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Friday, December 30, 2011

The human aspect of working in a hospital

I'll be honest that I'm not the best respiratory therapist.  Obviously there's a lot of respiratory wisdom and experience stuffed in my cranium, yet sometimes it takes a moment to sort through it all and come to a decision.  That's why I never would make a good doctor.

Yet, I suppose, it takes all kinds to make an institution run smoothly.  I'm usually silent when there's a lot of people around, and my voice is soft.  Yet one on one with my patients and the patient's family is where I excel.  I also have a knack for fine tuning machines so they work well for patients and keeping them comfortable.  I often go out of my way and use my soft skills keep people happy. 

So I'm good at PR.  I think that's a good asset because many RTs and RNs and most doctors tend to lose the human aspect after so many years of doing this job.  I've had many patients and family members thank me wholeheartedly for taking the time explaining things, or taking the time to give a patient on a BiPAP a break from the mask even though the doctor didn't order it.  One time I even brought a patient a burger, and another patient one of my books because she looked bored and said she loved to read. 

Just recently we had a patient who needed the BiPAP to take a deep enough breath to blow off CO2 and to oxygenate.  The doctor ordered not to take mask off no matter what.  Yet that doctor isn't sitting by the side of the bed with the crying patient whose face is aching and sweaty under the mask.

So I gave her a break.  The doctor later told me I wouldn't have done it if I had seen the x-ray.  Yet I said I did see the x-ray and I wasn't taking her off with the intention of keeping her off.  I did it for three reasons:

1.  To give her a rest
2.  To prove to her she needed it, because she quickly got short of breath.
3.  To allow her to rest her face, take a drink of water, blow her nose

You see, that's where I excel.  Then I explain to the patient the BiPAP is not long term, and while it's uncomfortable, it's much better than a tube in your throat.  If you had a tube in your throat you wouldn't get any breaks.

I think some folks become apathetic and lose sight of the human element.  Doctors order for Q4 breathing treatments without considering the patient also needs to sleep to get better.  They order for no breaks of the BiPAP mask, and they put catheters in patients who can just as easily pee in a can.

They rip the patient's gown down right in front of the family, and they say what's going on without making sure the patient and the family understands what's happening, or they blow up at you right in plain view of the patient. 

The family and the patient are stressed, and then I come into the room and explain everything in a simple method that boosts my ego a bit and has everyone in the patient's room feeling better -- a little better anyway.

You can shut the door, or pull the curtain, or explain things.  You can listen to the patient's stories or you can watch a ball game with the patient.  You can ask the patient if he needs anything and actually go out of your way to get it or do what they want.  You can fetch a nurse and reassure the patient.  You can make sure the patient's not in pain or the patient is breathing fine.  Yet you can't be assured anything will get done unless you do it yourself.

You can check on a COPD patient every two hours instead of every 4-6 just to assure the patient that you're right there and available -- that you're keeping an eye on him.  Family likes this too.  You can be proactive by assessing the patient and preventing the patient from crashing.

When you're at a code for a patient in bed one you can talk to the patient in bed two.  You can assure her that her room mate is a little sick but will be okay.  And then you can do a follow up with the patient in bed two to let her know what happened.  A little reassurance goes a long way.

All it takes to make someone happy sometimes is just a little notice of the human element.  Sure you have a job to do.  Sure that patient becomes just another part on the human assembly line, yet a person is still a person no matter how small as Horton the Elephant would say.  People get scared and anxious.  Hospitals are scary.  And I have the ability to take some of that edge off -- all of us can take that edge off.