medical manners Archives - Page 5 of 6 - Professional Courtesy, LLC

Are You A Real Health Care Professional?

July 19, 2013 by procourtesy

Are You a Real Health care Professional?
The healthcare arena today, has workers with many different levels of education. However, regardless of the letters after your name, there are certain skills that everyone should have in order to be perceived as a “professional” health care worker. While the technical skills are necessary to deliver competent care to a patient, the soft skills are the skills that set you apart. Not developing those skills can make you less effective as a caregiver and co-worker and tarnish the title, “professional.”

Patients assume you know how to do your job in the clinical sense, but it is how you deliver that care that makes all of the difference in their perception of the care they receive.

Take a step back and ask yourself some questions about how you conduct yourself when caring for patients and working with others.

Am I giving my patients my undivided attention immediately upon seeing them?
Do I introduce myself and state my position with every new patient encounter?
Do I shake hands with the patient and their family members?
Do I give good eye contact when speaking and listening to a patient? Can I note the color of their eyes?
Do I connect with the patient personally before starting to chart on the computer?
Do I look at the patient when I ask a question and return to the keyboard to enter data?
Am I respectful by addressing patients formally, especially older patients?
What message does my body language convey? Do I have my hand on the door knob and one foot out the door before I close the conversation with the patient?
Am I well-groomed from top to bottom? Do I have on clean shoes and a pressed uniform?
Do I chew gum in public?
Am I sensitive to the needs of my co-workers? Do I offer help before being asked?
Do I manage up my co-workers and the physicians?
Do I pull rank on team members?
Do I recognize the value of everyone on the team?

Don’t just let the letters behind your name define you as a professional. If you answered no to many of these questions it may be time to review some professional courtesy skills to improve the perception others have of you as a “professional” and to become a genuine professional.

The Importance of a Patient Advocate

April 21, 2013 by procourtesy

The Importance of a Patient Advocate

While dealing with my late husband’s illness and hospitalizations I soon realized the importance of taking on the role of his “patient advocate.” During several hospitalizations for a surgery, a head injury, that put him the ICU after a fall, and other ongoing care until he died, I felt the need, and was able to be his voice and protector. Even though, much of the time during his illness, he was able to make decisions and ask the appropriate questions, I too, could step in and ask, observe and trouble shoot. The fact that he was a physician and I was a nurse, didn’t hurt. However, having a medical background is not essential to be an effective patient advocate for your friends and family members.

When people are ill, in the hospital, or in a crisis situation, their ability to evaluate what is going on around them may be compromised. If they are seriously injured, coming out of anesthesia, on pain medication, bedridden or just feeling lousy, they may not have the energy or those critical thinking skills required to make informed decisions. That’s where a personal patient advocate can help tremendously.

I assumed that role again, on a recent vacation with good friends. One of my friends was injured from a fall at the airport curb as we were getting ready to leave for home. The stool that she stepped onto as she was getting out of the cab slipped as she put weight on it and she fell face and head first smacking the concrete curb. To say the least, a very scary situation for everyone involved. As we got her up and I looked at her, she was bleeding from a laceration to her left temple. A wheel chair was summoned, medics called and before we knew it, we were on our way to the University of California, San Diego Trauma Center, Hillcrest instead of going home.

She had not lost consciousness and had no confusion (worrisome signs for a head injury), but she was on blood thinners; a risk when you have an injury and are bleeding. It was, indeed, appropriate for her to be evaluated by a physician to make sure she was not bleeding inside her head. Remember actress, Natasha Richardson? She died two days after a head injury on a ski slope from a brain bleed that went undetected because she thought she was okay and didn’t have it checked out.

As we arrived at the trauma unit, my friend was whisked away into a trauma room where things happen pretty quickly with lots of people working on you at the same time…it was a well oiled machine. I was sent to a waiting area and was told that they would come and get me when they got her evaluated and some tests done. Fortunately for us, as close friends, I knew much of her medical history, what medications she was on and could have answered important questions if she couldn’t. She too, is a nurse and was able to do some of her own advocating. However, we were in a city that was not our home, dealing with a medical system and people we did not know. We were at the mercy, so to speak, of those taking care of her. And trusting them is part of the deal in this kind of situation.

Not too much time had passed after she had been assessed and had some tests when I was invited back to sit with her in the trauma room while we waited for those test results. At that point we learned that they wanted to admit her to be able to observe her overnight and so they could do another C.T. of her head, later in the day, to make sure that there wasn’t a slow bleed in her brain.

While in the waiting area I was able to call her husband, a physician, and tell him what had happened and keep him apprised throughout the day. When the test results came in we got her husband on the phone so the physician could talk to him directly and her husband could ask any questions of concern that he might have. This is “professional courtesy” in the medical business, but I would not hesitate to ask a physician to speak with anyone close to a patient who might not be there physically.

The staff at U.C.S.D. couldn’t have been nicer. They were able to get her a private room so I could stay with her through the night. They commandeered a lounge chair from another floor that turned into a cot so I could sleep in something other than a straight chair. I was very grateful and I think my friend was happy to have me close by. And she would have done the same for me.

As her advocate, I made sure that I got the names of everyone we encountered, what their role was in dealing with her. Getting names of those taking care of you or your family and friends is important. In crisis situations, it is nice to have a name to refer back to. Healthcare workers should always introduce themselves to the patient and family, but sometimes, that step is missed, especially in an emergency situation.

So, here are some guidelines for anyone who is assisting with family and friends in a medical setting:

If people do not introduce themselves to you, politely ask, “please tell me your name and what do you do here?”
Be another set of ears for the patient. Listen to the information given and ask questions if the patient is unable to ask for themselves or if they have forgotten something.
Take notes. Ask for clarification of medical terms in lay language.
Inquire as to when physicians might be making rounds so you can speak with them directly. Ask if you can make an appointment to meet with them while they are in the hospital.
While traveling with friends, have an idea of any health risks they may have and share yours.
Everyone should carry a brief medical history in their wallet or in their phone, that contains a list of medications, pertinent current and past medical information, allergies and contact numbers of friends and family members (ICE, in case of emergency)
If family members or friends are hospitalized, staying with them through the night is a huge comfort for them, but also, in these times of short staffing, you can be a great help in doing some of the small things that a patient needs.
When medication is dispensed, the patient and/or the advocate should always ask what the medication is and why it is being given, before taking it. Med errors do happen and another check is never a bad idea.
If someone you are with is injured in an emergency situation, stay as calm as possible. Take in the entire situation and get the names and contact information of those who assisted.
Keep track of the injured persons valuables and personal items.
Let medical people involved know who you are and your relationship to the patient. But do stay out-of-the-way of the medical people, especially in an emergency situation and let them do their job.
Do ask when you will be able to see the patient and what number to call if you have questions. Most special units have a direct line that family members can call to speak with someone in the unit and get an update.
Be polite, but if you feel the need to assert yourself do it in a respectful way. You will get better results than if you are angry or accusatory.
Check the I.D. bracelet of the patient to make sure the information on it is correct. In emergency and trauma units a fictitious name and patient I.D. number and date of birth may be assigned to a patient due to the fact that many people arrive without any identification. The patient’s real name with be added later.
If tests are done, it is okay to ask when you might get the results. Also, don’t be afraid to ask again. Nurses get busy and getting timely test results can sometimes get lost in the shuffle.
Do ask about comfort issues, like when they can eat,have something to drink, get up, wash up, brush their teeth, etc.
Upon dismissal, be sure to ask questions on what may be an issue after the patient leaves the hospital. Go over discharge information with the discharge nurse and get details about future appointments… who makes them. Ask about medications and where you can pick them up. And lastly, what should you do if a problem arises after dismissal.

Compassion in Healthcare…Stepping Outside the Box

January 19, 2012 by procourtesy

Compassion in Healthcare…Stepping Outside the Box
Upon recently learning that one of my longtime Canadian friends had lost his mother, after a lengthy illness, he shared this lovely story with me…

“Let me take some time to tell a cute story about her and the nursing home. It just happens to be the same facility that my grandmother died in 1979. Mum used to say she talked to her mother today and I always said “who is to say she didn’t”. Anyway, you may recall my mother was the Head Nurse of the Emergency Department at our hospital here in our town. She was a strong woman who bordered on bossy, a good trait considering the job.

Within the first 3-4 weeks of being in the nursing facility, she heard a call over the loud-speaker that there would be a nurses meeting in the board room at 1 o’clock. Sure enough, when the nurses and the Director went to the room, there was my mum sitting there. Now this is where the story, as related to me by the Head Nurse who had trained under my mother, gets interesting. Everyone knew my mum’s background. Our town was a small town (10,000) back in the day and everyone knew everyone. Rather than confront my mother and ask why she was there or tell her to leave, they simply gave her a legal piece of paper and a pen and continued on with the meeting. Upon conclusion, the Director adjourned the meeting and my mum stood up, rapped the table with her hand and said she thought these meetings were a good idea and walked out.

As a nurse and a care giver I know you can relate to this story better than most. I told this during my mother’s funeral and must admit I got a little emotional doing so. I did write a note to the Director thanking her and her team for the compassion.”

As a former nurse and etiquette expert, who does a lot of training in the medical arena, this story points up the importance of being able to step outside of the box and adapt the rules to fit the situation in any arena, but especially in health care. The last word from my friend says it all…”compassion”. It is so key in being a care giver, regardless of your position on the team. That young Nursing Director may not realize the impact that her small gesture of respect toward her former teacher meant to the patient’s family, but it was powerful. Obviously, my friend’s mother was a wonderful teacher and care giver…that will live on in the nurses she trained and will become part of her legacy. RIP Anne.

*This story is shared with the permission of my friend.

New Medicine, Same Manners

April 20, 2010 by procourtesy

New Medicine, Same Manners

The contemporary practice of medicine has taken a major shift for physicians and patients alike. The reasons for this shift are multifaceted: managed care, expenses, insurance, technology, and the list goes on and on.
Certainly, physicians and hospitals find challenges and feel a lack of control as they adjust to the rapid changes in the medical field. Similarly, patients must make adjustments as well, in order to feel they have a sense of control over their health care.
Historically, progress has two sides: we usually have great benefits, but also often lose something that is unique to the old way of doing things. Medicine is no different. The solo practice where the patient has a close one-on-one relationship with the “ole family doctor” is becoming rare.
However, this does not mean a patient has to sacrifice a meaningful relationship and excellent medical care with his or her physician who is a member of a large group. It does mean that the patient may have to shift his thinking or adjust her approach.
Patients who take more responsibility for their health and learn to effectively work with the medical system and their physician’s practice can reduce the miscommunication that is a common complaint today.
Some tips to navigate a modern medical system are:
• Be proactive before you get sick, if possible.
• Learn the routine of your physician’s office.
• Try to see the same physician at every appointment to establish a relationship.
• Learn the names of the medical staff.
• Learn when to place a call to the office. Avoid Monday mornings, before lunch and minutes before the office closes.
• Plan ahead for prescription refills. Don’t wait until the last minute or weekends.
• Learn how to navigate the telephone system by asking for the extension number of the nurse and how to get a “live” person.
• Understand the office’s protocol for emergencies.
• Find out what hospital your physician works in. Many medical groups split the hospitals for efficiency. Your physician may not make rounds or have privileges in your preferred hospital.
• Know the people who are providing your care. If the staff or physician does not let you know who they are, introduce yourself and ask their name and title or position.
• Turn off your cell phone! Taking calls during your appointment is rude and disruptive.
• Understand your physician’s protocol for receiving test results. Some offices only call patients with negative test results. If you are in doubt about the expectations or if you are anxious about test results, call the office.
• Keep a home file for each family member that contains all pertinent health information like: lab results, x-ray results health history and immunization history. This can help avoid errors and having to duplicate immunizations. Providing proof of immunizations is essential for school, work, military enlistment and more.
• List medications on a card and keep it in your wallet in case of an emergency hospital visit.
• Adult children of older parents can be more effective advocates if they keep copies of parent’s records.
• Call ahead and see if your physician is running behind if timely appointments are a concern. Ask again when you arrive and check periodically if your wait is getting lengthy.
• Be familiar with the privacy guidelines and be sure to document the family members who are privy to your medical information.
• Consider taking a family member or trusted friend to your appointments. If you are elderly or have serious medical issues, another person can act as an advocate and help prevent errors in information transmission.
• When making an appointment, note if you need to arrive 15 minutes ahead of your appointment time to fill out paperwork.
• Understand that courtesy is very important and infectious on all sides. Make sure you are considerate.
• If you encounter rudeness from a staff member or physician respond kindly. It will often diffuse the behavior. We all have a bad day, but if it is one individual, and the behavior is persistent, let the physician know. They can’t fix a problem if they don’t know about it.
• Change practices if the personalities and attitudes of a particular office are something you can’t live with. Be sure to let the office know why you left.
• Document serious glitches. For instance , if you call multiple times and no one returns your calls, let management know. Your time is valuable and waiting for long periods of time without a response can hold up progress.

Be a partner with your health care providers…it’s good medicine. Here’s to your health!

Respectful Care of the Elder Patient

February 22, 2010 by procourtesy

In the past month I have had the opportunity to accompany my parents to physician appointments and be part of their health updates. Even though, I was invited into the room by them, I was in no way in charge. My parents are very capable of making their own decisions, but appreciate having one of their daughters present as moral support. And in the event that we will have to be part of their decision making process we will be apprised of their health status.

At one appointment, as the physician entered the room he greeted my parents first and directed all of his remarks to them. I was so appreciative of that courtesy. The fact that my parents are getting older does not mean they should be slighted in any way and be treated in a patronizing manner.

That was not the case when I was helping with another family member out of state a few weeks ago. I drove and accompanied my family member to see her husband in a Rehab facility during my week long stay and helped with the process of transitioning both of them to an assisted living facility. During this time I found people directing the conversations to me and essentially ignoring my family members. At one point my in-law scolded the nurse and said, “you look at me…I am the one who will be living here, not her.” I thought that the nurse deserved that rebuke and hopefully she will change her approach when dealing with older patients and their families.

Treating patients of all ages with respect is important, but it is especially important when dealing with older people. At a time when many of the changes in their lives are beyond their control, genuine respect can help make them feel valued and a part of the decision making. Even if there are memory issues with older people, that is not a good enough reason to ignore them or treat them in a condescending way.

Here are some tips for all health care workers in dealing with older patients:

Refrain from calling them “honey”or “dear” or other patronizing terms… it’s insulting.
Address patients formally…Mr., Mrs., Ms. until you have been invited to call them by their first name.
Make direct eye contact with the patient when speaking to them.
Be careful not to speak too loudly that everyone within a mile can hear you.
Maintain personal privacy, as much as possible, when doing procedures or assisting with personal care.

Remember, this older person had a life before their illness and was a contributing member of society in their job, as a spouse, parent and grandparent…that should always be honored.

The Importance of a Patient Advocate

Compassion in Healthcare…Stepping Outside the Box

New Medicine, Same Manners

Respectful Care of the Elder Patient

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