A night in the ED

Around 945 last night, I received a call from my elderly neighbor. She had fallen, and sustained some injuries. After some assessment, and making sure her husband was going to be taken care of, we set off to the Emergency Department. The front end process was great; she was quickly checked in, placed in a room, and triaged. As someone who focuses on patient experience, I took this opportunity to not only be with my neighbor during this trying time but also to sit back, listen, and observe. Some things went superbly. The medical care was top notch. The medical team knew exactly what needed to be done to help with her problem. Their technical expertise and knowledge were second to none. In the end, after hours of treatment, the issue was resolved. The medical treatment worked. However, other essential skills in the reduction of patient suffering did not occur. Almost no one introduced themselves. Actually, out of the entire care team, the only caregivers who introduced themselves were the CT Tech, the resident, and the attending. Sadly, not a single nurse or clinical associate introduced themself. This is a huge opportunity that was missed to quickly establish trust and reduce suffering (anxiety over entrusting care to someone new). Please take a few moments at the beginning of your care of a patient to introduce yourself, who you are, what your role is on the care team, and a bonus would be a trust statement. A statement about you that can quickly help the patient establish trust in you are the caregiver. Follow-up is essential. The presence of little or no information is the breeding ground for fear and uncertainty. Fear and uncertainty are avoidable suffering. If you, as a caregiver, leave the room after telling a patient you are going to do something, follow-up. Empower your patient with information, reduce your patient's suffering with information. Lastly, please take the time to connect with your patients beyond their diagnosis. It takes on average 56 seconds to make a connection. I saw this last night. The caregivers saw my neighbor as someone who wanted everything to happen "fast," and was worried about being in the ED all night. What they missed was that my wonderful neighbor had immense anxiety about numerous things going on. They missed that she was worried about her elderly husband, who suffers from dementia who was at home with some friends while we were in the ED. They missed that she was terrified about being admitted because, as her husband's primary caregiver, she didn't know who would take care of him. They missed that she was worried about her friends who were currently in her home caring for her husband, because of everything they had been through over the last couple of weeks. They missed an opportunity to connect, validate concerns, and reduce suffering. We left this morning at about 430am. When we left, fears about the unknown had been resolved, her CT results for example. She was provided follow-up information, and the reason we went in the first place was fixed. To the entire careteam, thank you! Thank you for being there when my neighbor needed you! I had the privilege of personally thanking every caregiver that entered her room for caring for our community. Please remember, as you provide care, to not miss the opportunities to prevent avoidable suffering. Everything you do matters. Everything you don't do, that also matters.