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OPINION: In Fear, Freezing of Medical Care at GMH

By David Lubofsky

Ever since the nightmare started of losing my son Asher to alleged medical negligence, it has opened my eyes to many related problems within the Guam medical system from laws that do not hold anyone accountable for medical negligence, to a complete lack of adherence to basic protocols at GMH, to what appears to be island wide systemic medical negligence. The most recent twist that has raised its ugly head is the alleged abuse or bullying of Guam nurses by Physicians and other staff that seems to go unreported or not addressed. It is the dirty dark secret at GMH and GRMC and I have learned at some island clinics.

I read abuse of nurses by doctors is a big problem and of epidemic proportions across the country as well. This isn’t purely about how inappropriate and demeaning doctor bullying can be, it can also be disruptive and potentially very dangerous for patients with research showing a high percent of cases resulting in patients’ unanticipated death or permanent disability can be traced back to a “communications failure.”

About a year ago or so, I was approached by a GMH nurse who told me that nurses at GMH are bullied often by doctors and by senior staff or supervisors. She told me that this may be part of the reason patient care failed for Asher, as well as others, as nurses are told what to do and fear retaliation if they do anything else, including being bullied by doctors who possibly prefer to sleep as seemingly was the case with Asher’s care with no doctor coming into his room all night as his life slipped way.

I did not give it much attention at that time, beyond getting very upset, due to the legal process and the nurse wanted to be private and confidential until recently when the federal investigative CMS report into Asher’s treatment and death became public. Again, I was told by another nurse at GMH that nurses are afraid of doctors, have been yelled at by doctors and fear losing their jobs. This is especially true with the H1 nurses from the Philippines who fear losing their jobs and being sent home to families who rely on them.

The nurse told me it is a big issue that goes unaddressed by those in charge at GMH or by the Guam Board of Nurse Examiners, Guam Association of Nurses or by anyone on Guam. They fear to even speak out. Even a quick search on the internet, on GMH reviews, from a year ago, I found this review.

“It becomes a difficult work place as it usually results in bullying.“

On top of this, recently I ran into a prominent doctor on Guam and had a long talk with him. He told me that he has had to ask nurses at the hospital, “why do you not call me when there are changes in my patient’s conditions at night.” He said many of the nurses may not want to bother doctors, but acknowledged that many may have been bullied (or abused is my term), by professionals and fear to call. He told me that GMH just recently had an online “Bullying” seminar in effect because of this and that GRMC is or has developed policies regarding bullying. I saw the bullying seminar at GMH online, it seemed like a joke made for middle school kids. It is a check mark in compliance, not a reality check to mitigate Bullying. Nurses are the most important people at the hospital, and I have total respect for them, as they are hard workers and are usually quite pleasant.

I wrote to the Guam Board of Nurse Examiners regarding this and was told that I would get a response to my concerns and have also sent them to senators, but as of today no response from anyone. Licensing Boards do not just issue licenses, they protect the public and the nurses.

A nurse that is abused and afraid to wake up a doctor or speak her mind negates any critical medical care that the patient needs, as what seemingly may have happened to Asher. How many times have they, GMH nurses, been abused in the past? It is my observation that Asher’s nurses wanted to get him into the ICU, telling me three times and I asked many times. Apparently, no doctor called them back to authorize it. Were the nurses afraid to call again? It truly seems that way, or otherwise one must ask, “would they just allow my 5-year-old to die?” Is fear and intimidation a ruling factor in the demise of medical care at GMH?

Imagine, using a nurse’s immigration status against her to treat her as if she is less important than the doctors or supervising staff. This is wrong, its abuse. People are dying and suffering, and we have nurses that cannot function due to intimidation.

A good example of this also goes to Dr. Akimoto and how he exploded on the Director of PHSS on KUAM with sexist remarks and bad words. Do you think if he can do that with her, on KUAM, that he will not do it with nurses who wake him or make an error?

Doctors are not accountable on Guam for medical negligence and that creates apathy, the same apathy and lack of accountability that may relate to the abuse of other staff and allows them to think they can get away with it. This does not apply to all doctors of course. I do not mean to cast a net over the whole medical community, but apathy related to a lack of accountability is an inherently dangerous issue within the medical field on Guam due to protective laws at GMH and island wide.

Did my son die not only by alleged medical negligence with apathetic people who have no accountability and responsibility to their patients, but also due to the abuse of medical nursing staff by doctors that resulted in nurses “freezing in fear” the critical care Asher needed as they waited for a doctor to wake up, too intimidated to call again?

David Lubofsky is a resident of Tamuning.

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