HOW DO YOU GET NURSES TO ADOPT A COSTLESS LIFESAVING IDEA? Gawande makes the point that implementing antisepsis was tedious work, requiring surgeons to scrupulously use antiseptic solutions on their hands, their instruments and the thread they used in surgery. He says: “This has been the pattern of many important but stalled ideas. They attack problems that are big but, to most people, invisible; and making them work can be tedious, if not outright painful.”
Gawande then discusses the problem of persuading nurses in India to warm newborn babies by placing them on their mother’s chests rather than swaddling them separately from the mother—a simple and costless practice. Doing so can cut mortality rates for small or premature babies by a third. Gawande describes hospitals in rural India which he visited as part of a project organized by, among others, the Indian government and the World Health Organization. He found that “less than ten per cent of the newborns were given adequate warming.” One reason for the inadequate warming is that the symptoms of hypothermia are invisible. Another is simply resistance to change. (There is similar resistance in the United States where more than half of the babies who arrive in intensive care have hypothermia.)
Gawande says “Here we are in the first part of the twenty-first century, and we’re still trying to figure out how to get ideas from the first part of the twentieth century to take root.”
The biography of James Garfield by Candice Millard focuses on how the rejection of Lister’s discoveries by American doctors undoubtedly cost Garfield his life.