Patients are observing us while we interact with others in the hospital, and this can have a tremendous impact on the trust they put in our care.
Something I found quite eye-opening happened to me recently. I was having an email dialogue with one of my primary care patients, “Mrs. P,” whom I first met while I was the medicine ward attending in our hospital in February of 2005, and then she became my patient in my geriatrics primary care office in 2007.
She and I were discussing her diabetes care by email. In the course of that dialogue I mentioned to her that I was again currently attending on the inpatient medicine, the same floor where she and I first met 13 years ago. I told her I still remembered our first meeting vividly, but her response told me that I was oblivious to much more about our meeting. She relayed the following story to me that, despite knowing her all these years, she never told me before and I found surprising and educational.
A frightened patient in the ICU
Mrs. P had been working in sales full-time and in excellent health prior to having multiple serious complications after what was initially considered to be a relatively minor surgical procedure at another facility near her home. As her complications mounted, she was eventually transferred to our tertiary care facility. She had been in the intensive care unit and had a pretty rocky course there with many different care providers coming and going, and all of which felt chaotic, overwhelming and intensely frightening to her. Her husband drove several hours each day to visit her, and feared she would never leave the hospital. She had been in the hospital for a couple of weeks by the time my team met her on the wards.
On the day we first met she was waiting in a room that she shared with another patient, with her roommate in the bed nearest to the hallway and hers was next to the window, with a curtain drawn between the two beds. She said that the woman in the bed next to her was an elderly woman who had been crying out for what seemed like to her most of the morning. She reported that several people had passed her roommate by without seeming to notice or address her discomfort, including other doctors and nursing staff. As my team knocked on the door and entered to meet Mrs. P, we noticed her roommate’s crying and stopped at her roommate’s bed.
One minute of compassionate care
Although she was not our patient we offered to help, repositioning her to make her more comfortable and then alerting her nurse. We then proceeded to introduce ourselves to Mrs. P, and talk through creating a shared plan for the day. None of us at that time discussed her roommate. In truth, when Mrs. P told me this story, I didn’t even remember interacting with her roommate, as it had been such a brief and spontaneous exchange.
In her email to me now 13 years later, Mrs. P revealed that while she was waiting for us to come to her side of the room she was filled with anxiety about meeting yet another team of doctors, but that in listening to our exchange with her roommate, it was the first time during her hospital stay that she felt hopeful. She said she also observed not only how kind we were to the other patient, but our polite interaction with the nurse made her feel like she was going to have a team on her side.
The impact of patient observations
I was so grateful to know her version of the story of when we first met. Her story reminded me that for many patients, the hospital setting is incredibly frightening, but it also highlighted to me that not only do our patients notice and appreciate the care we provide to them, they’re also observing us while we interact with other individuals in the hospital, and this can have a tremendous impact on the trust they put in our care. In fact, that trust has fortified our relationship for well over a decade now!