As a union representative who has organized and represented registered nurses for the past 10 years, I found your article concerning hospital death rates (Part I, Dec. 18) to be interesting and informative.
Although the article reflects Dr. Henry Krakauer's hesitancy to "bandy numbers about" and draw conclusions from those numbers, those familiar with health-care delivery systems and personnel in acute-care hospitals know a major factor in determining whether or not a patient will survive a life-threatening stay is the training, expertise and professionalism of the physicians, registered nurses and other specialized personnel. This presumes the hospital has acquired and uses the most modern technology available; however, an amazingly technical machine in the hands of personnel who do not adequately perform, monitor or interpret, is as useless, and in some cases more dangerous, than no machine at all.
As the union representative for the registered nurses at Kaiser Foundation Hospital, Los Angeles, I have no hesitancy to "bandy numbers about." To Kaiser's credit and through the persistance of many highly motivated, bright and self-assured RNs, an atmosphere of professionalism, pride and caring exists at Kaiser Los Angeles.
As in any service industry, it is the quality, attitude and dedication of the people providing the service that determines the level of service and the level of success. In an acute-care hospital, service and success are magnified highly because of the life-and-death nature of the services rendered. Big business and the desire for profit at the expense of patient care is a real danger to the American population and to the dedicated professionals who try to maintain their integrity and their jobs at the same time.
Senior Field Representative
American Federation of Nurses
Local 535, SEIU, AFL-CIO