• Patients as Teachers

    May 25, 2012

    Healthcare leaders share the most important management lessons they have learned from patients.

    Patients Are People Firstpg64_photo-george-zara-1

    "We must respect the uniqueness of each person and understand hospitals are intimidating and scary environments, says George A. Zara, president & CEO, Sisters of Charity Providence Hospitals, Columbia, S.C. "Personally, I can recall one very difficult time in my life. My oldest daughter passed away at a hospital where I previously worked. I remember all of the physicians and nurses talking about her just as a patient. It was not until they realized that she was my daughter that they transformed their attitudes.

    "The general public often sees health care as big business. The only way that we can affect this image positively is to do our part to treat people as individuals. If we can do that, we are living up to our calling as medical professionals to serve others and our communities."  

    Communicate Often and Wellpg64_photo-shirley-calaway

    "Communication is a high priority for patients in terms of having an excellent experience while they are in the hospital, says Shirley Calaway, manager, service excellence, patient relations, volunteer resources, Bethesda North Hospital, Cincinnati. "Patients need communication from the staff members, nurses, and physicians. They want to be treated with respect and courtesy and want to know we are listening to them. As we increase the effectiveness and frequency of our communication with our patients, our hope is they will have an excellent experience in our hospital." 

    Listen for the Details

    pg64_photo-dan-silverman"The most important lesson I have learned from patients is to listen and not to discount seemingly incidental or vague events or concerns, says Dan Silverman, MD, chief medical officer, Samaritan Hospital and Albany Memorial Hospital, Troy, N.Y. "These often turn out to be pivotal in obtaining an accurate diagnosis. I had a patient who had chronic headaches, but on a second visit, I learned that other members of her household were also having headaches. It turned out that they had a furnace problem and were all suffering from carbon monoxide poisoning.

    "Here is a quote from Norman Dascher: 'The key is to support and empower the staff to implement and practice evidence-based medicine. Tell them that you'll never get in trouble for doing the right thing for the patient.'" 

    Little Things Make a Differencepg64_photo-maria-cvach

    "Spend the extra time to answer patients' questions, listen to them, make them comfortable, and let them know you are there to help them," says Maria Cvach, MS, RN, CCRN, assistant director of nursing, clinical standards, Central Nursing Administration, The Johns Hopkins Hospital, Baltimore. "This will help ensure their cooperation and good communication.

    "At the beginning of my shift, I meet all of my patients, post my name on their room boards, and let them know that I want them to call me for anything they need. The increase in technology threatens our ability to spend more time at the bedside, as we focus on monitors, computers, scanners, etc. It is so important to treat the patient, not the monitoring equipment."


    Flex to Meet Patients' Needs

    "Patients teach nurses many things, and one lesson that stands out for me is the importance of continually flexing to meet the needs of our patients," says Susan Clark, MSN, RN, clinical manager, float pool and GetWellNetwork, Winchester Medical Center, Winchester, Va. "I recently had to investigate a patient complaint concerning a nurse in our float pool who is very highly skilled and very attentive to patient needs, especially with pain control. The patient had a complaint that the float pool nurse was mean to her, would not answer her questions, would not answer her call light, refused to give her pain medication etc.

    "After reviewing the medical record, speaking with the primary nurse, the patient, and all the staff who worked on that shift, we found that this patient was having a reaction to her pain medicine. The patient revealed that she had had a previous reaction to this medication but did not ever relay that information to any of the nurses. The hallucinations that she had that night were real to her, and they made her feel anxious and scared, which escalated her pain need.

    "The float pool nurse had spent much of her shift with this patient and was very frustrated when she left that morning. She contacted me and voiced that she felt this patient was having some kind of reaction to her medicine but nothing like she had seen before. Other nurses noticed the nurse becoming frustrated during the night trying to meet this patient's needs, but no other nurse (not even the charge nurse) would step up to see what else (assignment-wise) could be done.

    "The lesson learned was that we need to always be re-evaluating our units' team assignments and patient team acuity for each nurse. Patient statuses can change in the blink of an eye and, if a nurse is stressed or overwhelmed, it may have an adverse affect on a patient's perception of care or a patient's outcome.

    "After the investigation, I talked with the unit leaders about how we should have looked outside the box on how we could have managed this patient's care that night. As charge nurses and nurse managers, we need to step in to help when this type of situation occurs so the nurse can step back, take a deep breath, and focus anew on the patient for the proper outcome to occur."