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Home  >  EMS Topics  >  Community Awareness  >  Dear hospital staff: Why can't you show some respect?
November 01, 2012
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EMS News in Focus
by Art Hsieh

Dear hospital staff: Why can't you show some respect?

At the end of the day, we are in the healing business

By Art Hsieh

A recent experience with the health care system reminded me just how much simple respect matters when delivering health care. Unlike the "stories" I normally comment on, this isn't something that will ever make the headlines. But it's something I feel compelled to share. 

A close relative of mine is an older woman in her eighties. Born and raised in the southern area of Boston, she raised seven children on her own after her husband died prematurely.

Over the decades she has helped to raise her children's kids as well. Money was never plentiful, and life was certainly difficult.

She worked until her late seventies and lives with one of her children now. Over the past several months she developed a decubitus ulcer that, despite aggressive home care, would not heal without surgical intervention.

She was admitted to a hospital in a city just north of Boston, and has spent the better part of a month within the system, shuttled between floors, transferred between rehabilitation centers, and finally discharged home with daily home health care.

For the most part, the care and attention she received was good to occasionally great. Standouts included a surgeon who took the time to explain every procedure, and the nurse on one of the floors who checked in regularly and assisted with the requests both the patient and visiting family members.

Yet, most of the interactions were simply fair to poor. If it wasn't for the persistence of another family member who became my relative's advocate, I'm fairly sure that she would have become yet another statistic of how poorly patients fare in our health care system.

If I could speak to the professionals who were involved, this is what I would say:

1. Dear Mrs. Nurse who apparently can't see: Yes, that "muck" on my relative's skin is in fact a skin graft. Pink skin is healthy skin, not infected skin. Trying to scrub it off and causing agony is not considered good care. Then, trying to defend your actions in front of another health care provider is just a bit pitiful.

2) Dear Ms. Nurse who apparently wasn't raised with manners: Yes, I can hear you when you complain about me to another staff person, asking for some pain medication repeatedly because it wasn't delivered the first time.

Or the second. Or the third time, 30 minutes after the first request. Moreover, when you are standing about 10 feet away, staring at me while you complain to another person, as if I wasn't standing there, you shouldn't act so surprised when I tell you, "Um, did you know I can hear you?"

I mean, I know you're busy and all,  but during the time you took to yack about me to a coworker, you couldn't have filled the order? Just sayin'.

3) Dear floor team that didn't take the time to explain certain procedures to the patient: When the patient's heart rate decreased to a potentially dangerous rate, you did the right thing by preparing the external pacemaker, just in case.

Just a small favor -- could you spend a minute to explain to the patient exactly what you're doing? This is how she experienced it: In the middle of night, after finally falling asleep, the lights came flashing on and a group of people hurried about her.

That was frightening. What really terrified her was that someone placed a pair of bug, cold gel pads on her chest. She doesn't know health care, but she has seen enough television to know that the pads meant she was dying, right then and there.

And no one, not a single person, would explain to her what was happening in a way that she could understand. After everyone left, she was left to suffer fear and trepidation alone, for hours until family came back in the morning.

4) Dear team of physician residents and attending who gaze intently at the wound and forget there's a patient attached to it: While you marvel at how well the graft is taking and clean the surgical site is, it might be okay to include the patient in the conversation.

Try something simple, like saying "Thanks Mrs. Patient for allowing us to use your wound as a teaching tool." Or even, "Hello Mrs. Patient, would it be okay for us to look at your wound for a little longer today so I can show the residents something?"

You may be amazed how easy it would be, and how reassured the patient would be.

There are lots of other stories to tell, but I won't bore you with the details. There are lessons to be learned from these interactions, not only for EMS providers but for anyone who has to interact with patients.

There is a well-known remedy known as respect. I know how busy things can be on the floor. I understand how frustrating patients and their families can be. I can empathize how things in your personal life can spill into your professional side and make a shift that much more miserable.

But, honestly…what does it matter? Is it that much effort to say hello, provide a quick reassurance, smile and brighten someone's day for but a brief moment?

Maybe it's not part of your job description, but it certainly is part of being simply human. At the end of the day, we are in the healing business. That includes the mending of the mind and soul, as well as the body. Just a gentle reminder of why you do this.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. In the profession since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a published textbook author, has presented at conferences nationwide, and continues to provide patient care at a rural hospital-based ALS system. Contact Art at Art.Hsieh@ems1.com.
Comments
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Kathy Bennett Kathy Bennett Thursday, November 01, 2012 6:30:49 PM I am a nurse and have been for over 20 years. This article is so true and so very sad. I know nurses are expected to do more with less, but there is no excuse for a lack of common decency and politeness.
Charles Phillips Charles Phillips Thursday, November 01, 2012 7:32:39 PM Art, I'm sorry to hear your mature relative was treated disrespectfully at this large teaching hospital. Unfortunately, nurses and doctors really are not taught interpersonal communication (or better known as bedside manner). Some of those caring for patients in a hospital setting have some sort of "I'm too good" to take care of a patient's needs syndrome, no matter how trivial it may seem to them. When bad attitudes are becoming a part of the way a patient is being treated, it's up to the patients and in your relative's case the family to report this bad behavior to those in charge (the nursing unit's head nurse, the medical team's attending physician, the hospital patient advocate, and the hospital administrator). These folks are supposed to make sure patients are properly and respectfully cared for. Hospitals hate bad publicity and when someone is treated badly, word gets around to the public, either by word of mouth or other forms of media. All professionals caring for patients need to focus on caring for the patients and leave their personal feelings and outside issues somewhere else. Our job, after personal safety, is to focus on assessing the patient and then treat them when necessary. All good patient care requires good interpersonal communication with the patient and those around them, explaining treatments, and listening to their concerns and fears.
Andrew Blawat Andrew Blawat Friday, November 02, 2012 4:45:58 AM I have feet in both worlds as I have been an EMT-P for 23 years and a R.N. for 8 years. The hx of a skin graft should have been noted in an admission assessment and passed on from shift to shift. If it was not noted the nurse should have asked the pt or family about it before trying to scrub. I differ with the assessment of ALL pink skin being healthy skin though. Relatives asking for pain medicine, rather than the pt, presents a problem. Often the pt does not want pain meds but the family thinks they know better than the pt. I have had family urge a pt to press their PCA button to the extent of the pt having periods of apnea with desaturation numerous times before. I have had family members insist on a pt getting pain meds despite the pt sleeping soundly. Yes, people lie and I do not trust their claim of being a medical professional. If I have the time I actually go online eventually and see if they are actual medical professionals. Many CNAs claim to be a nurse and many EMT's claim to be a medic. Some people just flat out lie. In addition, you have you have to look at the pt load and what a nurse has going on. Just a few days ago I had a pt c/o chest pain while another pt had a 103.2 temperature at the same time. I paged 2 different physicians, got stat orders for both of them, had an insulin drip going where the pt was hypoglycemic, one s/p cardiac stents, one s/p cardiac ablation, and a 6th pt headed up to me from the ED with a 9000+ d-dimer who had a hip fx. I had two very demanding families with 2 of these patients. Yes, the nurse should have not complained right by you but for her to do that she was probably overwhelmed. The explanation of the external pacer should have happened simultaneously with applying the pads. A simple "I'm just going to place these pads on you because your heart rate went down a bit (the word "bit" helps not to freak a patient out) and I'm putting these on you in case I have to speed up your heart a bit". Depending on what hospital you are at the team that came to the room was called SWAT or Rapid Response Team. They also have a pt load in the hospital and have to turn over their patients to some one else when they respond. As for the physicians I can't speak for them but as a travel nurse I have seen that they are overloaded the far majority of time.
Alan W. Rose Alan W. Rose Friday, November 02, 2012 5:19:56 PM The status of health 'care' these days is pathetic. In the last decade, my now deceased mother was an in-patient a few times. I saw my share of uncaring health care personnel, what's more disturbing is the number of obvious mistakes and errors I brought to the attention of the staff. They really hated seeing me coming down the hall but it didn't take long for them to realize they better bring their "A game" when dealing with Mom and I. Since I work for a hospital based EMS system, I always made sure to wear my ID badge so that the nursing staff could see that we were 'system family' and I always commented to Mom loudly enough for them to hear that I knew the number to the system complaint line if anything went badly. So sad that these things have to be done to get the care and service that all patients deserve.
Carol Pollard Carol Pollard Saturday, November 03, 2012 9:25:33 AM Art, This is very well put and hopefully it will be observed and put in to action by all health profession personele.
Jake Stein Jake Stein Sunday, November 04, 2012 9:53:39 AM Bashing nurses again? Art, what about all of those who work in EMS and can't be bothered enough to talk to the ONE patient in their care? Most would rather text or tune out with their iPOD rather than focus on some elderly patient whom they believe to be a total waste of their time and skills. Your article has now joined the many on here and other forums which dedicate their time to bashing nurses to make it sound like EMTs and Paramedics are the ONLY professionals who care. Sorry you had a bad experience with a nurse but your public bashing of noticing without noticing EMS has its own less then outstanding members working in it. Doesn't sound like you care as much now if nurses takes the expensive courses at some of the schools you have been affiliated with.
Kristi B Dahl Kristi B Dahl Sunday, November 04, 2012 6:25:51 PM well said! I too saw this when my dad was in SOME nurses and doctors are pretty good, but the majority just don't care and are there for their paycheck!
Judy Hilderman Judy Hilderman Monday, November 05, 2012 3:43:23 AM How very true and sure rings a bell in some cases

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