Healthcare Worker's Search for Meaning

"The last of human freedoms- the ability to choose one's attitude in a given set of circumstances" 
Viktor Frankl

When you are a healthcare worker there is one thing you never want to hear: a fatal error leads to patient death. Sadly, today was one of those days. This terrible event is mentally and physically painful to grasp and reminds us all of our inherent and human ability to fail. The pain of the family is extremely raw and the society’s response is intensely broadcasted, and for good reason. Today though, just for once, I will talk about the pain of the provider, the one entrusted with your safety.

I am a frontline worker. That means I go every day to work doing all I can to provide the best care for my patients. I can say the same thing about all my colleagues, and I wouldn’t exaggerate. I would probably extend this to the whole community of healthcare professionals everywhere. We put our time, our heart and soul in this profession and we are driven to seeing patients get better. We are wired to care, regardless of the circumstances we find ourselves in. For us, a fatal incident is felt acutely.

Let’s say you are working for this hospital, where a fatal event happened. What would be your first reaction? Blame the system? The party who won the election? Petition so that “heads will roll”? Or maybe you hang your head in shame, hoping it won’t be you next time making that error? I believe it’s all a matter of perspective, of how you see yourself in the world.  

It is unfortunate that too many times in the history of improving healthcare, there had to be a victim in order to spur change. Take for example Virginia Mason Medical Centre from Seattle, Cincinnati Children's Hospital, Johns Hopskins. They each created a vision and transformed healthcare after one of their patients died. Some cynics would say that someone has to die in order for something to improve. That is not necessarily true.

Improvement occurs constantly and continuously, although many might find it hard to believe. Yesterday for example, I found out about some quality improvement initiatives that had significant results on patient care in the same hospital we are talking about. I was amazed by the work of the teams on these units, the amount of extra time and passion they put into it, and the excellent patient outcomes. Only few years ago, “quality improvement” was a term rarely (if ever) used by frontline staff. Today, we talk about it, we become more and more aware of its importance, and we implement initiatives with great results. It is happening.

Healthcare organizations are the most complex form of human organization we have ever attempted to manage (Peter Drucker, 1993), and hence most difficult to change. We are risk averse, and changing this culture takes time and perseverance. We are stingy in offering praise to our frontline workers, although many go far and beyond their job description. We fail, yes, we do. But we also hurt deeply with every fatality and search for meaning. Still, we get up and start anew tomorrow. And while we will apologize for hurting you with a needle poke, we are unapologetic about our true intentions as healthcare workers: to improve ourselves, our system and the care our patients receive, and become as close to perfection as we humanly can.