Moral Injury In Healthcare: Time To Fight Back 

I’ve lost jobs because I stood up for my patients’ safety. I’ve been a nurse for almost 30 years and healthcare is no longer about doing the right thing for the patients. It’s about making the hospital money and avoiding litigation.

As a patient I feel this! I went to the ER for severe pain, localized to my left arm, about three years ago. They referred me to a orthopedic specialist and said they could do nothing for me (literally nothing, except more muscle relaxers that were only making it worse). The specialist they referred me to, who was part of their network, had me wait almost an hour extra past my appointment time, they took x-rays, and he only saw me for about 10min and decided it was a hematoma and left the room without explaining what that was or why he thought that. He never even touched my arm or answered any questions. He just heard I had been roller skating that past weekend, and despite not falling or anything, I clearly must have just injured myself. Told me to wear a sling and he was gone. They handed me the sling, in a box, and sent me on my way to figure it out. Luckily I'm massively skeptical about this stuff and I'd already heard terrible rumors about this doctor, so I had another appointment set up with my Dad's orthopedic guy but it was about 4 days out (soonest they could see me). The sling seemed to be working, but I was still concerned because I also felt like I was losing my arm functions. Low and behold, go to get that second opinion and during an actual physical exam (where he almost sent me through the roof) he's like "you have severe, and I mean severe, tendinitis in your left elbow". Huh, imagine that. Ended up being a worker's comp case (which was a nightmare), but I had already started losing range of motion in that elbow from the sling. Had to work through that and the tendinitis itself via physical therapy to get stuff under control. Also explained why the muscle relaxers were only putting me in more pain. So yup, the in-network guy almost cost me usable function of a joint and probably my job, where as the guy who was highly recommended made sure to do the right thing. I was FURIOUS. And of course when I tried to complain to the hospital you could tell they were just ignoring everything.

It’s getting very hard to care about patients genuinely. I’m a nurse and an empath and I couldn’t do what I wanted to do. It’s never about care, it’s just about checklists and protocols. Only people that don’t give a damn about patients and care only about money thrive in environment like this. I couldn’t do it just for money...

It breaks my heart as a nursing student..I grew up believing I wanted to go in to law..then I changed course and went in to healthcare..i cry so much every time I see a patient die who SHOULDN'T HAVE

ZDogg for President! Fantastic. Keep on keeping on, ZDogg. You’re a game changer.

I am a PA, and suffer from burnout... I have been dealing with this for approx 5 years or so with total length of time since being a PA is approx 7yrs. I have been in counseling over this... I did get the loan repayment program... So next Nov... I am going to decided if I want to cont this job... which was once a calling or say enough is enough... I did two tours in IRAQ as a Navy Corpsman and it was easier, than my daily job

Thank god I live in Ontario, Canada. My city’s cancer program is tops. Grateful. I feel so bad for what so many Americans have to go through. Asking patients to stand up is asking the vulnerable to stand up; will you, if in their hospital, or their doctor, back them up? Bless.😔🙏🏻🇨🇦

Quit my job as a DON a few months back, completely burnt out from 9+ years of crisis after crisis, staffing shortages and then the final straw is being told I needed to do more and create a better “team” so staff are as willing to work themselves to death. My problem now is now though every hospital and SNF are using the same clinical model so I don’t really have an option other then going back to the floor somewhere quiet where I can help my patients as best I can...doesn’t really feel like a good option. Definitely looking outside of healthcare for opportunities

Thank you so much for this! Just shared with FB and new counselor for my own "Moral injury"! Feels so good to be heard! I will be FIGHTING THE FIGHT!

I hope many stand with you, I thank you all in advance

Wow!! Your video of Moral Distress in Healthcare was powerful and hit home where I live and and used to work!! I am a Hospice Lifer believing whole heartedly in the hospice holistic philosophy of comprehensive pain and symptom management as well as a unified interdisciplinary team dedicated to practicing consistent communication for a peaceful pt death and successful positive family/caregiver experience. Sadly, I left hospice a month ago because of this very experience; however, my heart and soul will always remain a hospice nursing team member. I am now bringing my extensive knowledge, experience and high moral values directly to families of hospice patients who wants to fill the hospice gap during the last hours of life. Thanks again, I needed to view your video and you are my new hero!!

I just power up after every time I get burn out. Then I find a new level of burnout. Anybody else feel this way?

What really hurts is when one is able to make a comparison between what was the ' caring profession ' , do no harm , honesty, respect, and be accountable for mistakes made .....That was 1969 , where we nurses worked for pennies, but our patient's welfare came first.....I noticed a change in the early '80's and today I barely recognize the profession ....

I can relate Z-Dogg! I see this daily as a therapist at the agency I work for. I think we need to get rid of bad administrators & supervisors too.

There is some nebula of qualities that follows the air around *Dr. Dingdong* that you feel as a patient the moment they step into the room.

This is so spot on, today more than ever. Thank you for speaking the truth- everyone needs to hear this!

Thank you so much for everything you do here, and the brutal honesty, much needed.

We need the right tools to fight back. I don't want an MBA, but increasingly I'm feeling that it might be what I need to successfully and meaningfully advocate for my patients.

Or even worse is, if that patient you reluctantly "inter-system" referred them to, has a surgical complication... When your gut feeling told you they would have been better off going somewhere else...

I do hafta add, i enjoy watching your vids. Keep doing what you do. Sending love.

I hope the professionals can begin a movement to end this despicable system! You will have my support. ❤️

Our healthcare model is centered around a for profit health insurance and prescription drug industry. Until we have a universal healthcare system, all these issues you're talking about are just going to get worse.

Always appreciate when your conscience speaks out loud. As a patient, I have been subjected to expensive, ineffective treatments by actually good decent doctors who are in fact good people working in a lousy system. For example a great dermatologist once referred me to a laser treatment for a surgical scar. After she was liberated from her practice, she confessed that that laser treatment wasn't effective and prescribed silicon wraps for my scars which worked beautifully. She was previously under pressure to mutually refer patients with this laser surgeon. Each institution seems to have a different protocol for treatments. For example, UCSF pulmonology has different drugs that they prescribe versus say the Palo Alto Medical Foundation or Stanford. I'm not sure if these differing protocols are due to economics, physician preference or experience in certain protocols. I suspect that optimizing patient benefits isn't necessarily at the top of this list.

That's why I left bedside nursing. Drove me effing nuts.

Best talk!!!!!!!

amen

this is a great video...so important

Lmao what did Penn Jillet do? I'm so out of the loop. 😂

My health system outsources their hospitalists and I seem to be the only one bothered by it. I think it diminishes continuity of care and lacks skin in the game for these hospitalists.

let's talk about this for students... this is so hard.

Haha. Dr ding dong. That made me laugh...

I'm 57. When I was a kid the family doctor knew me and my parents. My dad had his own doctor, who knew him well and saw him every six months and every year he had a physical. So far as I know, Blue Cross payed for most of it and my dad paid for the deductible. This was the 1960's. Doctors had nice offices and a few nurses and receptionists, and everyone knew the patients by name. No one would have imagined my dad's doctor would refer him to any specialist who my dad's doctor didn't trust, because my dad's doctor of course would not want to lose him as a patient. By the 1980's the system was a sea of paperwork and clerks who simply sign papers and distribute them to other people who are paid to sign them and pass them off to others. The entire system has been broken half a Century now and appears to only be getting worse. Now it appears to consider people nothing more than a single data point in a sea of fiduciary statistical reports to stock holders. This is why we need single payer. Let the bean counters find useful and productive jobs, or let them live off welfare.

It is SO obvious that the nurses who don’t “give a sht” are being selected for. Lots of new nurses start, eager to help, the ones that last long term are (often) not the ones I would want taking care of my family. I know this varies but I see it a lot. Admin doesn’t even care about bad outcomes, as long as the nurse doesn’t complain.

One thumbs down? Dr. Dingdong just unsubscribed.

This is happening in Veterinary medicine, as well. :'( The best veterinarians and the best technicians are suffering.

Rules: 1. I’m Intv Cardio. Being told what tools, stents, pacemakers I “have” to use. These are complex procedures. I’m facile with and comfortable with certain “tools.” But I’m told what I have to use.....and I’m the one who gets sued if something goes foul. One tool may be $100 less then the one I like...but trust me. Doesn’t get rebated to the patient. 2. Nurse told me she can’t measure a CVP off a dual lumen Shirley dialysis catheter (that I put in). Patient done with dialysis. Catheter out soon. A CVP would truly help me....Cardiomyopathy and renal insufficiency...Since when can a young nurse with community college degree tell me “no,” I won’t measure a CVP off the Dialysis Catheter because it is a rule. I’m left frustrated I can’t do what is best for patient

Gr8 Post. I Wub you!

3:13 I AM READY

Working in assistant living facility has taught me only $$$.matters. Burned out loath my job. Universal healthcare not for profit.

I'm so sad.. I'm a neuro-telemetry monitor watched a chest tube removed, no report of extra sedation, ICP went over 35, EEG went flat.. herniation.. I was 1500 mi away too far

Now we are talking. Together we can change the system. Alone we will continue bear the consequences of it and so will the population. Even worse, we contribute to it and sustain its existence. Heal people, let the over concentrated business of healthcare expire.

Paging Dr. Dingdong

Dearest brothers and sisters. I stand beside you. While we witness the death of a beautiful calling- the desire to care for our fellow man. We do this at a time in their lives when they are at their most vulnerable. When they need us the most. And YET; Daily and sometimes hourly we are separated from the ill, our charges, the very ones we swore to advocate for. Over the last 10 years of my nursing experiences, I have been berated for not pushing through admissions (in a For Profit hospice) even though the family didn't even realize their loved one was being referred for hospice! These lashings occurred every day at 5p during a meeting in which the CEO of the company came in for our 'pep talk'. I've come in to receive report to learn that there was no report on 4-5 poor souls because the nurse had not even SEEN them during her 12 hour shift! Because the acuity of her 26 patient load was too high to manage. Some who admitted this did so with tears in their eyes and hearts breaking. Others who had the same case load were cavalier, stone faced and blamed others. Accepting no moral obligation. I've watched the nurses that care move from position to position praying they can break a whole through the ever tightening fabric of apathy. The others stay and become interlacing fibers strengthening the moral decay. Before nursing some 30 years ago I was in the military X7 yrs. This was good preparation for the war at hand. This is going to be a difficult road. But I believe one thing. They've underestimated their opponents. You and I. Fight well. My apologies for the wordiness of this rant. I blame it on the Good Doctor.

In California, the governor just signed a Nursing Whistleblower Protection Bill. I think physicians need the same thing. Front line providers need to be able to report anonymously willful harm. My daughter was killed in a hospital and I've been reading the medical records. I'm so horrified. My non-terminally ill daughter enter the hospital for gastric distress and ended up being euthanized against her will - not just my opinion either - it is also the opinion of the depty attorney general who prosecuted the nurses who were caught red handed in the act of grinding 12 hour time release morphine into my sleeping daughter's freshly placed feeding tube (no pain charted all day). this isn't the only act that killed my daughter 14 hours later, to make sure she died one of the grinding nurses then just started escalating fentanyl until she stopped breathing - another nurse escalated Propofol and in her blood stream at death was an overdose of another when drug as well. The reason why I mention this story here is because there was another nurse a day before who honored my daughter's refusal to NOT take the TAB Morphine, and she also didn't start the fentanyl when it was ordered either because blood pressure was too low . This nurse was thrown under the bus by the hospital after I filed complaints about the perps. I asked the nursing board why this other nurse was being charged with anything and they said the hospital gets first shot to review complaints and can add others to it - and the hospital added the nurse that refused to harm my daughter. So I clearly see what the hospital staff is up against. If you do not participate in scheduled harm, then you will be prosecuted, and you will not even be able to actually save the patient from this fate. I see it - and me this graceless traumatized, grief-stricken, horrified, mother who failed to save her daughter no matter how I tried - even I see you guys as yet another level of victim - not the lst victim and not the 2nd but probably the 3rd level. But only YOU GUYS CAN STOP THIS GREED FUELD DEATH SPIRAL OF PATIENTS AND MORALITY AND LIBERTY, PURUSIT OF HAPPINESS, CIVIL RIGHTES, ETC.... YOU HAVE TO GET BRAVER AND GROUP TOGETHER. FIGHT FOR WHISTLEBLOWER PROTECTION AND ALSO SINGLE PAYER HEALTHCARE that pulls all the data together under the possible real time scrutiny of a government run healthcare - instead of a profit seeking entity with some government oversight made up of people who plan to cycle back into a lucrative industry job on the provider side for a big bag of money. Hopefully, government will become once again FOR THE PEOPLE and be trust worthy of this responsibility - but I KNOW corporatocracy cannot be trust worthy of this kind of BLIND FAITH . I watched Dirty Dancing for the first time lately - not even sure why - I think I couldn't sleep and thought a boring teen love story would knock me out - but instead I found a gem of hope. In the first scene the book The Fountainhead is mentioned as a guide to learn about which people matter and which dont; but at the beginning of the 3rd Act Johnny says "baby taught him that there are some people in the world that are willing to stand up for others even if it costs them something." We have to again learn to feel grateful about the opportunity to really stand up for something and somebody, anybody who has been stripped of their voice and life. we will all lose something standing up for the vulnerable, but maybe we will learn it's worth it. if you want all the documents to prove the above story let me know - it's way worse than I've described. Alternatively, you can also google NBC investigates Kaiser death 2017 TERRY PANEPINTO - this woman should NOT be dead. Like my daughter she entered same bank of east bay hospitals with gastric distress - only Terry was brain dead in less that 12 hours. I was told after my daughter's death by both a guy from the BOARD OF DIRECTORS AT THE HOSPITALS and also the Dept of Public Health that a bunch of safety measures were now in place so that no other patient would die by nurses overdosing them with sedation while IGNORING VITALS SIGNS - but then Terry dies and it hits the news...so it's clear to me this is going on A LOT and didn't slow down one bit after those "safety measures" were put in place. Plus the hospital did NOT report these drugs "errors" to the DOPH and was NOT fined for this in either case, and the DOPH did NOT fine IMMEDIATE JEOPARDY VIOLATIONS on either death as well...it's just ridiculous. PLEASE FIND A WAY TO STOP THIS. - I watched my daughter beg for her life while being drowned by fluid overload prior to the final overdose it was so terrible - she was so beautiful and sweet and kind and wise and generous and had many many friends who miss her still, like me. today is her birthday : (

Zzdog for President of the United States of America🤙🏼💯😍

I thought things would be better when I returned to Canada - I was WRONG, Canada spends nearly 12% of its gross domestic product on health care - so about 254 Billion or $6840 per Canadian. Entire provinces are amalgamating in order to save money - the province I returned to Saskatchewan, only has 1.1 million people - and it use to have the most hospital beds per capita in the free world - that changed! Now they are bringing in business consultants - to LEAN out the process of health care. Turning our hospitals in to factories - how do you compare the population that uses the ER to a Honda factory in Japan - crazy thinking.

The chronic pain community are rejecting surgeries because of bad treatment and lack of compassion when dealing with the post op pain that has become prevalent in our society. Hit them in their pocket to wake them up. Thats the only thing they understand, MONEY

Holy shit - your example story was my life until recently when our institution separated with this person. I asked multiple people, how can it be ok to do X, Y, Z to pts with NO accountability?!?! There was NO WHERE to turn with my concerns.

HOWWWWWW??? I was just talking about this with some colleagues at work! Question is how...what are the action steps to making this happen? How do we make this change happen? I only dream of the day when healthcare might actually be about the people and not the paper

😍

I just now realized Z Pack is a reference to azithromycin

I've just quit a 30 year nursing career due to the cruel and unreasonable treatment I was expected to give to a terminally ill MS patient. I knew what they were doing was wrong and harmful and I ended up having a mental breakdown after a year of struggling. I was a good nurse. I loved my job. Nursing is nothing more than an arse covering exercise now. I'm out for good. Care homes are glorified concentration camps.

Withholding Ivermectin was one of them.

Sir, if you want to impart change to a broken system please encourage your colleagues to name names. What hospital systems, doctors, and insurance companies are doing this. Document it, share it, and run the "bottom line" folks out of the industry. Keeping the specifics out of the public eye only perpetuates the problem. Great videos, by the way!!

Sounds like the socialized care at the va....which is 1 reason why i stopped going.

After reading a lot of the comments I see the Good Doctor is being urged into the presidential campaign. While I know we deserve someone like him in office....Let's preserve his brains, heart and integrity for the right war. That will keep him more than busy and he will be able to focus on a cause that presidents do not have the time or ability to address. Instead we may ask him to act as the conservationist of human rights. God knows humanity needs him!

Can you do an asmr video?

let's get to the root of the problem: money driving health care; money driving politics; money driving science and the cdc, fda. vote Bernie and he will change this.

Why Are NOT the Doctors.. all over the Country.. Standing UP.. to the DEA.. CDC.. Ect.. Unbelievable. . We have what we Tolerate " !!! Pain Patients all over the Country as you know are suffering bad.. But.. Doctors.. Need's to file Suit against the System.. They are the only one's that can reverse what's happening !! '

One of the major problems we refuse to talk about are all the slimy Indian doctors in our profession, who have slowly made themselves a majority demographic. They primarily come from a bartering culture which is no surprise when you see how they practice a business model. It’s also a social stigma growing up in an Indian family that unless you become a doctor, you’re considered a disgrace to the family. I had many Indian classmates who explained the social pressures they had and that their hearts are not in it.

I suffer from moral distress when I'm forced to hand out opioids (aka legalized heroin) like candy to patients who don't need it because it's been pushed by the pharmaceutical agenda.

Socialism doesn’t jive with great healthcare