Reader's Great Response to the Dystopian Hospital Code of Conduct for Patients
"You don't need a written code of conduct. Just be a real, living, breathing person who is trying to help another person get through a potentially unpleasant experience."
This story is a reader’s response to my recent article about the dystopian patients’ code of conduct in MA. I was so touched by it that I am publishing it with his permission. It was written by Andy Rivett, a nuclear medicine technologist from Niagara. Here it is:
Hi Tessa,
It amazes me to read that the new standards make it incumbent upon the patient to behave in a prescribed way. A big part of managing patients is knowing that they are arriving for procedures or admission to a hospital and it isn't necessarily a happy time for them. Some patients are sick, nervous, frustrated and angry and they show it. That is to be expected and I consider it a part of my job to make their experience OK, if not the thing they really want to do.
The codified standards are a new thing. I'm old (67) and just before I retired from the hospital I had a patient (another old guy even older than me) compliment my co-worker by saying, "Oh, you are beautiful".....it certainly was said in the most decent way; not like a lascivious old man with a nudge and a wink and sexual innuendos....nothing of the sort.
A physician working with me (very young guy) chewed the patient out for this. So unnecessary!! This is the Brave New World that we live in. We're not supposed to say anything that could ever even remotely suggest a real human interaction.
There is a line that separates normal human interaction from abuse but it shouldn't be a fine line. If my patients want to swear; I let them. If they want to cry I will put an arm around them. If they want to tell me stories from 50 years ago, I do my best to let them tell their story. Almost NEVER are these human reactions anything but a reaction to an unpleasant situation or a painful situation from the present or past.
What am I if I cannot/should not tolerate this? I become less than human and worse than that I could represent the cold institution that healthcare is becoming.
I have methods of managing difficult patients and the first one, the most obvious one is to empathize with the patient. You have to give them a chance to speak. You have to read their body language and figure out if they are not comfortable with the procedure or if they feel that they have signed a consent form without truly understanding. Some are so pathetically bullied by the system that they come to me and say, "Well, I signed the informed consent so I guess I'll do this but I'm not really comfortable with this". They are afraid that if they don't do the test that the ordering physician will be angry. I also do things to distract patients during a procedure so that they don't concentrate on the IV needle or the scary machine rotating around them. It's something I've learned over the years and it gives me satisfaction to know that I can do this.
That's when I explain slowly and calmly what is being done, any possible side effects, the drugs I will use, etcetera, etcetera. I will even suggest that if they really are uncomfortable with some aspect of the test that there are other options. If they aren't totally OK, I take the consent form and rip it up in front of them. I always say to such people, "it is your body and your decision, you can have this done at a later date if you change your mind. That's totally OK".
I work in a clinic now as a semi-retired tech. I deal with all sorts of people. I can't remember abusive patients more than a handful of times over a career spanning over 45 years. You don't need a written code of conduct. Just be a real, living, breathing person who is trying to help another person get through a potentially unpleasant experience.
That's all any of us can do really. Take that away and you take our humanity away.
Andy Rivett
Thank you, Andy, and God bless you. You said it all.
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Wow. That brought a tear to my eye. I'm only a few years behind that nurse and, although I am not a health care provider, I can most certainly remember when we were human patients first and not just a commodity. I can also remember when we were "allowed" to compliment one another without being scared of "offending" someone. I remember when we could say, Merry Christmas, Happy Easter and any other greeting and it was taken as it was meant: Care for the other person. I remember when holding a door open was a kindness, but now I often have people go through the opposite door. Trying to be kind and nice and *human* has all been turned on it's head *for no logical reason*. I'm not sure how we can turn this back around but I would recommend: Turn off the TV news and the pop culture crap that seems to revel in people's misery and almost seems to promote treating each other like "nobodies". Thanks for posting this Tessa. It was well worth the read. :)
Tessa, As a long-time practitioner, every word Andy said is spot on. Even though it usually makes me run late (sorry patients to follow, but your time will come) I try and have a fully engaged conversation with every patient. I am a hematologist and most of my patients are not in very good places -- this is an impossibly stressful situation for them. I always explain that they are their own science experiment and that we will do the very best we can, but it often is not easy and it almost never is fun. People understand that...they just want some indication that I do, too. And I do.
That was a good choice to reprint Andy's piece. Thank you.