This is my second blog chronicling one patient’s experience during her 6-week journey with a health care organization. In my last blog post, I talked about words that wound, words that work, and words that WOW. Even the most well-intentioned caregivers can say things that leave a patient feeling uneasy if not frightened. Elizabeth’s next encounter reinforces just how important it is for health care workers at all levels of the organization to filter their statements through the ears of their patients.
Let me tell you about yesterday. I had one test. They instilled dye into my bladder to see if it would flow into my ureters and kidneys. This ensures that there are no blockages and that the chemo can flow to the kidneys unobstructed. When the xray tech noted that my ureters were joined together from a previous surgery, he was amazed. I said “I didn’t have that done here.” He whistled and shook his head smiling. “Nope, I know you didn’t,” he said. “We would never have done that. The way they did it with you, you could end up losing both kidneys if your cancer spreads to the attached ureters.”
When I asked Elizabeth how this comment made her feel, she replied, “My first reaction was terror at the thought that what another surgeon had done to me in the past was incorrect and was now placing me at even greater risk of losing my kidneys. It dredged up the grief and regret over all the past surgeries and the fact that I had felt so out of control – that I never had a voice or a choice in what was happening.” She added, “The tech was really sweet though. He was just in his ‘science mode.’ That’s what I call it when the staff talks from the science part of the brain rather than the emotional side. Employees are proud to work here, where they are often in the lead with new techniques. But I wish they realized that telling someone they’ve had the “wrong” kind of surgery creates anxiety, regret, grief – all of which I felt. They are so proud of the great work done in their organization that sometimes the staff will say these things and not realize the impact that their comments have.”
Because she has a long history with her providers, Elizabeth has a high level of confidence in the health care organization where she is receiving her care. She has confidence in her physicians and the clinical quality that she receives. Because of this, she is able to overlook this type of comment. In this case, the tech obviously wasn’t thinking when he made his comments. Here he is talking to a woman with cancer and he tells her something that not only reinforces the grief and regret she has over previous surgeries, but now worries that her current condition will end up costing her even further damage.
What would have been a more confidence-building conversation? In this case, the tech could have done better by simply saying nothing. Neither the provider nor the patient benefited by the exchange in this scenario. It’s important to filter all comments made to patients through these two questions: Is this information necessary? Who will benefit? If it is not clearly necessary, and neither party will benefit from the exchange, then silence is golden.