It has been a long time since I have been a patient. I have spent a LOT of time as a patient, but the most recent time was quite a long time ago. I don't really count my pregnancy/labor/delivery/postpartum experiences as "patient" ones per se, because I really wasn't sick (though sometimes I felt not the best!) and it was a joyful event, and I knew what was happening (most of the time!), and many of the "patient" things (IV, hospital gown) were removed soon after I got to the postpartum floor. In fact, my recent brush with cholecystitis was my first hospitalization for an illness/surgery since I have been an adult. Now that I feel more like a person and less like a ball of pain/fatigue/ickiness, I have had some time to reflect on my experiences as a patient and come up with some insights that may be helpful to me in my career as a physical therapist. I hope I do some of these things already (some of you have seen me in practice and may know better than I), but it's always good to pay closer attention to the "nonessential essentials" of patient care-that is, those things that do not directly help the person's physical condition but are part of the intervention nonetheless.
1. It is helpful to reassure people that what they are feeling is real, and they are not crazy. I actually tried to wait out this "attack" instead of going to the hospital, because I thought I was either manufacturing my symptoms, or perhaps there was a non emergency cause (such as gas or food poisoning). The whole way there, I was afraid that they would take one look at me in the ER, laugh, and tell me nothing was wrong. Of course, they wouldn't have laughed to my face (I hope)...that would not be professional! But still. It was oddly reassuring to hear the doctor tell me there was something wrong and he was pretty sure he knew what it was, but just needed confirmatory testing. It was even reassuring that the nurse told me she couldn't believe I was so quiet and I really should be complaining more/asking for pain medication more frequently.
2. There are several ways to say "this is normal." One of them makes you feel ignored and dismissed. The other is reassuring and says, "Even though I know this does not feel good, it is part of getting better and it will get easier/less painful." Eye contact and taking time to listen and ask questions really makes a big difference here!
3. Sometimes something is not normal, and if you assume it is just because it sounds like something you've heard before, you can miss something. I complained to one of my night nurses that my IV spot in my hand was really pretty painful-in fact, it was making my whole hand hurt and swell (to the point where she had to cut off my hospital bracelet and give me a new one because the old one was cutting into my skin). She told me the ER probably just put it on too tight in the rush to get me back and that since the IV was flowing well, there was nothing wrong with it. Later (after surgery) I winced as a new medication went into my IV in the recovery room and the anesthesiologist asked what was wrong. I told her, but then stated, "but my nurse said that it wasn't really that painful and everything is fine." She raised her eyebrow and retorted, "It's YOUR hand! How does she know?" and then checked it. Turns out the tip of the IV was at the bifurcation point of the vein and that was causing the pain and swelling, and could cause a blowout if left there (I'd already had several veins blow). She moved the IV (and you know it's bad if I request the IV to be moved...I am a hard stick and HATE having IVs started) and the pain was eased immediately. My hand still hurts, but it was nice to not have that pain on top of the others!
4. You can be extremely busy but still make your patients feel like they are important. Most of my nurses gave me the impression that they were very harried and had many things to do and people to care for in addition to me. One of them made me feel like it was fine to push the "call" button even for simple things. I can't really pinpoint what the others did or said that made me feel they were so busy (they certainly did not verbally tell me they were busy or had a lot to do), but I am certain the one had the same workload as the others, yet she still made me feel that my needs were legitimate and important.
5. Even if you can't make someone feel better right then, it helps them to know that you take their pain seriously. Pain is not normal or a state that we should accept as ongoing and inevitable, but it's easy to do when it's been a while since you've felt good!
6. Patients like to know what is going on! I was in the hospital for 3 days and on the third, we were waiting for discharge or the order to come through that I could try eating (I was on a liquid diet). When my day nurse came on, she didn't know the status of either request but did her best to find out. We spent the whole day waiting for an update (she finally got approval for me to eat, but had to wait a bit longer to figure out what was happening with my discharge). It would have been nice to know that what we were waiting for was liver enzyme results to make sure it was safe for me to go home!
I'm sure there are more...for those of you in patient care/customer service (or those who have been a patient) what are some other seemingly small things that can make a big difference in your care experience?
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