21 August 2013
When, Oh When Will Hospitals Actually Care?
Probably Never! Some of doctors working for the hospitals may actually care, but the hospitals and administrators are only interested in growing the bottom line. So if patients are uncomfortable and not getting enough sleep – that is tough for them. Next, some will say I am castigating nurses unreasonably, but this is not the intent. It is just that they are positioned to carry out the wishes of administration and are positioned not to think for themselves. They operate following established protocols and this routine becomes a habit.
Yes, what I learned from Dr. Peter Ubel does require doctors down to think for themselves and learn cooperation. In exploring this with a nurse, she laughed at me and said impossible. When I asked if this was because they could not work and cooperate with others or they are just too pig-headed to cooperate, she knew I was testing her. She said, explain it to me.
I made sure she knew the ideas were from a doctor during his experiences while in the hospital. When she finished reading the blog, even she was surprised that these were not being considered and some put into practice. I made a comment about lack of cooperation and that I felt these were great ideas, but that I doubted that hospital administrators would allow this much efficiency. The cooperation would generate efficiencies and even some time savings, but it would be too easy for someone to fall through the cracks and administrators just could not allow this.
The nurse said that could be solved by having a room listing and check off boxes for each nurse, aide, and others needing to do something for each patient. She even said that the phlebotomist could check in early in the evening with her schedule for those on the different floors and everyone could see what could be coordinated to reduce the frequency of interruptions and work it around to coordinate them.
I asked about doctors that insist on having blood drawn and midnight and 4:00 A.M. Will they create problems if it happens to be five to ten minutes late? She admitted that some doctors do demand that accuracy, but that can generally be accommodated. She said she would need to discuss this with the head nurse and this is where the most resistance could be encountered. She asked me to print out the blog and find an email address for Dr. Ubel to make it possible for her to get in contact with him as see if there was anything he could add and make it more convincing for the head nurse.
It is interesting what a doctor's blog can start. I admit I was baiting the nurse and thinking it would not even be possible to see this remotely attempted. I now know that it can work. Yes, there was resistance at the beginning until more realized that patients were happier and unnecessary interruptions were being eliminated. When two doctors realized the advantages, they quietly talked to other doctors and the word spread.
Some patients still require scheduled interruptions for medical reasons, but the percentage of change was about the same as Dr Ubel said Dr. Bartick achieved in her study. The nurse says that they occasionally do better, but it depends on the patient mix and why the patients are hospitalized.
I encourage everyone to read Dr. Ubel's blog here.