Putting The Patient First, Caring About A Patient Not Just Providing Care To A Patient

On several occasions I have been told that I care too much. I have had people question why I’ve donate kobo readers, portable dvd players and stuff to my unit. I have in the past been told I was not allowed to do extra things for patients like come in on my time off and take them down for coffee and a change of scenery or buy them a newspaper with my own money. I guess I understand the policy but I think it is sad that acts of kindness are considered “unprofessional” in a profession where our job is about caring.

Patients can receive high quality attention to health issues and still be lacking in care. I am not suggesting that everyone bring in meals or Christmas gifts for the patients they care for. Not everyone has that connection to their patients but should acts of kindness, that are equal for all patients…be discouraged. I know there needs to be limits but it would be nice if small acts of kindness were highlighted

Often I have heard healthcare staff around the country talk about how understaffed their floors are. There are target wait times and admission lengths that are to be met and so many “tasks” to do that they do not spend much of their time actually “caring”. They are providing care by charting, giving medication, bathing, helping with daily needs but very little time is spend interacting with, comforting or caring for patients.

I have spoken to families and patients all over Ontario in various communities, with various health conditions and the one thing they all found missing was compassion and kindness. They understood if they had to wait, but it was the “inconvenience” they felt like if they asked for anything that was frustrating. It was the fact that everyone was too busy, or too focused on their own agenda that no one stopped to listen, truly listen to how the patient or family felt.

Often patients and families with chronic medical or mental health conditions end up in the hospital or emergency because they couldn’t find support or resources or anyone to listen in the weeks or days before. Patients and families in the hospital can feel alone, scared or frustrated by not being listened to. Not just about the one condition they are in the hospital for but about how they are feeling, what is going on in their life while they are in our care.

After families leave the hospital they are again given support for the condition that required medical care, but what about every other area of their life that is affected by their condition or that affects their condition. Do we care about our patient and their family? or do we provide the necessary care to them? I am grateful for my job at the hospital because I had a really hard time asking home care clients for pay and would end up spending hours doing extras that I wouldn’t charge them for. I have been told it’s wrong to care that much for your patients, to truly celebrate their progress and to mourn their loss but I went into Health care because I care. Patients do better when they have emotional and physical support.

Stephen G Post stated (Professor of Preventive Medicine at Stony Brook University, and Director of the Center for Medical Humanities, Compassionate Care, and Bioethics

Published on July 29, 2011 in The Joy Of Giving:)

“We do not believe in ourselves until
someone reveals that something deep inside us is valuable, worth listening to,
worthy of our trust, sacred to our touch.”
e.e. cummings

To be optimally beneficial for patients, every physician without exception should be both technically excellent and practice with compassionate care. However much the technical advances in medicine are beneficial to patients, no one who is ill should have to suffer the indignity of a technically competent but uncaring doctor, nurse, or other staff member.  Too many patients experience de-humanizing and impersonal treatment, so much so that this is now a crisis in healthcare systems, proving destructive not only for patients, but for professionals, families, and the systems themselves.

The oft-quoted Dr. Francis Peabody of Harvard wrote nearly a century ago, “The secret to the care of the patient is in caring for the patient.” In the absence of compassion, patients are dissatisfied and professionals lament a loss of meaning and gratification in their work.  For the most part, the solution lies in the small acts that show care. Good is in the details, and we must all accept that we are role models.

It is not the case that most professionals do not want to care about patients, but they become very task oriented in an environment where speed is praised and rewarded, and as a consequence they can lose sight of the patient as a person unless they are both self-aware and intentionally care-full. If they lose the deeper meaning of their professional lives, many will eventually suffer adverse consequences. It takes considerable resolve to carve out the space for compassionate care regardless of environment, but in the end, doing so involves relatively small purposeful acts that change the emotional and social quality of an interactions so as to allow greater healing of the whole person.

There is a certain humility involved is carving out this space. Humility requires unflinching self-awareness, empathic skills, and gratitude for the privilege of caring for sick persons (Coulehan, 2010).

a review of 21 studies related quality of physician-patient communication with increased physical functioning, emotional health, and decreased physical symptoms of pain in patients (Stewart, 1995). Studies of patients in end-of-life care show a strong association between the undermining of dignity and depression, anxiety, desire for death, hopelessness, feeling of being a burden on others, and overall poorer quality of life. When “dignity therapy” is applied, in which dying patients are asked about what means the most to them in life and what they would like to be remembered for, 76% reported a heightened sense of dignity, 68% reported an increased sense of purpose, and most reported an alleviation of stress and other benefits (Chochinov, et al., 2005, 2008; Chochinov, 2007).

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