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.
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