Burnout is a public health crisis, says an MUSC expert. It’s finally getting the serious scrutiny it deserves.
The year was 1969, and Charleston was a hotbed of civil rights activity. A who’s who of national activist leaders like Coretta Scott King made their way to Charleston to support the more than 400 hospital workers who had walked off their Medical College Hospital, now MUSC Health, and Charleston County Hospital jobs. The strike in its entirety would last 113 days. Some workers were fired. The workers’ grievances? Race, respect, pay and patient safety.
At the time, neither of the two hospitals employed black doctors or nurses. Black nurses could only work as aides — that included Mary Moultrie, a licensed practical nurse with seven years of experience at the Goldwater Memorial Hospital in New York City. MCH would not recognize her LPN credentials.
History credits Moultrie as the organizer of the strike, owing to the fact that she raised concerns when a white charge nurse refused to hand-off patients to her or other black nurses. A hand-off is the transfer and acceptance of care and critical information from one nurse to another to ensure continuity and the safety of the patient.
The charge nurse ordered the black staff to take care of patients without receiving a report, or, she told them, they could go home. In a subsequent meeting with leadership, feeling this refusal to hand-off was a continued patient safety issue — among other issues —the black nurses held their ground. In all, 12 were fired for speaking up for patient safety, fair wages and equitable treatment.
Moultrie had the support of and forged a bond with at least one hospital leader. Having just the year before returned to his alma mater, Layton McCurdy, a young Department of Psychiatry chairman, found himself right in the thick of things. When university president William McCord chose not to enter into negotiations with the strikers, McCurdy said leadership fell to the new provost, Dr. James Colbert, to break the stalemate and come to a settlement. He solicited McCurdy’s help, and with a small group of others, they met every day, determined to work with strikers toward resolutions.
The goal, McCurdy explained, was to keep the hospital operating. They were successful.
He remembers the feeling of walking with Colbert and then-Gov. Robert McNair to announce the end of the strike. In the end, the 12 fired workers would be rehired, pay raised to the federal level and a formal grievance procedure and credit union established. Colbert also worked to ensure hiring practices and personnel practices were changed. “Dr. Colbert was my hero at the time,” McCurdy said.
These were some of the personal recollections McCurdy shared during a panel discussion — part of the week of events honoring the 50th anniversary of the Charleston Hospital Workers Strike. “MUSC in 1969: The Care Giver Perspective,” addressed the poor treatment of black nurses in 1969 and how things at MUSC have progressed since then. Marking the anniversary of the strike, McCurdy’s firsthand account provided the audience a window into the tumult that tested the Holy City’s resilience.
McCurdy explained that after the strike, he hired Moultrie to work on the 10th floor in psychiatry. He recalled introducing her to her new workplace, while civil rights activist Andrew Young and Ralph Abernathy, co-founder of the Southern Christian Leadership Conference, were along to ensure her welfare.
Finally, the tide began to turn. In a 2008 interview, Mary Moultrie remembered one such example. “At one point, even in the cafeteria, the blacks and whites didn’t sit down and have lunch together, even if they worked in the same unit. When we got back to work that was different. If black and white staff was working together, and you were scheduled for work at the same time, then you’d go down and sit and eat together and talk. So there was a change.”
Moultrie and McCurdy remained friends until her death in 2015. She never failed to challenge him to keep progress moving forward. McCurdy would later become dean of the MUSC College of Medicine and initiated numerous programs that were at the forefront of the diversity and inclusion efforts in medicine.
At the third day of events that commemorated the 50th anniversary of the hospital workers strike, Anton Gunn, chief diversity officer for MUSC Health, kicked off the panel discussion.
“The context of this event,” he said, “is to talk about health care and nursing practices as it relates to what happened in 1969 — where we are today and where we hope we are going as an organization.”
Kim Curnell-Pean, nurse manager of 8 West and moderator of the event, shared personal experiences related to her professional journey dealing with prejudice and progress at MUSC over the last quarter century.
Twenty-three years ago, she started out as a patient care technician and transporter. Later, she would attend the MUSC College of Nursing and subsequently take her first job as an R.N. on 8 East. That was a foundational experience for her — she was not only able to hone her nursing skills, but the nursing staff felt very familiar.
“Not only did they look like me,” she said, “they had worked with my mother — a retired nurse. Working side by side, they took me under their wing and trained me.”
In five months, she was charge nurse for the floor.
Her journey afforded her a lot of opportunity for leadership, but it also came with its share of challenges. She became the manager of an admissions/med-surg unit. Six months later, she expanded it into 8 West — building it from the ground up.
However, not everyone was convinced she was up to the task.
“You always have the perception that perhaps this individual — meaning myself as an African American — is not equipped to handle such an undertaking. That presented itself with challenges for me in terms of being accepted. Being in a room where no one else looked like me. Being able to articulate and voice my opinions — and being dismissed.”
The year was 2008. Her fellow colleague and preceptor refused to orient her to the role of nurse manager — because of the color of her skin, Curnell-Pean said. But she was not deterred. Instead, she sought direct training from administrators in charge of the processes and systems that were critical to her job, determined that prejudice would not derail her.
Still, over the course of her journey, she encountered racial bias from all sides. She’s had patients who had a hard time accepting that as a black woman, she was the nurse manager. “I would come into the room, and they would say, ‘So you’re with housekeeping or dietary or admissions — even though I’d clearly introduced myself as the nurse manager.’ Still, I always told them they would have the best care possible on 8 West.”
She felt like she was flying solo. “For a long time, I was the only nurse manager of color.” Others did not accept her as one of them. She recalled a monthly nurse manager committee meeting that stood out.
“The chair of the nurse manager committee was leading an open discussion. I posed a thought and interjected options for us to pursue a different process. He stood up, and he said, ‘Who are you, and why are you speaking?’”
Appalled at his behavior, one nurse manager came to her defense. But only one. “The other nurse managers in the room laughed, thinking he was humorous,” she recalled. “But I would not let anyone stifle what I was capable of doing.”
She never gave up. Not even when there were rules that applied to her but didn’t apply to colleagues or different deadlines she had to meet that others didn’t.
“Yes. There were days when I wanted to say “You know what – enough of this. This is too much for me. Nobody should endure this. No one should have to do this.” Then she was reminded — it was never about her.
“So, when you move yourself out of the way, and stop making it about yourself, and understand that it’s about the people that came before you and set you into the place where you are now. Had it not been for women like my mother and her sisters that are also nurses, for Mary Moultrie, that actually fought for me to get to where I am…” Curnell-Pean said, her voice trailing off.
“How dare I think that I’m going to throw in the towel at this point and time. Being reminded of that — my duty, my destiny is to actually forge a way and push forward so that I can help others behind me grow to where I am, if not exceed and proceed and progress continually in their career path, so they can continue to make progress in this journey, this fight for equality.”
Fast forward. Now the manager of 8 West for 11 years, she and her unit have received numerous awards for their work and innovative achievements.
Panelists Debbie Bryant, DNP, associate dean for practice at the College of Nursing; Jerry Mansfield, Ph.D., R.N., executive chief nursing officer and patient experience officer for MUSC Health; and Darrick Paul, chief people officer for MUSC Health, pointed to ways MUSC is continuing to evolve in its goal to increase inclusion and equity.
“Hearing about a strike as a new leader causes you to take pause,” said Mansfield. “I began to talk to colleagues, Debbie or Anton and Darrick, and we began to get an appreciation for what those events might have been like for individuals. It opens your eyes to concerns about what might still exist.”
“When I hear the story of Mary, what caused her to take that step was a white nurse would not give a report to a black nurse. It just astonishes me. So, events like this are important because they remind us that as far as we think we’ve come — there is clear acknowledgment in this university and this medical center that we are not done. And for every acknowledgment or award or some recognition we get for making strides in this area, I just feel comfortable working here that it’s still an active work in progress. We’ve just got to keep at it.”
Paul discussed the current state of nursing employment at MUSC in relationship to 1969.
“Well, I was 1 year old in ‘69 — so, I can’t give you an example of what it was like then,” he said to appreciative laughter. “But I like to say we’re making strides and efforts. But one area in my opinion is in leadership. In nursing leadership, I would venture to say we haven’t moved that far in terms of African American nurses in leadership. Regardless of the characteristics, when people look like you and can relate to you, that helps to acclimate you to the organization and to an environment.”
He also said that MUSC has an opportunity to create an environment where nurses will want to aspire to higher levels within the organization in a system that will allow them to achieve those levels.
“While I think we’ve made tremendous inroads, I think that where we have the greatest opportunity to ensure that we have leadership to make sure policies, practices, et cetera, are inclusive enough that all on the team would want to move forward.”
Paul said that today, MUSC has 2,000 nurses — 170 of which are black. “This is one of the areas we’re moving forward in, striving to move the needle.” But he said, he doesn’t think it’s a nursing issue or an MUSC issue. He thinks it’s a Charleston issue, due in large part to demographics and pipeline issues.
A common thread among the panelists was the idea that the health care work force should be reflective of the people it serves. Greater inclusiveness is better for patients, Paul said.
Bryant agreed. The associate dean said the CON has the same challenges in its student pipeline. “The College of Nursing applicant pool of students is high. The African American applicants we get are the brightest of the bright. They have the choice to go anywhere. Students want to come somewhere they can get mentoring, where they see someone who looks like them. The college’s faculty is committed to the success of all students and increasing AA enrollment, retention, and graduation rates.
In terms of the recruitment of African American faculty and students, she said the college is doing “OK” and likely better than many other institutions.
“Do we want to do much better? Absolutely. From 1972 through 86, we had 44 African American Bachelor of Science in Nursing grads — an average of 0 to 3 per year. Our current average is approximately 20%. Is that good enough — knowing the South Carolina African American population is approximately 30%. No.”
Still, she sees improvements. “Understanding that MUSC has progressed over the years, from challenges experienced at that time, growing from them, learning from them, establishing a different structure because of them has been what I have seen and am grateful to have been part of. Sitting next to Dr. McCurdy, I have understood and respected his work and what he’s done for many years.”
A longtime champion of diversity and inclusion, McCurdy said there’s reason to be hopeful for what can be achieved with a deep commitment. “One of the mistakes we make is we say this can’t be solved,” he said. “We can’t erase the bias and prejudice that exists in all of us, regardless of the context of which we grew up in, but we can work at it and continue to work at it.”
Burnout is a public health crisis, says an MUSC expert. It’s finally getting the serious scrutiny it deserves.
Cecil Williams photographed many significant moments in South Carolina civil rights history, including the Charleston hospital workers strike.
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