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Thread: Compassionate Care....Well, sometimes

  1. #1
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    Default Compassionate Care....Well, sometimes

    This is today's blog post about what happened to us last week:


    Last week, Nicholas had an appointment at the hospital sleep study clinic. Nick has severe apnea and we wanted a current read on how often he stops breathing during sleep. We were to arrive at the hospital with his nurse and an overnight bag at 10:15pm and departure was set for 6:30am the following day. Nick and his nurse were told that someone would collect them in a wheelchair van at about 7:30 in the morning. The week before, the head nurse at Nick's residence had spoken at length to the receptionist at the clinic and informed her of all Nick's special needs.

    Fast forward to our arrival at the hospital. A smiling technician greeted us and commented, "Oh, Nicholas is in a wheelchair?" I nodded and asked for the hoist that would work with Nick's special sling. He said that there was no hoist and no one on the unit had any knowledge of Nick's special needs. Without the right hoist, I explained, Nicholas could not be transferred from his chair to the bed. If Nick couldn't lie in bed for the night, the study could not be done. The technician managed to find two orderlies from another department who seemed bemused at having to help lift Nick into the bed. Arrangements for the morning transfer back into the chair were uncertain, but we decided to go ahead and prepare Nick for the test. We settled him into a comfortable position after all the electrodes and leads had been connected and left the hospital around midnight.

    The next day, I found out that Nicholas had been asked to leave the unit at 5:30am because that was the preferred time for the transfer out of bed by the orderlies. Nick and his nurse waited two hours in the hospital lobby for their ride. Nick was tired and sore - the hospital mattress had been uncomfortable and sitting is painful for Nick at the best of times.

    A couple of days later, I was visiting Nick when I was called to the telephone. It was the respiratory doctor who had ordered the sleep study. He was full of sincere apologies. He couldn't understand how the messages about Nick's special needs were not passed along and he was sorry for the pain and inconvenience caused to Nicholas and his family and carers.

    Another mother's blog this week described a visit to an ultra-sound clinic with her daughter that went badly. Those clinic staff were simply surly and refused to assist in lifting this young woman from her chair to the examination table.

    Today on my Facebook feed, I noticed a story from the Guardian. Apparently, in the UK, a new report into the treatment of elderly people in care homes recommends that nurses and doctors be hired based on their capacity for compassion as much as for their exam results. Good idea, I thought, but then wondered whether compassion can be measured or tested. So, I googled and found an article on measuring compassion in the Nursing Times. A tidbit from that article:

    A new King's Fund report – titled Enabling Compassionate Care in Acute Hospital Services and published this week – also points the finger at a ‘technical shift’, especially in training.

    It described core training for the nursing and medical professions as essentially ‘biomedical’, adding that although ‘effective clinical care is clearly fundamentally important… human aspects of care must also be valued in training and in terms of career progression’.

    The article went on to offer opposing opinions from gurus within the medical profession as to whether compassion can or should be a recruitment criterion. They all agreed on one point, though. Professionals who are overworked, underpaid and treated with little respect by their superiors are more likely to treat their charges with little compassion or care.

    I believe that we should use compassion as a criterion for recruitment and I think a good place to start would be with the senior management. An ethic of compassionate care must come from the top and be expected at every level in the organization, not just for end users. The radical idea of demanding that everyone be very nice to each other is being tried in Alaskan and Australian hospitals (see previous posts on the NUKA model of care). No one in those centres has passed out or died yet from too much kindness.
    See the original post with links if want to know more at http://donnathomson.blogspot.com
    Donna, Mum to Natalie (22), ablebodied, kind and beautiful and Nicholas(26), severe CP, non-verbal, tube fed, multiple surgeries, chronic pain, happy kid except when the Liverpool football club or the Ottawa Senators Hockey Team are losing!
    Check out my blog: http://www.donnathomson.com


  2. #2
    Distinguished Community Member Earth Mother 2 Angels's Avatar
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    ((((((Donna & Nick))))))

    I'm so sorry that Nicholas had to endure all of that. Sounds like the receptionist at the clinic didn't pass on the information about Nick's needs.

    Since I can be a smart alec sometimes, I would have responded to the technician's comment, "Oh, Nicholas is in a wheelchair?" with a flat out, "No." Then silence. What a question!

    For a sleep study, one would think that a comfortable bed would be provided. I am always astonished at how uncomfortable the mattresses in ICU are, actually all hospital mattresses. At home, Jon has an alternating pressure, low air loss mattress, which is very comfy and keeps his skin in tact. He always comes home from the hospital with pressure sores, because of their mattresses.

    Convenience for the staff (orderlies) overrode the welfare of the patient. Every hospital/clinic should have a hoist/lift.

    While it was thoughtful of the doctor to phone you and apologize, I hope that he will go further by speaking to the staff about their treatment of Nick and any other patient with specific or special needs. Otherwise this will go uncorrected, and other patients will be subject to the same lack of concern and caring.

    That people, who choose to work in the medical profession, need to be trained to be compassionate seems incongruous. Shouldn't compassion be a compelling pre-requisite of their career choice? The entire point of the medical profession is helping people.

    At our hospital, every employee is kind and thoughtful. The parking valets, the housekeepers, the professional staff ... everyone. (Okay ... some doctors didn't get the memo ... we have our surly, off putting docs, for certain.) It is a criterion for hire that all patients are treated with dignity and respect, and with gentleness and kindness. It makes a world of difference for the patients, as well as the staff.

    If more medical facilities incorporated this attitude in their hiring, we would not encounter the kinds of callousness shown toward Nicholas.

    I hope that the study will reveal helpful information. I wonder if it will be impacted by Nick's physical discomfort during the testing.


    Love & Light,

    Rose
    Mom to Jon, 48, (seizure disorder; Gtube; trache; colostomy; osteoporosis; hypothyroid; enlarged prostate; lymphedema, assorted mysteries) and Michael, 32, (intractable seizures; Gtube), who were born with an undiagnosed progressive neuromuscular disease and courageous spirits. Our Angel Michael received his wings in 2003 and now resides in Heaven. Our Angel Jon lives at home with me and Jim, the world's most wonderful dad.

  3. #3
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    Hi Rose, Well there was definitely a failure to communicate. No one really meant harm, everyone was nice and the hoist they eventually produced was just the wrong kind and could not work with Nick's sling. Nick is like Jon- the hospital mattresses are not good for his skin or comfort. Nick, too, uses an alternating air mattress at his home and it works wonders for his comfort and his skin. We know that pain is a seizure trigger and sure enough, in the early hours, Nick had a whopper of a seizure in the hospital bed. Re the compassion as a prerequisite of hiring, I am trying to find an article about an Australian hospital that I have somewhere that talks about using aboriginal values to reorganize procedures in a broken hospital - it all begins with smiles and hugs. Not saccharin, just sensible. Anyway, bedtime and I'll try to find the article tomorrow! xoDonna
    Donna, Mum to Natalie (22), ablebodied, kind and beautiful and Nicholas(26), severe CP, non-verbal, tube fed, multiple surgeries, chronic pain, happy kid except when the Liverpool football club or the Ottawa Senators Hockey Team are losing!
    Check out my blog: http://www.donnathomson.com


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