[kaila]

Usually , the nurse cannot tell you the status of a test, because she does not know the answer. Let me give you an example: You are scheduled for an MRI. An emergency bumps you off the schedule. The nurse tells you you may have to wait an hour. Then a second emergency bumps you. It is called triage, the sickest get treated first. We don't know who is coming through the ER door.
If you do not understand your follow up instructions, then you were not listening. Every clinic now gives post discharge instructions, and so do hospitals. If you are not listening, not our fault.
Patients also need to be more independent on their care. The dependency of patients is increasing,to the point that the hospital has to worry about your transportation needs, your living situation, your drug addiction. It would be much easier if every patient was identical, was not needy with their social issues. Identical-just like cars coming off the assembly line. Then you can apply business principles. Widgets don't talk back, scream at you,and throw things at you.

[Vermont Lt]

Please take a breath and read what I am saying in conversational tone, and not an argument. Because part of the problem we are discussing has to do with “traditional hospital” administration and management. This is not about YOU. I have had this conversation with my wife a thousand times, and the management does not want to consider that the “way it has always been done” doesn’t apply.

One of the things I did in my career is review communications procedures, and your answer shows me is that there had been a failure in the way you were taught to communicate to patients. (The generic “you”, not you specifically.)

To say that if the patient doesn’t understand instructions they are not listening is a bad answer for someone who communicates life altering information.

Your patient might not understand because they a) Dont speak English, B)Hard of hearing, C)Are scared to death (well not to death), or D) the message is rushed and full of jargon and medical terms that YOU use every day, but they do not.

Your patients are afraid of the medical professionals. They see you all as smarter than them, you are rushed, you are easily frustrated with having to explain the thing for the 10,000th time, or, the patient is just stupid and wants to go have a smoke or another fluffernutter.

Because we are “anonymous” here, I will bet you a thousand dollars (imaginary of course) that you can tell when a patient is leaving that they have no idea of what you just told them. They have doll eyes and just nod.

The national rate on this particular item, “Patients who understand their care when they leave the hospital” is at 51% nationally. That is not YOUR problem (and by that I mean you specifically) but rather an institutional problem.

And we all know if you do not know what to do upon leaving, they will be back. And there goes your reimbursement.

My wife explains to me they are instituting a new care plan where someone “follows” the patient through recovery. The key is to make sure they follow up correctly and do their post care work. Talk about expensive!

But the key thought is that it will reduce re-admits, and thus keep reimbursements at a higher level.

But I think that they are looking at it wrong. And I think you are looking at it wrong. You seem to think that service industries do not have their customers screaming at them and throwing stuff at them. I managed field service operations for a telecom company. Not only did people throw dog feces at us, or scream at us. They shot at us. Really. People died disconnecting cable and telephone lines.

So, lets get rid of the “we work harder than anyone” crap.

The way to solve this particular problem is to look at the problem. The problem is that the message is not getting through. No one seems to be figuring out why that is. Rather, now it seems they will send someone out to keep giving them a message they don’t understand.

I suggest that the messages should be delivered by someone else, somewhere else. The someone should be someone trained to communicate in a way that is meaningful, and by people who can confirm understanding. It should be done in an environment that is not pressure ridden, nor intimidating. And yes, nurses can be intimidating.

As someone who trained direct service agents to explain the same thing over, and over, and over again to people who could be idiots (You don’t need a degree to get a phone...anyone can get them. And they do!) It takes a particular set of skills to get that done.

I guarantee you that it would be done cheaper and with better results than any of the other money dumps I hear about hospitals.

Finally, and I hope you have gotten this far, as a person with nurses in my family and with a wife who brings this stuff home every day...and as someone who has been a patient with wonderful nurses...you and your profession has my respect. You have to be a special person to do what you do. I understand the training and time it takes.

But the time has come for EVERYONE to accept the facts and understand we have to change the way we are doing things.

This is but one example.

I appreciate your time. I hope you have a wonderful weekend....it is snowing like hell here. And my Pats are under fire for their balls. Its not looking good here.