During these unprecedented times, when family and friends cannot go into a hospital to visit their loved ones or talk to the nurses, doctors, and therapists about their loved one, we have to rely on those professionals on the inside to keep the lines of communication open.

I have a friend who has been in the hospital for 11 weeks. The experience has taught me the importance of communication, empathy, and family support.

My friend’s family is actively involved, but they have been frustrated by the lack of communication despite reaching out to the healthcare team day after day.

I have tried to support them by helping them understand how the ‘system’ works and connect them with key people when they run into roadblocks. Some days it helps, but most days, there are just excuses that does not help or relieve their frustrations.

I frankly have been embarrassed and sad about how poor things have been handled. My friend’s daughter and son make calls to ask for information, and ‘maybe’ someone will call them back. Doctors say they will call back but infrequently do. The nurses and the case managers say we don’t know what is happening – that they are waiting for the doctors to come to the floor – when asked when will the doctor be in – no one knows….so we wait – while minutes, hours, days, weeks go by.

In this email, I make some suggestions and ask you to add yours so we can help those on the inside know what we on the outside need when our family members/friends are in the hospital.

If you have a family member or friend who has been in the hospital, please share this post with them and their care team so together  start to improve the patient and the family experience.

Please put your suggestions in the comment section so others can see the ideas that you are sharing. If you are a nurse/doctor or other healthcare professionals, please feel free to share what you are doing in your organization to keep communication lines open during this challenging time. Together we can improve things.

 Here are my suggestions:

  1. For all patients in a hospital, the nurse caring for the patient or the case manager on the floor should ask families to designate one person responsible for getting all updates.
  2. Each shift, the designated person should be called and given an update on each shift. Calls should be done any time during the shift to keep the family updated. If possible, set a time so the designated person is available for the call.
  3. When a doctor comes to see a patient, the family should be called and asked if they want to be part of the visit. I know doctors come in and out at all hours, but one or two nurses could be assigned to make rounds with the doctors and call families, so they are on the phone to talk to the doctor about their loved one. They need information and know the plan of care – even if there are no changes – sharing your insights is essential to understand what is happening to a loved one.
  4. When tests are done, the family should be aware of the test and when to expect results. Again when the doctor visits, a call should be made to update the family about the outcome and the plan of care.
  5. If the patient is getting therapy or is in a specialty unit, updates need to be given more frequently. The nurse should provide the patients’ designated person their number and recommend they call if they need to know something.
  6. Communication should be increased during this time – not decreased.
  7. If a patient is complicated, consider a family conference where the doctors discuss the plan at least weekly. Today we have the technology to have a virtual call or just a phone call with several people patched in to discuss how the patient is doing. Doing so allows the family to know the issues, challenges, roadblocks. The family needs to be aware of the plan if they want to go a different route or have an idea that could help.
  8. My friend is awake and alert, but she does not remember what people tell her when they come in. Even on her good days, she was not good at remembering details, so she always wanted someone with her so she could remember to ask a question, or have that ‘second’ set of ears to hear what she is being told.” With COVID 19 this is not an option. So what are we doing to fill this gap? How about taking her cell phone and recording the visit – than she could play it back for her family or patching them into a call when the doctor visits the patient. Today we need to be creative and think outside the box. It
  9. If the nurses are too busy to do this, then the charge nurse/number manager, supervisors need to step up to help. This is a time when all hands need to be on deck.
  10. I know COVID 19 has put an additional burden on the care team. I am sorry for this, and I am not trying to be insensitive to your work, but having a family member in the hospital and not getting information is like having a person in jail. It is just not right, and WE all have to do better.
  11. If you have had a family member or friend in the hospital, how has your care been? Are you getting information so that you know what is going on? How was the communication? Did you feel your family member or friend was safe? Did you feel you were kept informed? What did you do to improve the situation? Please share so we all can learn.
  12. I would also like to remind the healthcare team that every patient who comes into the hospital has their advanced directives. Review them with the patient and the designated person, so we know they are up to date. This is a very challenging time, and we all know our patient’s condition can change on a dime – so knowing what their wishes are, is essential.
  13. I would also ask that the Hospital Administration make a list of significant numbers that the designated family member is given to get in touch with a person if communication is not flowing to their satisfaction.
  14. Today, most hospitals have Case Managers, a Patient Experience team, and Patient/Health Advocates who are in place as a liaison between the patient and the care team. They should be mobilized to be making calls to designated family members so that everyone on the team knows communication flows and the plan of care.

I know these are challenging times, but we have to remember that the patient and their families need to be kept up to their family member’s status. Let me know what ideas you have.

We Can And Must Do Better!

 

 

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