Change and the Adventist Hospital

LIKE it or not, changes in medical care and changes in hospital organization and management must be accepted as fact. Government regulations and requirements have become so all-inclusive it is no longer possible for a medical institution to establish its own policies and standards dictated by its own philosophy and objectives. . .

-professor of nursing, Loma Linda University, at the time this article was written

LIKE it or not, changes in medical care and changes in hospital organization and management must be accepted as fact. Government regulations and requirements have become so all-inclusive it is no longer possible for a medical institution to establish its own policies and standards dictated by its own philosophy and objectives. Thus Adventist institutions have lost some of the distinctive features that have kept them, for a much longer period of time, from many of the influences and pressures felt in most hospitals, but now these forces must be reckoned with.

What does this mean then? Shall the Adventist hospital become just another community hospital? Shall it lose the characteristics that have set it apart? Or, with the necessary changes, is there reason to hope that our hospitals can still be unique in the community of medical institutions? I think they can and, furthermore, I think they must if they are to attract patients, for unless we have something to offer that cannot readily be found elsewhere, the public will not beat a path to our door.

When I had the privilege of visiting in Australia, in 1971, I visited the Warburton Sanitarium and Hospital, located in a beautiful mountainous area. It is about fifty miles from the nearest city and has the peaceful rural atmosphere that reminds one of St. Helena. It is in a largely Seventh-day Adventist community, and there are no nearby industries to call people to the area.

Warburton serves two kinds of patients—acute and long-term, or chronic. For the acutely ill' there are the usual facilities found in modern general hospitals. For the long-term patient there is much emphasis on rehabilitation. The physical therapy department is well equipped and extensively used. Patients are encouraged to be out of their rooms as much as possible. One sees them in occupational therapy, in the parlors, in the dining room, and on the roof.

This institution, in spite of its isolation, is enjoying a patronage which, while not overflowing, is sufficient for operation in the black. A modest addition has recently been made to increase the number of hospital beds.

As I visited, I began to look for reasons for its success in a location that might make it look doomed to failure. Indeed, the man who met us at the airport said, "The person responsible for locating a hospital way out here ought to have his head examined." Yet it does keep operating, and appears to be meeting a real need in the community, both physically and spiritually. As I looked and listened, I think I saw two outstanding reasons for its ability to continue to attract patients:

1. The complete, wholehearted dedication of the entire staff to reaching the objectives of the hospital.

2. The outstandingly good work that is being done by the staff in all departments. They seemed to have the attitude, "This is God's work and it demands our best."

The medical director is a man who is sincerely concerned with the welfare of his patients. He takes time to visit with each one frequently—not to chat about the weather or baseball scores—but about the patient's needs, his progress, his goals for the future. He is actively teaching healthful living, not in formal lectures, but on a direct one-to-one basis. Public meetings are held where various aspects of our health message are presented, but these do not replace the personal work with the patient.

In talking about his program, he said this, "We are no better professionally than the average physician in this community, but the personal interest, the time we spend personally with the patients on their health and medical problems, is something extra that they would not get in another institution. They appreciate it."

This same spirit of personal interest is found in the employees. I do not know how much time they spend visiting patients, probably not much, for they are not overstaffed and they are busy. But they personalize their service so that the patients feel that they are VIPIs (very important persons, indeed), and they like it.

It is the personalized service that makes one institution stand out above others. It is remembering that Mrs. Jones likes hot water instead of cold for brushing her teeth in the morning, and getting it for her without being reminded. It is taking time to help Mr. Parker out of bed and into a chair before meal time because he prefers to eat his meals sitting up. It is answering Mrs. Russell's frequent calls promptly and cheerfully, even though they are for nonessentials and you are busy.

At the National League for Nursing convention in Dallas in 1971, Dr. Ashley Montague presented the address. Dr. Montague offered love as the panacea for all of today's ills. He spoke of the dehumanization of people that begins at birth when the infant is isolated in a nursery and fed from a bottle, when it should be cuddled in its mother's arms and fed from her breast. This dehumanization continues through life and is one of the bases for today's alienation of the youth. It is found in schools, in industry, and particularly in hospitals. Humanization depends on love. To be a humanizing agent we must learn to love. One learns to love by loving just as one learns to speak by talking. This humanizing love is something we can and should give to our patients and to all we are called to serve in our health-related ministry. It is part of the personalized service of which we have been speaking; indeed, personal interest that is not based on love is selfish and may actually be detrimental.

Some may protest that our hospital workers do not have time for that kind of service. Let me say that service based on love does not necessarily take more time than perfunctory, thought less care. No hospital can afford the luxury of providing workers to entertain patients, but no Seventh-day Adventist hospital is so well patronized that it can afford to have its patients feel that they are of no personal concern to the workers.

Over in Vietnam there is an orphanage overflowing with children made homeless and parentless by the ravages of war. In the infant unit there are children who have never learned to walk. When they were old enough to stand and walk, there was no one to give the necessary help; so they continue to crawl. Eventually their legs below the knees simply atrophy, making walking physically impossible. Now this need not be so. If somebody took the time to give a little assistance and encouragement, this condition could be avoided. But the employees are busy, grossly understaffed, with inadequate facilities, and they have seen so much suffering and death that many have ceased to be moved by human need.

This is an extreme example of the effects of lack of caring, but it serves to illustrate the importance of personal love and interest. We would not expect to find children with atrophied legs because they were not taught to walk, but people with withered hopes and atrophy of faith and courage are within reaching distance of most of us. They need the touch of loving concern.

And what about spiritual ministry? Prayer at bedtime is a sort of hallmark of Adventist institutions. I trust we will never discard that practice. But prayer to be effective must be preceded by good nursing practice. No prayer, however beautifully worded or sincerely offered, can offset inadequate, inefficient, or sloppy care. Prayer will not take the wrinkles out of a draw sheet, nor the ache out of a poorly massaged back. It is wonderful to pray for a good night's sleep after doing everything possible to make a good night's sleep possible.

Yes, winds of change are blowing down our hospital corridors and through the halls of our other institutions. You personally are one of the kingpins in determining whether they will blow in the Fall of Hope and the Winter of Despair or the Spring of Hope and the Summer of Fulfillment. God grant that it be the latter.

Adapted from a talk given in the spring of 1971 to employees of St. Helena (Calif.) Hospital and Health Center.

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-professor of nursing, Loma Linda University, at the time this article was written

March 1974

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