Journal of Sacred Work

Days 329-333 – Hospital-Acquired Suffering

 "Why, sometimes I've believed as many as six impossible things before breakfast." – Alice in Wonderland, Lewis Carroll Sacred Encounter  

   As a physician he treated patients for more than fifty years. Now eighty years old he increasingly finds himself on the other side of the caregiving model. 

   "It's one nightmare after another. Recently, I had an agonizing sore throat after a procedure & tried to convince staff that something had been left in." Afraid to bother an attending physician at night they refused to check themselves. "I finally reached into my throat, found two extra nasogastric tubes caught there, and pulled them out myself."

   Even though they know the system doctors often experience as much suffering as do the rest of us. Few  take active steps to solve the problem. 

   There is already enough suffering in the hospital experience. Why does the system add more?

   Part of the answer is the abject failure of both lay & physician leaders to appreciate that the definition of suffering must be expanded.

   Ask any patient who has experienced the extended pain of a full bladder. They will tell your their pain was often worse than anything to do with their disease. The issue is often short-staffing.  Nurses suffer as well.

   Meanwhile, executives remote from direct caregiving earn fat salaries. Maybe those paychecks would be justified if those same leaders were dedicated to solving hospital-acquired suffering. 

   Among the worst indignities is "healthcare" that inflicts unnecessary treatments & "Code Blues" on patients who are not only terminal but have left DNR instructions. 

   The refusal to prioritize some of these issues as real medical problems instead of minor inconveniences is a problem whose answer lies at the feet of leadership. Their failure to address it demonstrates a cynical disregard for the mission of loving care.  

-Erie Chapman

Sacred Encounter painting by Liz Wessel

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4 responses to “Days 329-333 – Hospital-Acquired Suffering”

  1. ~liz Wessel Avatar
    ~liz Wessel

    Erie, your calling out that “the definition of suffering must be expanded” is spot on. Equally distressing is the reality that “Among the worse indignities is “healthcare” that insists on inflicting unnecessary treatments & Code Blues on patients who are not only terminal but have previously left DNR instructions.”
    I have many colleagues who are working diligently to improve systems so that a person’s stated wishes in an Advance Directive are readily visible and accessible in the EMR. Foremost though is for people to begin to have the conversation with their loved ones about their wishes and goals and what makes their life meaningful, prior to a crisis. IHI makes the analogy with allergies. AD’s should be as important as allergies because everyone is aware of them and they are clearly noted in the EMR. Sadly this is not the case with AD’s, hence they are often not respected or honored. Many IS systems still lack connectivity across care settings. Progress is being made but it is not quick enough.
    A cultural shift is needed from a focus on technology to human caring. I applaud you for raising these concerns. Stinging words help to shake us from complacency with the status quo.
    P.S. I had a recent encounter with my healthcare providers and I was truly surprised with the wonderful care I received at every touch point. One night my doctor called me at 8:15 pm to talk with me about an infection I picked up in my recent travels. A week later he called again to check how I was doing. It may not seem like much but this caring gesture meant the world to me.

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  2. sbeng@att.net Avatar
    sbeng@att.net

    Erie: The Mission of Radical Loving Care is the main priority of each Health Care Facility where the patient is hospitalized or any orders were given by the Administration Department for follow-up patient care in the home. When the latter situation is not carried out it would cost the Hospital more when the patient is re-admitted back to the hospital. This was my experience while working as a Visiting nurse. I admitted a patient who was an essentially wheelchair bound patient. I requested a special cushion for her as she was up sitting in her wheelchair most of the time during the day. This special cushion which would prevent the occurrences of bedsores and would cost them more. The request was denied. The patient did develop bedsores and was re-admitted back to the hospital for care. I was sure that this situation not only costs the hospital more it added more suffering to the the patient. Thank you Erie for your effort in initiating, promoting and encouraging Radical Loving Care in the Health Care Facilities.

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  3. Jolyon Avatar
    Jolyon

    I am going to ramble…
    Hospital-Acquired Suffering? I have wrestled with this question all week. Like a fork in the road, one can take either path to find an answer. I have travelled each this week. If a society refuses to let their children play in the dirt, avoid breastfeeding, wipe all surfaces down with germicide, take antibiotics for viruses and feed even more antibiotics to animals just to make them grow larger, then what? If this society goes into a hospital for care and gets a hospital acquired infection, is it really the hospital to blame or is it the society that has killed off the immune defenses?
    What Erie is asking for all of us to do, as I see it, is to be in the now with each person we encounter and try to help. Since all individuals are unique it is hard to put down and digitize a person for quantifying, as a remote “bean-counter” may do. I often ask why the remote staff of a hospital does not make rounds and try to understand what patients must do for their stay. All the remote staff wants is do is stay away but get a full report card back from the patient about how great their stay was (or a report from you if the happiness percentile is down this month).
    When a nurse gets 99 drug seeking patients in a row in the ER it is hard to be prepared to meet the hundredth, next. But what if it was you and you had the pain and wanted the relief but were not like the addicted 99 before you. The suffering is as real to you as it is to others, but hopefully you will not be met with hospital acquired indifference. The indifference is the safety wall.
    I believe the indifference settles in after a long time of bullying. Bullying by patients, doctors and administrators. Bullying satisfies the ego. Makes the ego a place in line. The center of attention. But we all know our Mr. Trumps in life. They may get to the front of the line but that is because all those that cared, walked away.
    Nurses should not be bullied into not calling the doctor. Hospitals and staff should stand up and document the “care” ignored as well as the care given.
    I remember well that when I was younger and very ill, I had a couple of doctors come by the house and check up on me as I would be too exhausted if I went to their office. It encouraged me to get better so that I could repay them with an office visit. But there have been other times when other doctors exhausted me by making me wait needlessly for hours for a procedure. Indifference.
    Be in the now. And hug a co-worker. After these last few weeks, the world needs more hugs.

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  4. Woody Wessel Avatar
    Woody Wessel

    It sort of reminds me of the movie “The Hospital”. Sometimes and in some places you can be over looked or over treated to death.

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