Monday, June 30, 2008

LIVE GHOSTS IN THE ROOM

MITSS Support Team Member and Doctoral Student in Psychology, Erin O'Donnell, shares some reflections regarding her godson's hospitalization. Erin chronicles a very common problem with seemingly routine healthcare communication -- one that needs to be addressed in our quest for true patient-centered care:

On Wednesday morning, my 4 month old godson received a heart transplant in another state. Naturally, this is a big moment and gift beyond words. There is so much that can be said about the magic and miracle of organ donation; the amazing donor families, the science and the great treatment teams. However, I would like to comment on the something else.

Today, my friend, my godson’s mom, called me and said, “People say stupid things sometimes.” She went on to tell me about how the person she thinks was the anesthesiologist (the doctor didn’t adequately identify her role) introduced her name to my friend when entering her son’s room in the Cardiac Intensive Care Unit. The doctor then began talking to the other surgeon in the room as if my friend, the mother, were not in the room. This conversation included saying, “Most transplant babies are off the ventilator after 2 days.” Everyone in the room knew that this was 4 days after the transplant. It was an insensitive comment to make in front of the mother in that manner. The part that my friend found most rude was that the comment could wait until they left the room, since it was information all parties present already knew. When I expressed my irritation with the fact that the treatment team was talking as if she weren’t in the room, instead of integrating her into the team, my friend said that such discussions happen ALL THE TIME! How many times in our lives do people talk about us or our loved ones in front of us and pretend as if we don’t exist in the room? Is this a strange phenomenon that has become commonplace in the healthcare setting? How should a patient or family member confront such behavior without being seen as a problem patient? How did this kind of behavior originate in the first place? I wonder if it started as some sort of communication shortcut.

I do not believe either of the providers in the room were intentionally insensitive nor do I believe that they are callous people. This is a more widespread problem. It seems there are great barriers to overcome when discussing the importance of integrating the patient and family in their own treatment decisions, particularly when there are still providers that “forget” that they even exist at all.

Erin O'Donnell
MITSS Support Team Member

3 comments:

deborah said...

I'm afraid in today's acute care environment there's more attention to "lack of time" than there is to the principle of including patients and families in discussions of care. The fewer the people you talk to, the more control you have over your time. That's the way I interpret that behavior anyway. "Lack of time" has become some sort of anthem in health care today. People sing it constantly. Its supposed to be explanation and excuse for behavior that sends the opposite message of compassion and support. It's time we started singing a new song.

Miss Deb

ejnodonnell said...

Thank you for your comment, Miss Deb. That is a very interesting point. I like the metaphor taking up a new anthem to sing. I would love to continue to hear other perspectives out there, as well.

FYI, my godson was extubated yesterday and is doing well.

Erin O'Donnell

Anonymous said...

Would like to comment on the news today in the Globe about the admission of a local hospital acknowledging the surgical error that occured. I must appaud this hospital in noting in the comments that told this pt about the event once the pt was recovered and alert enough to take it all in. How upsetting for all involved pt, family and staff but how much easier for all involved that from the begining the thought was to allow the pt to become alert enough to take it in and support begun. As we work to encourage disclosure and support I must express to the physicans, staff involved that this step alone will begin to help this pt cope and in the end also help allto move through this process..

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