It’s possible to become a patient-advocate without alienating hospital staff. You can help your patient without getting in the way of important tests, or hampering treatments
Doctors are not super humans and they cannot cure all their patients. However, sometimes they are so focussed on the technical aspects of the medical care they provide, that they forget that a pat on the shoulder and a reassuring smile can make a world of a difference to the patient.
A Win-Win Patient MantraApollo Hospitals Chennai has introduced a patient tracking solution called Patient Mantra. They use this to identify the location of patient in the health check-up process, so they can track how long they have been waiting at any given location. This helps them to resolve bottlenecks.
It’s possible to become an advocate without upsetting hospital staff. There’s no need to rock the boat and put your patient’s life in danger. Being an advocate is all about being informed, present, persistent, and caring. It is not about being loud, arrogant, adversarial, or obnoxious. It’s a delicate balancing act, rendered with humility and helpfulness, where everybody has to learn to be a team player.
You thank people who serve you at restaurants, so why not do it in the hospital too? If you are polite to nurses and ward boys, they will respond in kind. Have faith in the system. Believe that everyone wants to be helpful. Saying a sincere “Thank you” will make hospital staff feel good about their job and they will be more polite in the future.
Some staff members may still regard you as a nuisance. A few may appreciate your efforts and others may feel threatened. Don’t put them on the defensive. Don’t let the negatives of a situation vitiate the hospital environment. On the other hand, don’t get cowed down by the hospital staff either. You are not there to win a popularity contest - you are there to save a life. Not everybody has the skill or ability of being able to connect with others quickly and easily, but a good patient-advocate has mastered this art.
Mrs. Chadha was extremely excited about finally being able to go home after a prolonged stay in the hospital, where she was recovering from a critical illness. On the morning of her discharge, Dr. Bhatia co-ordinated with her advocate, who carefully reviewed all of Mrs. Chadha’s medical needs. A nurse met with her and her son to review all the medications. Her advocate made arrangements with her doctor for the first follow-up. The dietician carefully reviewed the diet plans ordered by Dr. Bhatia and the physiotherapist reviewed her exercise programme. When Mrs. Chadha left the hospital, she was pleased and grateful that all of her follow-up care had been arranged by her advocate.
Because patients can’t fight for their rights any better than defendants can argue their own cases, or citizens can file their tax returns without the help of a CA, patients need the help of a patient advocate to make their hospital stay comfortable. In fact, progressive hospitals are investing in employing professional patient-advocates, whose job it is to make the hospital more hospitable. Patient advocates help to pamper patients, so that they go home fully recovered, and full of praise for the hospital and the medical staff.
These professionals should not be viewed as competitors to the medical team, but as partners who can fill the gap in services, and assist patients in negotiating the complex healthcare system. The real value of a patient-advocate lies in her ability to represent the patient - and every patient is special and unique. She can assist the doctor in understanding the patient’s experience and her personal preferences, so that the doctor can customise the solution he offers to the patient. A patient advocate helps the medical team to deliver friendly efficient and effective service, tailored to the patient’s needs, by being a partner, teammate and personal coach. To illustrate, let me give you an example:
A 37-year-old patient with a serious lung infection had to be shifted to a ventilator and was put in a medically induced coma in the ICU. On the third day, he suddenly became alert and couldn’t figure out where he was. His arms were restrained and he could not spot any of his family members around him. He had had a tracheotomy done two days ago to assist him in breathing so he couldn’t even speak. When he came around, he naturally panicked and gestured wildly to the nurse attendant in the ICU.
The nurse-patient relationship is one of unequal power. Although the nurse may not immediately perceive it, the nurse has more power than the patient. The nurse has more authority and influence in the health care system, specialised knowledge, access to sensitive information, and the ability to advocate for the patient and his family. The appropriate use of power, in a caring manner, enables the nurse to partner with the patient and his family.
Thankfully, she was a good nurse and she recognised that the patient was conscious and anxious. She rushed to the patient’s side, took his hand in hers and in a soft, crooning voice addressed him by name, while trying to assure him that everything was alright and that the doctors were making sure that his lungs were functioning normally. Then she offered to inform his family that he was awake. While doing all this, the nurse took care not to let go of the patient’s
All hospital staff members must learn to read a situation from the patients’ point of view. Surrounded by a battery of specialists — cardiologists, endocrinologists, orthopaedists, neurologists, and more, patients are scared, confused, and vulnerable. Specialists are often too busy to give their patients the full attention they deserve. That’s when the others around them can step in to fill the void. If and when the opportunity presents itself, the supporting battalion of nurses, paramedics, ward boys, hospital administrators, and clerks must serve as patient advocates. It costs them nothing, but can deliver rich returns - both from the sense of personal satisfaction such acts of kindness generate; as well as the resulting enhancement of the hospital’s reputation. At the bare minimum, this would bring a smile to a harried patient’s face - and a patient who goes home with happy memories of her hospital stay will become a brand-ambassador for the hospital.
Playing the role of a patient-advocate
Even if you cannot afford a full time patient advocate, there’s a lot you can do personally to advocate for your patient. Once you arrive at the hospital and have provided staff with the information needed to admit or treat your loved one, you should:
- Find out who the “attending physician” is. This is the person who will coordinate and oversee your loved one’s care, work with consulting physicians and specialists, and have responsibility for your patient’s treatment plan.
- Get the phone numbers for the attending physician and make sure that he knows how to contact you directly regarding your loved one’s care.
- Keep a list of questions ready to ask your attending physician. You never know when the doctor will show up by your patient’s bedside. A typical visit won’t last more than 10 minutes. If, for some reason you won’t be in the room when the doctor visits, leave your list with the nurse.
- Introduce yourself to the nursing staff. They will be providing the bulk of the hands- on care to your loved one. They should be able to answer most of your questions on medication, treatments or procedures. If they can’t, they will direct you to another clinician who can. Nurses typically work on 12-hour shifts (i.e. from 6 a.m. to 6 p.m.) so find out when the shift change is and try to wait until the nurse on duty has the information she needs to answer your questions.
- Get to know the hospital’s discharge planner or case manager. It is their job to help with discharging your loved one and ensuring that you have all the information you need before leaving the hospital. She can provide you information about local resources, referrals to other medical professionals, when to follow up, etc.