An open letter to all hospital staff

10 Jul

hospital

by Carolyn Thomas  @HeartSisters

Dear hospital employees,

After a particularly bizarre experience undergoing a treadmill stress echocardiogram at your hospital recently, I decided to do something that I have never done before.  I called the Cardiology Department manager to complain about her staff.  (Incidentally, a recent opinion survey of international travellers found that Canadians were #1 in only one category:  “Least likely to complain when things go wrong” - so you can appreciate that lodging an official complaint is a fairly Big Deal here!)

In my best PR fashion, I told the manager how distressing the appointment had been for me because of the behaviour of the two cardiac technicians in the room. 

It’s not so much that they were openly rude. It was their insufferable lack of people skills that had pushed me right over the edge:

  • no introductions
  • no eye contact
  • no consideration of how awkward this test can be
  • no explanation of  the test procedures
  • not even the flimsiest effort at polite conversation

To them, I was merely the 1 o’clock appointment, the obstacle between them and their next coffee break, just a piece of meat on a slab – but worse, an invisible piece of meat.

And by the way, next time I’m ordered to strip to the waist in front of a strange man, he’d better buy me dinner first.

The department manager was very receptive to my phonecall, particularly since mine was her second complaint in less than a week.

She followed up immediately with her staff, returned my calls promptly, and even solicited my input about how patient care in her cardiac department might be further improved.

To this end, I offered her the following tips – and if you substitute Cardiology-Speak for Emergency, Gynecology, Oncology, Radiology, Renal, Day Surgery, or the hospital department where you work every day, I suspect these tips may be universally useful.

Carolyn’s Top 10 Tips on How to Treat Your Patients

1.       Acknowledge the existence of arriving patients by saying something like:  “Hello.  How are you? My name is ____ and I’ll be doing your ___ procedure today.”

2.       Make eye contact when you are speaking to another human being.

3.       Just because you do these same procedures day in and day out routinely, do not make assumptions that patients know anything at all about the procedure that’s about to be done to them.

4.       These tests/procedures have been ordered because a cardiac event has already happened, is happening, or might happen in the very near future.  This is extremely serious for most patients.  There is no such thing as a “routine” cardiac test or procedure, especially once you’ve had a heart attack.  Patients can feel nervous, worried, apprehensive, frightened, embarrassed, intimidated, vulnerable, highly sensitive, distressed or uncomfortable just thinking that there might be something (else) wrong with their hearts.

5.       Say: “Today’s test/procedure will start with ____, and then we’ll do ____, and then finish up with _____.”  (I had never undergone a stress echo before June 15th, for example, but I knew about this test only because when I was at Mayo Clinic in October, the staff at their Cardiovascular Diagnostic Center toured us through the echocardiography labs and explained the stress echo procedure in detail).  But even for patients who already know, it’s just common courtesy to review the information for them.

6.       Explain everything that is about to happen before you touch a patient’s body.

7.       Then ask your patient: “Do you have any questions about today’s procedure?” before beginning.

8.       Stripping to the waist is not a big deal to most men, but it is a very big deal to women – especially with a man sitting in the same room (who has not even introduced himself!  Is he the tech? Is he the doc? Is he the janitor? )

9.       Instead, immediately offer your female patients a private or curtained-off area to remove their clothing, a clean, folded hospital gown, and a surface to put their clothing on when ready, so they’re not standing there half naked in a big room, clutching their clothes and underwear in front of two strangers, and wondering what to do next. Q: Why do I even have to be telling educated, intelligent people this in the first place?

10.   For helpful hints about how to treat patients with respect and politeness even in the most awkwardly embarrassing clinical setting, ask the hospital docs and nurses who do sigmoidoscopies/colonoscopies to give you some pointers.  These people are generally amazing – unfailingly considerate, pleasant, friendly and understanding, all qualities that go a long way to reduce patient discomfort.

Your patient,

Carolyn calligraphy

.

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© 2009 Carolyn Thomas  www.myheartsisters.org

This essay was also featured as a guest post on Better Health

See also:

k

11 Responses to “An open letter to all hospital staff”

  1. Elizabeth Y. May 15, 2014 at 6:37 am #

    Wouldn’t it be wonderful to have a little questionnaire prior to a procedure on what you would like to talk about during the procedure? Small talk is tough with strangers that you don’t know anything about. Medical personnel need to take a class from hairdressers on how to create “small talk”.

    Techs, Nurses and Doctors talking over patients is maddening, same as the cashiers in a store who do not acknowledge that you even exist beyond how much you owe.

    A little bit of customer service goes a long way and it’s the person on the table in front of you who deserves the attention.

    Like

    • Carolyn Thomas May 15, 2014 at 10:06 am #

      Right on, Elizabeth! “Small talk” can be as simple as asking a question as if you’re interested in the other person’s life. “It’s the person on the table in front of you who deserves your attention” = should be embroidered on a pillow by every med student….

      Like

  2. A Hopeful Doc December 3, 2013 at 8:35 pm #

    Really appreciate hearing your thoughts, sorry about your poor experience.

    Like

    • Carolyn Thomas December 3, 2013 at 8:42 pm #

      Thanks for taking the time to comment – pls share this with your fellow med students!

      Like

  3. Shawna RN April 28, 2013 at 10:53 pm #

    Just wanted to let you know that I’ve forwarded this to my colleagues in OB-GYN and will post a printed version on our staff room board at the hospital. A good reality check for all of us. Thanks – love your website!

    Like

    • Carolyn Thomas April 29, 2013 at 9:39 am #

      Thanks so much for helping to spread the word (from a patient’s perspective!)

      Like

  4. Julia September 30, 2009 at 6:01 am #

    There are two great blogs that deal with patient privacy run by Dr Joel Sherman & Dr Maurice Bernstein…
    Google their names and patient privacy and they should appear…they’re both American doctors.
    Thought some of you might be interested.

    Like

  5. Lefteddie September 15, 2009 at 9:09 am #

    Carolyn,

    I’m sorry you had these negative experiences; no one should have to experience these unpleasant things, man or woman from our caregivers. These are the professionals we entrust to protect our privacy and dignity. I’m a man and we experience the same thing when if comes to intimate exposure. I seems only natural that our caregivers would ASK if we would prefer same gender staff when intimate exposure is involved, it just seems like a natural thing to ask, but they don’t, they just assume its all right to put us the patient in this compromising position. I guess it doesn’t bother them because they are the ones standing fully clothed.

    They need to empathize more with how the patient feels during these embarrassing and humiliating exams. So, number one should be, ASK your patient if they would prefer a same gender provider to perform the exam, don’t put the patient in the position that they have to be the one to ask. Some will care, some won’t and many will. Out of those that do care, not all will stand up for their rights to privacy for a number of reasons, not wanting to rock the boat, feeling it will affect their care in some way, etc.

    So just because a patient doesn’t object, don’t take that as “it’s ok”. Caregivers, please ASK your patients if they would prefer a same gender caregiver for these embarrassing exams.

    Lefteddie

    Like

  6. Julia September 9, 2009 at 6:54 pm #

    Great list…
    I’d add one more…offer same sex personnel when exposure is required.
    It makes a huge difference.
    I was required to have breast biopsies last year and actually rang ahead of time and said I’d feel more comfortable with female staff.
    I was breezily told they only employ female staff at BreastScreen…when you’re positioning yourself face first on a table and getting off after the biopsies, your breasts swinging to and fro and being handled…I was terribly grateful for my female doctor and nurse.
    It would have made an unpleasant experience FAR, FAR worse with males in the room.
    Not all men and women care, but many of us do…
    Also, ensure the area is private…nothing worse than someone barging in when you’re in a compromised position.
    My husband was having a scrotal ultrasound when the door opened and someone entered with the next patient, “Oh, sorry, didn’t know this room was busy”….
    Absolutely no excuse when people are entrusting you with their dignity and bodily privacy.

    Like

    • Carolyn Thomas September 9, 2009 at 7:54 pm #

      Good grief – you’d think hanging a simple sign on the door saying “Patient procedure in progress: DO NOT ENTER’ would occur to somebody. I still contend that for some hospital staff, they won’t become considerate any time soon – until they too become patients one day.

      I’ve had male health care professionals who were kind and sensitive, and I’ve had females who were rude and obnoxious. It’s sometimes less about the gender of the care provider and more about their personality or lack thereof.

      Thanks, Julia!
      C

      Like

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