Care, Compassion and Communication - a Health Care Myth?
You might have noticed that The Patient Project went through a hiatus for the last few months. This is due to the fact that I found myself standing in the patient’s shoes, or let’s rather say laying in the patient’s bed. I underwent surgery in April which unfortunately led to a number of complications and a lengthy recovery period. After spending 10 days in two different hospitals I often found myself questioning whether the health care environment is still upholding the values it was initially built on.
As someone who teaches medical students on the law and ethics of their profession, I’ve started to wonder whether our focus should be on filling the syllabus with the latest legislation or whether we should rather invoke discussions on how to be more compassionate with patients or why communication is important? One of my reoccurring teaching topics is informed consent. During these lectures, I try to remind the students of the importance of communication - especially since this plays such an important role when assessing whether there was true informed consent. I usually advise them to talk to their patients in a language they understand and to explain all the benefits, risk and costs of the treatment. It is quite clear that the National Health Act regards this as one of the duties of a health care professional. I don’t linger for too long on the basics of communication because mistakenly I assume that basic communication skills are supposed to come naturally to practitioners. After my health care experience, I’m seriously rethinking this approach.
During both my admissions I found myself confused and removed from conversations with my treating team. Due to the nature of my work, I have a basic understanding of medical jargon. If I don’t understand I’m usually quick to either contact a practitioner to assist me or look up the term but now things were of course different. I was tired, in pain and being treated with various medication which influenced my mental abilities. Having various practitioners discussing my case in front of me but not exactly with me did not make the situation any better.
I don’t want to turn this piece into a ranting session, so I’ll only highlight the major incidents that stood out for me during my admissions.
[Before I kick-off, I would just like to mention that I am absolutely aware of the resource and time constraints in health care and I have the utmost sympathy with the situation. But, it should not mean that other aspects of health care can just be neglected.]
· After clearly stating that I was on asthma medication, but I do not have asthma (it was experimental treatment) the nurse continued to attach an asthmatic hospital band. This part of my admission procedure was also further improved by the fact that three nurses repeated my admission paperwork.
· Next, an anaesthetic informed consent form was placed in front of me and I was told to sign. At this stage, I hadn’t seen my anaesthetist yet and I raised my concern about the fact that I couldn’t sign the form unless I was informed of the content. I didn’t bother getting into the fact that a pre-med would render me incapable to sign.
· After my surgery, the complications started to kick in, on top of this I had to deal with the fact that four different leg compression machines were attached to my legs but none of them worked and my partner had to alert the nursing staff that my morphine pump kept on displaying error messages and was malfunctioning. Months later we have been advised that the machines had to be calibrated and the staff retrained.
· Since, I had drainpipes and drips I needed assistance to go to the loo. I was assisted by a male nurse (even after I expressed that I would prefer a female). At the time I should have been happy about the fact that I was assisted as later that evening a nurse watched me wrestle open the foil of pain pills with one hand and my teeth but provided no help.
· I waited 5 days to received approval for an MRI from my medical aid. On this note, I’d just like to add that I’ve had to query every single co-payment and a big percentage was eventually paid but months later I’m still in the process of arguing with my medical aid about PMB payments. No one is in the mood to worry about payments when they’re going through a tough time.
· After being transferred to another hospital I had to deal with having my drip reapplied countless times. Even after having a little Michelin man arm the nurse continued to advise me that it was the meds that made my arm burn and not the fact that the drip was clearly not inserted correctly. My bedding was not changed for 3 days. My drain pipes were leaking all over the floor for an entire evening. To make it all worse I would go through days were one of my treating doctors would say I’m discharged and halfway through the process the other would say no way. And so, it continues…
I’m pretty sure you get the picture – it was definitely not the best time of my life! Every day brought a new practitioner and more tests but less certainty.
When reading about patient care, you often stumble upon the c’s. The three C’s that are often referred to are care, compassion and communication. A great deal is written on these concepts – some even ask whether these concepts can still be realised in a modern-day health care setting. These c’s seem self-explanatory but during and after my experience it feels like the importance of these c’s is often underestimated. Months later, I’m trying to figure out what these c’s mean to me and what it’s supposed to mean in a health care system.
I guess in an ideal world, it would at a bare minimum mean the following:
CARE: A patient already feels vulnerable in the hospital setting. The very least that can be done to improve their experience and set their fears aside is to provide consistent competent care.
COMMUNICATION: Everybody on the treatment team should actively communicate with the patient - it should be a priority to make sure that patients understand and are comfortable with their treatment plan. After all, communication is not supposed to be one-sided and should involve listening. Basically, at the end of the day, the patient should feel part of the treatment team and should always be given the chance to make choices about his/her healthcare.
COMPASSION – The relationship between the patient and the treatment team should be based on empathy, respect and upholding the dignity of the patient at all times.
I realise that applying the above to real-life scenario’s where practitioners are overworked is not as easy as it seems. I do I know for certain right though that some change has to happen to our health care system and the way patients are treated. Don’t get me wrong though, I’m not entirely convinced yet by the recent buzz surrounding the proposed National Health Insurance but I do think this proposal will at least force us to start rethinking health care and perhaps move back towards an approach which is truly patient-centred and respects the human rights guaranteed by our Constitution.
DISCLAIMER: Please note, I do not wish to bring my treating team, the health care providers or the health care profession in disrepute with this piece. It is merely a personal reflection of my own experience.
What has your most recent healthcare experience been like? Was it a good or bad experience?? The Patient Project would like to know! Share your thoughts with us in the comments below or on our social media pages: