Republicans blame President Obama for letting Ebola cross the border, because Presidents are supposed to be able to stop such things with their magical brain waves, apparently. Others are calling for the head of the CDC to resign, or perhaps to commit ritual suicide. But the picture that is emerging just about everywhere but on Fox News is that Ebola spread to two nurses (so far) largely because of really bad hospital management.
Which takes us to our next installment of “When Capitalism Kills.” I’m not sure when the last one was, but I’m sure I’ve written on this general theme before.
The husband of an ER nurse at a Florida hospital formerly owned by Gov. Rick “ball fan envy” Scott writes at TPM that his wife’s place of employment is run like most large companies/corporations in America. That is, the people at the top have no background or interest in how the products or services their companies provide actually happen. They are strictly money guys who have backgrounds in finance or something related but couldn’t manage production of their own products if you put a gun to their heads and threatened to shoot them if they don’t get that toothpaste into the tube.
Further, they have no respect for the expertise of the people who really are somehow making the products or services happen and would no more think to consult them about how to run the company better than they’d try to fly off the roof of corporate headquarters. Instead, if they decide something is amiss they hire outside consultants who will spend a few days having lunches with upper management and who will provide recommendations that, if implemented, would make everything worse. Just about anyone who has ever worked in the trenches of production or engineering departments of large companies/corporations will tell you this.
If you are such a person, read this and tell me how familiar it sounds —
… it is obvious to those who work there that the combination of lax training and toxic labor relations ‘leaders’ like him have brought to the company are emblematic of a big problem for US hospitals if a major outbreak of ebola or other infectious disease occurs. My wife’s ER has an ‘ebola cart’ with some lightweight protective gear and written instructions for putting on a PPE, but the instructions are a loose bundle of papers and the pictures don’t match the gear in the cart and has inaccuracies that put them at serious risk. It’s an object of gallows humor for the staff. That’s the totality of their training or preparedness so far. As we all now know, PPEs are not easy to put on and take off correctly. Even though nurses all have experience with standard droplet control (they see TB and HIV all the time), ebola is a special case. They have gone months and months without a nurse education director because no one wants to deal with their management and take the position. Her coworkers are clear that they will refuse to treat an ebola patient because they have woefully inadequate training in the correct procedures and lack proper gear.
And yet the head of infectious disease at this hospital went on the local news to proclaim the hospital was ready to receive ebola patients safely. They obviously didn’t bother to speak to a single nurse on the front lines. I’m not particularly panic-y about ebola, even though obviously the family members of ER personnel have a lot at stake in ebola preparedness. But I think that this situation will be the weak link in any major national response. So many of our hospitals are run by lunatics like Rick Scott who seek only the highest profit margin. They do not invest in training, they build charting mechanisms that are good for billing but not treating patients, they constantly fight with their unionized employees, they lie to the public, etc, etc. We like to imagine that competent, highly-skilled medical institutions like Emory will save us, but we have way more Dallas Presbyterians in this country than we have Emorys. You can see exactly this managerial incompetence—and toxic labor relations—woven through the statement released by the nurses at Dallas Presbyterian today. Also see the head of National Nurses United on All In With Chris Hayes for a similar perspective.
To put it bluntly: we’ve entrusted our national medical system to the managerial competence and goodwill of the Rick Scotts of the world, and that is much scarier than a podium fan.
One of the nurses at the Texas hospital said that in the second week of the Ebola crisis at her hospital she was provided insufficient protective gear that left her neck exposed. Meanwhile the hospital was releasing statements to the press saying they were taking every precaution and going beyond CDC recommendations.
In other words, standard corporate bullshit.
Meanwhile, many politicians of both parties are babbling about hiring an “Ebola czar,” who no doubt would end up being the public sector equivalent of private sector consultants — some Very Important Person who will perform public “we’re doing something about this” theater. And nothing any VIP does will ever trickle down to the level of the people directly confronting Ebola in hospitals, working with inadequate direction and protection because management doesn’t know the difference between a virus and vichyssoise.
Because here in America, that’s how we roll.