There is a crisis of confidence in the intensive care unit of Erasmus MC, led by Diederik Gommers. At least twenty nurses have sent fire letters to the management. In it, they describe their despair at the “battle of attrition” that the corona pandemic is for them, and the dismay of the leadership over their complaints. The staff does not feel heard by the management and Gommers, who is also chairman of the Dutch Association for Intensive Care. A number of employees have also submitted complaints to the hospital’s ombudsman.
Last Monday a crisis meeting between Gommers, IC director Johanneke Mulder and the concerned staff got out of hand. This is apparent from an internal one and a half hour video recording of the meeting, which was viewed by NRC. In the meeting, Gommers presented plans to expand the 40 intensive care beds in Erasmus MC to 50 or even 56, without any support among the staff. The meeting then degenerates into a confrontation between Gommers and Mulder on the one hand and a number of ICU nurses on the other. They say they no longer trust the IC leadership.
One nurse, three patients
During the two corona waves, Erasmus MC has admitted more corona patients than some other hospitals. As a result, Erasmus received a relatively large share of corona patients in the ICU. In the video, Gommers says that the management of other hospitals received fewer patients than had been agreed. “If they don’t keep the agreements… If they screw things up.” A nurse in the room says: “Maybe they did listen to their staff.” Gommers: “I think that’s lame.”
For a long time, the ICU nurses in Erasmus MC each had to care for three serious patients at the same time, where they normally have one or at most two under their care. According to Gommers, the agreement was that all ICs would do this, but that did not happen. A nurse in the ward: “We are not protected.”
During two corona waves, Erasmus MC has admitted more corona patients than other hospitals
Absenteeism in the ICU in Erasmus MC is high. Nurses, they say, have repeatedly asked leadership not to “scale up” any further and admit more ICU patients. They blame the management of the department (Gommers) and of the hospital (Ernst Kuipers) for having opened more beds. “Over our backs,” said one nurse during the meeting. Another, who had knocked on Gommers’s door before, says: „When I sat opposite you, you said that I was pretending, that we were nagging. And here you say you want to start the conversation. Diederik, I don’t trust you at all.”
At the meeting, the tone of which gradually becomes grim, intensive care director Johanneke Mulder throws fuel on the fire by accusing those present of spoiled behaviour. She says the nurses in the ICU have received much more attention and gifts than those in other wards, so much that they had to go “home sick” because of all the donated pizza slices and pies. The hospital also organized a summer party, especially for the IC department. However, there was no budget for extra salary for the nurses, she says. “The organization may say ‘no’ to that,” although that “isn’t the message you want to hear.”
The Very Hungry Caterpillar
After reading all the angry letters from nurses, the conclusion of IC director Mulder (a business administrator who previously worked for Twynstra Gudde, among others) is that the staff, she says during the meeting, are nagging. “I get a bit of a caterpillar never enough impression.” A nurse from the ward responds: “We are hurt and not heard, and you ignore that. You can throw so many sausage rolls at it.” Another says: “We already indicated in the spring that we no longer wanted to scale up, and then we scaled up anyway. I am angry about that.”
Gommers says in a reaction on Friday morning that he was surprised by all the emotions that were released during the filmed meeting. But also that he “is not going to promise that there will be no more scaling up.” According to Gommers, the reason for the unrest is the proposal to have medical students help out in the ICU if necessary. In previous peaks, other nurses were added as ‘buddies’ to the ICU staff, but that system did not function properly. In addition, conversations with external ‘burn-out coaches’ and with their own team leaders must manage the stress and unrest among the nurses, according to Gommers.