The website blog offers reflections and experiences by current and former HCMC employees and staff members about their work and careers at the Medical Center. The interviews were conducted and edited by Iric Nathanson and Thomas R. Mattison.
Iric Nathanson writes local history. He is the author of Minneapolis in the Twentieth Century: The Growth of and American City (MHS Press, 2010). Thomas R. Mattison worked at the General Hospital/Hennepin County Medical Center from 1966 to 1984 and was the HCMC Administrator for 7 years. They have co-authored articles about the history of HCMC for the Historical Society of Hennepin County and the Minnesota Historical Society.
September 23, 2013
Marie Dougan worked as a nurse and a nursing supervisor at HCMC for 29 years. In 1997, she retired as Supervisor of Supplemental Staff.
This is her story
I had always wanted to be a nurse. Back when I was growing up, there weren’t a lot of career paths for women. You could be a teacher, a stenographer or a nurse. I didn’t want to teach and I didn’t want to be a stenographer, so nursing was the path that I chose.
I graduated from nursing school in California with a five-year degree, and worked there for several years. Then we moved to Michigan. We were there for only about 15 months, before my family relocated to Minnesota. When we first came here, I worked part time in a doctor’s office. But when my children were ready for school, I decided that it was time for me to get back into the profession full time.
There was a nursing program here at HCMC that put us through a refresher course. I needed that, because I had worked in a clinic for nine years. The program enabled us to work from nine to three with the weekends off, and that fit my schedule. I worked as a float nurse for a year and then took a position with the school of nursing at the hospital.
When the school closed, I went back into the hospital where I worked as a supervisor of the orthopedics ward, and then I moved on to a new position where I supervised the float and temporary nurses.
When I first came here to HCMC, we were in the old hospital. The facility, itself, was very confusing. It was very scattered. There were open wards and a lot of separate annexes so you had to go from one building to another. There were bars on the windows. And I wasn’t used to the clientele we had at the hospital.
All of this was overwhelming. I remember telling my husband on that first day that I was never going back. He said, “Well, maybe you should give it one more chance,” I did, and 29 years later I was still here.
Gradually, over time, I got used to the environment. I enjoyed the work, and made friends with people on the staff. I can’t say that there was any one point in time, when I made up my mind to stay. It was a gradual process.
At the beginning, I certainly never expected to stay for 30 years. But the job grew on me. The working was never boring. It was always interesting.
As a supervisor, I was responsible for the 18-bed men’s orthopedic ward, and the 20-bed women’s orthopedic and surgical ward. Every afternoon, we would get the fresh surgicals. There were 22 beds along the wall, and we would fill those beds. But then there were beds in the aisles, and we would fill them, as well. We would put the convalescing patients in the aisles, and then we would put the people who needed more care along the wall. There were no curtains to screen off the patients. The ward was packed with patients, from the foot of the bed to head of the bed. People stayed in the hospital longer then, so that is one of the reasons the ward was always full.
When I was a float nurse, I did a lot of physical work—getting patients in and out of bill, giving bath, helping them walk, whatever needed to be done.
When I was a float nurse, I would come in at 9 AM in the morning; the overnight nursing supervisor was still there, waiting to be relieved of her charge duties. Because I didn’t work in the same ward every day, I needed to learn about the patients and their needs very quickly.
Almost every day, there were difficult situations to deal with. I remember coming into the ward, and finding a handgun in one of the patient’s drawer. I was somewhat taken aback, so I asked the man, “did you bring this in for a purpose.” He said, no, but it was with him when he was admitted. So I said ,” you know, it is against regulations to have this in the hospital, so we will need to take it and keep it for you.” He was OK with that, so I hurried up and called security.
When I moved to a supervisory position, I was very involved in patient care. I knew every patient. I knew about their physical and emotional needs, and I knew about the care that my staff was providing for them. The work may not have been as physical as when I was a float nurse, but it was very demanding. I was there at seven in the morning, and I stayed until about 4:30 in the afternoon, so I overlapped with all three shifts. I had to oversee the work of a large staff. If one of my nurses made a mistake, I was ultimately responsible. The “buck” stopped with me.
In the early 70s, there was a severe nursing shortage, and that was a very stressful time. One of my staff remembers seeing me sitting in a hallway crying, because I could not find the nurses I needed to do the work that needed to be done. We tried to balance workloads as best we could, but it was very difficult.
I remember coming to work one day in the old hospital, and it was absolute chaos in the wards. We had one gentleman who needed to go to a nursing home, but he didn’t want to go. He made quite a fuss, and demanded to make a phone call. Meanwhile, the one television in the ward had broken, and the patients were very upset about that. Plus, there were several women patients who very irate about something, and were making their concerns known in no uncertain terms. On top of that, the place was packed with beds. There wasn’t a square inch of open space.
Just then, Jane Phillips, the hospital’s head of nursing appeared with several of the county commissioners. I thought to myself: “This is awful. I am done for. I will never see another day here.”
Jane and the commissioners made their inspection and started to leave. Jane was just going out the door, when I went over to her and started to apologize. But she just smiled and gave me a thumbs up. I realized that meant that the negative conditions in the wards had a positive impact on the commissioners. It helped them understand the need for a new hospital.
When we moved to the new hospital in 1976, it was a big change. My staff went through a real grieving process for what they were leaving behind. They felt there was a real sense of camaraderie in the old hospital that would not be replicated in the new hospital. I remember the day we transferred to the new hospital. After the patients had been relocated, one of my nurses stayed behind with me to finish up the move. She was crying. My nurses were grieving, but I wasn’t. I was ready for the move.
The profession of nursing has changed a lot since my early days in the field. The status separation between the doctors and the nurses is not the way it used to be. Then, the nurses trailed along behind the doctors, holding the charts, while the doctors were making their rounds. That doesn’t happen anymore. Now, we are treated like professionals. There is a realization that all of use, the doctors and the nurses, are all working for the same goals to improve the lives our patients, and that is a very positive development.
August 16, 2013
Dr. Gaylan Rockswold’s ties to HCMC extend back to 1964 when he was a medical student on clinical rotations at what was then Hennepin General Hospital. Following his residency, Dr. Rockswold joined the medical center’s staff in 1974. From 1974 to 2011 he headed the Department of Neurosurgery. Currently, he chairs the Hennepin Health Foundation.
This is his story.
I grew up in Northern Minnesota, where I went to high school. Back then, I thought about becoming a civil engineer. Then I took one of those vocational interest tests and I scored off the charts in medicine. I went on to St. Olaf for pre-med and never looked back.
Early on, in medical school at the University, I thought I wanted to become a general practitioner. That was the model of a physician in my hometown, but after a while, my thinking began to change.
My first clinical rotation was here at what was then General Hospital. I was a surgical clerk with Claude Hitchcock. Being around surgeons and surgery really peaked my interest in that specialty. Later, I met Lyle French and Shelley Chou who were giants in the field of neurosurgery and wonderful role models for me. In medical school, I loved the neurosciences. Finally, I realized that what I really wanted to do was to become a neurosurgeon.
I was a medical student here at this hospital in 1964-65. After that, in 1966-67, I was a rotating intern. I came back as a chief neurosurgery resident. Then, I joined the staff in 1974, so my connection with HCMC goes back nearly 50 years.
Life as an intern was quite different during my time, compared to today. There was much less supervision then. Interns and residents were responsible for patient care. Staff probably made formal rounds once or twice a week and they were available to consult about the new patients. Interns were often stretched to breaking point in terms of their workload. Often we were in the surgical areas every other night. You would put in about 36 hours, go home for 12 hours and you would be back for another 36. That was routine. In the emergency room we worked 12 hours on and 12 hours off for 50 days straight. Our hours were really quite horrible.
Today, I think the pendulum may have swung too far in the other direction. Interns and residents have fewer responsibilities than they did in my day. Back then, the interns and the residents were overworked. That needed to change, and it has, but we did learn how to discipline ourselves. We learned that there were times when you needed to get up at 2 AM and prepare to operate. You couldn’t tell yourself that you were sleep deprived and you couldn’t function. That just didn’t work. You had to learn how to get up and do your job, and do it right.
My first experience here was when I was in medical school, and we were in the old General Hospital. There wasn’t air conditioning except for a couple of window air conditioners in the ICU. Otherwise, it was hot and the wards were open with curtains between the beds. There was a strong sense of camaraderie among people working together back then, just as there is now, but it was very different then. The operating rooms were small and were on the upper floor. Today there are a lot of rules and procedures that must be followed. The work got done quite well back then, I think, even though there were not so many rules.
As a young student and intern, you don’t have much time to think about your working conditions. Your perspective is narrow. You are trying to get through your 36-hour workday. There may be a few hours of sleep, but it is all work all the time. You just accept your working conditions for what they are, and that is what I did when I was an intern and resident here.
I was here at HCMC when the move was made to the new hospital in 1976. All of a sudden here was this wonderful, beautiful new medical center. Then, many of us realized what we had been putting up with at the old General, all this time. People with a broader vision-- the administrators and the political leaders—saw the old hospital as an inadequate facility, but for the interns and the residents, that wasn’t our main concern. We were just trying to get through the day.
For those of us who are surgeons, it takes a long time to hone our skills. It happens very gradually. It is a little like putting a frog in cold water and then heating the water slowly. That frog doesn’t realize what is happening to him. That is how it is when you are learning to be a surgeon. You start out drawing blood and then you do some general surgery. For me, that happened for the first time when I was an intern and I made an incision into the patient’s skin to remove a fatty tumor called a lipoma. It was a simple procedure, but it is something I still remember today.
The whole concept of resident training is like an apprenticeship. Step by step, you are given more responsibility and less supervision. It is a gradual process, from that first lipoma until you start clipping ruptured aneurysms in the brain. For me the process stretched out over almost a decade – eight years to be exact, from that first day as an intern until I finally finished neurosurgery training.
Once you become a staff physician, as I did, your role changes. You are no longer a resident. The buck stops with you. You are ultimately responsible for that patient and his or her care, so the sense of responsibility goes up. Now, you are responsible for the students and the residents, as well as for the patients, so you take on more of a supervisory and teaching role. You become more confident as you do more cases. There is a confidence level that keeps growing.
Some people have said that in neurosurgery you don’t have relationships with patients; that it isn’t like primary care, but I can tell you that if you have a brain tumor and you come to see me, and I take it out and you are cured, you won’t forget it. You have a relationship with me. I can run into someone at Byerly’s 20-30 years later and they’ll remember me.
Often there are times when our patients are in life-threatening situations and we have to deal with their families and their loved ones. We need to show empathy and compassion, but you can’t go overboard with that. The family needs to feel that you are in charge; that you are the expert and that you are going to do your very best job for them, and then you need to deliver, in terms of the right judgment and carrying out the right procedure for that patient.
To gain that ability involves certain intrinsic qualities. When you have trained 70-80 chief residents, you know that some people have that quality to a greater degree than others. For some people, it is in their nature, but it is a skill that most can gain with time.
I have put up a CT scan to show a father his child’s posterior brain tumor, and the father goes over like a dead tree, fainting right on the spot. That shows the emotional impact of our work. You go in to talk to the family after a procedure for a malignant brain tumor and the whole waiting room is wailing, and then there is the situation involving a young person who has had a really bad brain injury. You have a family conference and you have to explain that it is time to put a stop to the extraordinary use of ventilators. I did a lot of that, but it was always difficult.
As a neurosurgeon, it does take a certain amount of courage and self confidence to put yourself on the line, day in and day out, in the operating room. When you are first starting out in the field as a young surgeon, the worst thing that can happen to you is to have a procedure go wrong. You feel sick physically and emotionally. I remember a problem I had, early on, with a brain tumor surgery. Fortunately, the patient recovered, but initially he was markedly weaker on one side of his body. I couldn’t even eat for a few days until he got better. Now, with a lot more experience, it’s easier to handle those situations.
I am very pleased and proud of the neurosurgery program here at HCMC. When I was here as an intern at the old General, the program was very small. We had one intern covering urology, plastic surgery and neurosurgery. As a junior, if there was a problem you were supposed to get on the phone and find a downtown neurosurgeon, and you can image how easy that was.
Now, we have three neurosurgeons on the staff. We have two of the 10 University of Minnesota neurosurgery residents that rotate here at any given time. In total, we have 10 medical personnel working in this surgical specialty. Last year we admitted 988 traumatic brain injury patients, which makes HCMC the leader in market share. When I started on the staff, we did about 200 operations each year. Now, we do about 500 operations annually, so the program has really grown.
We are going to face some major challenges here at HCMC over the next 10 years. With the advent of the Affordable Care Act, we need to maintain our population base and increase the number of patients with insurance so we can preserve and strengthen our basic safety net function. As the health care systems become increasingly centralized, we need to emphasize what we do really well. We have certain centers of excellence that are nationally recognized--transplants, treatment for severe burns and traumatic brain injuries. We take care of really sick patients and we do critical care exceptionally well. That is something we need to remember during this time when the health care system is undergoing such rapid change.
July 18, 2013
Dale Stuepfert served as Director of the Chaplains Department at HCMC from 1984 to 2000. This is his story:
I came to Minnesota in 1980 after working at private medical centers in Des Moines. My first job here was at a small suburban hospital. I soon discovered that it was struggling to survive, and I realized that I needed to move on.
When a new position opened up at HCMC, and I knew it could be the right fit for me. It meant that I would be able to develop a chaplaincy program in a much larger setting. I applied for the job and was hired. But then I realized that I had some negative assumptions about a large government hospital—assumptions that I wasn’t fully aware of in the excitement of moving on to a new position.
I had worked at a large Lutheran hospital, a Methodist hospital and an Episcopal hospital—all about the same size as Hennepin. I had assumed that Hennepin would have less holistic care. I had some negative stereotypes that government people just worked for their paychecks, and that there would be less community among the employees. But within a week of being here, all my stereotypes were blown away. Hennepin had more community than any of the church hospitals where I had worked before. Holistic care surpassed any of those other places. And the people here were not just working for their paychecks. They were wonderful. I loved it here. I loved the diversity. I knew it was the right place for me.
Like most chaplains, one of my major tasks was listening. And that is not as simple as it sounds. Listening is not always easy—particularly when we are with people who are in the middle of a crisis. We need to be the ones who are doing the listening, who can be supportive of the families and friends whose loved ones may be facing great peril.
When you come into a big institution like a hospital, you have to conform to the institution. The institution doesn’t conform to you. People come here and they may be terrified, and then they have to conform to all these rules: “You have to sit here. You can’t go there. You can’t see your loved one. You’ll have to wait until we are done.”
Someone in the hospital needs to deal with these terrified people from the place they are at during such a traumatic time. And that is what we chaplains do. We try to make the hospital a more hospitable place by listening to people and hearing what their concerns are. The doctors and the nurses often care about this, but they have too many functions to perform. They can’t listen as much as they might want to do.
At HCMC, we often spent more times with family and friends than we do with the patients, who may be unconscious or not very alert. We chaplains were there 24 hours a day, and one of us was always on call. When I was first on the job, I set up the policy that we were automatically called if there was a life-threatening situation in ER. The nurses went along with the policy but it took them some time to adjust to it. I remember the time when I went down to the E.R. and the nurse told me, ”Dale. I know I was supposed to call you first. We have this young man who had been in a car accident and he had a bad spinal cord injury. His parents are there. They are an older couple and they are upset. I asked them if they wanted to see a chaplain. The wife said: ‘No that’s OK. We are fine. In fact my husband is a minister.’ ”
But I told the nurse , “I am going in to see them, anyway.” So I went in, and introduced myself. The couple was very cordial. “Thank you for coming, Chaplain, but we are fine,” the wife told me.” My husband is a minister.” “Yes. I am a seminary professor,” he added.
I said to them: “You know , we chaplains can do a lot of stuff here. One thing I can do is get you a cup of coffee.” So that is what I did. An hour and half later, I left them in surgical intensive care. I had taken them up there, showed them where they could wait, and helped them get in to where they could see their son for the first time. And when I left, I got this warm embrace from the wife and a firm handshake from the husband. I hadn’t talked to them about faith issues. But I had helped them be in the hospital and I think I made them feel that someone was listening to them.
That was one side of what we do. But not everyone is as composed, as that couple was, at least on the surface. Sometimes we have to be the focus of the person’s anger. People who are in the middle of a crisis can be quite volatile. They can start screaming about the doctors and the people who were supposed to be taking care of their loved one. We saw it as our job to be there and take it, and let people move on past their anger. Maybe they had a question that they though the medical staff didn’t answer properly. So we were able pass on the question to the staff and help interpret the answer for the family member.
I remember that there was a doctor who was killed in an ER department in California. Then even people here at Hennepin got scared. We had a lot of volatile people coming into the ER. So the staff wanted more security. As a response, the hospital brought in a group of experts to look at our situation—some experts from Texas, as I remember. They spent weeks talking to people here. In the end, they recommended that the hospital do two things—increase the security staff by a couple of people and bring in more chaplains. That was amazing! Usually, I had to fight for a year or two to add one person to the staff, And just like that, overnight, we had new overnight chaplains in the hospital.
Only once was one of my chaplains hurt in a melee with a family member. A young man had been told that his son had been brought into the ER and the situation was serious. The man demanded to go in and see his son, but the nurse said: “No. You can’t do that. You are not allowed back there.” And he got angry and started swearing at her. My macho chaplain stepped in between her and the young man, and told him that he couldn’t talk to her like that. Boom! The man swung at him and decked him.
The chaplain’s mistake was that he moved into the man’s space. He could have done the same thing by staying at arm’s length, and talking to the man. He would have gotten the man’s anger but he wouldn’t have been punched.
As chaplains, we are involved in emotional issues, day after day. But we have to learn to separate ourselves from those issues when our shifts are done. It is part of our training.
Hennepin was and still is an intense place. It was a real privilege for me to be there, and to be a part of so many people’s lives.