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What to do When Your Patient Dies

January 23, 2014 by procourtesy

What to Do When Your Patient Dies

Over the years, many people have shared with me their disappointment at the lack of acknowledgment from their physician when their loved one died. Especially, when their loved one had been a long time patient of the physician. In fact, many people have shared that they switched physicians because of what they perceived as a slight.

When people go to a physician for many years, especially the family physician, it is not unusual to feel a real bond with that physician and staff. Think about it, medical people are involved in some of the most intimate times in a person’s life. They are there when babies are born, when your kids get raised, when loved ones are diagnosed with terrible illnesses and yes, when people die. So, it makes sense to me that when a patient dies, some acknowledgment should be made by the physician and or his or her staff to the family.

I also think hospitals should have protocols in place to acknowledge the death of patients in their facilities. Many hospitals send congratulations on the births that take place in their delivery units, why would you not note something on the opposite end of that spectrum.

At a time when health care seems less and less personal to patients some simple, but thoughtful gestures of concern and sympathy can let patients know that you really care about them and their families.

Here are some things a medical practice could consider:

Have a policy in place as to how you are going to acknowledge the death of one of your patients.
Sending a hand written note from the physician and staff would be greatly appreciated.
A token floral arrangement is another option.
Send a representative from your office to the calling at the funeral home.
Follow up with a phone call after a short period of time to the surviving family member if they are your patient.

Hospitals could send a personalized letter of condolence to the family…no generic form letters for this situation.

Reach out and let your patients know that you care. I guarantee they will appreciate it.

Let me know what your office or hospital does. I am very interested to know.

A footnote: I have had several dogs over the past years and when any of them died we got a heartfelt sympathy note from our Vet…I think people deserve the same from their physicians.

Survey for Grief Book

January 21, 2014 by procourtesy

Survey for Grief Book

I am doing research for a book that I am writing on dealing with grief and the etiquette that goes with it. I’d appreciate your comments to the questions listed below. Feel free to answer as many or as few as you’d like. Also, feel free to add more comments separately.

If you think of any other questions that you feel would be of value, please share those, too.

To respect your privacy feel free to email me your comments directly at karen.hickman@p/ The identity of anyone replying will be protected using a pseudonym and or changing details to protect your privacy.

Thank you for sharing your thoughts on a difficult subject. My goal in writing this book is to enlighten people on the best ways they can help friends and loved ones when they are experiencing loss in their lives.

1. If you have lost a loved one, what was your relationship to the deceased; a spouse, parent, child, sibling, grandparent or friend

2. How long has it been since your loved one died?

3. Was their death sudden or after a long illness? If sudden, what was the worst part for you?

4. If they had an illness of any length, were you able to care for your loved at home?

5. If you kept your loved one at home, did you have help? If yes, who?

6. Did your loved one die in the hospital or another medical facility? If so, were the needs of your loved one met?

7. Did the staff demonstrate compassion toward your loved one and your family?

8. Did your family member’s physician and/or staff acknowledge the death of your loved one with a note or a funeral home visit?

9. If yes, were you appreciative?

10. Has the grief process been more difficult than you had imagined?

11. Was there a point in time when you felt a shift and lessening of your grief? If so, how long after your loved one died was it?

12. Who were the most supportive people to you after your loved one died? What were the most helpful things people did for you

13. Who were the least helpful? Why?

14. What were some of the most surprising things people said to you after the death of your loved one?

15. What questions did you dislike answering.

16. Did you seek counseling? Was it a group or private counseling?

17. Was your counseling helpful?

18. Were there any particular books on grief related topics that you found helpful? If so, which ones?

19. Was there anything in particular that helped ease your pain? For instance, certain rituals, meditation, wearing an article of clothing of your loved one, etc.

20. If there was one piece of advice that you would give someone who is new to the grief process, what would it be?

Resolve to be Civil in 2014

January 6, 2014 by procourtesy

Resolve to be Civil in 2014

Are you the kind who makes New Years resolutions? If so, I’d like to challenge you to be more civil in every aspect of your life. It seems that civility has gone out of style and many of us need to be reminded as to what that means.

Civility is an important frame-work of our society. Without it, we all seem to run a muck and treat each other poorly. The rules of etiquette tell us how to treat each other. It isn’t about pretense; it’s about consideration for others.

As I review some of the posts on social media and in the news, of people being out right mean toward others, I become very sad. When did it become okay to call a beautiful women “fat” because she has held onto a few pounds after having a baby. Or how about those who feel they have the right to insult others because they hold an opposing view on politics, religion or any other social, hot topic.

So in 2014 consider some of these resolutions:

If you can’t say anything nice, don’t say anything at all.
Talk to people, not about them.
Be kind, it costs very little.
Do more than your share at work.
Be positive. No one likes to work with, or be around negative people.
Find the good in everybody.
Be grateful for something in your life everyday.
Treasure your friends and loved ones.
Volunteer somewhere, regardless of how busy you are.
Respect the opinions of others, even if they differ from yours.
Listen more, talk less.

We have heard many of these points from the time we were very young, but sometimes, in a cynical world, we forget how important they are.

In so many of my seminars people tell me that what I teach is really just common sense…yes, it is. The trouble with common sense is that it is not always very common.

So, I too, will join you in working on this list of resolutions.

Happy 2014.

Shoes Off at the Door, Please

December 19, 2013 by procourtesy

Shoes Off!

Shoes Off at the Door, Please
In the midst of the social flurry of the holidays many people are doing a lot of entertaining at home. Having friends into your home is the ultimate compliment to them, but inflexible house rules can be off-putting and send mixed messages.

Many people employ the “shoes off at the door practice” in their homes. This, obviously protects floors and carpeting and is a great rule for the family and kids, but can be offensive to guests who are invited to a social gathering in your home. Asking them to remove their shoes when they are all dressed up may suggest you care more about the carpet than you do them. It’s a little like having guests sit on the plastic covering the white sofa.

Since the practice of removing shoes before entering someone’s home is not part of the American culture there may be some ways to preserve your floors and make your guests feel welcome. Likewise, guests can do a few things to show respect to their host’s home.

Be prepared with door mats and rugs so guests can wipe their feet well before entering.
In messy weather keep sidewalks and driveways as clear as possible.
Guests wearing boots would do well to carry their shoes and be prepared to change at the door.
Check your shoes before entering someone’s home to make sure you are not tracking in something you picked up outside.
Take care to buff newly polished shoes well to avoid excess polish rubbing off on carpets and the skirts of furniture.
If you have a unique situation such as, a boat or special flooring, be prepared with socks or an alternate foot covering for your guests. This says you welcome them and want them to be comfortable.
Don’t forget to check your socks for holes in case you have to remove your shoes.

Best wishes for a very Happy Holiday season.

Reach Out and Touch Your Patients

December 4, 2013 by procourtesy

More and more, I hear business people say that they don’t like to touch people, shake hands or to be touched by others due to the risk of getting germs. This is a very sad commentary, as far as I am concerned. But even sadder, to me, was to hear nurses say they don’t like to touch their patients because they feel they are unclean or they don’t want to risk getting their germs.

While I appreciate not wanting to get someone’s germs that may cause an illness, I think to take the “no touch” approach with your patients is risky and very damaging to developing a mutually respectful relationship.

Nurses and physicians are certainly taught techniques on hand washing, maintaining sterile fields, dealing with patients who are infectious by using isolation procedures and various other ways to protect themselves and avoid spreading diseases to other people. So why the resistance to touch your patients?

I think it is multifaceted with some of it brought on by how high-tech medicine has become. Healthcare workers are now booting up their computers to enter data and the answers to the questions they ask their patients, often, before they even shake their hand or make eye contact with them. Physicians are now able to do every test imaginable to diagnose patients that it seems rather easy to forget about actually putting your hands on the patient. I have even had people tell me they received a complete physical without ever having taken any clothes off. This is unimaginable to me. If physicians aren’t actually looking at someone’s body, I would guess they are missing some things.

We know from studies that babies who are not touched fail to thrive and some, even die. The human touch is a big part of diagnosing and healing. Imagine the elderly patient who lives alone and has no one to hug them. Touching people and being touched is essential to life. We all seek touch from those we love. Why not make sure it is part of the equation when caring for patients.

So, here are some tips to ensure you make some sort of physical contact with your patients:

Upon entering a patient’s room in the hospital or the office exam room, extend your hand to meet them before you go to the computer to start asking questions.
If handshaking is not possible, touch the patient on the shoulder, or arm. This is a comforting gesture when consoling them or delivering bad news…something they will appreciate.

Spend a few moments talking directly to the patient. Note the color of their eyes to make sure you are making appropriate eye contact.
Introduce yourself and let them know what you do and who you are; nurse, tech, P.A., etc.
While entering data in your computer, look at the patient while asking the question and then look at the keyboard when entering their answers. Reassure the patient that you are listening to them.
Shake hands or extend another touch upon leaving the exam room. Your touch will be noted.

If you still don’t want to touch your patients, maybe you should reevaluate why you went into medicine. Compassion is important in caring for the sick.

And for those business people who don’t like to shake hands…to refuse to shake hands with someone is a huge insult. Shaking hands is the universally accepted way to touch others in almost, every country in the world. So, reach out and touch someone, then go use your antibacterial wipes

What to do When Your Patient Dies

Survey for Grief Book

Resolve to be Civil in 2014

Shoes Off at the Door, Please

Reach Out and Touch Your Patients

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