One of the more insulting and disgusting maneuvers that most physicians and nurses have to contend with in our tough professional careers is the sickening, absurd re-positioning of our roles in a care team by the hospital and clinic administrators. Feverishly eager to find a “better edge” to supposedly deliver a much more “efficient care”—a not so subtle euphemism to mask their perennial quest to save a buck—they usually sit down in their plush air-conditioned offices to concoct all kind of specious changes to our work schedules and organigrams–effectively treating  us as inter-changeable peons in the big chessboard of their institutional structure. And, being usually totally ignorant of how a particular health care delivery team really works, they almost never fail to pick a humble nurse who, being very professional and committed, seemingly does not make much ado at her critical role in the team. She just soldiers on. Their maladroit tampering will trigger a chain reaction with unforeseen consequences.

The jockeying games.

Abusing an equine metaphor, we could say that they treat us as just a bunch of race horses—highly trained but docile animals all the same—whose standing they must continually re-arrange in the start line to get the best performance in the race track; infused with a self-serving objectification of their subalterns,  they “candidly” believe they can make do without any consideration whatsoever for our thoughts, desires, personal issues—let alone our feelings and aspirations. After all, horses do not feel. Or do they?

We have been far too meek to confront them in order to at least voice our concerns. Unfortunately, this perverse maneuvering affects our nursing colleagues the most. Career nurses have taken a long, long time to acquire the skills and expertise to fill critical positions in a specialized care team, something that cannot be replicated “on demand” by the bureaucrats manipulating their schedules and labor requirements.

Moreover, the same difficult and exhausting learning process involves all the other members of a particular care team, which endows them with their precious value. If a careless bureaucrat decides one day, out of the blue, to take one of these highly skilled nurses from that habitat and force-land her in a completely different team altogether, often great misery ensues for all, including the sacrosanct “bottom line.” Even the humblest of nurses is usually much more important than all the physicians combined in order to secure the smooth functioning of a specialized care team. What would happen to the daily surgical schedule of a major hospital if the nurse that does the final check-up at 6 AM is being replaced by a novice graduate in the OR suites?

Worse of all, these committed and expert women have painstakingly accommodated their family obligations to the draconian demands of their career obligations, which is no easy feat. The daily schedules of these devoted wives, mothers and daughters have been methodically calibrated to the latest minute in order to achieve their utmost efficiency for good outcomes for their loved ones. How can they suddenly switch gears and find the alternate arrangements for their partners, children, elderly parents, pets, etc., in that gratuitously provoked (often manly) mess in their agendas?

The institutional mandarins should stop playing around with our personal lives.

What do you think? Please tell us.

Don’t leave me alone.

5 thoughts on “Physician and Nurse burn-out – part II Jockeying games

      1. Sì, a Milano.
        Ebbene, è uno scenario surreale. Sai i quadri-le piazze di Dechirico? Devo dire che la gente si sta comportando molto bene, vengono rispettate le raccomandazioni, la gente osserva le distanze tra persone e fa le file ordinatamente, Milano mostra di essere una civile grande città del Nord. Certo, è una prova dura, psicologicamente.
        Sembra di essere in guerra. Le cose fino a ieri facili adesso diventano impossibili o difficili. Devo dire che l’impianto sanitario italiano è ottimo e alla faccia degli USA e del loro Trump, dove lui fa il superman quando il virus ce l’hanno ma i tamponi costano. Vergogna per gli USA! Sono gli USA che volevano esportare la democrazia? Quale democrazia?

      2. Caro Guido, e andato a la Universita Bocconi per fare parte de mi studi per la laurea a Columbia University ed sonno molto familiare con tua citta. Ieri ho visto nel TG1 una panoramica della stazione Milano Termini che mi ha datto paura. Nessuno! Neanche un cane o un perro sul binari. Sembrava un film da “fine del mondo” Si, io so che gli Italiani hanno preso conscienza della gravita perche mia famiglia a San Donna di Pieve e fermata nella casa con soltanto qualunche occasionale visite ai supermerchati. Coraggio caro amico!

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