
there anything that the general public can do, because so
much of what you're talking about is it seems to
be in my opinion or just from my perspective. Again,
as a guy who only goes to hospitals to still blankets, No,
I don't take the black mantalin, don't clean it up
for me, and still them. These are very wonderful blankets.
(42:28):
As a person who's just on the outside looking in,
it seems that a lot of the solutions here lie
within the institution. But how do I, as just Joe
blow citizen, what can I do to help alleviate some
of these challenges? Is it looking at what our elected
officials are doing? How much does politic? Is there someone
I need to vote out? Like? What can do I
(42:49):
show up to the hospital and try to protest? Like
what can we do as regular people to help be
a part of the solution on this issue? Yeah, So
a couple of things. First of all, it's not just
the blankets. The real money is the warm blankets. So
make sure you ask for that next time. It will
change your life. It will change your life. So thank
you all. Thank You're very welcome for that tip. So
(43:12):
what can the public do? A couple of things. One is,
if you get great care at your facility, right the
CEO of the hospital and mention the people who cared
for you by name and tell them what a great
job they did. And if you saw quality of care concerns,
if you heard about mandatory over time or unsafe staffing,
put that into and say, hey, this is not what
(43:33):
I expect from my community hospital. Because they are accountable
to the public. Most of our hospitals in the country
are nonprofit and they're supposed to serve the community, so
they need to respond to you. If you know a
hospital executive, you can say, what are you doing to
keep your nurses safe? And the answer shouldn't be pizza
parties or coloring books. The answers should be eliminating mandatory
(43:53):
over time, humane staffing levels, and listening to nurses and
acting on their issues. And do you have a safety
committee for nursing and healthcare workers? We have patient safety
committees in every hospital. Do we have a group of
experts focused on healthcare workers safety? Missing piece? Finally, for
the policy piece, a couple of points. Every state healthcare
(44:17):
Most hospital issues are managed at the state level. Moving
throughout the country is legislation on um panalizing verbal and
physical abuses towards healthcare workers. Zero tolerance. You hit or
strike a nurse, or you call him a name, you're out,
full stop. We're not gonna, We're not gonna, you know,
with limited circumstances, you are we we are not obligated
(44:39):
to treat you, and you can be charged with a
with a crime. UM also mandatory staff, mandatory overtime, and
staffing ratios that are humane and safe. There's legislation in
many states. California has a staffing mandate uh some states
are working on banning mandatory overtime. We know those work
that keeps not only nurses safe, but it keeps patients safe.
(45:03):
So so those are a couple of things. And then
the final thing at the federal level, we talked about
the nursing pipeline for faculty. We don't have enough funding
to incentivize expert nurses to either stay at the bedside
to teach, or to teach in nursing schools. And if
we want more nurses, that's where we need to start.
And that's a solvable problem. That's a we have money, right,
(45:23):
I hope we have money. That's a money problem that
we can solve. And our nursing schools, you know, we
can work on our back end to make it work
that we can add, you know, bring more of those
people in that we're turning away year after year after year. Well,
I'm happy that you are a nurse educator and that
you're a nurse, and that you're a doctor of nursing
because with a name like you know, Dr Freeze, you
(45:46):
easily could have been a villain, all right, some sort
of comic book person that wreak havoc on the city,
but instead you reak love. Dr Christopher Freese, thank you
so much for going beyond the scenes with us today,
and Madeleine, I will see you again on year I
don't know, see the next pizza party, right, Thank you all. Hey,
(46:18):
listen to The Daily Show Beyond the Scenes on Apple podcast,
the I Heart Radio app, or wherever you get your podcasts.
We don't care. Just listen to us. Even if you
get your podcast from a dude named Tony in a
back alley, we don't care. Just listen.
Hey, welcome to Beyond the Scenes. Look, this is the
podcast that's like, you know, you know, you know what
this podcast is. Like. This podcast is that big gas
bag of Eminem's that you dump into your popcorn right
as the movie starting. So did you get a little
bit of sweet along with that butter re salty savory? Right?
It's that contrast, you know, That's what this podcast is.
(00:29):
You know, it's the goodness that you didn't even know
you needed until that weird kid Marcella's did it that
one time and now you can never go back. There
was a kid one time he put he put his
French fries in his ice cream and I was like,
that is disgusting, And then I tasted it. I was like,
that is brilliant. I need to figure out where the
kid is these days. Anyway, speaking of my failing health
(00:49):
due to an unsustainable diet of ice cream and French fries.
Today we are diving into the latest debacle to hit
the American health care system, the nursing crisis. Give him
a clip, nurses understanding me pistol right now. And no
matter how dedicated you want to a profession, everyone has
a breaking point. And nearly two years into serving on
the front lines of this war, a lot of them
(01:11):
are starting to update their LinkedIn's. Some hospitals experiencing critical
staffing shortages, as frontline workers say they feel like they're underwater.
Survey during the pandemic found that six of intensive care
nurses are burned out burnout, stress grueling hours. There are
multiple reasons career nurses are choosing to leave. Mississippi has
(01:34):
at least two thousand fewer nurses than it did at
the beginning of the year. In Kentucky, more than twenty
hospitals report critical staffing shortages. In hard hit New York,
there was a four increase in nurses looking for new jobs.
We are joined today to break down this Daily Show
segment with number one Daily Show associate producer. You've heard
(01:55):
on this wonderful program before, Madeline. Coon's Madeline. How are
you doing today? I'm good, Roy, It's good to be back.
Always a pleasure. What is this third? Fourth time? I
think it's third. I think I'm tied with CJ. Now
I don't know. It's it's all a blur. I'm just heady.
Also joining us on the program today is a longtime
(02:17):
nurse and nurse educator, a doctor of nursing, a doctor
of nursing, you know, just to show those physicians what's
what Dr Christopher Freeze. Dr Freeze, welcome aboard beyond the scenes.
It's great to be with you. Thanks so much for
having me. Thank you. And I know that the people
um listening cannot see this, but I want to acknowledge
(02:37):
how color coordinated your couches with the background in the
the your living space. There's a color um what's what's
the word, like a palette? The color story. That's yeah,
my girlfriend is the color story. Everybody's worried about books
in the background trying to impress people, but not you don't.
You got the turquoise contrasted with a little bit of
a brown. It's very it's very nice, very nice. Thank you.
(03:00):
We're going for a ten out of ten, so thank you. Well,
we'll see Room Raiders a bunch of assholes. They gave
me a six. They can kiss my sorry about that.
We're here to talk about things that are much more
upright and appropriate, Madeline. This segment that we did on
the Daily Show, we just played a little bit of
a piece of the original segment, but for folks that
that mystic give us a little bit of an overview
(03:21):
of what the segment covered up and how it came
to your attention to Yeah, so the pieces essentially, uh,
it's about how the crux of how we have a
critical national nursing shortage which is only getting worse. By
the way. It's not magically solved since we did this piece,
and a lot of that is due to nurses burning
(03:42):
out on the job. And this particularly why we did
it when we did earlier this year, is because it's
you know, after after I feel like the vaccines came
in and we were all, yeah, we have a vaccine,
the pandemic is over. Except well, we were going dining
nurses and all the healthcare workers were being thrown into
(04:05):
another pandemic, and that was the pandemic of the unvaccinated.
And the ridiculous and really like truly awful fact of
that is that unlike the first wave, when we were
all kind of dealing with something we couldn't control, this
one was completely preventable and it did not have to happen.
So then, as you were piecing this together for the show,
the thing we've talked about on this podcast in the
past about is how we can find an issue and
(04:28):
then you can find eight different aspects of this issue
to address. What were the ones that you all decided
to dial it in on and why I know that
on the one hand, we could talk about the mental
health part of it, but then you can also talk
about the staffing part of it, but then you can
also talk about the public negligence part of it. So
just how did you all, as you all were producing
(04:50):
and putting this piece together, how did you all decide
the hierarchy of important things to make sure it stayed
in the piece and didn't get edited out part of it?
I will say, I think the heart of the piece
that I really wanted to try to address in some way.
I'm not a nurse, but I've had some I've had
more interaction with the hospital system, I think than the
average Americans. So like when I was young, I was
(05:10):
in the hospital, I was hospitalized a lot for pneumonia.
And I'm definitely a product of my parents health insurance
and modern medicine and I am fine. But the you know,
one of the reasons I'm still here is because of
the you know, I mean fantastic doctors, but fantastic nurses.
So a lot of my earliest memories are of just
like nurses in that care and just like experiencing firsthand
(05:32):
what a difference like that level of like human care
makes like. Okay, So for example, um, I'm gonna go
off on an anecdote now that I thought of, But
when I was so, I was a young kid in
the hospital and they would always put these i vs
in my hands all the time, And as a kid,
I hated that because I wanted to play with my hands,
because you're when you're in the hospital for long time,
is actually kind of boring because you just not much
(05:52):
to do as a patient, not as a hospital worker,
as a patient, as a kid. Um, And when they
listened and they put the ivy in my foot, and
what you think would be hard because I wouldn't be
able to walk around, But what the nurses did is
they let me ride you like those long, big i
V polls. They would let me ride around the hospital
on those like the silver Surfer or something. And so
(06:15):
I think, when when I think back to that time,
I think it's something that could have been a very
scary memory is actually very warm, and that all of
that had to do with the level of care I received,
and so when I was looking for pieces and seeing
how nurses are being affected by COVID, there was a
part of me that remembered the level of care that
(06:37):
you can get wh nurses are able to do their
job versus what we're seeing happening now. And that's what
I started looking at, saying like, how can how how
can we tell that story? How can we show what
should be? And how can we show it is? Because
Dr Freeze, you know, when you look at healthcare in
the modern era in this country now, like it's not
just about knowing your job from a ticky technical I
(06:59):
v find the main standpoint you also, it seems that
the job of nurse is a little bit part sociologists
as well, where you have to be able to relate
to people. And I would even argue that there might
be a little small element of social work and trying
to just connect with people on a normal human basis,
But you have a lot of different confluences happening. What
(07:22):
do you believe are the primary challenges for nurses and
the health care system right now? Well, how much time
do we have right now? So first I want to
say that each and every day, nurses are delivering exceptional
care across the country. They are they are getting it
done for their patients technically, socially, physically. They are problem
(07:45):
solving behind the scenes there you know, I call it,
you know, part technical, part psychology, part air traffic controller,
and and that's the part that a lot of people
don't see. So a lot of excellent nursing care is
still happening. But we're on the brink, and we've been
on the brink for about almost two years now. So
when we think about the priorities, what I'm really worried
(08:05):
about is at some point our public health officials will
have a lower level of concern for COVID than they
do right now. They will say, we're in a phase
that we can quote manage this. We we have an ability.
You know, the case counts are very very low. We're
not seeing these big white spikes that we're still seeing.
And everybody's gonna say, oh, great, problems solving. They're gonna
(08:28):
walk away and they're gonna leave nurses in the lurch
without solving the underlying structural things that are happening to
nurses every day and have been happening for a decade.
So my team has been studying nursing work places for
two decades now. A couple of things that I'm very
worried about. One is executives are not spending enough time
(08:48):
on understanding the working conditions of nurses and how they
need to fix them. They're not listening to nurses and
solving their problems within the health care system. Exactly right, okay,
Executives in the health care system are not listening carefully
to nurses concerns and acting upon those concerns. When nurses
tell you they have a problem, they have a problem.
(09:09):
They're not making it up. And when nurses have problems
in their workplaces, we've known that patients are more likely
to die, patients are more likely to have complications, patients
are more likely to have to stay longer in the hospital.
None of us want any of that. So firstus, we
have to have our health care executives listen deeply and
carefully to nurses and work very strategically on those problems.
(09:31):
Then we have a couple of structural things, not very sexy,
but we still allow many nurses, as you point out,
to work mandatory over time, their boss can come to them,
they've worked a twelve hours shift. It's five o'clock at night.
They've worked ten hours NonStop, and their boss can come
to them at five pm and say, guess what, you're
staying in another four hours. And we don't do that
(09:51):
to pilots. Your pilot flies you from New York to
l A. They get off the plane and they go
home and rest drivers and they drivers to make sure
they're not even cheating exactly right. So so we've got
a couple of structural things like that. We also have well,
guess what, we're running short on a nurse, so you're
gonna take another one to three patients. And right now
(10:14):
in the COVID area, we're seeing that in the I
c U. I've never heard of that in the I
c U and twenty five years of nursing. So executives
have decided to put the labor problems on the backs
of nurses rather than solving the underlying problem. And I
think that problem predated COVID and it's only gotten worse
during COVID. So if we really focus on those issues,
(10:37):
we're going to have a healthy, safe nursing workforce that
can care for us during COVID and after COVID and
if we don't pay attention to that stuff, we're going
to be in a whole world of hurt and we're
going to see more of the stuff that we're seeing now,
Nurses leaving in droves, too many, too many patients to
care for, unsafe staffing, etcetera. It's a vicious cycle. If
(10:58):
we don't break the change, I'm gonna ask a question,
it's gonna seem more of it. But it's from a
fiscal place. Why would the executives by break the backs
of the employees whose job it is is to help
keep the customer a lot? Like if we're just going
base level making money in health care, if people die
(11:22):
that it's not good fiscally for business. So why would
we create a place where the workers cannot do their
job the right What what is the advantage in an
executive doing that? Like if we said they're not a sponsor,
let's just use Amazon for example. Okay, yeah, Amazon is
(11:46):
gonna pay you as little as possible and not put
you in the union because it makes them more money.
Overworking nurses doesn't make you more money. The patient is
the patient. The cost just the cost, So why would
you want the patient to die like, what are the
advantages in the executive infrastructure of a hospital in being
(12:07):
assholes like this? Well, I have a lot of friends
who are executives, so let me put that on there,
and I think a lot of that. Then they're cool,
you know what I mean? Those other people right, So
you know I think that first of all, a lot
of the executives are trying to do the right thing,
but we don't have the incentives lined up. And I
spoke about this earlier. So Number one, when you, unfortunately
(12:30):
are in the hospital and you get a bill when
you go home, do me a favor and look at
your bill and you tell me. This is a quiz
for everybody listening. Go take a look at that bill
and tell me where the bill for nursing services is.
You know where it is. Room and board nurses are
part of the room and board part of a hospital bill.
(12:51):
So if you have cancer and I'm on college nurse
and I am giving you expert care for you, Lukenia,
and I'm in your room every hour drawing blood and
checking your giving you blood products to save your life,
and giving you antibiotics and all that stuff, and and
the person next to you or the room down the
hall has an appendix removed, and they're there for twelve hours,
(13:14):
and I give them to tile and all and send
them on their way. The bill for the day is
the same. So right now, nurses are widgets in the
hospital and they are the largest part of the hospital budget.
And so when times get tough, guess where they're gonna cut.
Guess where they're gonna cut the corner without nurses stepping
(13:35):
up and saying this is no longer safe, this is
no longer acceptable. We need a different structure. And so
it's a it's a tricky thing. It's gonna be hard
to solve. But what I'm what executives can do right
now is really listen carefully to what their nurses are
telling them and act on it. And what they can
do tomorrow is eliminate mandatory over time because that's unsafe,
(13:55):
and we know it's unsafe, and they can work carefully
to get those numbers right so that we have an
adequate number of nurses to care for the patients because
it's unsustainable. But the primary problem is we do not value,
either numerically or monetarily, the kind of nursing care that
patients in the US need in hospitals. One of the
things that I found researching that you really struck me
(14:17):
was just, you know, not just the level of care,
but just all of the different types of care that
nurses do that I don't think we really think of that.
You know, it's not it is drying blood and it
is giving medicine, but you're also you're helping patients shave,
you know. The nurses are the ones holding the phones
that people can talk to patients. Like. There's a lot
of things that if you did put them on a
hospital bill, it would probably look like a CBS receipt,
(14:38):
you know, because it's like, all right, that's like, you know,
maybe maybe we should start, you know, putting those on
so people can actually understand that that type of care
because or talking to the doctor and the pharmacist when
you're not even the room to say you just ordered
an errant medication that's going to put this patient at risk.
Do you really want to do that? Yeah? Are? You know?
(15:01):
So there's all this work happening behind the scenes, this
air traffic control function. Nobody sees it and nobody's paying
for it. It's just happening, and it's part of my work.
And so you can either have me overloaded where I'm
trying to do that for too many planes, too many
patients in this example, or we can do it in
a way where I have the time and space to
really care for patients or teach them about their new
(15:23):
leukemia diagnosis or their new surgery whatever they just had done.
So you get what you pay for. And right now
we're lumping this into room and board. It's basically a
Hyatt bill. Sorry if they're a sponsor of yours, but
you know we don't. I love this idea of the
scene because if we did that for a nurse, what
did you do for this patient for twelve hours? It
would be a sicker tape parade because that's the thing
(15:47):
that I think is interesting as well, because it's all
hidden under room and board. I don't even think Americans
even know what. We don't know everything that a nurse
to do. Like, all you know is that the nurse
is the person who is in charge of apparently from
what you're saying, Dr Freeze everything from medicine and the
right dosage to batteries for my TV remote, which is
(16:07):
always my concern when I'm visiting someone in the hospital.
Is that the television has an inadequate amount of channels.
But um, what I'm gathering is that that's probably not
a bigger issue in the eyes of the administration right now. Well,
you know, if you're visiting, you shouldn't be inconvenience if
you can't access cable. So what is the point of
visiting you in the hospital if I can't watch Comedy Central?
(16:30):
Wink wink, shameless plug. So then, with all of that happening, Madeline,
how do you all It seems like and I could
be wrong, Dr Freeze jumping in if I am, but
it would seem like the issue of the stress of
this job and what the pandemic did um to morale.
(16:50):
It's also somewhat of a, if not a newer issue,
definitely more prominent and more prevalent now, So how did
you all decide on how to sparse that into the story?
I think the challenge with trying to put together a
piece like this is that you have to figure out
when you're going to make jokes, but also when you're
going to take it seriously. I would say the best
(17:13):
asset that we have, I mean, and you know this
at the Daily Show, Roy, is that like, we just
have a lot of I mean, there's a lot of
hands on these pieces. There's a lot of people working
on them. It's a really collaborative effort. And so one
of the people I mentioned above, the very talented people,
is one of our producers, Allison, who did a lot
of work on this piece. And when we were talking
about burnout specifically for nurses, which again is not a
(17:33):
funny topic, it's very serious, it's very depressing. But she
found a clip of a nurse speaking about how you know,
when they're talking about their burnout, and the solution by there,
you know, I guess the hospital executives was to kind
of throw a pizza party. People just still, honestly do
not understand how severe this is, how bad staffing for
(17:56):
nursing is. When tom's are tough and things are getting rough,
still have a pizza party. You know, you guys are
spread really really thin, and we can't get new nurses,
but here's pizza. Okay. No, people, No, you cannot solve
a nurse shortage with a pizza party. In fact, it's
probably gonna make the problem worse because it's the lost
(18:19):
food you want to feed someone who needs to stay
awake for a double shift, you know. So it's it's
finding things like that to still be able to talk
about an issue. Pizza is probably a good problem solving
until about the eighth grade. After that, you gotta be
taken us at minimum the cheesecake factory after the break.
Dr Freeze, I want to throw that same question at you,
because I know that you have a lot of colleagues
(18:40):
that are still in a lot of these you know, hotspots,
and are dealing with all of the problems that you're
talking about. And I'm very curious not only about the
mental health issues that are happening right now within our
within our hospital system with nurses, but also what are
y'all telling the new nurses that are coming. How do
you convinced to take this job? What did the nursing
(19:04):
recruitment post to look like? This is beyond the scenes.
We'll be right back. I have a lot of questions
for you. I'm sorry, Dr Freeze. You've spoken about the
mental health challenges that are faced by nurses. What makes
these challenges so acute? You know, what is it about
the job that is creating all of this stress and
(19:27):
how is that affecting the nursing population, you know, even
by gender. So it's a really important topic because I
think the take home message for your readers, we're all
spending a lot of time worrying about nurses right now,
and probably everyone listening has a family member, a friend
who's a nurse just because of the numbers. Are four
million of us out there in the US, right But
(19:47):
but the big take home message for everybody to know
is nurses were in trouble before the pandemic. So our
team at the University of Michigan had done some work
to understand and I'm gonna just give folks mentioned we're
gonna talk about some unpleasant topics like suicide, just to
prepare people. We actually did some work to show that
um deaths by suicide were two times higher among female
(20:11):
nurses than the rest of the US population. And that
data went through before the pandemic, and the curve was
like this for the last eleven years that we studied it.
It was a steady increase over time. The all time
peak was the when we have the latest data that
to our group. Another group, now you could say that's
still very rare, you know, but I mean I would
(20:32):
say every nurse we lose is you know, a tragedy,
and the numbers are still rising, rising numbers, rising numbers, right,
So it's a it's alarming finding. But the other point
is a survey by the Mayo Clinic just showed that
even thinking about suicide and self harm was on the
rise during the same period. So, you know, not thankfully,
not everyone is going to have a tragic event, but
(20:55):
nurses have had behavioral and mental health challenges before the pandemic.
I think there's a couple of things going on. Number
one is the work is stressful. We've talked about mandatory
over time and shifts and workload. The other thing we
haven't talked a lot about is violence, verbal and physical
violence against nurses is continuing to rise, was rising before
the pandemic, and we do not have a strategy in
(21:17):
the US to control that. So nurses are in an
in an unsafe, hostile environment for their work and then
think about what's going on around them. Plus of the
US nurse population is female. They're often caregivers at work
and their caregivers at home for family members, for kids,
for etcetera. So you put all that together in a
(21:40):
tough work environment, and you you can imagine why people
are having stress. The other piece we know about nurses
and other healthcare workers is it's very hard for them
to seek health care services for mental health because of
the stigma involved. They don't want to be seen that
they can't handle their work. They don't want to be
seen as a patient for that problem. And the police
(22:01):
and pride that comes with the position that white wall is.
You know, we'll call it a white wall of silence
instead of the blue line. You know, there's we don't
want to talk about this stuff because we want to
be seen as professionals. We can handle our stuff. But
you know, it's like diabetes. You can't just wash this away.
If you have a mental health condition, or you have
(22:23):
a substance use issue or whatever you have, there's no
thinking that a healthcare worker is is less immune to
that problem. And they need as much help, if not
different kind of help than anyone else. And they repeatedly
say in surveys it is hard for them to find
services that understand their needs. They feel they can't do
it confidentially. They're they're worried about retribution, they're worried about
(22:44):
getting fired, they're worried about losing their license. So until
we solve that problem, we're not going to solve the
mental health crisis among nurses. The final point I want
to add on this is some of my colleagues work.
Dr Christian chow at U c l A. Has shown
in a survey that nurses have a lot. In a
large survey of nurses and the Nurses Health Study, a
substantial proportion of them had childhood trauma, physical, verbal, sexual
(23:09):
trauma in their past, far higher than the US population.
So we're trying to put all of this together, but
we're flying blind because we really don't have good understanding
of what the exact issues are. We know what the
clumps of things are, but we don't know really how
they fit together to create a problem where a nurse
is really in trouble. So then you we're dealing with
(23:32):
a workforce that themselves may be broken and unhealed from
their own traumas while also working in a stressful situation
to heal everybody else. Now, then when we talk about
just the workforce in general, why has it been so difficult?
And this is just me, a layman. This is a
guy who I've gone to the hospital a couple of times,
(23:56):
really good blankets at the hospital. If you could steal one,
please do yourself a favor and get you one of
those nice hospitals. UM, as a layman, why can't we
just hire more nurses? That's just part of the issue,
Like that's always been the approach to if we want
to use policing. Isn't a one to one, but that's
(24:18):
always been something where that's a job with decent pay,
decent over time, decent retirement. So you don't really have
the bigger issue in recruiting over there. Why why can't
we just add more nurses to the workforce, And why
hasn't that been um a solution. Yeah, so a couple
of things. So we need special training, right for nurses.
You can't just kind of walk in from another sector
(24:40):
and become a nurse. There's there's you know, at least
two up to four years of training and then you
need extensive on the job training. And the problem is
we have a pipeline problem. So you we joked earlier,
you know, how do you get people into the field.
We turn away eight to ten qualify people for nurse,
every nursing school position, every student position. There are eight
(25:01):
to tend people behind them that we turn away because
we don't have enough capacity. Why don't we have enough capacity.
We don't have enough faculty. We don't have enough people
to teach both in the school of nursing and in
the hospital. Those expert nurses who are leaving, we need
those folks to help teach our students. So when we
have experts leave, we don't have enough people to teach
(25:23):
our students, and we don't have enough faculty, we can't
teach our students. And nurses make more money practicing than
they do teaching. We have an aligned the incentive to say,
if you want to be if you're an expert nurse,
we want you to be an expert teacher, and we're
going to reward you for that. Instead we say, oh,
you're gonna take a pay cut. So how's that going
(25:45):
to work. Also, I'm wondering dr freeze if there's something
like with a I mean, obviously there's a there's a shortage,
which is a critical issue, but in terms of like
a distribution, because I mean, I think one of the
things about being in New York is that I kind
of take it for granted, like we do, like we
have a lot of hospitals here, you know, like you
can you can uber to a hospital, but there's a
lot of more rural parts of the country that a
(26:09):
lot you know, a lot of nurses have been lured
away to be traveling nurses, right because it pays more money,
and you know, we don't hold that against them, obviously,
but those shortages are so much different than here where
I don't think we would feel it. What is the
difference between what a traveler nurse is just someone who
comes in and they're higher privately by a particular hospital. Hey,
come be a nurse here for a little while, contract
(26:29):
for higher bouts. Usually if it's like six to thirteen
week contracts, and so you pay a print, they pay,
they get a premium pay. They get paid to relocate
and they're there for six to thirteen weeks, and they
typically are placed in the shortest staffed units. You know,
they're filled, they're filling holes. And so people will say,
I'll go in, I'll do this. I would call it jokingly,
(26:53):
hazard pay. I'm gonna do this for for six to
thirteen weeks and then I'm gonna leave and then I'm
gonna go on to somewhere else. Some people stay um,
but it's really to fill that critical whole um. So
that's the that's the travel nursing thing, and what we're
seeing right now, the big kerfuffle is we've got expert
nurses who have been in the same unit with a
lot of expertise for ten twelve years caring for these patients,
(27:16):
and then an a travel nurse comes in and is
making twice the salary for that that blitz of time,
and so the ten twelve year veterans looking around saying,
why am I staying here? What's this about? So that's
the newer phenomena that we're seeing. You know, you're you're
you're putting me through the ringer, you're giving me lukewarm
pepperoni pizza. The one today I heard is coloring books.
(27:40):
So congratulations, you're getting a coloring book. So, you know,
the list goes on and then I look around and
there's this curse. There's this person from a travel agency
who's gonna be here for six to thirteen weeks making
double sometimes triple my pay. Why would I stay? And
I don't have a good answer for them. I don't
(28:01):
have a good answer. So then you look at that's
like private sector security who gets sent over to the
Middle East and fight alongside our troops, and the troops
are like what like, yeah, dude, and my equipment is
better than yours. So that's that's wild. So when we
when we look at this madeline and we haven't even
had time to even unpack what all of these stresses
(28:23):
on the nurses and taking on too many patients, what
that means for the patients who are actually the ones
at the center of all this and the ones who
need to care. How do you and the writers, how
are you bringing levit? Look, I'm just be honest. This
ship is sad. It's very sad because it's very real.
(28:44):
How do you all balance the jokes what we want,
which when you want? How you balance deciding when to
make someone laugh versus when to make them feel This
definitely felt more like a feeling peace to me. But
I'd lean heavily on the writers for that. I think
they have more of a burden to, you know, write
the script around the story that we're trying to tell.
(29:06):
But it's difficult. I mean it's difficult. You know, sometimes
things just you know, they're not funny, but at the
same time find you know, finding pockets where we can
actually laugh about something is really important. Because I was
thinking about Dr Freees what you're saying earlier about the
mental health challenges. And you know, one of the things
that I hope pieces like this do is, you know,
(29:29):
show the show the human side of somebody. Because if
if you can relate to someone and see that they're human,
then there is room for a comedy and there's also
room for you know, having other feelings. But I think,
you know, thinking about how we talk about nurses and
how we kind of put them as heroes and maybe
how that actually isn't that helpful for people who are
trying to seek mental health services because that might just
(29:51):
be a bigger burden on somebody. Yeah, one of the
senior nursing assistance I learned my craft from twenty five
years ago. Early on, she said to me, if you're
not laughing, you're crying. So having a bit of lightness
about and we see the pizza rolled in and we
all just kind of roll our eyes and oh, well,
isn't that nice? And thank you? Or you know, so
we understand that, and I think we appreciate when people
(30:13):
are really supportive. You know, my heart went out we
saw signs in the parking lot at Michigan when people
came and you know, supported us, and you know, as
I was driving and I'm like, okay, now, is everybody
going to sign up for the vaccine? Is everybody going
to do their part and stay safe and stay home
and stay out of trouble while they're clanging their pots
and pans and while they're putting signs out. And that's
the piece that I think a lot of nurses are
(30:35):
still struggling with, like, thanks for that, but we're asking
you to do these two or three other things that
are really a pain in the butt. We get it,
but they're gonna keep you safe. And I think that's
where a lot of nurses are kind of, you know,
looking up up at the sky wondering what's going on here.
I think that's the mystery. You are a hero and
I can't wait to see in two weeks when I
(30:57):
catch COVID with my untroxolated bunks. And that's how badly
I want to meet you. And you've just touched on
something as well, Dr Freeze. I want to talk about
it after the break here, because when we talk about
people refusing the vaccine, there's people on both sides of
that issue. And I want to get your opinion on
people in the healthcare industry who are refusing the vaccination
and these higher ups, some of whom that are your
(31:19):
friends and very cool, whether or not these vaccine mandates
are the right thing to do in a time where
you're short staffed. Uh, this is beyond the scenes, and uh,
we'll be right back. I'm gonna claim a pot for you,
Dr Freeze. Let me go get a pot, right, where's
my pizza? Beyond the scenes, we are discussing the crisis
(31:46):
that has struck our health care systems. Specifically are men
and women that are nurses and apparently, unbeknownst to me, Madeline, Uh,
pizza has been one of the biggest solutions now since
clearly pizza has been a bridge and boosting morale. Dr Freeze,
(32:08):
do we have to go to meet lover's pizza to
get our healthcare workers to accept the vaccine? Uh? Stuff, chriss?
What do we need to do? Set up to go fund?
See pepperonis that have the oil in it? Like, what
is it? Little? You know? I'm a scientist, so uh
(32:29):
you know, I'm a scientist, So I'd like to do
a randomized trial of you know, different pizza compared to
coloring books compared to massage chairs, you know, and kind
of just see which one of those. Uh, when we
can throw in pot clanging at the same time, maybe
we'll maybe we'll hit bingo. I don't know. The dwindling
number of nurses means that their job is only getting harder,
(32:52):
and as an extra insult, some of their colleagues are
abandonship for a much stupider reason at a time when
they're already staffing shortages. Some nurses are threatening to quit
your forced to get the COVID vaccine. One hospital in
upstate New York will stop delivering babies after workers resigned
over vaccine mandates. Houston Hospital System has fired or accepted
(33:15):
the resignations of more than one hundred and fifty nurses
and other staff members who refused mandatory COVID vaccinations. Show
of hands, how many of you have gotten a COVID vaccine?
These are four healthcare workers from different hospitals in North Carolina.
Why not? We don't know what the long term side
effects are. It also hasn't been proven to be effective.
(33:38):
The CDC and many public health experts say that it's
more than effective. I have the right to question anybody
in this country. I want to question. You're entitled to
an opinion. But these are facts, are they though? Are
they fact? Wow? You know this nurse is a genius. Yo.
She knows in order to stop an unvaccinated person, you
(33:59):
must think like an unvaccinated person. In order to kill COVID,
you must first die of COVID. It's so obvious. Now,
what do you make of healthcare workers who have decided
to decline the vaccine? Do you think that reflects poorly
on the healthcare system? I guess there are a hypocrisy
in that, and that you, being one who cares about
everyone's health, not doing the thing that the healthcare system
(34:22):
says is healthy. So I've spent a decent amount of
time first understanding the science behind these vaccines. They they have.
The science behind these vaccines has been around for two
decades um, but it hasn't been very publicly shared and
hasn't been really well understood, right, And so the entire
US population is trying to get up to speed with
(34:43):
with what we understand about these vaccines and why they
are safe and clearly why they're effective and just like
the US population, there is a subgroup within the health
care sector who have questions and concerns. I don't like
to use the term anti vacts or vaccining hesitant. What
the way I like to frame it is people have
unanswered questions. And the way I like to approach that
(35:07):
is come to people and have open conversations where I'm
not their boss, I am their peer, I am their
colleague trying to answer questions. And you know, when I staff,
I usually come in a little bit early and spend
some time with the nurses and just have informal conversations
about what's going on and answer to their questions because
there's a lot of uncertainty out there, even if you're
(35:28):
a healthcare provider. It's literally changing every day for a
lot of the recommendations. So what I've come across are
some very common questions about long term safety, about nursing
or childbearing issues. And the way I've tried to tackle
that is get the experts to those colleagues who have questions.
Rather than command and control, rather than bosses, rather than
(35:52):
punitive strategies, is to have a conversation and for folks
to do that, and you know, I remember a particular
own nurse, not that I worked directly with this person,
but someone I know pretty well and new baby and
a lot of questions and said, you know, I'm just
not ready yet. And so I could turn that conversation
off and say alright, good luck, you're on your own
(36:13):
or whatever. But we've kept the dialogue open, and I
think that's the strategy, is to continue to have a
dialogue and answer questions. The final thing I'll say about
this is I think in some ways the media got
this a bit wrong. They looked at the same statistics
I did, and they came out with one out of
however many nurses, nine or ten nurses is decline. It
(36:36):
will say they'll leave their job or decline the vaccine.
I saw an overwhelming majority or more of healthcare workers
are ready to sign up and get the vaccine. And
then we fast forward that story a few weeks later,
and what we see is very few people actually leaving
their jobs because of this. So I we were in
a unique snapshot in time. It was a highly emotional,
(36:59):
um challenging period. There's still a lot of unanswered questions,
and I felt like as we were watching that story
unfold and time, we got a little ahead of ourselves
and not really stressing the positives and then following up
to say, well, actually, how many people really are gonaic journalism?
The NYPD was having was going to have all of
(37:21):
these officers and ended up being like thirty, it's going
to be thousands and murder will Reigne Supreme isn't like
there are tens of us? Yeah. Uh, I did have
a question for you, Dr Freeze. You know, one of
the things that we touched on in the piece was
I guess how burned out nurses affect patients? Uh? You know,
(37:44):
cancers don't stop just because there's a pandemic. Other things.
You know, you don't stop breaking bones, you know, everything
else doesn't stop, Like the hospital system doesn't stop, and
people don't stop getting sick. So like, how is that?
I guess how how have you seen the knock on
effects of all of this happening? Yeah? So two things
on that. One is that even if you're not caring
for COVID patients, you saw a dramatic change in your
(38:07):
work during this period. That continues because your patients are
coming to you with more complicated problems because they couldn't
get their cancer screening, and so now they present with
a cancer at a later stage, or they have a
complication that we couldn't manage before they got diagnosed. Number one.
Number two, we had a lot of visitor restrictions, and
(38:28):
so we didn't have family members and loved ones who
could provide that extra emotional support for patients in the hospital.
And as you said, we had nurses with face times
and yeah, no, no one's checking the batteries. Uh, no
one's making sure the channels on the right channel at
you know, nine tenths t nine cents or whatever. Uh
(38:48):
So those pieces add up. I mean, I don't want
to trivialize that. You know, when you are alone and
scared in a hospital or you know, in my in
my family member's case, you know, they had to go
a very complicated diabetes. They had to go to the
office by themselves. Their loved one couldn't come with them
to make sure everything was being monitored properly and carefully,
and they follow up with questions, so everything got more
(39:09):
complicated and and and much of that stays to this day.
And then for the patients, as we said, cancer doesn't wait,
and heart attacks still happen, and in my case, broken
ankles still happen, and so I needed to seek care
in this pandemic. And you you are worried that are
am I going to get the care that I need?
(39:30):
Is everything going to work out? In my case, it
worked out beautifully. I couldn't have been more comfortable or
treated better. But but we have seen very clearly that
some care is falling through the cracks and continues to
do so. So that's bad for patients, and then it's
also bad for healthcare workers because they can't give their
very best, and so it continues to pour salt on
(39:51):
that wound that we're in this vicious cycle that we
can't seem to quite get out of. And I'm not
able to give my very best to my patients for
re sasons that are really outside of my control. And
I think that's always been hard for me as a nurse.
When I know something could have gone better but it
couldn't because of something beyond my control. That's very hard
to live with day in and day out. So then
(40:13):
do you think things right now, Dr Freeze are trending
the right way? Are we still kind of in a
bit of a holding pattern where it could still go
either way right now, So I think we have a
mixed picture. The one thing that I'm amazed at um
you know, a few weeks ago to transfer patient to
the intensive care unit for management of their their cancer.
(40:34):
They had a problem with their cancer complication, but there
were COVID patients in a separate part of that ward.
And the amount of intensive, unbelievable care that nurses and
doctors and respiratory therapists and pharmacists are giving you these patients.
We know far much more on how to treat patients
with COVID, and we are we are doing a better
(40:56):
job of managing COVID because we've learned a lot in
the last two years and that's a tribute to the
folks on the front line and the researchers who have
helped do that. So that's a positive. We have very
safe and effective vaccines and we now basically you can
walk in almost anywhere you want and you can get them.
So those are triumphs and we should celebrate them. And
at the same time, our nurses, doctors, pharmacists, respiratory therapists,
(41:19):
other folks have kept America's heartbeat going for all their
non COVID stuff. For the most part. But but, but
the net is fraid, the net is very fraid. And
I'm very worried that there is probably a group of
folks who are falling through the cracks, either because they
can't get in for care or the care that they
get is suboptimal because we'restrained so hard. And what I
(41:43):
really worry about is we're not going to fix this problem.
As COVID eases, We're gonna say, well, back to normal,
no problem. We have to learn from this and we
have to start making the changes now so that patients
today are safer and patients six nine months, nine months
a year from now, regardless of COVID or otherwise, they're safer.
(42:04):
And I feel like we're going to forget that. Is
there anything that the general public can do, because so
much of what you're talking about is it seems to
be in my opinion or just from my perspective. Again,
as a guy who only goes to hospitals to still blankets, No,
I don't take the black mantalin, don't clean it up
for me, and still them. These are very wonderful blankets.
(42:28):
As a person who's just on the outside looking in,
it seems that a lot of the solutions here lie
within the institution. But how do I, as just Joe
blow citizen, what can I do to help alleviate some
of these challenges? Is it looking at what our elected
officials are doing? How much does politic? Is there someone
I need to vote out? Like? What can do I
(42:49):
show up to the hospital and try to protest? Like
what can we do as regular people to help be
a part of the solution on this issue? Yeah, So
a couple of things. First of all, it's not just
the blankets. The real money is the warm blankets. So
make sure you ask for that next time. It will
change your life. It will change your life. So thank
you all. Thank You're very welcome for that tip. So
(43:12):
what can the public do? A couple of things. One is,
if you get great care at your facility, right the
CEO of the hospital and mention the people who cared
for you by name and tell them what a great
job they did. And if you saw quality of care concerns,
if you heard about mandatory over time or unsafe staffing,
put that into and say, hey, this is not what
(43:33):
I expect from my community hospital. Because they are accountable
to the public. Most of our hospitals in the country
are nonprofit and they're supposed to serve the community, so
they need to respond to you. If you know a
hospital executive, you can say, what are you doing to
keep your nurses safe? And the answer shouldn't be pizza
parties or coloring books. The answers should be eliminating mandatory
(43:53):
over time, humane staffing levels, and listening to nurses and
acting on their issues. And do you have a safety
committee for nursing and healthcare workers? We have patient safety
committees in every hospital. Do we have a group of
experts focused on healthcare workers safety? Missing piece? Finally, for
the policy piece, a couple of points. Every state healthcare
(44:17):
Most hospital issues are managed at the state level. Moving
throughout the country is legislation on um panalizing verbal and
physical abuses towards healthcare workers. Zero tolerance. You hit or
strike a nurse, or you call him a name, you're out,
full stop. We're not gonna, We're not gonna, you know,
with limited circumstances, you are we we are not obligated
(44:39):
to treat you, and you can be charged with a
with a crime. UM also mandatory staff, mandatory overtime, and
staffing ratios that are humane and safe. There's legislation in
many states. California has a staffing mandate uh some states
are working on banning mandatory overtime. We know those work
that keeps not only nurses safe, but it keeps patients safe.
(45:03):
So so those are a couple of things. And then
the final thing at the federal level, we talked about
the nursing pipeline for faculty. We don't have enough funding
to incentivize expert nurses to either stay at the bedside
to teach, or to teach in nursing schools. And if
we want more nurses, that's where we need to start.
And that's a solvable problem. That's a we have money, right,
(45:23):
I hope we have money. That's a money problem that
we can solve. And our nursing schools, you know, we
can work on our back end to make it work
that we can add, you know, bring more of those
people in that we're turning away year after year after year. Well,
I'm happy that you are a nurse educator and that
you're a nurse, and that you're a doctor of nursing
because with a name like you know, Dr Freeze, you
(45:46):
easily could have been a villain, all right, some sort
of comic book person that wreak havoc on the city,
but instead you reak love. Dr Christopher Freese, thank you
so much for going beyond the scenes with us today,
and Madeleine, I will see you again on year I
don't know, see the next pizza party, right, Thank you all. Hey,
(46:18):
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