Previous Blogs

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. 


Lynn Abrahamsen served as HCMC’s Chief Operating Officer beginning in 2001 and as Chief Executive Officer from 2006-2009.

 Lynn Abrahamsen

This is her story.

 

I got into the field of hospital administration somewhat indirectly.  I had been trained as a social worker.  After I got my degree, I decided to try out the field of medical social work.  I was at the University of Minnesota Hospitals then, working as an assistant director of a department.   After I was there for a while, the University Hospital’s administrator, John Westerman, said to me one day, “If you really are going to stay in hospital management, you should go through the University’s master’s degree program in hospital administration.”

I decided to follow John’s advice.  He really encouraged me to get into this field.  I might not have thought about it on my own. I did know from working at the University as a social worker that I was more of a people person than a paper work person.

Back when I went through the graduate hospital administration program, it involved one year of academic work and then a residency for a year.  I chose HCMC for my residency because I wanted to stay in the academic arena.

When I came here as a resident, the hospital was new and very up to date, but we really had two hospitals:  HCMC and Metropolitan Medical Center (MMC).  One of my assignments was to work with Tom Mattison, who was then the HCMC administrator. He wanted me to work on helping to fully implement the many shared service and facility agreements between HCMC and MMC and to expand cooperative arrangements between the two organizations.

My first year at HCMC during my residency involved a lot observing.  I followed the senior administrators around and took a lot of minutes.  That year was the final phase of my academic work.

During my residency, I delivered my first child at HCMC, so I had an experience as a patient while I was doing my training here.  I was glad I had an opportunity to get a patient’s perspective on the hospital.  It helped inform my later work as an administrator.

After my residency, I was gone for a year when my husband had an assignment in Denmark. When I came back to Minnesota, Tom offered me a job as an assistant administrator.

When I came to work at Hennepin, my major assignment was to help organize a new physician organization here at the hospital. We realized we were “leaving money on the table” from the payers with our model of employed physicians, so we needed to have the physicians form their own organization for billing purposes.

It took us several years to put the new system in place. We ended up with a new 501(c)3 organization for the physicians called Hennepin Faculty Associates.  HFA meant that the physicians were no longer part of the hospital staff—at least in a technical sense.  With the new organization in place, HCMC contracted with HFA for medical services.

Putting HFA together involved a lot of change for all the stakeholders.  We needed to explain to the Hennepin County Board, to the physicians, and to the broader community about the change and why it was necessary.

After HFA was established in 1984, I worked for the new organization for several years, overseeing the organization’s administrative work.  I got malpractice insurance set up, and I managed the personnel services for the 300 physicians on the payroll.  Then, I left when most of the work that I needed to do had been accomplished.

After that, I did some consulting and worked with other health care organizations. In 2000, I came back to HCMC when I was tapped to be the hospital’s Chief Operating Officer (COO).  The first big thing that happened during those years was 9-11.  That changed a lot of things for this country.  For hospitals, it changed how they responded to major emergencies. 

As a national burn center, we were waiting to hear if we would be receiving an influx of burn patients after the attacks on the World Trade Center.  That never happened.  But we had to set up command structures to deal with disasters like the one we had just experienced.  We put that new structure to good use later, when theI 35W bridge collapsed in 2007.

After 9-11, I went to a training retreat in Virginia with a group of city and county leaders. The group included Minneapolis Mayor-elect Rybak and the Fire Chief at that time, Rocco Forte. At that session, we learned that the secret of a good command center is having people who know each other and who feel comfortable challenging decisions that they think are not appropriate. 

I remember we had this exercise imagining that a real disaster had hit Minneapolis. While we were doing role-playing, Rocco announced that he was going to shut down our hospital. But I challenged him on that, saying that was not his call. That exercise was very important, because it showed us the importance of having open lines of communication in the event of a disaster.  Imagine all the confusion that would have ensued if there had been an actual disaster and no one knew who was in charge.

The 9-11 disaster caused many large public institutions like ours to do heavy disaster preparedness.  We had always had disaster alerts and drills, but 9-11 brought us to a new and higher level of readiness with clear command structures.

When the I-35W bridge had collapsed in August 2007, I had just driven home on West River Parkway under the bridge, only about 20 minutes before it went down.  I was home working in the garden when I got the call about the collapse.  I rushed back to the hospital, still in my gardening clothes.  Our command system was in place.  The administrator on call, Lori Johnson, was in charge.  What was my role at that point? There was no reason for me to take over from Lori. She had everything under control. I was there to give advice, but Lori remained in charge and did a great job.  We received many, but not all of the people who were injured in the collapse, and we provided good care for them.

During my time as CEO, several important changes took place at HCMC.  One involved the move to electronic record keeping.  That was a major transformation, costing over $50 million. It meant that all the staff had to get used to a whole new way of maintaining their patients’ records. We needed to get buy-in from nurses and the physicians, and it took some time for that to happen.

The other major change during my time was the new governance structure for the hospital. HCMC became a quasi-independent entity with its own Board.  Hennepin County continued to own our real estate, but the operation of the hospital was under the control of an appointed board.  We needed to make this change because we were increasingly finding ourselves at a disadvantage in a competitive environment.  As a county department, we had been held back by cumbersome county purchasing and personnel systems.  Our compensation system was not competitive in certain areas.  We needed to be more nimble, and the new structure helped make that possible.

As HCMC faces the future, it will need to operate in a fast changing health care system.  Competitive pressures will remain and get more intense.  But we need to remember that there is a tremendous amount of goodwill for this hospital in the broader community.  This is the place we look to when there is a disaster like the bridge collapse.  This is the place that people come when there is a major auto accident.  The challenge will be to maintain our mission and refine a business model that can help the hospital survive and flourish in this new health care world.


 

November 14, 2013

Dr. Michael Belzer is Chief Medical Officer at the Hennepin County Medical Center

Dr. Belzer

This is his story:

My father was a physician but his practice was quite different from medical practice today.   When I was in high school in the 1960s, I remember travelling with him on house calls.  He had the classic black bag with a stethoscope, antibiotics and a whole kit of things to deal with emergencies.

Back then, emergency room medicine was not a specialty.  If one of my father’s patients had an immediate medical problem, that patient would go to the emergency room at Fairview Hospital and be seen by the physician on call, often a resident.  More likely than not, my father would drive to the hospital and see the patient.

 My father would never have had a nurse return a phone call.  That was unheard of back then. Today, if you call a clinic you will get a return call from a clerical person or maybe a nurse.

Then, my father would make all the phone calls himself.   At the end of the day, he had a long list of people to call, and he would work his way down the list. There were no pagers, so it wasn’t always easy to connect with your doctor.

There were also in-kind payments.  This was the time before federal support for health care—before Medicare and Medicaid.  Either you had private insurance or you paid in cash.  And if you didn’t have money, you might pay with whatever you had—groceries, liquor, knitted sweaters.

Then, physicians like my father would begin their day by driving to the hospital.  They would meet with their colleagues in the doctors’ lounge, begin their rounds and start writing orders.  They would finish their rounds and drive back to the clinic or to their office, where they would spend the afternoon seeing patients.  At the end of the day, they would drive back to the hospital, admit patients and write more orders.  It was a long day.  Often 10, 11 or even 12 hours.

Now, there is a growing practice of hospitalists—physicians who spend all their time in the hospital.  Today, many internists and family practitioners have very little contact with hospitals.  There is getting to be a dramatic separation between ambulatory and hospital care.

My early experience was quite different from that of my father.  After medical school, I did a three-year residency in Chapel Hill, North Carolina, and then a three-year fellowship in hematology-oncology at UCLA medical center in Los Angeles.

When I came back to Minneapolis, I went to work here at HCMC. My job as a hematology-oncology specialist was to provide clinic as well as in-hospital care.  That work would have been very different if I had been out in Edina or Wayzata, rather than here at a large safety net hospital.    Out there, if I told someone that they had breast cancer or lung cancer, the patient would probably be distraught.  They would never get past the word “cancer.”  They would want a second opinion.  Here it was very different.  If I told one of my patients that they had a terminal illness, the response often was “OK. So what’s next?” 

For people who have had very difficult lives, the emotional impact is very interesting when you tell them they are going to die.  It took a different skill on my part as an oncologist to deal with that.  When I got into this field, I understood that I would be dealing with terminally ill patients.  Probably, the most important role of an oncologist is to manage deaths.

If you don’t do it right, you have damaged family members for the rest of their lives.  If I had 15 people who cared about their terminally ill loved one, those people were every bit as important as the patient.  I was going to make sure that the patient was as comfortable as possible.  I also needed to make sure that the 15 people accepted the situation and understood what was happening with their family member.  If I didn’t handle the situation properly, they were going to be angry at the physician, at the medical center and at the whole field of medicine.

I had to figure out for myself how I was to do cancer work-oncology—and do it well.  There are lots of ways to do it poorly—talking to the patient on the fly—not really listening.  But I wasn’t going to do that.  When I met with a patient, I had a virtual script.  I would sit down and ask the patient:  “Please tell me what you understand about your disease.”  I wanted to make sure I knew what they did and they did not understand, so I would not be talking over their heads.  Then, I would ask them if they had questions.  But the most important thing was to make sure I had enough time to spend with the patient and their family.  There is nothing worse than rushing through all of this.   Some practitioners do that because the situation is uncomfortable and they want to get out of that situation as soon as possible.  But that is not what good care is all about.

I was a medical student when the old General was still in use, but the new hospital had already been built when I came here as a resident in 1980.   There was definitely a special aura, a culture and a feeling to the old hospital.

Under the medical leaders of that earlier era—men like Claude Hitchcock, Dick Raile and Al Schultz—it was clear that you were not at the University Hospital, at the VA or at one of the private hospitals.

 This hospital was very personality dependent.    I remember coming here for my surgery rotation in 1972 and 1973.  I had long hair and beard, which was the style of the day.   I met Dr. Claude Hitchcock for the first time, and he asked me: “Is your father Dr. Mike Belzer?”  I said, “Yes, he is my father. “  “He is a fine man and a fine doctor,” Claude responded.  “Now, am I going to have to tell him that you can’t work here until you cut your hair and shave your beard?”  I stammered and said.  “No sir, that won’t be necessary.  I’ll take care of it.”  I went home and thought about it for about a minute.  And then I did what he wanted me to do; I cut my hair and shaved off the beard.

Back when I was a medical student, the hospital system revolved around the physician.  The physician was definitely the “captain of the ship.”   The schedule at the hospital was under his or her control.   If the doctor wanted to go to a Twins game on Wednesday afternoon, it was easy to get the clinic cancelled.  Or if the doctor only wanted to see patients with a certain illness on Thursday mornings, that could be arranged.

Now that has all changed. The physician is no longer the captain of the ship. Teams are very important. They deliver the care. And the teams can involve nurses, physician assistants, and pharmacists.

In 2011, a surgery professor at Harvard Medical School, Atul Gawande, wrote a very interesting article in the New Yorker magazine entitled “Cowboys  and Pit Crews.”   Cowboys refer to those people who are autonomous, who chart their own course of action for themselves. That is how I saw myself when I started practicing medicine. “Pit crews” refers to those teams of mechanics at the Indianapolis 500 races who work together very precisely and in a very coordinated way to make sure that the racecars are in top working order. Gawande maintains that health care is moving from the cowboy model to the pit crew model.  That is certainly the case here at HCMC.


 

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:

 Dale Stuepfert

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.

 


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