Treat nurses as professionals

Re: "Nurses: Key to Making or Breaking Your Future Margin" by Richard J. Bogue, H&HN Daily May 29

I am in full support of your recommendations, yet I want to bring one thing to your attention that you misstated in my view. Under the sections of suggestions to leaders, you mention collaboration with colleges to "train" nurses. Dogs are trained as well as the rare cat. Nurses are educated — if you wish others to recognize the incredible work and caring that nurses provide, treat them as professionals, use the word "nurse" to refer to the registered professional nurse only and provide them with sufficient registered nurses and support personnel so nurses are with their patients and not running for meds or tracking down IV pumps or doing the work better suited to the UAPs in the hospital setting. I have been an RN for 39 years with more than 35 years in management positions, including both director or chief nursing officer. For patients to come first, leaders must put their nurses first. My motto: "If you take excellent care of the nurses, they will be able to take excellent care of their, and your, patients."

— Kathleen M. Mulcahey, MSN, R.N.
Director, RN IN THE HOUSE Tutoring Services
Collingswood, N.J.

Families matter

Re: "The Frustrations of Sick Americans" by Susan B. Frampton, H&HN Daily June 13

Patient- and family-centered care is an approach to the planning, delivery and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients and families. It redefines the relationships in health care. Patient- and family-centered practitioners recognize the vital role that families play in ensuring the health and well-being of infants, children, adolescents and family members of all ages. They acknowledge that emotional, social and developmental support are integral components of health care. They promote the health and well-being of individuals and families and restore dignity and control to them.

Patient- and family-centered care is an approach to health care that shapes policies, programs, facility design and staff day-to-day interactions. It leads to better health outcomes and wiser allocation of resources, and greater patient and family satisfaction.

— JKaufman

Don't dock the docs

Re: "Is This Really Necessary? Taking a Second Look at Common Medical Procedures" by Emily Friedman, H&HN Daily June 5

As a physician, I am not sure that physician reimbursement should be tied to outcome. How often have I told my pulmonary patients not to smoke, yet they continue to do so. Why should I be penalized because they decide to continue to harm themselves? May I refuse to see patients who smoke? What about the renal patient who is discharged from the hospital and goes out and has a beer and peanuts. I can give them the tools, but they don't always listen. The reimbursement system is wrong.

— Jmdorf

The value of chaplains

Re: "A Steady Dose of Empathy" by Ruth Malloy and Jim Otto, H&HN Daily June 7

As a longtime board-certified chaplain currently affiliated with HealthCare Chaplaincy in New York City, and from my clinical experience in ICUs, EDs and on palliative care teams in major medical centers, I agree that empathy is essential. Having worked closely with physicians for several years, I know that most — not all, but most — do have empathy for their patients but struggle in how to express it while attending to the numerous clinical pieces they have to be attentive to. I've also coached and trained medical residents on how to learn and utilize these skills — which is yet another challenging endeavor when the medical education program is so demanding. I do believe that board-certified professional chaplains can be an organization's — and physician's — best resource not only in educating, but also modeling empathy. … I'd like to see more conversation on how chaplains might partner with physicians more closely not only in identifying the ways empathy can be communicated, but also in enhancing the whole patient-family experience.

— Sue Wintz