There’s a couple of habits in large institutions. First, they are risk averse. No one wants to make a mistake. We talk nonchalantly about Edison and the light bulb and innovation, the importance of taking risks, but that’s not the practice especially with those publicly accountable bastions of the community like hospitals.
Secondly, the individual is hoodwinked into thinking they can make a difference, but there is a pragmatic methodology that opposes this. It could be how an interview is structured, or not, or there is simply no valuable follow up or accountability to that individual who either has a valid point, or raises questions; these are the tools of risk aversion.
My Grand River experience continued recently, a full 6 weeks after the February incident that left me smouldering – having been verbally attacked and berated by an ER nurse in a follow up call at home after I had left the hospital without telling anyone. I had based my leaving on feelings of insecurity and even safety, and the assumption that if there was an issue with my case they would have contacted me. By the ER nurse’s abrupt correction, they didn’t do that at Grand River, and further more I had (somehow) wasted tax payer’s money by leaving.
Having left a voice mail on the hospital feedback line, I was told an administrator would get back to me within days. Time came and went; 6 weeks of time. I had long given up on Grand River’s complaint process, especially having gone through another awful experience at St. Mary’s, which I have also recorded – openly. You tend to want to forget these things and move on.
I was surprised and reasonably buoyed by the contact from the hospital to set up a call with two administrators within days. My only concern was that I didn’t have the time to prepare, as I had been while waiting for the first call that never came. I felt however, and trusted, that my integrity was intact, and with very little effort I could recount the shock and indignity at the ER nurse: the unprofessionalism, the downright abuse – or both.
I told the hospital previously that I am not comfortable with phone calls: I get tongue tied, my mind races too fast, and it’s difficult for me to get out an idea in an orderly manner. Actually it’s more like hit or miss. If there is any reason for conflict, correction, or contradiction, I get emotionally hijacked and lose all perspective; it’s a fear response, and discomfort more than anger. I get upset, stammer, and look for a window to jump from.
So there I was, in my office at work, speaking candidly to hospital administrators. On speaker phone, they began with their understanding that my ER experience came down to how the hospital handles overcrowding – the fact that I was moved out of a treatment room and into a chair in the hallway, where I was in the way of hospital operations, like food carts, (but not sufficiently in the way for any member of the ER team to check in with me – make eye contact, smile, say hello, you know…the general assurances that you haven’t been entirely forgotten.)
I objected immediately. This wasn’t at all the primary reason for my complaint. My complaint was because I received a call from the ER nurse at home, and she berated me, shut me down, objected to my questions about follow up, and was rude to me on the phone. So I corrected the administrators. At that point I found something out – several things actually. The ER nurse noted a follow up call on the file, but skipped the part about me wasting tax payer’s money. She also skipped the rudeness, and the denial of my assertion that on a previous occasion a doctor had called me, informing me of test results. I was amazed by the administrators’ admission that under a doctor’s instruction, a nurse can indeed update a patient who has left.
I proceeded with the phone call. I started to get the feeling we weren’t working with the same playbook. There was some slight questioning about my ‘recollection’ so I stated I made my notes within 24 hours of the incident, and that it was factual. I pulled up the notes – which are now on my blog. I referred to the notes directly – even reading passages like testimony on a witness stand. I was sympathetic about the usual wait-time complaints – never my issue, as stated on my blog. I even understood prioritization and having to shift people around if necessary.
However, I stressed that communication is necessary. Updating patients along the way is fundamental, and hospital experiences are not all about needles and bandages, scalpels and plaster casts. This treatment has to come along with information, and just as important courtesy, which alleviates the stress and anxiety of being in a hospital in the first place.
When I prepared to express concerns following the icident 6 weeks ago, I read broadly on nursing standards, hospital experience, and patients rights. It was interesting that the Registered Nurses Association of Ontario has advanced courses in compassionate care. Small things – that I didn’t receive – like standing in front of a patient, making eye contact, reflecting back what patients are saying; a virtual menu of best practices. Where were they at Grand River?
Turns out, patient experience and quality of care is a hot topic across the western world. Just do a preliminary search and you’ll find articles on patient-centred care, patients being ‘partners’ in health care, and more holistic approaches to services. Even patients rights – which, by the way, all three hospitals in Waterloo Region subscribe to in a standardized form – are set out, although in our neck of the woods they call them ‘values,’ probably for pragmatic reasons, and they are hard to find too:
As a patient or client, I value that:
I am provided with high-quality care and services that focus on my whole being – mind, body and spirit.
My family and I are treated with respect, compassion and understanding of our unique needs.
I am an active partner in my health care and as such am given reliable and current information so I can make informed decisions.
I can express my appreciation or concerns about my health care experience knowing that my health care providers are actively listening.
Notice the words, “I value that:” Doesn’t it kind of seem like a priveledge bestowed upon us by those holding all the power?
Look, I understand that hospitals have had trouble with wait times, levels of service, even ‘events’ as they are called where people have died from infections while in care. And I get that hospitals are putting standards into place across the board to alleviate health care system inadequacies. These are positive improvements and they have my unwavering support; I just seem to have fallen through the cracks on…a bad day?
I don’t want to be labelled a complainer, difficult, or be dismissed, but the result of the conversation with the administrators was, well, no result! I was thanked for my input. I am data for statistics I guess. And, I kind of felt my evidence was being filtered though a he-said/ she-said way.
What I really wanted was a road map of the improvement process: Where’s the flow chart that shows how a complaint is followed up? Who along the line reviews the complaint, and above all, what steps are put into place to correct the situation and ensure it doesn’t happen again? It would be easy to send a memo to staff reminding them to be more compassionate with patients. There are a number of quality improvement resources accessible on-line for compassionate care, even webinars and seminars, and there are best practices throughout the hospital community.
I am not satisfied. That I am left with no resolution is a failure.