After working at Saint Francis Hospital as a Licensed Psychiatric Technician from 1974 to 1985, and then a Registered Nurse from 1985 until 1994, I was essentially pushed out by Liz Gray, who had been hired to create some turn over in staff. Many of us at the Saint Francis’ Western Psychiatric Center had been there many years and were at the top of the pay scale there. After Ronald Reagan in the 1980’s, hospitals across the nation turned their attention away from good patient care to profits. They called it “managed care” but it really was about decreasing actual patient care so that more profits could be generated for C.E.O.’s and any shareholders if there were shareholders.
Previous to Reagan, from my perspective, most businesses valued experienced employees that were well qualified but those employees become expensive over time. After the 80’s, businesses, including hospitals, embraced staff turnover to maximize profit. Businesses were no longer interested in retaining employees that had the most experience and were most expensive. Now, businesses were finding ways to harass their long time older employees so that they would voluntarily leave. At the same time, treating acute psychiatric patients on hospital units with qualified and experienced staff was expensive for hospitals. Hospitals started increasing patient to staff ratios at an alarming and unsafe rate. At Saint Francis, all but one of the Licensed Psychiatric Technicians were laid off and replaced with unskilled twenty-somethings. The treatment programs and group therapy were replaced with custodial care.
I had developed the computer program, MacNursing, on my off hours while working at Saint Francis. The “admissions nurse” position had been created around my computer program. All of the patients were admitted into my system. All of the admissions paperwork was done on my system. The care plans were written in my system. Most of the forms needed by the State of California for Short Doyle funds, 5150’s and 5250’s were all generated from my program. People care from other facilities to see how I had computerized the nursing admissions process and made it much more efficient. Managers I had previous to Liz Gray loved the computer program that I had created and wholeheartedly supported it. Even Liz Gray loved it initially because she could get any kind of statistics she needed from the program. But, ultimately, her job was obviously staff turnover and I had been working at Saint Francis since 1974 and had to go to meet her goals. (A couple of years after I left Saint Francis, I was hired as a consultant to update my computer system for them but without any leadership or supervision, the program wasn’t put into use after that. The program was also purchased at Saint Luke’s Hospital’s psychiatric unit and had it’s biggest installation at the Veteran’s Hospital Spinal Cord Injury unit in Palo Alto).
After watching my peers harassed into leaving Saint Francis and watching one of my best friends walk out in anger and frustration, my day eventually came. Liz Gray made it a point to harass me in some way almost every day. I started looking around for another job and put in applications. The final straw was her shutting down MacNursing to spite me. John George was hiring and I took a four day a week job there on their “Unit D.” Elaine was my manager.
John George was a pretty horrible place to work. Each unit only had to Registered Nurses, one Licensed Vocational Nurse or Licensed Psychiatric Technician and the rest of the staff were merely high school graduates with no real qualifications, experience or education. Each unit had approximately 24 patients. It was a “Civil Service” job to some extent and very poorly managed in my estimation with poor morale and practically non-existent discipline. Middle managers hired staff that should have never been working with a vulnerable population, that did not understand basic concepts of care, and then those same middle managers would hold the R.N.’s responsible for the staff!! It was a no-win situation for the R.N.’s that seemed to be the only staff held accountable for anything.
John George felt like a dangerous place. Patients were sometimes violent and acted out. Sometimes the patient violence was in response to poor staff interactions. One psychiatrist was killed when a patient stabbed him in the neck with a pencil. It was not unheard of for some staff to be having sex with the patients. I don’t have to really go through all the horrible things that happened there because many of them have already been reported by the media. While I was working there, though, nothing every really seemed to change.
At some point, my friend, Cynthia, heard of positions at the Kaiser Call Center in Vallejo for Registered Nurses. At that time, I was commuting 45 minutes each way from Vallejo to John George. Working at the Call Center would require the ability to talk on the phone with patients while navigating screens on a computer. These were skills that I excelled at.
For a while, I worked both jobs but was happy to finally submit this letter of resignation!
Patient Care Coordinator
John George Psychiatric Pavilion
First, I just want to thank you for your flexibility these last few months regarding my scheduling.It has been very helpful with my transition to Kaiser but it has made this letter very difficult. When people have been good to you, it is hard to say good-bye.
I have been working at Kaiser or John George every weekend for most weekends of the last few months. I have neglected my painting, friends and other interests in my life. The forty mile commute each way is feeling longer and longer. Although I will miss adult psychiatry and many of the staff at John George, I must hereby, reluctantly, submit my resignation. I had already requested the week-end 2/5/2000 and the week-end of 2/10/2000 so my resignation can go into effect at that point.
Sylvan Rogers, R.N.