Patient Advocate

I spent 4 days at the bedside of a patient (and dear friend) which gave me another opportunity to practice and learn advocacy skills. There was nothing earth shattering about our stay but it sure was interesting.

I arrived before 8:00 each morning and stayed until after 9 PM. The registered nurses each had 4 patients with a certified nurse’s assistant having 10 patients. There was a “floater” nurse who helped when needed.

The hospital staff were unusually friendly. They smiled in the hallway and greeted each other as well as the patients. It was more like a hotel atmosphere than a hospital. This friendliness did not always lead into the patient’s room. Even though in most cases the nurse and nurse assistants were very friendly and kind, there were some who were not as patient or caring.

Kindness, I learned long ago is not a synonym for quality and being nice does not make for patient’s safety. Being kind and caring does open the door for a dialogue that can help avoid a bad outcome. For instance, when the night nurse gave the patient a new medication, the patient stopped him and asked why she was getting that and if there had been some mistake.

Years ago, I remember the nurses might say that “the doctor ordered it” so it was OK but in this case the nurse stopped and said he would check on it. He was pleasant and very willing to confirm the medication was correct, leaving the patient to believe it was OK to question.

Upon his return, the nurse explained why the patient was given the new medication. He continued, following his explanation to say that there are many medication errors made so it was good that the new medication was questioned. He was empowering the patient to speak up again in the future.

Another nurse came back the next day after doing a full search on why the patient’s mediation was different when questioned. This absolutely impressed the patient.

When a doctor came in to see the patient he chatted for awhile and then went over to examine her. As he took out his stethoscope I asked him to please wash before the examination. He explained “I did wash but will be happy to do it again” He left the room and returned drying his hands telling us “don’t ever hesitate to ask anyone to wash their hands, we all should be doing it” He too really empowered the patient to speak up and be involved.

The small things like treating the patient with dignity, covering them up for privacy and pulling the curtain were there for the nurses but not for the physical therapist. The PT continually compared the patient I was with to the patient in the next bed “she walked today so you can too” or telling us what she did with the patient in the next bed the day before. The patient in the next bed had the same procedure done a day earlier so the two women got along well and shared their pain and concerns but it was not for the PT to continually talk about the other patient – within hearing distance. This was both disappointing and wrong.

What was disappointing was the lack of information available to patients letting them know it’s OK to ask, question and speak up about their care. The empty walls in the hospital could have had patient safety posters, hand washing notices or friendly reminders about checking wrist bands, checking medications or letting us know who is I charge. It was also disappointing that the nurse was rarely available on some shifts and when the patient had questions, the nurse would scoot in and out without answering questions. The patient was not terribly sickly, so these areas are just cosmetic on what seemed to be a good, sound health system.