QSEN: The Lewis Blackman Story (Part Three)

Summary

The transcript discusses the need for a patient-centered culture in healthcare, emphasizing the importance of communication and respect. The speaker recounts an experience where a lack of responsiveness from medical staff created barriers to care. They highlight the need for empowered nurses and physicians to listen and engage with patients, suggesting that better teamwork and understanding could prevent similar situations. The speaker also points out the absence of visible teamwork and the challenges faced when trying to navigate the healthcare system during a crisis.

Takeaways

• 🔑 Empowerment through communication: The patient's family felt empowered if a nurse had listened and engaged in a collaborative discussion to address their concerns.
• 🚫 Lack of responsiveness: The family faced a lack of responsiveness from the medical staff, which included both nurses and physicians.
• 🗣️ Importance of clear communication: The family emphasized the importance of being heard and understood, especially when they were advocating for their son's health.
• 👨‍⚕️ Role of the attending physician: The attending physician was seen as a roadblock due to their unavailability and unwillingness to be contacted.
• 🏥 Hospital environment impact: The family felt that the hospital's quiet Sunday afternoon setting contributed to the lack of immediate action.
• 📞 Lack of knowledge about hospital procedures: The family was unaware of how to contact the necessary medical staff or even the existence of a supervisor for the nurse.
• 👥 Absence of teamwork: The script suggests that there was no visible teamwork among the nursing or medical staff, which could have improved the situation.
• 🤔 Need for moral accountability: There was a perceived lack of moral accountability among the healthcare providers, who did not acknowledge their roles in the patient's care.
• 👶 Vulnerability of different patients: The family recognized that their situation could be worse for patients who lack communication skills or have more severe conditions.
• 📢 Advocacy for change: The script implies a need for systemic changes to foster a more patient-centered culture within healthcare institutions.

Q & A

What was the main issue the speaker faced with the healthcare system?

The main issue was a lack of a patient-centered culture, where the speaker felt helpless due to roadblocks in communication with healthcare providers and a lack of responsiveness to their concerns.

What specific actions could have made the speaker feel more empowered?

The speaker would have felt more empowered if there was a nurse who listened to them and engaged in a give-and-take discussion to lay out a plan of action, including calling the attending physician.

Why did the speaker feel that their communication was not taken seriously?

The speaker felt that their communication was not taken seriously because the healthcare providers did not believe them and did not understand the seriousness of the situation, despite the speaker's son being articulate and having no communication issues.

What was the situation like for the speaker on that Sunday afternoon?

On that Sunday afternoon, the hospital was nearly empty, with only an intern and a nurse present, who did not believe or understand the seriousness of the speaker's situation.

What did the speaker not know about the hospital's procedures?

The speaker did not know about the existence of a supervisor for the nurse, how to contact the doctors outside of the hospital, or that the doctors might have an answering service.

What is the role of the administrator on-call in this context?

The administrator on-call is expected to have a significant influence on ensuring things go well within the hospital, and they should be aware of who the on-call person is at any given time.

What did the speaker observe about the moral accountability of the individuals involved?

The speaker observed a lack of moral accountability, as there was no acknowledgment of the healthcare providers' responsibilities in addressing the speaker's concerns.

How did the speaker perceive the teamwork within the healthcare setting?

The speaker did not observe any teamwork, as there was no evidence of coordinated effort or communication among the nursing, medical, or overall healthcare team.

What was the speaker's experience with the Rapid Response Teams?

The speaker mentioned Rapid Response Teams as a potential solution to the problem of healthcare providers not wanting to be bothered, but did not provide specific details about their experience with these teams.

What is the speaker's suggestion for teaching people not to be intimidated in healthcare settings?

The speaker suggests that there are specialists who can teach people not to be intimidated, though they do not provide specifics on how this is done.

What information should South Carolina hospitals provide to patients according to the speaker?

South Carolina hospitals are required to provide certain information about emergency numbers to patients, but the speaker implies that the information may not be clear or easily interpretable as emergency contact information.

Outlines

00:00

🏥 Empowering Patients in Healthcare

The speaker discusses the challenges of changing hospital culture to become more patient-centered. They recount a personal experience where they felt helpless due to a lack of communication and responsiveness from the medical staff. The key to empowerment, according to the speaker, would have been a nurse who would listen and engage in a collaborative discussion to develop a plan of action. The speaker also highlights the importance of respect and interactivity in healthcare, and the need for clear communication channels. They express concern for families without the same communication advantages and note the lack of visible teamwork among medical staff.

Keywords

💡Patient-centered

Patient-centered care refers to a healthcare approach where decisions are made in active partnership with patients, taking into account their preferences, needs, and values. In the script, the desire to make the culture more patient-centered indicates a shift towards prioritizing the patient's experience and input in their care. The speaker mentions the importance of a nurse listening to them, which is a key aspect of patient-centered care.

💡Empowerment

Empowerment in a healthcare context means giving patients the ability to make informed decisions about their health and care. The script discusses how the lack of empowerment was felt when the attending physician was not readily accessible, and the nurse was seen as a roadblock. Empowerment would have been achieved through a collaborative discussion with the nurse, allowing the patient's family to have a say in the plan of action.

💡Roadblocks

Roadblocks in the script refer to the obstacles that hindered the patient's family from receiving the care they felt was necessary. It symbolizes systemic issues within the hospital that prevent patients from accessing the care they need. The nurse and physician are mentioned as potential roadblocks, indicating a lack of communication or responsiveness.

💡Communication

Effective communication is critical in healthcare to ensure that patients' needs are understood and addressed. The script highlights the lack of communication from the healthcare providers' side, particularly the attending physician, which led to a feeling of helplessness. The family's articulate teenager could communicate well, but the hospital staff did not believe or understand the seriousness of the situation.

💡Rapid Response Teams

Rapid Response Teams are multidisciplinary teams that respond quickly to patients who are deteriorating, aiming to prevent critical conditions. The script mentions these teams as a potential solution to the problem of not being able to reach the attending physician. It suggests that such teams could be a way to improve responsiveness and patient outcomes.

💡Moral Accountability

Moral accountability implies that healthcare professionals have a responsibility to act ethically and responsibly towards their patients. The script discusses the lack of responsiveness and acknowledgment of this responsibility, suggesting that the healthcare team failed to meet this moral obligation.

💡Teamwork

Teamwork in healthcare involves coordinated efforts among healthcare professionals to provide comprehensive care. The script notes a lack of teamwork, as there was no evidence of effective collaboration between the nursing and medical teams. This lack of teamwork could have contributed to the family's negative experience.

💡Hospital Operator

The hospital operator is typically the first point of contact for patients and their families seeking assistance or information. The script mentions that the operator should know who the administrator on-call is, indicating a potential pathway for patients to receive help when direct communication with healthcare providers is not possible.

💡Emergency Numbers

Emergency numbers are contact points for immediate assistance in urgent situations. The script discusses the requirement for South Carolina hospitals to provide information about emergency numbers to patients. However, it implies that the information provided might not be clear or easily interpretable as 'emergency' by everyone.

💡Respect

Respect in healthcare means valuing patients as individuals and acknowledging their rights and autonomy. The script emphasizes the importance of respect and interactivity, suggesting that the healthcare providers did not treat the patient's family with the respect they deserved, contributing to their negative experience.

💡Intimidation

Intimidation can occur when patients or their families feel fearful or hesitant to speak up due to the perceived authority of healthcare providers. The script raises the question of how to teach people not to be intimidated, indicating that the family may have felt this way, which is a barrier to effective communication and patient-centered care.

Highlights

The importance of making healthcare more patient-centered.

The need for nurses to listen to patients' concerns.

The lack of empowerment felt by patients due to communication barriers.

The desire for a collaborative approach between patients and healthcare providers.

The lack of belief and responsiveness from healthcare providers.

The value of a good give-and-take discussion with a nurse.

The challenge of communication when the patient is a child or non-verbal.

The role of the hospital administrator in ensuring positive outcomes.

The difficulty in accessing emergency numbers and information.

The lack of awareness about the existence of supervisors and on-call personnel.

The absence of a visible medical team and their responsiveness.

The importance of moral accountability in healthcare.

The lack of teamwork observed in the healthcare setting.

The impact of intimidation on patients and how to overcome it.

The necessity for healthcare providers to be approachable and responsive.

The potential for Rapid Response Teams to improve patient care.

The need for better communication and interaction in healthcare.

Transcripts

I'll ask you all a question how do you

do it if you assume

everyone wants to change the culture and

make it more patient-centered how do you

do that how do you teach that so we were

helpless we were not in Peppard at all

what would have made you more empowered

what would have made us more empowered

would have been a nurse who listened to

us and we because we were repeatedly

asking for the attending physician and

there was a roadblock part of it was the

nurse and I think part of it was the

physician himself and those may not be

entirely unfitted what would have made

us empowered I think would have been the

ability to have a really good

give-and-take discussion with the nurse

and lay out a plan of action with her to

say you know I will I will do this as I

will call the attending and you know

I'll tell him this and what do you want

me to tell her my discussion would have

been a huge help I think they didn't

believe us and if they had talked to us

you know my son was a highly articulate

teenager they there was no problem in

communication from our side and then

when I think about this happening to a

family like ours if you get someone who

doesn't have those advantages or a very

small child who can't talk at all it's

much worse situation so you know I think

respect and interact interactivity is

really the the key to me administrator

on-call has great impetus for things to

go well and the hospital operator always

knows who that person is we know that

now on that day I mean if I can paint

the picture this was a Sunday afternoon

the hospital was just dead there was no

one there but the intern

the nurse and they did not believe us

did not understand did not believe that

we knew that there was a serious problem

we couldn't think of a way to get around

these roadblocks we didn't know we had

no idea that the nurse even had a

supervisor we didn't the doctors were

not in the hospital not in their offices

we didn't know how to get hold of them

it actually didn't occur to me that they

might have an answering service like a

regular doctor I just thought they were

different because they were Hospital

doctors and South Carolina hospitals are

required to give certain amount of

information about emergency numbers to

patients but of course they found ways

to give that information that I'm not

sure everyone would interpret as

emergency you talked a lot about the

individual's moral accountability the

lack of responsiveness you got in terms

of people acknowledging theirs I wonder

what you observed about teams either how

the nursing team worked together how the

medical team worked together or more

importantly how the entire healthcare

team worked or did not work together to

be perfectly honest I didn't see any

teams any evidence of teamwork at all on

the part of your of course

the you know people interacted out of my

sight but certainly there was not much

sign that the people even really knew

each other

I can recall an instance where the

attending told me not to call him in the

middle of the night he did not want to

be bothered well that's why we have

Rapid Response Teams I think two teeth

how do you teach people not to be

intimidated I don't know but I'm sure

there are people who specialize in that