A Patient’s Perspective

To help launch an initiative on patient and family-centered care, I recently gave a speech to the employees of a large metropolitan hospital where I had 5 surgeries from 2008 to 2010. Here’s an excerpt of that speech.

I am honored to speak to all of you today. During the two-and-a-half years as a patient at this hospital, I experienced some outstanding care and also, unfortunately, some that left me feeling very frustrated. I’d like to share a bit of my perspective with you today.

You all know that the people coming to the hospital are at their most vulnerable state—frightened, nervous, and anxious about what’s going to happen to them. They are looking to you—the doctors, the nurses, the guards, the greeters, the transporters, the custodial staff—to care for them and make them better.

While you may be used to working in this environment and seeing people with many difficult and complex conditions, we patients are not. We’re not in our element. I didn’t like having to take a number to be seen like at the motor vehicle administration. I didn’t want to be treated like a number; I wanted to feel like a valued customer in a first-class, world-renown hospital that you are.

I remember the emergency room doctor telling me: “Well I have good news and bad news. The good news is you didn’t have a stroke; the bad news is you have a brain tumor.” I really don’t remember anything else that followed. I couldn’t believe it. There’s some research that says that patients only hear about 10% of what the doctor says after hearing a devastating diagnosis. Thank goodness my husband was there to support me and listen as the doctor relayed what was going to happen next.

But not everyone is so fortunate. English may not be their first language, they may be alone, or they may be so sick or in such pain that they can’t even focus on what you’re saying.

Looking back on my experience, I do remember many wonderful things that people did:

• The greeter at the entrance who smiled on the day of the surgery and remembered my name as I arrived; or
• The transporter who helped me into the wheelchair after my craniotomy and made sure I was warm enough as we made our way to get a CT scan; or
• The physician who finally coordinated the team of doctors to come up with the game plan and included me in the discussion.

But I also remember the not-so-nice things that happened, like:

• Being told that I could be discharged at 10 a.m. and still there at 7 p.m. waiting for all the paperwork to be signed and for a wheelchair that never arrived; or
• Waiting in recovery for 7 ½ hours because no room was available after it was promised three hours earlier—until my husband came in and suddenly a room became ready; or
• The team of residents that entered my room to discuss my case among themselves at bedside, and treated us as if we were invisible.

I realize things don’t always go smoothly and there’s a lot on everyone’s plate, but sometimes a simple apology can go a long way to recover from a bad situation. I truly believe that everyone comes to work wanting to do their best and sometimes there are situations that are just beyond your control. But it’s how you handle those situations when things go wrong that make all the difference in the world to a patient.

Every interaction is an opportunity. If you can listen to patients and find out about their concerns, you can be a healing presence. Are they worried about how they’re going to pay for their medication, or worried about who’s going to take care of them when they get home? Perhaps you can lead them to the right resources.
And if there’s a communication challenge–either the patient can’t or won’t communicate with you–then try to engage their family members. They can be the patient’s best advocate. Family presence in the patient’s room—on a 24/7 basis—can truly contribute to a speedy recovery.

So if you can work in partnership with patients and listen to their concerns, there is evidence that they are more likely to comply with the treatment plan, have better outcomes, reduce readmissions, and even lower costs.
Nothing is more meaningful than helping the sick to get well. Thank you for listening, and thank you for all the important work that you do.

Happy Holidays to you all.