Monday, June 24, 2013

Patient Centered Smile

Measuring Kindness?

The patient, we know will die at some point from the cancer that has quickly taken over his body.  After a treatment, he is too weak to go home with his wife and now ends up in a hospital that I often hear advertised on the radio.   I am familiar with this hospital and its specialties as being one of the best.  This is a “great” hospital to be in if you have cancer – but what makes it so great?  Is anyone counting the survival rate?
When I arrived with the wife who has to start making decisions about her husband coming home, we park in the parking garage where the attendants are shouting orders to people to move their car and telling them what to do next.  As we walk through the hallways, people who obviously work for this hospital are engrossed in conversation, staring straight ahead or talking on their phone.  I looked for eye contact or any acknowledgment that we were customers of this facility. Nothing.

The wife left messages, and needed to speak to the discharge person to take her husband home, get home care, or bring him to a hospice facility.  Her calls weren’t returned so it was best to get to the hospital to have a conversation.  The discharge nurse was involved with other patients and we were told she would be paged.

As I often tell Care Coordinators how they can help, I was there to make this meeting happen so the wife could just be at her husband’s side.  After working on phone calls about insurance, medical needs, paying bills and dealing with her husband’s business information that she was never before involved with, I thought that the least I could do is help make this meeting as smooth as possible.

When I walked over to what I thought was the nurse’s station where 2 women in white coats were working on a computer, one looked up and said “The Secretary’s desk is over there” pointing to the other side of the hallway.  She didn’t smile, she didn’t ask what my needs were; she just pointed with a pen.  The woman next to her looked up also and then immediately back at her computer.
Besides the very charming aid in the patient’s room, this was my first encounter at this hospital with a medical professional who actually spoke to me and the nerve endings in my arms and back stood straight up.   I knew why I was angry, upset and frustrated.  It was because my first encounter with a medical professional hadn’t had the decency to smile and no one has yet to make me feel welcome.

I asked the “secretary” for the discharge nurse who said the patient’s nurse had to get her.  Then I was told the nurse was busy with other patients.  I asked the aide and he said that he would see to it that the nurse gets the message.  The nurse comes out and tells me the discharge nurse is busy.  When I tell the nurse that we came to the hospital because the wife’s phone calls were not being answered, he then called the discharge nurse.  It’s now getting late in the day so I asked for the nurse manager.  I was now told the discharge nurse is waiting for an important call and will see us when it comes in. 
At each opportunity I was made to feel that others needs were more important than our needs.

So it goes that this may be a wonderful, or even the “best” hospital but I may have been a different person going in were staff to smile, greet me warmly, pretend I was important or even acknowledge us as a customer. 

Patient safety or patient centered care can start with a simple smile.  It costs nothing but opens doors for better communication which we all know leads to better outcomes.

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