Brenda Dunn’s story by Dr. Michael F. Mascia, MD, MPH

Michael: We are honored to have these words from BRENDA Dunn, one of our most experienced and helpful members.  She is a wise and experienced mother, grandmother, patient and nurse who openly shares her knowledge and good humor with others in need.  She learned much the hard way … as a patient, after a professional life dedicated to best care for and treatment of patients.

First, I think we need to know your story … Your history of work and all and anything you want to tell about the medical adventures and misadventures you have experienced.  Tell us your story as a professional and as a patient.

Brenda: My life as wanting to be a nurse, started back I guess when I was about 8 and saving baby or traumatized birds. I of course wanted to be a vet. but knew no money and no way of getting a proper education.

Aged  14 my father sent me up to the local surgical hospital [ 6 beds] where I scrubbed instruments, and washed the operation drapes/linen for 6 weeks for no pay. Never did work out who was punishing who and why.

I started off as a nurse aid in a Maternity home, [where only maternity patients are] scrubbing wooden benches, and burning the morning toast.  Petrified of all the little babies in the nursery, and having to carry them out to the mothers, In those days they stayed  7-10 days, and mothers only got their babies to handle at  feeding time. Luckily the mothers took pity on me and showed me how to put on the napkins so they would stay on, No safety pins were allowed to be used, it was all in the tricky tuck in that kept them on.

My first interaction with an alcoholic Matron.  and my despising of  midwives  and their nasty ways.
I left as I did not wish to have as a priority in my daily chores of having all the wheels on the beds facing inwards, counting the folds in the curtains when they were opened in the morning. OR being the bouncing ball to compensate for the  morning alcoholic hangover headache.

I then went  to work at a telephone exchange, but sitting there saying “number please” was not my scene. My aunt became unwell and so I went to live and work for them on their farm, Got to see real maternity disasters with the sheep, during lambing and so introduced to the real world. But that sadly had to end  that summer, and so back to  nurse aiding whilst I waited to turn  17 and start my training.

I  became a hospital trained  RN. There I found out that  human babies do not arrive like lambs and my shrieking that the head was coming and needed to be pushed back so we could see the hooves, luckily was met with much hilarity by the mother, who happened to be a farmer’s wife. She claimed it was the best delivery ever, she felt nothing, laughing at my shock n horror. [baby #5]

Once I was registered, I   moved hospitals to start working in the new Coronary care unit, they were just starting up  and I thought it amazing that Id have a chance of bringing someone back to life. Luckily I had many successful  CPR stories. I then tried my hand in the ICU, in those days it was known as the hole in the wall. a  4 bedded room  with a desk in the corner,  and  3x Bird respirators that we as the nurse had to know how to pull apart and put back together again. No monitoring gear, just the hold the wrist to measure the pulse  and look at the patient every  15 min.

Over the years I got to do time in the New Born Unit, different operating room specialities, including as a surgical assistant, and  ER, I finished my career by working part time in Rest homes and community hospitals.

My professional career as a patient,  started off very early on, and rocky at the start. I was tossed out in the laundry basket as a  10 day old baby, mistaken for a bundle of linen.

My first  encounter with that things can go wrong and probably will. Was for an orthopaedic operation on my elbow, In those days, one was given a pre-med, no choice. I was in my first year as a RN. I was wheeled to the operating room and the anaesthetist came to put the needle in my left arm, I was feeling slightly sedated and so asked why since that was the arm to be operated on. An argument followed as to which arm  it was. and I got told several times that I’d had a pre-med and didn’t know.  I got really angry at that, and have never had sedation since.

Surgeon came in and sorted things out.

My next big challenge came  during my pregnancy,  I was married to a doctor and he was doing his research for his doctorate. I used to go up to the library in the evenings and find the journals he was wanting information from. In between the lists Id read other articles and read where it was possible that cerebral accidents could occur if patients with migraines from traumatic head injury were given ergot.

I had discussed this with my obstetrician, and he agreed that I didn’t have to have it. and in big red pen on my chart was written NO ERGOT.

LoW and behold at the  31 wks I got fed up with being pregnant and landed up for observation in the Maternity wing, due to  my waters breaking. The Professor had to go and take the final exams of the med student for that day in another city,but he checked in on me at 6am and said behave..

WRONG,  anyway at  9.30 am, I informed the staff I was going to have my baby, they could either be ready or not but I wasn’t waiting.

So at 10am to shut me up I was taken into the delivery suite, , where the assist Prof examined me to find a baby ready. [ I don’t muck around and thought 2 x contractions were sufficient.]

Then this awful midwifery student came with the Ergot injection.. I fair screamed at her. and she went off crying. The obstetrician of course who had no idea,  went to delivery the placenta and found two cute little feet instead. . Total panic as he thought Id had it. one very fast breech delivery of twin two.

That, then had me realize that  I was forever going to be a marked patient, That my life would never be safe in hospital.

Jump forward  20 yrs,  I chose my surgeon, we discussed to long-length what why and how the operation would be done  and everything went wrong. It snowballed to a long list of medical misadventures, negligence, nurses bad attitudes and so I became my own advocate. Very hard to do when on the staff, but it got worse when I left.

It didn’t matter if I  kept quiet,  demanded  special attention, if there was a slack moment I seemed to get it.

I then worked in  ER and suddenly met all these folk who were totally petrified of the healthcare system.  I was one of the few nurses who could  suture  wounds. So would have patients begging me to sew them up so they didn’t have to go to the big hospital. Word had gotten around in the small town that I could do anything !! That brought home to me, that something was really wrong with our care. When grown gang guys from the bush would cry, if they were sent up the road to the city hospital

We made a pact, I only did simple wounds, no muscle or tendon or nerve repair.

The ER doctor would check the wound then leave me to it, chainsaw wounds are very time consuming. I then observed many other incidents of medical misadventure with the patient being treated as tho it was their fault.

By now the internet and social media were taking off. I belonged to several  support groups, and once again, the same old story.

I found myself forever explaining what should be done, what shouldn’t and why.

I finally joined up with FB and due to the time zone differences found that in my evening those in the USA were sitting in the ER in the early hours of the morning, desperate for information. Especially mothers being told their child needed urgent attention.  Many sessions of private messaging went on. And I think I can say several children and adults are still alive due to my  being able to inform.

 

Michael: Then, what brought you to SPM?  Why did you join SPM and what were your expectations?

Brenda: I first heard of e-Dave via the Inspire support group. I went to the website, and saw that it had the policy and aims that I felt needed to be demanded/encouraged/policy made. Especially the give me my data at the right time and not the 20 working days, or longer.

I joined up and the first few months lurked. I was impressed and in awe of all the titles beneath the signature. And my basic  front line experience seemed  really low on the scale.

But without a foundation, one only has a wobbly house. So I came up with the fieldmouse ID,  that I’m working for all at the coal face as such

I am lucky that I did live in Boston for two years so do understand  a little of the culture difference. I had also been a subscriber to the  Nursing 2000* nursing journal where I found what I considered good nursing attitude and policy. I tried to improve my own approach to nursing. I also then expected more for  the care, [I wasn’t receiving].

 

Michael: What does SPM do for you?

Brenda: It gives me courage, it gives me a sounding block, it gives me a landmark to work out where I am, IF I am expecting too much for myself or others. It is so easy to be dragged into that swirl of ever decreasing circles. I get support and I get friendships that I never thought of expecting. I haven’t a clue when the topic is all about IT and insurances. but just glad I don’t have to know about it.

I still read those topics as it helps to then understand, why a simple system cant just be programmed and everyone be happy. Our system is different,but our system is the same. A few bad apples make the bowl moldy.

 

Michael: What do you give SPM?

Brenda: I can give information about the things that worked back in the old days or didn’t. I have been able to help certain peeps in dire distress, by sharing my experiences. So behind the scenes contacts set up, Id like to think I was able to help. I know there are very few down-under folk on the SPM.

Why I don’t know but I do.

There is that little nagging culture that if its set up by Americans it must be for Americans. Also  the healthcare system is so different to the rest of the world. Our culture doesn’t like  profit going to business organizations. We expect them to be healthy but not greedy.

We have that submissive, we must be thankful for small mercies, and what our taxes will buy us. So no official complaints about the system are made, I try and encourage those to take on the SPM mantra,

I give it another 10 years and the cultures will have gelled.

 

Michael: If you ruled the world, how would you fix the BoM (Business of Medicine)?

Brenda: First I would do what happened at the middle management courses I got sent to. Break up all the key players into groups, so in each group would be a patient, surgeon , medical, para medical [LIKE IR or pathology]  manager and accountant, orderly.  those now in 5x groups  would then go off with  key  topics to discuss and given  30 mins.  Each topic would affect or be driven by one of the specialities.  so not only what bugs pathology but also the orderly/cleaner, or accountant.

The person whose speciality it is, is the master of the group for that topic, and so each person lands up being ‘boss’

After collating their thoughts and key points they would all present their findings and the good points get  onto that magical whiteboard.Much audience participation, but boy does it sort the chaff from the oats.

Within 3 days I’m sure that parking,  ER overload, managing the hospital efficiently etc would be thrashed out. Then within 3 weeks a flow chart of how to correct the problem/policy/change would be signed off and trialled  3 month later an analysis of the changes and retweaked. At 6mths most would have been put into concrete and for re-analysis in 2-5 yrs time

The biggest one that I see facing the patient is the way insurance co have been allowed to decide who and what will be tested. treated or turned away. IF that is a topic that has undergone  the system of change then insurance companies will be told  that either they comply with human rights to care… or they get shafted. no ifs or butts.Time to start giving the same treatment plan back to insurance companies.

Same with  IT systems and patients records. IF it doesnt allow other establishments to ‘read the data’ then they fall off the desk.. simple.

I am a great believer in the KISS approach.

The last one is most important

Michael: Thank you, Brenda, for your willingness to share with us.