Remarks by Secretary Eric K. Shinseki

2009 Secretary's Awards for Excellence in Nursing
Washington, DC
May 12, 2009

Gerald, thank you for that kind introduction, and good morning, everyone.    

Welcome, and thank you for joining us.  I’m very honored to participate in this important ceremony to recognize some of our very best, who have distinguished themselves by their excellence in nursing.   

I entered the military in 1965, just as Vietnam was surging.  Over half of my first five years of service was spent in a hospital bed recovering from injuries.  On those wards, we always appreciated our surgeons, but we loved our nurses.  We saw our surgeons in the operating room and on grand rounds and appreciated their surgical skills, but our nurses—they were with us every day, every step of the way, good days and bad, and on those days when you didn’t think you could gut it out anymore.    

I’ve never really had an opportunity to thank all those nurses, male and female, in my multiple hospitalizations, who got us back on our feet and functioning again—in my case, able to meet the worldwide deployability requirements of a 38-year military career.    So, as we honor these wonderfully caring people for their excellence in nursing this morning, it’s also my chance to say thanks to your profession for those who had a profound impact on my life.     

Here at VA, over 288,000 employees come to work each day all across the country.    Over 230,000 of them are part of our health care system; they populate our hospitals and our clinics, our nursing homes and Vet Centers, our VISN offices and, here, at 810 Vermont.  We care for veterans.  We honor them, we advocate for them, and we nurture them when they are in need.  Our people are the ones who will fulfill the president’s vision to transform VA into a 21st century model for governance.   

For the severely injured and the seriously ill, who spend long days, weeks and months in our hospitals, recovering, recuperating, and rehabilitating, nurses represent both a daily routine, that sense of competence and confidence that comes with structure, as well as the expectation of better days, subtlety delivered through a “you won’t have me to mother you forever” attitude.  For some, the anxiety about the unknowns are overwhelming, almost desperate, and those are the days when you are at your best.  

I hold close the memory of one incredible nurse, who had a significant impact on my life—a seasoned trauma nurse in the amputee ward at the Medevac hospital in Danang, where I was being stabilized, after stepping on a landmine, for onward movement to the states.   

My foot had been badly damaged and the wound was still open, raw, and painful.    I did not fully understand the extent of damage, how long the road to recovery would be, or how this injury could potentially change the rest of my life.  I was young and invincible.    

Soon after my arrival on her large ward, this trauma nurse stopped by to have a conversation about what I could expect when I returned to my final stateside hospital.  She indicated that I would, in all probability, be offered an amputation to remove my right foot, and implied that I would be expected to sign the release forms.  Great pressure might be leveraged if I hesitated signing.

“They are going to give you a lot of reasons why they think this has to happen,” she said, “but the basic reason is that, right now, no one makes a prosthetic for the kind of injury you have, but they do make one for the entire foot.”   It was apparently common practice to remove the entire foot whenever serious foot damge occurred.    She also informed me that removing the ankle itself was problematic because she had never seen a prosthetic device do what an ankle does.   

She then asked whether I might be interested in trying to save my ankle.  When I answered, “yes,” she told me that I was going to have to demonstrate mobility in that ankle.    And to retain mobility, she suggested rotating it—a lot—as painful as that would be inside my bandages.  And as she turned to leave, she said, “every time I see you, Captain, I expect to see you rotating that ankle.”  Stern would have been a polite description of her bedside manner.  There was no question about who was in charge of that ward.  And so, for the rest of my time in that Danang hospital, every time I heard or saw her coming, I started rotating that ankle just as fast and hard as pain would allow.    

Well, sure enough, after being returned to the U.S., after examination of my still-open wounds and consideration of all the options, I was informed that I needed an amputation at the ankle.

My, “no thanks,” most assuredly did not sit well with my surgeon, and what followed was an extended dialogue of back and forths that ultimately led to some stern warnings but an agreement to try to fit a prosthetic device to my injuries, rather than the other way around.  The wounds were closed, and my therapy and rehabilitation began.

Now, you can appreciate what that nurse means to me.  She gave me some good advice that changed the course of my life.  Had she not spoken and had I not worked to keep my ankle mobile, I am certain I would not have been able to argue for a different outcome.  I would not have been allowed to remain in uniform or to compete in my profession.    

Because of that compassionate, yet-firm, professional, who understood that “providing health care” meant much more than changing bandages, readjusting pillows, and ensuring patients take their medication, my life took a decidedly different course.  She made a tremendous difference in my life and maybe the lives of many of the other 50-75 wounded patients under her temporary care.

Today, we are here to honor six very special people, who have put quality, compassion, and ‘care’  into health care—four nurses, a health technician, and the Director of one of our VA Medical Centers.  Our award recipients have demonstrated levels of professionalism far beyond what is expected.   

They understand the key roles that nursing plays in clinical quality and patient safety.  They understand that each patient is a unique individual with unique needs, from the 19-year-old Veteran of Baghdad to the 38-year-old Veteran of Kuwait, from the 60-something Veteran of the Ia Drang valley to the 76-year-old and 87-year-old Veterans of Chosin Reservoir and Omaha beach.

Our awardees were selected from a field of high performers by their peers.  No one critically identifies superior performance better than a peer, and they have undergone a rigorous selection process.  Their extraordinary efforts are part of the reason why, in my lifetime, VA has changed from an institution starkly portrayed in the movie, Born on the Fourth of July, to today, when VA is lauded for delivering the ‘Best Care Anywhere.’     

Buildings, facilities, equipment and labs do not look after those who are sick; technology and processes don’t care for the wounded or engage with patients’ families; electronic records and information technology, alone, do not provide the very best care for our clients.  People do.  And the front line in healthcare is nursing.  Excellence here enables excellence throughout the entire system.  For their contributions, we are indebted to these very special professionals this morning.

Now, let’s present them their much deserved awards.

Thank you