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Home > Topics > Community Awareness
November 01, 2012
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EMS News in Focus
by Arthur Hsieh

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

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

By Arthur 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.
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