Thursday, July 24, 2008

More lessons learned from switching sides

On May 16, I posted a letter from one of our staff people that generated many comments. Today, the original author of that letter offered a follow-on comment on that entry, and I re-post it here for you to see.

I am the BIDMC employee that wrote the original email to Paul about "switching sides". My mother died a few weeks ago, and today I went to see my mother's favorite nurses to give her a bracelet that I had given to my mother during one of her hospital stays to "brighten up her hospital jonnie." It was a very emotional moment for me, but she was the person that I thought of every time I looked at that bracelet. This is the nurse had been with us since her diagnosis and had made a poster for my mother to "fight hard" while she was on vacation. She was the nurse who helped move my mother off of her bed sore when her nurse that day said she needed to finish her lunch (truly the minority at BIDMC). This is who I think of when I recollect the people who took care of my mother.

All I can say, is that after a two month stay in a long term care facility, BIDMC is doing a phenomenal job, and their dedication to caring for patients and trying to get better every day at it cannot be challenged. The same issues exist throughout our health care system, but the difference is that BIDMC leadership cares. My mother's long term care facility was for-profit, and although the individual nurses and aides tried very hard to care for her, the resources just did not exist. I compared her nurses to flight attendants as they walked up and down with their medication carts distributing drugs. They had no time to be nurses. In addition, we did not receive any hospice assistance until three days prior to my mother's passing and this was because a family friend knew a hospice nurse; had I requested hospice care, my mother would have been transferred from covered under Medicare to not being covered at all, other than a hospice consultation to the family. What is right about that?

My mother died in peace. I know she is in a better place. This experience had been extremely eye opening for me. I continue (from my first day at BIDMC) to be proud to work here, but will always strive for communication, communication, communication.

4 comments:

Christian Sinclair, MD said...

Thanks for writing this follow-up letter.

I wanted to clarify one statement:

"had I requested hospice care, my mother would have been transferred from covered under Medicare to not being covered at all, other than a hospice consultation to the family. What is right about that?"

Hospice is well-covered by the Medicare Hospice Benefit and is how most people receive hospice care. Whether in the home, nursing home hospice facility or even sometimes the hospital, hospice can cover treatment for patients with Medicare, Medicaid and most commercial insurances.

Is there any way the reader could clarify this statement? I hope she did not receive misinformation about what hospice covers and does not cover.

Christian Sinclair, MD said...

On the point about nurses not having enough time to actually be nurses, I think the time has come for a new type of capital campaign. Companies are always having capital campaigns for buildings and technologies but what about having a capital campaign for 'human capital?"

Imagine hearing a hospital say they are going to raise $XX million dollars to help make sure they have the best staffing ratios in the city so they can provide the best and most compassionate care. If anyone knows of a company doing, especially in health care, please leave a comment. I know you have posted a lot about union stuff here and I don't want to get into the politics of this, but I just think that would be such a novel idea.

If it has reasons to fail, please don't burst my utopian bubble.

Christian Sinclair, MD said...

And I too am very sorry for your loss. Thanks for sharing your life with us so that we can reflect and discuss your experience.

Mark Rasmussen said...

Paul, et al.
I am the nurse manager who is fortunate enough to have this dynamic nurse on my unit.
I knew the story well. I had seen the interaction, and thought what a great moment to capture! Later that day I had a staff meeting and discussed this moment as an opportunity for professional and personal growth. The nurse in the scenario is working on an application for the clinical advancement program here at the medical center. I read your blog, and was moved by the letter, more so because of my personal involvement in the story. Then I thought what a great opportunity for the whole staff to see how special the caring is we provide everyday. All too frequently we tend to focus and perseverate on the negative. Today would be different. I gathered the staff together, as an unannounced staff meeting. Most were intrigued as to what was going on. I began the meeting by asking the nurse directly involved to explain the origin and background of the bracelet she was wearing. She provided the room with the particulars about how she had received the bracelet. Once she finish, I began to tell the staff about your blog (I know it’s hard to believe it’s not in everyone’s favorites on their computers). I then showed the blog entry, and read it aloud to the staff. I then click onto the previous entry to reference the nursing and patient care technician statements. Once the entries were read, I told them I can tell them how dynamic and great the care is they provide everyday to our patients. I can tell them what I see everyday, not only on my unit, but throughout the medical center. Now I had an opportunity to show them, for them to see what it means to families and patients the care we provide to them. The impact we make, and yet we may never fathom the depths of compassion or caring we provide. Here was the moment to remind us why we are health care professionals. This was a moment to make a story into history.
Mark