I have only a very small amount of experience as a hospital patient – a couple of bouts with short stay procedural stuff. I consider myself extremely fortunate. On the other hand, unfortunately, I have a vast amount of experience as an immediate family member of one. Contender for Guinness worthy. I’m not writing this because I want sympathy, certainly not prayers, not even best wishes. In fact, if you post some kind of related drivel like that in the comments I will edit it out.
I’m writing this because I want hospital administrators down to nurses to wake the hell up. I’m pretty sure this is the first time I have used a four letter word on this blog, so know that I am as serious as the quadruple cardiac bypass my mother recently underwent to prevent more muscle damage.
We have been around to various hospitals over the years – this isn’t meant to be about the experiences at just one institution, but over the past three weeks I have amassed enough examples of head shaking, jaw dropping inappropriate care that I’ll just stick to the present examples.
Do you know who has their ducks in a row? Nursing Assistants and Cleaning Staff. Their jobs are the grungiest and most back breaking. Their pay is the lowest while their attitudes, smiles and care are the best. It seems the more responsibility you have, higher your salary is and longer you have worked in a hospital, the less you care, the more desensitized you are, the more godly you think you are. There are wonderful exceptions but they are exceptions.
I’m not kidding.
The attitudes – High and mighty, egotistical and eccentric, desensitized and assembly like. Maybe it’s a pitfall of having patients’ lives in their hands all day, day after day – a negative psychological effect. Where are the team meetings and employee support groups led by psychologists to assist staff to manage high job stress and maintain good mental health?
Family dismissal - How about waiting in the open heart waiting room with no coffee? No water? You’re on edge, you don’t feel comfortable leaving. The promise of hourly calls that are late while you are on pins and needles because your wife and mother are splayed open with her heart stopped? Coming into the waiting room to deliver sensitive news to families in front of others. I felt bad for the other family in the room who heard there was no hope for their loved one and almost lost it thinking of my own mother as the list of unfortunate complications she suffered were laid out verbally and the physician said ‘go say your goodbyes’ to them in front of me and my father. Where is the respect, the dignity, privacy and comfort that is needed in difficult moments?
Neglect – They talk and walk around you instead of include you for continuity of care when staff is not in the room or the patient goes home – That’s a mistake. I was on my way to a conference and thought to swing by the hospital on my way to find my mother barely attended after having a PICC line inserted. How long is it reasonable to have a post surgical cardiac patient on a gurney in a transport bay waiting to go back to their room with no one checking on them? An hour? Where are the service level agreements for standards of care?
I had to insist militantly that someone check my mother’s blood sugar because I could tell she wasn’t acting herself – and after squabbling that it had been routinely checked, that it required two signatures to check it more than four times a day – and I said I didn’t care, they found it was 39 – critically low. That sent them running for packets of sugar and OJ.
When you ask why the arm and fingers are so swollen and purple you get – it’s fluid retention and needs elevation, when really it’s a blood clot they know is there but aren’t honest about until there is no denying it’s not simple edema.
These are just a few of many unfortunate observations. I think you get the idea and I don’t need to go on about more specifics. If you are a healthcare provider, you can say you work at a great hospital – and maybe you think you do. But I stand fast when I say
Family have a bona fide job as caregivers - go ahead discard their needs and your patient’s support system goes down the drain… Staff should work with families as part of an integrated team of providers of care. I found myself lacking confidence in the care on two occasions when my mother was unable to advocate for herself due to her condition – I slept in a cardiac chair next to her to be sure she got the care she needed. I was happy to do it for her, but it shouldn’t need to be done.
I feel badly for those who do not have a knowledgeable independent advocate to monitor and question care, challenge decisions and offer suggestions.
- Hospital administrators could enhance the quality of care by including customer service and sensitivity training in their new hire orientation and annual training calendars.
- Patients should be treated as consumers and be encouraged to participate in their care through informed choices.
- Service level agreements should be part of operational effectiveness.
- Hospitals should ask patients fortunate enough to have engaged and available immediate family members if they would like to name one of them as their advocate to receive thorough daily briefings on their progress.
- Immediate family (or a person designated by the patient) should be treated as co-consumers and partners in the patient’s healthcare.
- Hospitals could use barcodes on patient wristbands to track their location in the hospital. If the patient is taken out of their room their wristband could be scanned at their destination. There should be no mystery as to their whereabouts – their location should be able to be tracked on any unit computer (isn’t this a serious no-brainer?). They should be scanned upon return to their room. This would also provide great time/use statistics for the facility.
What tips do you have for hospital healthcare policies and workforce?