Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

No Patient is an Island

Pyramid Lake, Jasper National Park, Alberta, Canada.


Acknowledging and engaging with patients’ support system in the clinic or hospital may improve health outcomes.

“My mom is in there. I know it. And I know she’s miserable.”


That was the first thing my patient’s son said to me. His mother had been on a breathing tube for weeks but was awake. When her son came to her bedside, we were compelled to reassess goals of care. She wasn’t getting better despite all our efforts. That had been the truth for quite a while now and we knew it. She knew it, too. “Tell us what you want. You ready to go Ma? It’s okay,” he said gently.


She nodded her head fervently and reached for his hand. After discussions with her team and clinical reassessments, we removed her tube. She squeezed her son’s hand. “Thank you,” she whispered. She was finally comfortable and able to speak during her final days.


When entering the room of a patient, take the time to acknowledge their loved ones. Here are 6 reasons why this is important:


1. They are often fierce advocates.

This is particularly helpful for patients who are critically ill and unable to speak for themselves. Family members lend a voice when our patients need it most. We must be cognizant of this.


2. Studies show that engaged family members help patients.

Patients may have improved quality of care with appropriate familial engagement. This becomes increasingly important when having conversations about caregiving, patient education, and medications when discharging patients.


3. Acknowledging patients’ families can be protective for minoritized patients. 

Given the history of biases and racism towards minoritized groups in medicine, we must work to build trust in individual encounters. Acknowledging your patients’ support system can help build rapport. It communicates to your patient, “I see you, and your support system.”


4. Engaging with patients’ loved ones can help make decisions in clinical care.

Family members may recall important details regarding a patient’s medical history that can give insight and perspective on patients’ presentation.


5. This could help you save a life.

Sometimes those who accompany patients to the hospital don’t have the patient’s best interests at heart. Greeting the family member may be your first sign that your patient is in imminent danger. Observing the dynamic between the patient and family member could clue you in to the need to investigate further. Research shows that many victims of abuse and/or human trafficking seek care at a hospital.


6. It’s a small way to stay grounded in humanity and practice empathy.

Acknowledging the family’s presence at the bedside is a vow to our patient’s humanity. It’s a reminder that they’re loved and taken care of. We must see our patients as parents, friends, siblings, or significant others. Because if it were us in that hospital bed, we would want to be seen that way too.