Monday, June 29, 2015

My Recent Hospital Stay and the Care of the Computer

This did happen but should not be seen as disparaging the nurses and doctors who were responsible for my care.  They performed my procedure efficiently and skillfully.  Those health professionals are just working in a healthcare system undergoing dramatic change legislatively, financially, technically and even socially.  That is difficult for all concerned – doctors, nurses, and patients.  As we proceed with these changes, and with making better use of computer systems and electronic media in medicine, we must never lose the human aspects of caring. 

I was recently discharged from the hospital after suffering an acute problem that required an invasive procedure. For those of you worried about depersonalization of medical and nursing care I want to reassure you.  The commitment to caring for the computer is front and center.  The nurse and the doctor are diligent in paying attention to the computer, frequently touching the computer to show concern, and feeding it frequently.  But it is not only the computer being cared for.  The checklists are all being filled in.  The population health data repository is being enriched whether or not the data is accurate or needed for the individual patient care.  That makes the regulators and the health policy experts (and admittedly I may be considered to be one) happy.  That means that we will have data to study, and to ponder and to drive new regulations and policies.  I am excited to know that the databases that are produced by the questions that are asked will be robust. 

As the patient, I felt better as the nurse sat across the room from me in front of the computer terminal, asking me questions that sometimes had little relationship to me or the reason that I was in the hospital.  It was good for the population health database.  The bright, young nurse had been well trained and touched the computer frequently to show her concern.  When something had to be done that required touching me, the patient, she carefully, and with great concern, called in the nurse’s aide to do such tasks such as take my vital signs so that her concentration on the computer checklist was not diverted.  That also allowed for the principle of practicing at the top of your license to be fulfilled.  I felt happy and secure that all documentation was in order and that all procedures were followed to the letter.  I knew that she was helping the hospital capture all the needed information for payment and that the system would be better for the reimbursement being done properly.  I knew that the Joint Commission, which accredits hospitals, would give this particular hospital a high mark for having followed process and documented in a rigorous way. When she asked me, as it was the next question on the list, what my goal was for the day, and I told her that it was to survive until the next day, she dutifully recorded it and even got up from the computer terminal to write it on the whiteboard for all to see. 

When it came time to prep me for the procedure, which required washing and shaving certain areas of my body that were to be the focus of the procedure, she carefully and thoughtfully again called the nurse’s aide to get that done. The nurse’s aide asked me in turn if I would do it myself and even if I had a razor as they had moved floors and could not find it on that floor.  Her concern for my sensitivity at being touched was striking and the annoyance that she showed as I told her that I would rather that she prepped me was only to show her concern for invading my space.  The entire time, I knew that the nurse was at the monitoring station in the center of the floor and was able to watch for any abnormalities of my heart.  I felt safe and cared for.  When the monitor alarms went off and no one came, I could just push the buttons and I knew the caring voice of a nurse would be projected into my room saying soothingly, “can I help you?” in order to make me feel as though she was in the room with me.  That was always followed by a message that she would get someone into my room as soon as they were available.  It made me feel less afraid.

The entire time I never did see my doctor, except at the time of the procedure, however I knew that he could access the electronic medical record from anywhere in order to make his day and night more efficient.  I felt good knowing that he really did not have to see me or talk to me at all but that he was in charge and on top of all of my care.  I knew that having him say hello before I was sedated was enough to have trust that all of my concerns and fears were being addressed. 


So be reassured: Caring for the computer, filling the database, and driving efficiency remains the focus of medical care today.  As a patient, that should make you all sleep well at night.