Friday, July 28, 2017
The surgery went well. There was no infection. The medication was correct and the patient didn’t fall. So why was this 24-hour hospital stay so awful that the patient talked about it for almost an hour as one of the worst experiences this patient ever had?
The humane and respectful behaviors we all expect from those caring for us were missing. A cup of coffee when the patient requested it, the phone and remote within reach, retrieve a fallen pillow on the floor, some crackers, a response to the call bell are just some of the things that can make a patients experience better in the hospital. We all recognize that hospital staff are often overworked or short staffed yet a friendly response to a patients request can mean the world.
Families often need to work or go to school and can’t sit by the patient’s bedside. But having someone available to meet these needs can really change the patient’s perspective of how their care was. And yes, it can mean a better outcome. If the patient got out of bed to reach what fell on the floor and fell, that could cause serious injury and a substantial cost to the hospital and patient’s insurance. Eating inappropriate food brought in by loved ones because the patient didn’t have anything else to eat, might cause a problem with healing causing a longer hospital stay.
So, even though a patient may be sharing that there was the lack of comfort care, there are some concerns of patient safety that can be addressed. If you know someone going to the hospital, even if you have no patient safety training, consider bringing a book and sitting in the waiting room and check on the patient every 15 minutes. You won’t be a burden and you can be sure the patient is getting what they need.
Wednesday, July 19, 2017
You Don't Know What I'm Thinking
A little boy about 10 years old fell off his bike and ran to the grownups to be patched up. His mother and the other adults told him “don’t worry, you will be fine” without ever asking him what’s on his mind.
The next day his bandages had blood on them and it seemed his cuts may have opened up. He brought his concerns about a bloody bandage to the grownups. Again he was told don’t worry and this time was told no one ever died from blood on the bandage. This was a second time the grownups decided he could not speak about his concerns. Did they or he, even know what they were?
A wet, bloody bandage should not be OK on a hospitalized patient. It should not be OK on a boy riding his bike. Blood seeping through a bandage should be questioned. Telling a child he /she won’t die because they have a cut or worse, is not addressing what they are concerned about. Are we raising children to not question the care they receive because when they want to cry, they are told things like “you won’t die from that”?
Play this same scene out when a 60 year old woman has indigestion that seems ”weird” and the doctor says no one ever died from indigestion so she stops in her tracks from questioning the care she received. An adult questions that maybe she is getting the wrong medication - and a nurse says “stop worrying so much”.
When people are frustrated, scared or inconvenienced by sickness or an injury, healthcare providers as well as friends or family members often respond to what they, themselves think the patient / person is feeling or in ways that make themselves feel better. They respond with what makes them comfortable in the conversation.
In our Family Centered Patient Advocacy training tools we use a scenario of a woman screaming in the bed at a hospital that she wants to go home. Nurses are too busy to release her, the doctor isn’t available and she has everyone on her floor angry at her. When I asked her why she wants to go home she explained her child will be getting off the bus and she needs to be there. One phone call to be sure her daughter was met at the bus stop and the patient was fine. No one asked why she was so desperate to leave. They assumed she just didn’t want to be there.
Not asking what is troubling someone such as tell me why are you upset and crying, what are you concerned about or how can I help make you feel better, is closing the conversation to learning and even more important - building relationships.