This is the seventh entry in my in-depth interview with a patient undergoing cancer treatment.
What stories will your patients remember and talk about? Managing expectations is always important, but particularly so in the emergency room. When a patient makes the decision to go to the ER, he or she is feeling the need for immediate attention. When that expectation is not met, trust diminishes rapidly and can form an indelible memory. In Elizabeth’s story about a past event, she clearly demonstrates the lasting effect of a bad experience. Here, she talks about recent side effects from the chemo and concerns about relying on the ER.
I do feel so much safer staying close to the hospital, especially with the side effects that come and go. My doctor has advised me to go directly to the ER if my fever reaches a certain point. Each time I’ve felt sick in the last few days, I’ve been grateful that I have the hospital close by, though the idea of visiting that emergency room makes me nervous. The last time I was there, it was eight hours on an uncomfortable cot. They kept closing the door and would disappear for hours at a time. When I told them I wanted the door left open, I was told that they have a policy to keep it closed for “client confidentiality.” I said that I had a policy too—to nab anyone I saw in the hall because, otherwise, I’m forgotten. The nurse laughed. I didn’t.
That was several years ago, so, hopefully, it’s better by now. At the time, my body may not have been working, but my brain was. Had that been compromised, I would have needed an advocate.
When I asked Elizabeth what could have made that ER visit a better, more confidence-building memory for her, she replied, “Attention and information.”
When they shut the door and didn’t return for hours on end, I knew I had been forgotten. Period. When I’m feeling sick, scared, and vulnerable, I need to know that I can count on the caregivers to be present and to keep me informed. This would be a whole different story if they had just stopped in to check on me once every half-hour or so. Even if nothing had changed in terms of the doctor’s orders, I needed to know what was going on and to know that somebody cared about how I was doing. Just seeing someone would have made a big difference, not to mention helping me to feel more comfortable.
In this example, regular rounds would have done wonders in alleviating fears, providing comfort measures, and, ultimately, increasing trust.