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Learning to Speak Up

Jack’s schizophrenia prevented him from understanding the importance of taking antibiotics for a diabetic leg ulcer. As a student nurse, I was caring for him on the psychiatric unit where I worked.  Based on his olive skin, Jack may have been of Greek descent. Average height and weight, he had thinning black hair, beady eyes, and a hooked nose. Jack’s face remained expressionless, and he usually kept his head down, shoulders hunched.

He’d been found wandering the streets, years ago, so we didn’t know much about him. Jack rarely spoke, and I wondered if he’d suffered a trauma earlier in life.

“Hey, Jack, how’re you doing?”

“I’m AWLLL right. . . I’m AWLLL right. . . .“

Although Jack couldn’t hold a conversation, he belted out such an enthusiastic rendition of  “Somewhere over the Rainbow” that Judy Garland would have been proud. His attending physician found Jack’s singing hilarious and brought two colleagues to the unit. Standing in the hallway, the physician said, “Get a load of this. Hey, Jack, sing your song.”

On cue, loud, and terribly off-key, Jack performed “SomeWHERE Over the RAINbow, blue BIRDS sing. . . ”  He didn’t miss a beat, and the three roared with laughter. I never imagined medical professionals’ behavior could be so unkind. Forty years later, I still regret not interrupting the fun at Jack’s expense. Rather than speak up for him, I froze. Looking back, had I found the nerve to confront the physicians, the angry attending probably would’ve barged into my head nurse’s office, “Get rid of that mouthy student.”

Several months later, I was in another patient’s room where a resident physician attempted to start an IV on Ken. Tears streamed down the patient’s face as the resident cursed, jabbing the IV needle into the patient’s forearm.

No! Not on my watch.

This time, instead of doing nothing, I left the room in search of a weapon. Locating Joy, the charge RN, I blurted out, “The resident’s hurting Mr. Jones. Come quick. Stop him.”

She hurried down the hall and entered Ken’s room. In a calm, soft voice, she simply said, “Your behavior’s unacceptable.”

Startled, he looked up at Joy.

“Yeah, you’re right. He’s a hard stick. I’m sorry. I’ll get someone else to start it.”

I’ll always remember the small step I took that day towards becoming a patient advocate.

Marilyn Barton
Hampton, Virginia


10 thoughts on “Learning to Speak Up”

  1. Marilyn , thank you for this well done article that reminds all of us that WE are the patient advocates and must stand for them when they can’t!

    1. Thanks, Terry. Agree, plus there are many more venues to speak up for patients than there were forty years ago.

  2. Forty years ago most doctors were men. I suspect that the gender change has eliminated at least some boorish behavior. Excellent thought provoking article.

    1. Thanks, Mary. Agree, and there’s more emphasis on the team approach so people have more chances to speak up.

  3. Such a good “story” Marilyn, very well told, very well written. The challenges of speaking up are very common, as in frequent, for many of us. A junior anything, a woman, a child or teen, men too, most of us experience challenges in learning to speak up. Thank you.

    1. Marilyn Barton

      Thanks, Vicki. For at least fifteen years, hospital staff have attended classes on patient safety and are encouraged to speak up, which is great. However, you’re correct, it can still be difficult for the junior person.

  4. Marilyn, when we first started nursing it was considered inappropriate to confront a physician with their behavior. I am glad you got the charge nurse to intervene in a patient’s case.
    Thank goodness we have moved forward with interdisciplinary teams and collegial practice with all team members. Is it perfect-no. It is a work in progress for the benefit of our patients. Thank you for telling your story. Blessings.

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