Recently, we sat down with Theresa Brown, a best-selling author, New York times contributor, and registered nurse based out of Pittsburgh. She talked with us about the current state of healthcare, both within the city and nationally, and shed some much-needed light onto the life of an RN. Below are the highlights.
Sam Bisno: Our first question is just: Why did you become a nurse?
Theresa Brown: Oh, right. So this is what I call the million dollar question, because everyone is like, “You’d have to give me a million dollars to quit being a professor and become a nurse instead.” Now, it probably would probably be like ten million dollars. So the short version is that I had a slow realization that I didn’t want to be a professor for the rest of my life and then I had kids and felt like, “Wow, what if I could do a job like this?” That was kind of what I call dealing with the mess of life. Diapers and sickness but also love and joy and craziness and fun. And I have a friend who’s a nurse. I was talking to her about it and she said, “Well, you know you could become a nurse.” And it had never crossed my mind and then I looked into it.
Isaac Degenholtz: So how long have you been practicing in Pittsburgh?
TB: I think about 11 years.
ID: You’ve done a lot throughout your career. You’re a registered nurse, a bestselling author, and a New York Times contributor. What is your proudest accomplishment?
TB: Okay, we’ll leave the kids aside. I would say my sense of activism about nursing. I think always trying to make clear how important nursing is to healthcare and really raise the profile of nursing. I feel like that’s happening more and more. Not that I’m personally responsible for that, but I think I’ve played a part. And then activism for healthcare for having affordable healt care for all Americans.
SB: Obviously, Pittsburgh is known on a nationwide scale for its healthcare system. Hospitals continue to be one of the city’s largest employers. As an RN who has worked for both UPMC and AHN, do you feel like Pittsburgh is delivering on its promises to patients in terms of quality of care? Is Pittsburgh really the nation’s leader in healthcare, or is there room for improvement?
TB: I think there’s room for improvement. What I see is these two behemoths – really, UPMC is a bit of a bully in the business part of healthcare. So you have these two big companies, one definitely more aggressive than the other. I would say that’s UPMC. And they each have to put a huge amount of resources into this battle with each other, and it just makes sense to me that all that money and time and energy could be going into healthcare. I was just reading about this new negotiation regarding the cuts to Medicare patients and what they’ll be able to access. And I just thought of all the money that’s gone to lawyers on both sides to work on this, instead of to nurses or physicians or to quality improvement projects or anything that has anything to do with healthcare, rather than making money for one system or the other.
SB: So we touched on this idea of promises made to patients in the area. What about promises made to workers? Thousands of healthcare workers in the city can’t even afford to look after their own health. What’s working and what isn’t on that front?
TB: I do know that that’s definitely an issue, that a lot of UPMC staff feel like their insurance is not very good. When I started working as a nurse, I got insurance through my husband, who is a Pitt faculty member, and people told me, “Don’t don’t give that up for the insurance you’d get as a nurse,” which really surprised me because I thought that as someone working for healthcare, the least you would do is care for the health of your staff so that they can care for other people. It would be lovely to see and embrace the values that we as a city supposedly espouse toward the people providing healthcare and care for them so that they can care for others. What’s going to make that happen? We could try shame, we could try to appeal to the quality of care. You could try to get a sense of civic responsibility. All of those it might help shake some stuff up.
SB: RNs are obviously at the front line of bedside care. From where you sit, what knowledge or skills do RNs have that others may not? How important is it to lift up nurses’ voices? Are we doing enough of it and, if not, how do we do more?
TB: I don’t think we’re ever doing enough of that. So I’m taking your questions in reverse order. How do we do more of that? An international campaign called Nursing Now has just launched and Kate Middleton, the Duchess of Cambridge, is involved with that. And I’m just learning more about it. I think that’s fabulous, to have a worldwide movement that apparently is funded and has a real board behind it and is saying, “Let’s really showcase what nurses do.” Tthat’s wonderful. But how did we get there? Fine-tuned clinical knowledge that nurses tend to call intuition because it feels like intuition, but it’s an assessment ability that you develop with experience. So you walk into a room and say, “You don’t look right.” Maybe it’s that they just had lunch and it really didn’t agree with them, or maybe that’s something bad that’s starting to happen. So that ability not to diagnose, but to sound the alarm, is such an important skill and it saves people’s lives. And I think the other thing is to be a truth teller.
SB: Could you tell us a quick story about some time that you feel really exemplifies the trials and joys of being a nurse in today’s world?
TB: I had a patient once. We were discharging and it was around Christmastime and he needed to go home on a number of certain medications for a number of days and his insurance wouldn’t cover it and he didn’t have any money of his own. And getting him out of the hospital with that drug was this long, complicated thing about what the case manager, who is also an RN, could do, and what the social worker could do, and what the pharmacists could do. It was several hours that it took but, finally, we did get this patient out of the hospital and he had a 10 day supply of the drugs that he needed. And it is very frustrating, because you start to feel like, “Wow, that’s so stupid. What a waste of everyone’s time.” But we made it happen. And the fact that it was right before Christmas puts a little star on the top of the tree. I think when we think about nursing we don’t think about things like that.
ID: Finally, do you have any advice for students of Obama who might want to be doctors or nurses?
TB: I would say that both are great professions. Think about really learning to see which appeals to you more, and be aware that there are lots of difficulties now in both fields and lots of people working very hard to make it better.
Ms. Brown’s best-selling book, The Shift, is available to purchase from most mainstream retailers. We’d like to extend to her our gratitude for taking the time to field our questions.