by Carolyn Thomas ♥ @HeartSisters
I’ve lived on both sides of this scenario. For many years, my workplace was a hospital where I worked as the Communications Coordinator on the hospice/palliative care unit. I’d arrive at the hospital for work early each morning and easily navigate the maze of hospital corridors leading up to my office. I’d chat happily over coffee with my nurse and physician colleagues arriving for shift change, and then unlock my office door to prepare for that day’s busy schedule. Showing up at the hospital became as routine for me as showing up for work had been during over three decades of my PR career in corporate, government and not-for-profit sectors in other workplaces.
Yet on some level, I always knew that my familiar hospital workplace was anything but familiar to people out there who were making their way into that same hospital – but as patients.
From my office window, for example, I could watch dozens of people below walking from the patient parking lot toward the main door of the hospital. While my own days started with all the routine of just another day at work, I often wondered what the same days were like for all of those people arriving for their hospital procedures, diagnostic tests or specialist appointments. Accompanying each person was a drama, about to unfold on the hospital stage each day.
I knew that what was the most routinely ordinary day for me may have meant a long countdown to whatever had been circled on that day’s calendar for patients. This was the day these people had been either waiting for or dreading.
Today might be the day they’d finally learn results which had the power to forever change their lives. I never took that for granted, the profound difference between the perfect ordinariness of my working day and the very big deal this day meant to patients and their families.
My ‘normal’ morning was kicked off by chatty pre-shift coffee with my work friends. And the hospital staff that all of those patients were about to meet were likely enjoying a chatty coffee with their colleagues, too, just like me.
No big deal, just an ordinary day – unless you were one of the patients.
Vancouver’s Sue Robins recently wrote on her eponymous blog about her experience as a cancer patient in this succinct yet profound summary:
“I have this pipe dream that one day patients will work together with health professionals to set research priorities to figure out how to minimize the many indignities that are inflicted on us in hospitals.
“What is a big deal for me is not a big deal for healthcare professionals.”
Sue is correct. After my heart attack, and subsequent complicated diagnosis of coronary microvascular disease, arriving at the same hospital suddenly became a big deal to me in ways I could never have anticipated given that I’d worked at this hospital for many years.
I now had to find my way to new areas of our large hospital I’d never seen before, to cardiology departments that were unfamiliar and surreal, in order to undergo strange diagnostic tests, scary cardiac procedures and endless follow-up appointments that were in turn unfamiliar and surreal.
As I once explained to hospital staff (Carolyn’s Top 10 Tips on How to Treat Your Patients) after one particularly upsetting experience at a treadmill stress echocardiogram appointment in my hospital:
“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 you’re about to perform on them.
“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 cardiac event. Patients can feel distraught, vulnerable, or afraid just thinking that there might be something (else) wrong with their hearts.”
This may also help to enlighten certain health care professionals who attempt to reassure half-naked patients trying awkwardly to cover assorted body parts with those stupid hospital gowns. Such reassurances often end up sounding like:
“Don’t be embarrassed! I’ve seen lots of half-naked bodies in my job!”
News flash! Embarrassment is not about YOU, hospital staffer!
This is NOT about you and your comfort level, but about US and our discomfort level. We do not care how much bare skin you’ve personally seen, poked or stuck a scalpel into. All we care about is that it’s our own body parts that are hanging out in shockingly immodest fashion during an already significantly stressful event.
It’s neither reassuring nor respectful to remind a patient that she’s merely your 1 o’clock procedure, the obstacle between you and your next coffee break, just a piece of meat on a slab – but worse, an invisible piece of meat.
And my Top 10 Tips reminder to men who work as lab techs (and who do not bother to introduce themselves to each patient!):
“Next time I’m ordered to strip to the waist in front of a strange man, he’d better buy me dinner first.”
This sentiment may indeed feel like a news flash for longtime hospital staff who might have never paused to consider that a patient’s medical visits are very different from merely showing up for work.
I believe this lack of consideration is also why so many physicians and other healthcare professionals inevitably report a “Eureka!” moment when facing their own health crises. No matter how many years of experience listening to and treating patients they may have, they will likely announce loudly to their colleagues and beyond, for example, that hospitals are demoralizing, medical procedures frightening, lack of dignity embarrassing, symptoms distressing, dependence humiliating, the simplest of tasks exhausting, anxiety relentless, their past as a healthy person but a dim memory, and their future looming bleak and uncertain as patients. Who knew? See my guest post, Why Physicians Must Stop Saying: “We Are All Patients (published in the British Medical Journal – BMJ).
Familiarity, as they say, may breed contempt. Not open-faced contempt, but that wide dismissive distance between those familiar with health care as a workplace and their patients making that long scary walk through the hospital doors. Patients are the ones who go home from that day’s procedure or specialty clinic or diagnostic lab often trying desperately to make sense of what’s happening to them. Physicians, nurses and other hospital staff, by comparison are the ones who go home that evening to essentially the same life they’d enjoyed the day before, and the day before that.
Dr. Rita Charon, one of the pioneers in the field of Narrative Medicine, and author of the book Narrative Medicine: Honoring the Stories of Illness explains the patient perspective to her medical colleagues like this:
“While doctors are knowledgeable about disease, they do not adequately appreciate that illness changes everything for the patient.”
Q: Have you ever experienced a hospital workplace as both employee and patient?
.♥
NOTE FROM CAROLYN: I wrote much more about becoming a hospital patient in my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the code HTWN to save 30% off the list price).
See also:
An open letter to all hospital staff
Patient engagement as described by 31 non-patients
The new country called Heart Disease
The lost art of common courtesy in medicine
Kindness in health care: missing in action?
Heart Sisters 
I was my mom’s caregiver while she was getting palliative care for cancer. I recently started volunteering at my local hospital in the cancer clinic and I am appalled at the lack of compassion from a few of the nurses.
A nurse yelled at an elderly patient last week for being late. After she yelled at him I had to assist him to fill out his symptoms assessment on the computer and he rated his depression level an 8 out 10 explaining that he has lost 15 family members in the last 5 years, lives alone and has cancer and now he’s getting yelled at.
I’m uncertain if I can continue in this sort of environment but feel such compassion for the patients.
LikeLiked by 1 person
That’s a heartbreaking scenario, Michelle. A nurse yelling at an elderly patient at the cancer clinic? It’s appalling….
LikeLike
Great read, and very true.
LikeLiked by 1 person
Thanks, Mike…
LikeLike
All my thoughts expressed sooooo well! Thank you😉
LikeLiked by 1 person
Thank YOU, Carol!
LikeLike
Hi Carolyn, I was wondering if you could write an article or comment on angina. I have it everyday. They now have me on 30mg of nitro morning and night. I started wearing support stockings because my legs are swelling. I know my heart disease is progressing, but I can’t get any direct answers. I am 63 and they finally put me on disability. Shortness of breath, tired all the time. Is there a time frame?
LikeLiked by 1 person
I was just thinking that I need to update some existing posts here about angina. Thanks for that reminder, Lu Ann! I’m not a physician so of course cannot comment on your specific case, but I can say generally that many people experiencing daily angina are candidates for wearing a nitro patch. Make an appointment with your cardiologist to discuss this, and also important other issues like your other symptoms, treatment options and time frames. Best of luck to you…
LikeLike
Yes, just two different hospitals. When I was a young nurse and later as a retired nurse in another state. After my heart attack, angioplasties, and seven stents I surrendered my modesty and thank God I was still living. At Mayo’s St Mary’s, I had the best of the best and never realized the seriousness of me being in CCU.
But I agree my anxiety runs high with follow up visits and tests. Good old nurses always searching for the what ifs?
LikeLiked by 1 person
Hi Teula – my nurse friends would likely agree with your searching for the “what ifs” comment. I suspect it’s an occupational hazard. Some heart patients I know tell me they feel more anxious because they don’t really know what’s going on, while others say they feel that way because they do! Hope you are doing well now…
LikeLike
You nailed it! After my open heart surgery and 10 days in the hospital, I learned many things. One was to be prepared to check your dignity at the front door. Thank you for spreading your word to health professionals!
LikeLiked by 1 person
Hi Maria – thanks for that piece of advice for all incoming hospital patients: “Be prepared to check your dignity at the front door!” But it doesn’t have to be that way. It just takes a wee bit of empathy and common courtesy, and a willingness to see one’s patient as a scared and vulnerable human being.
LikeLike
So very true. Medical professionals can become desensitized to the very real trauma their patients are experiencing. Even worse, they can add to that trauma by thoughtless comments or a dismissive attitude. I wonder if there is anything as patients we can do to engender a more authentic encounter…without becoming “that difficult patient”.
LikeLiked by 1 person
Ah, that’s always the issue, isn’t it? Being the good patient, not wanting to make a fuss… I wrote about this here, in a post called “Would It Kill You To Treat Your Patients With Respect?” – after a dental appointment in which the hygienist cleaning my teeth was carrying on a conversation with her colleague IN THE NEXT ROOM about a meeting that one of them had attended the night before.
I was stunned (and feeling increasingly annoyed) – neither were even pretending to be remotely interested in the poor schmucks lying in their chairs during this loud yelling back and forth. I finally couldn’t stand it anymore, and decided to interrupt this long chat by shooting my hand up (I know, a “difficult patient” thing to do!) and I asked my hygienist: “Would you like to go finish your conversation with your friend in the other room? Because while you’re working on my procedure, I would prefer that you focused on me instead of on her.”
The best part – after starting a defensive explanation of WHY her chatty conversation was so necessary, my hygienist caught herself mid-sentence, stopped, and said “You’re absolutely right. I’m sorry about that.” I was glad I did interrupt that day. I’ve had it with the lack of simple common courtesy in medicine!
LikeLike