Wednesday, February 2, 2011

When the Beep is a Heart......

Last week a dear friend fell on the ice, hit his head, and had a stroke. He was taken from the rural critical access facility to a larger facility in the “city”. The family (most of who were from the city) had so many trials gaining information necessary to help care for their father, and I was struck by something – we have gallons of information available about patients now and the only people who get to see it are the “educated” ones. One day he was doing better and the next he was in ICU and the family was told to “prepare”.

It’s always hard for me to go to a hospital – it’s kind of like eating at a restaurant when you have been in food service. When I walked into ICU and looked at his monitors it was so striking – We have been in heavy R&D lately developing new metrics, and producing our new software program. I stood in that ICU, stroking the beard of my friend, and thinking it’s not just math. It wasn’t just a number that needed to be processed for automation or documentation – it was his heart, it was his life. This man, who the night before his fall had called to sing happy birthday to my son, was hooked up to all of these machines.

Do you ever feel like you are just looking at a page full of numbers when you are analyzing the work your do? “Alert quantities” take on such a different meaning when you are staring into the face of friend.

How do we make it all about him – the patient? How do we make it meaningful to this man and his family? They were so scared. They didn’t understand and by the time I arrived at the hospital – they didn’t trust the staff because they weren’t being communicated with clearly. As I talked with them there were a few things that stood out to me that every family should know going into a hospital.

  • Have an advocate with the patient, and keep track of “vital” information. When the nursing staff is collecting information, ask what they are doing and be engaged in the answer. It may not make sense on day one but it will by day 2 or 3 it will start to make sense. If it still doesn’t make sense ask more questions, or see if the hospital has a Patient Advocate.
    • For example, if your family member has a fever – ask why – ask what tests are being done to figure out why – ask what his temperature should be.
  • Use the internet to understand the condition – but remember the internet is not always right, and it can’t see your family member.
  • Know your caregivers by name – the Nurse is the one who gives medicine – the Care Tech is the one that brings ice chips, helps the patient to the bathroom, and does the leg work. The Nurse is probably tending to 5-6 people during her shift and the Care Tech may have as many as 12. If you have a problem the person in charge of the Nurses is the Charge Nurse.  Get to know the Unit Secretary too – the person at the center desk that answers the phone - they are often air traffic control for the unit.
  • Use a life line - Phone a friend. When you are in the thick of it, and emotions are high you may not be thinking clearly. Call someone you are close to and download – they may have different perspective and be able to help you refocus.
  • Take a break. If you are the only person from your family available to sit with the patient – know that the care staff will be there when you are not. Just let them know you are going to the cafeteria or getting some dinner. When BFB was in the hospital the hardest thing I had to do was leave for an hour – but my Nurse (who was wonderful) insisted so that I could relax and refocus.
  • Pray Continually – this one is my personal advice, but it works. Even if you don’t believe -sometimes you just need a release and no person around.

As we move into an era of “Smart Phones” let’s not create a Soulless environment where we have so much data and we forget that the man in ICU is someone’s Dad, Grandpa, and friend. Technology must be an enabling medium – it must be something that allows a caregiver to care – not limit their ability to engage. Every click is a moment they aren’t engaged with a family – every alarm is a moment they aren’t focused on a patient.
How do we create less “technology drain” and create more “patient engagement”? We all need to make sure that our focus is creating an environment that is conducive to healing, or if the family is saying good bye create an environment of peace.

1 comment:

  1. This is a wonderful post, Kourtney. I'm not personally in the patient advocate "game" - I know *of* that world but not a lot *about* it - but to me this is perhaps the best introduction I've ever seen to what the subject is about. Well done.


Thanks for Posting on Clinical Transformation!

Kourtney Govro