Chapter 03: Becoming Director of Nursing at MD Anderson 14:30 Louis J. Marchiafava, PhD

Chapter 03: Becoming Director of Nursing at MD Anderson 14:30 Louis J. Marchiafava, PhD

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Identifier

HilkemeyerR_01_20000523_C03

Publication Date

5-23-2000

Publisher

The Historical Resources Center, Research Medical Library, The University of Texas Cancer Center

City

Houston, Texas

Keywords

Building the Institution; Joining MD Anderson; Building/Transforming the Institution; MD Anderson Culture; Working Environment; Portraits

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Renilda Hilkemeyer, RN, BS, Dr.P.H.:

So anyway, that is what I was doing. I did the same thing when I came down here. Well, I got down here also by accident because Dr. [R. Lee] Clark was on every board you could think of in Washington, and he goes to Washington one day and he runs into Rosalie Peterson. She was in the Field Demonstrations Branch. This was what it was called before the NCI [National Cancer Institute] name. He said he was looking for a director of nursing and could she help him out? And she said, "I've told your boss-to-be that I don't think you'd leave Missouri, but if you'd come to Texas, you could do the job that they need at M.D. Anderson." So, I actually got a very good referral, if you want to look at it that way, because you couldn't get much higher than that, in that particular area. And so, it was interesting and I used part of this in my talk this week.

Anyway, I got a notice that they wanted me to come down for an interview. So, I thought, well, I haven't been to Texas before. I must just as well have a plane ride or something. So, I came to Texas. And my search committee was the Chiefs of Medicine, Surgery, Radiotherapy, and the Associate Administrator. Not one nurse on the committee. I didn't even get to see the nurses. I had to ask to see them because that wasn't any of their business that there was a director being looked for. That was not the way things were done. So, I spent two days. Dr. [R. Lee] Clark was the last person I got to see. I had already made a number of mental notes just walking around. It didn't take me long because I was pretty good. I had been doing this for five years. And I did a lot more than they knew. I knew that because… whether they thought they did or not.

Louis J. Marchiafava, PhD:

Are you talking about the doctors or the nurses?

Renilda Hilkemeyer, RN, BS, Dr.P.H.:

Both. I had some on both sides of the fence. So anyway, I said to Dr. [R. Lee] Clark...he said, "Well, I hear good things about you. Are you going to take our Director of Nursing job?" and I said, "Well, I am going to go home and think about it but there are a couple of things you are going to have to answer for me now before I even want to think about it. Number one, you have no education for your nurses or your aides. And so, I would expect to get some education staff and get started on that. Number two, your budget is set up so you've got 70% aides and 30% nurses, and that can't be, to take care of these sick people. You can't have that kind of thing. Third, your salaries are terrible. You are paying $250 a month for a registered nurse. Regardless of what she does, where she does it, whether she works days, evenings, nights or whatever, and that is it. I could probably put up with some of that, but the thing I can't put up with is that everything I see is everybody's got their nose in the nursing department and nobody is running the nursing department in nursing. So, if I take the job, then I would want the responsibility and the authority for the department. Not just the responsibility but the authority as well."

Dr. [R. Lee] Clark was a very handsome man, and when he would get that twinkle in his eye, I learned afterward, he really was tickled about it. So, he said to me, "Honey, you can have it. The only reason everybody else has got it is I don't have anybody to run it these days!"

Louis J. Marchiafava, PhD:

What was your opinion of him when you first met him in the early years?

Renilda Hilkemeyer, RN, BS, Dr.P.H.:

Well, Dr. [R. Lee] Clark was a very brilliant man, and Dr. Clark wanted the top. He didn't want halfway jobs. If you did a job, he wanted it done well. And he said to me, "Rosalie [Peterson] tells me you are good." I said, "Well, Rosalie [Peterson] knows of me. I have not only been doing the work down there but I have been on some of those committees, so I know somewhat about what goes on with them." And I also knew Dr. [R. Lee] Clark, I figured, was a man of his word. If he said he was going to do it, he was going to do it. He wasn't just going to let it slide by somewhere. And so, as a matter of fact, when I finally said yes, I would come, I ran the Department of Nursing for about three months over the telephone from here to there because I had my classes scheduled and I was not going to turn my class over to somebody else just because I was going to take another job. I was going to finish my classes. But I had the thing running so well .... it would take two or three people to do the job I was doing. So, the challenge was gone mostly from it. And I thought this was going to be a challenge galore if I ever make it on. And so, anyway, I hadn't been here too long until I...I was telling Steve (?) a while ago -he couldn't believe that ...until I had a call one morning, the secretary said to me, Gert (?) said, "The doctor wants to come down and talk with you." So, he came down and he said, "I am the Chief" of such and such service. He said, "I am firing one of my nurses up here today." I said, "You are doing what?" He said, "I didn't like the way they had the beach party on Saturday in Galveston." I said, "That is none of your business whether they had a party in Galveston or not. Furthermore, you can't fire that nurse. I am in charge. Dr. [R. Lee] Clark has put me in charge, and I will be doing the hiring and the firing." Oh, I'll tell you, that door, you could hear it reverberate all the way down the end of the hall and back! He said, "I will see about that." I said, "Fine." So, I called Dr. [R. Lee] Clark's office. Marion Wall was his administrative assistant. I said, "Marion, you'd better get ready for company." She said, "Who is coming?" and I told her. And she said, "Well, you'd better get ready, too. Dr. [R. Lee] Clark will expect you up here." I said, "That's fine." So, I went, and I thought, this is it: either he supports me or he doesn't and I'll go back home tomorrow morning, because I wouldn't stay under the circumstances. So, I really felt kind of sorry for him because this was one of his men that had been here quite a while. And he said, "I have hired Ms. Hilkemeyer as our Director of Nursing, and I want the best nursing department anywhere and she can do it. She is going to be making a lot of changes and this is one of them. You can't hire and fire nurses anymore. That is her job."

Louis J. Marchiafava, PhD:

How did the doctor respond to that?

Renilda Hilkemeyer, RN, BS, Dr.P.H.:

Well, he couldn't do much else but take it, because that was his boss just like it was my boss. But I thought, really and truly, I didn't know whether... I figured I was in pretty good shape because I knew they needed somebody badly. I had been doing their work for three months over the telephone. And papers, reams of stuff they would send me for decisions to make and take care of while they were here.

Louis J. Marchiafava, PhD:

Well, they were hiring you before you even arrived.

Renilda Hilkemeyer, RN, BS, Dr.P.H.:

Oh, yes. They didn't pay me. I had to negotiate my own salary. They wanted to pay me $100 less than I was already making. I said, "No way." And I was able to get well, we had a business manager at that time also, and when I went by to see him, they wanted me to talk to him. I said, "What is your budget for nursing?" He said, "Don't ask me! They can't tell me what they want or what they need. I just put some money aside." I said, "Well, that's fine. Are we going to have any trouble?" He said, "No. I will help you." Staffing was pathetic because we didn't have any staff. Staffing was exceedingly poor. They had somebody that was in the Nursing office, a clerk that was trying to do staffing. I couldn't figure out why they were so short on days. I could understand evenings and nights. She decided that if she couldn't fill evenings and nights, lot of days, she didn't have any help either. So, she just quit recruiting anybody. It was interesting, I don't mind telling you!

Louis J. Marchiafava, PhD:

This is a good point to turn over the tape.

Renilda Hilkemeyer, RN, BS, Dr.P.H.:

O.K.

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Chapter 03: Becoming Director of Nursing at MD Anderson 14:30 Louis J. Marchiafava, PhD

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