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.
For example, when I entered the echo lab, one of the two men present sat at a corner desk. He did not look up at me when I walked in, did not say hello, did not introduce himself. Was he the tech? Was he the doc? Was he the janitor? Who knows?
It’s not so much that he and his equally disinterested colleague 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 phone call, 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. (And by the way, I learned later from friends who work at this hospital that copies of my “list” ended up posted on bulletin boards in staff rooms throughout the building).
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.” (For more on the importance of introducing yourself to patients, visit #HelloMyNameIs, a U.K. campaign launched by the late physician-turned-terminal cancer patient Dr. Kate Granger. And read Dr. Kate’s comment to my blog post, The Lost Art of Common Courtesy in Medicine).*
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. See also: A perfectly ordinary workday. Unless you’re the patient
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 bothered to even introduce himself!)
9. Instead, immediately offer your female patients a private or curtained-off area to remove their clothing, a clean, folded hospital gown, and a clean surface to put their clothing on when ready, so they’re not standing there – as I had to do in front of those two echo lab techs – half naked in a big room, clutching blouse and underwear in front of two strangers, and wondering what to do next. Q: And by the way, 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.
♥ NOTE FROM CAROLYN: I offered this and other entirely unsolicited advice to health care professionals in my book “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your favourite local bookshop (please support independent booksellers) or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the JHUP code HTWN to save 20% off the list price).
© Carolyn Thomas www.myheartsisters.org
* Dr. Kate Granger died on July 23, 2016. The physician who told her that her cancer had spread did not introduce himself, and did not make eye contact with her. She was so disturbed by his behaviour that she launched her #HelloMyNameIs campaign to encourage all health care staff to introduce themselves to their patients. RIP, Dr. Kate.
Would it kill you to treat your patients with respect?
The lost art of common courtesy in medicine
Patient privacy, modesty, and staff burnout
13 thoughts on “An open letter to all hospital staff”
Thank you for bringing this type of physician behavior to our attention, as well as the people we rely on to guide us through sometimes very challenging issues with our health! I too have experienced this type of behavior from ‘doctors’ — we as patients should be knowledgeable that it is ‘unacceptable’ and requires us to report it as you did.
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Thanks for this, Judith! I’ve actually encountered examples of this lack of common courtesy far more from techs and admin staff during cardiac (and other) diagnostic appointments than from physicians. But I think that departmental managers are the ones who can affect behaviours from the top down: an ineffective manager who doesn’t care about professional and courteous behaviour will have staff who are equally ignorant.
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.
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….
Really appreciate hearing your thoughts, sorry about your poor experience.
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Thanks for taking the time to comment – pls share this with your fellow med students!
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!
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Thanks so much for helping to spread the word (from a patient’s perspective!)
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.
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Thanks, Julia! I wrote a guest post for Dr. Sherman’s site here.
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.
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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.
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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.