I spent the majority of the day with a friend who is in the hospital. The care she was receiving was not adequate and she needed someone to be there with her even though she was lucid the staff was not taking her seriously. Missteps, miscommunication and poor treatment were the issues at hand.
Sadly perception is the biggest problem in any patient care situation. And what one person says in what they feel is a perfectly reasonable tone of voice and perfectly reasonable delivery style, can when heard by someone in extreme pain be completely misconstrued. A problem arises from this mis-perception of the discussion, or the treatment. And lack of understanding of the patient and their specific psychological and emotional problems can exacerbate the issue.
Today a doctor came into my friends room and proposed a plan of action for the following day. Unfortunately I stepped out and was not privy to the entire conversation and I really wish I had stayed. Because the understanding of the patient was that this doctor wanted to get her up and moving so that she could be booted out of the room and out of the hospital ASAP. He left and I returned and she became hysterical in the retelling of the episode. The surgeon had not been in at this point and the idea of being booted out of the hospital with a pain level of 8-10 uncontrolled pain had her completely freaked out. Worry about possible continued damage from this suggested proposed plan had her thinking she would end up paralyzed. By the time the surgeon had finally come to see her and confirmed that surgery would be the best course of action she had calmed down and was able to speak to him and have her questions answered. But she had been put through a needlessly stress full situation that could have been avoided had the doctor taken the time to stop and read her chart before walking into the room and by simply listening to the conversation rather than taking notes and getting caught up in what he was writing and missing sections of the conversation. This simple act of not being heard and not caring enough to walk into the room prepared was ridiculous.
Here is my concern, what happens with patients who are not able to advocate for themselves; those who are incapacitated, those who speak another language or those who can't speak or hear at all; who looks after them and their needs? With the new Electronic Medical Record age nurses spend so much time with the COW (computer on wheels) that their time with the patients is diminished, especially if they have 4 or 5 patients at a time.
I wonder if the incapacitated patient is a preferable one for the lazy nurse. With an incapacitated patient the nurse doesn't have to answer the call lights all day long. When the nurse has a non lucid patient they won't know what they have been given for medications, and won't know that what the nurse is trying to give them is not correct, and above all will not argue.This makes life so much simpler for the nurse who does not want to be bothered.
How can patients protect themselves? Have a friend or family member present at all discussions. Someone must be there for you and only you. Someone who you can trust who will assist in speaking for you if you can't and will understand the medical lingo. DO NOT bring your family member who has challenges of their own to be this person. If you do not have a family member or friend who can be this person for you where can you turn?
This is the dilemma I saw today. For those who are language challenged all hospitals offer interpreter services but sometimes it takes a while to get them lined up. For those who can't speak there needs to be an alternative to the nurse call box. What good is a box that they need to speak into if the patient can't speak? In this modern computer age we should build tablets into each bed with a messenger program for the patient to message the nurse. Call boxes are old school! Actually this would work also if they had a built in interpreter that the patient could select the language. Of course this idea only works on lucid patients!!!!
We are left with those who are completely incapacitated with no family or friends to speak for them. And sadly we will need to rely on medical personnel and hope and pray that they got into nursing to care for people and not just for the outrageous salary's that they are paying these days.
Sadly perception is the biggest problem in any patient care situation. And what one person says in what they feel is a perfectly reasonable tone of voice and perfectly reasonable delivery style, can when heard by someone in extreme pain be completely misconstrued. A problem arises from this mis-perception of the discussion, or the treatment. And lack of understanding of the patient and their specific psychological and emotional problems can exacerbate the issue.
Today a doctor came into my friends room and proposed a plan of action for the following day. Unfortunately I stepped out and was not privy to the entire conversation and I really wish I had stayed. Because the understanding of the patient was that this doctor wanted to get her up and moving so that she could be booted out of the room and out of the hospital ASAP. He left and I returned and she became hysterical in the retelling of the episode. The surgeon had not been in at this point and the idea of being booted out of the hospital with a pain level of 8-10 uncontrolled pain had her completely freaked out. Worry about possible continued damage from this suggested proposed plan had her thinking she would end up paralyzed. By the time the surgeon had finally come to see her and confirmed that surgery would be the best course of action she had calmed down and was able to speak to him and have her questions answered. But she had been put through a needlessly stress full situation that could have been avoided had the doctor taken the time to stop and read her chart before walking into the room and by simply listening to the conversation rather than taking notes and getting caught up in what he was writing and missing sections of the conversation. This simple act of not being heard and not caring enough to walk into the room prepared was ridiculous.
Here is my concern, what happens with patients who are not able to advocate for themselves; those who are incapacitated, those who speak another language or those who can't speak or hear at all; who looks after them and their needs? With the new Electronic Medical Record age nurses spend so much time with the COW (computer on wheels) that their time with the patients is diminished, especially if they have 4 or 5 patients at a time.
I wonder if the incapacitated patient is a preferable one for the lazy nurse. With an incapacitated patient the nurse doesn't have to answer the call lights all day long. When the nurse has a non lucid patient they won't know what they have been given for medications, and won't know that what the nurse is trying to give them is not correct, and above all will not argue.This makes life so much simpler for the nurse who does not want to be bothered.
How can patients protect themselves? Have a friend or family member present at all discussions. Someone must be there for you and only you. Someone who you can trust who will assist in speaking for you if you can't and will understand the medical lingo. DO NOT bring your family member who has challenges of their own to be this person. If you do not have a family member or friend who can be this person for you where can you turn?
This is the dilemma I saw today. For those who are language challenged all hospitals offer interpreter services but sometimes it takes a while to get them lined up. For those who can't speak there needs to be an alternative to the nurse call box. What good is a box that they need to speak into if the patient can't speak? In this modern computer age we should build tablets into each bed with a messenger program for the patient to message the nurse. Call boxes are old school! Actually this would work also if they had a built in interpreter that the patient could select the language. Of course this idea only works on lucid patients!!!!
We are left with those who are completely incapacitated with no family or friends to speak for them. And sadly we will need to rely on medical personnel and hope and pray that they got into nursing to care for people and not just for the outrageous salary's that they are paying these days.
