Conspiracy of Kindness
Sharma Vaughn, RN, MPA
Executive Director, Community Care Alliance
Western Healthcare Alliance
April 22, 2020
The hospital will remain nameless. Some people will think they probably shouldn’t have done it. Others of us think these are the most important things a person can do. So, for all intents and purposes of a publicly posted blurb, it never happened, and everyone will remain nameless – Scout’s honor.
The puppy wasn’t breathing well. Newly born, it was of a snub-nosed kind of breed, and its new, distraught owner/mommy was very worried that it had inhaled milk while nursing. She was right. The x-ray (that was…ahem…not taken) confirmed it was likely aspiration pneumonia.
There was no veterinarian in town and none remotely close. In the meantime, the doughy ball of fur needed help, and the hospital team could give it. So, they did. And they aren’t the only hospital who has done it. The menagerie was always disinfected and swept away, infection control resuming its pristine reign. The only thing left behind to speak of the conspiracy would be the smiles.
The senior nurses would say that they cut their teeth on these kinds of stories. Before my time, there were stories of horses, steadfast and present until their cowboy met their western sunset. There were kittens in the pockets of nurses, the secret of the tiny stowaway guarded fiercely in quiet smiles of conspiring patients who delighted in the soft fur and joy of having been needed by someone or something.
But for the record, there are no names, faces, dates, or places. It didn’t happen, except that the hospital walls were saturated in the conspiracies of kindness that lifted everyone’s heart.
Necessity is usually the mother of invention, they say. As a nurse in a small-town hospital I recall many such moments. Like the times we plastered Elmer’s School Glue on tender skin to pull out cactus spikes. Necessity: the reason we keep construction tools in the ER. Necessity inspired the day out on the highway when we used the floor liner in the hatchback of a Subaru as a gurney for the unfortunate motorcyclist who needed his spine immobilized.
This kind of thinking predates us, though. Our heritage was a profession of invention. Those matriarchs and patriarchs used broomsticks to tighten sheets around pelvic fractures; or cups of ice to shape nasogastric tubes to glide down the nose and into the stomach; or hot, wet washcloths to find veins for an IV. We revered the tales of doors removed from their hinges to make backboards, and the two-wheel drive station wagon ambulance that picked up patients on remote oil-field desert roads.
This kind of creativity carried over into the culture of the hospital. When severe weather separated us from the care a patient needed, would the town employees be willing to plow the pass? They sure would. They’d done it before.
When short on antibiotics and socked in from bad weather we’d plan creatively. Would the sheriff deputies make a medicine run for us? They sure would. They’d done it before.
And right now, thinking creatively in the absence of funds or resources, the hospital stands up disaster response for a pandemic. They work incident command for eight hours, and then begin their regular day of work.
Funding for rural healthcare has never made sense at first glance. Why put up a hospital in a community with so few people? Because people are valuable. The truth is that rural hospitals can deliver care much more affordably than their urban counterparts. The fact that we have fewer patients to spread the cost makes it problematic to justify among urban circles that don’t know how important our neighbors are. They simply don’t know Bill, who runs the feedstore. They’ve never met Dee who keeps your coffee hot and your welcome warm in the café. And please, no one tell them that the shortest DMV lines in the state lead to Shirley who gives you a logical DMV experience, so unlike any other DMV visits that you think you must be in an alternate reality.
Broad sweeping political decisions very often don’t consider rural needs. The pressure for an accountable healthcare system needed in some urban areas threatens the existence of healthcare in others.
Do rural people deserve healthcare? I’m not talking about every small town having a neurosurgeon. I mean primary care, preventative care, emergency care, and elder care.
Right now, we have major political movement in Colorado to contain healthcare costs. Healthcare is out of control. How should we curb it? Should we let the golden dome set hospital prices, the same prices that historically won’t get paid by any payor anyway? Should we rally the community to take a stand against the hospital, allowing alternative programs to route care in another direction because a hospital has been using a profitable service to keep an unprofitable service open?
I think there are other options. By consulting the past as we face the future, we learn a lot from the times a town comes together. Like when Community Hospital in Grand Junction donated hundreds of masks to the homeless and to shelter workers. Wasn’t that just last week?
Or when Rangely District Hospital, unaccustomed to being in the spotlight, used the moments of public attention to point to the needs of small business in its community. They started selling shirts and sending proceeds to the town to support small businesses.
It’s about solutions like what Montrose Memorial Hospital has been doing in supporting preventative care. Sounds like bad business for the hospital, sure, but collaborative effort to reduce the cost of care and improve health is just the right thing to do.
The collaboration isn’t just about healthcare. It’s about the economy, relationships, education, forgiveness, creativity, and faith. It’s the most important thing we can do. Besides, we’ve done it before, this conspiracy of kindness.