Putting the care back in healthcare
Wednesday, December 05, 2018
With the exponential increase of technology in the delivery of healthcare, we run the risk of dehumanizing healthcare in the interest of expediency and cost containment. At the same time, nurses in hospitals face untenable nurse-patient ratios, and even in milieus like home health and hospice we also feel the crunch of delivering as much care as possible in as little time as we can.
Where will these trends take us and how can we put the notion of care back into healthcare?
It’s All About the Patient
Healthcare is all about the delivery of patient care. Consumer demand is one of the underpinnings of healthcare, and in many cases we sadly underdeliver and underperform.
Think of the average emergency department experience: patients generally come to the ED because they’re worried, injured, sick, or otherwise decompensated or vulnerable. In the United States, consumers without insurance are often forced to use the ED or urgent care as a poor substitute for primary care.
In a country where prevention is a buzzword, too many still live without affordable health insurance and are thus caught between a rock and a hard place when it comes to tending to their own health.
Some facilities are creating urgent care centers within or adjacent to their emergency departments. A triage center staffed by nurses evaluates patients and shunts them to either the ED or urgent care, removing patients from the ED queue who can be more efficiently handled by the urgent care team. This is a move towards the rehumanization of emergent and urgent care delivery.
On hospital floors, nurses are often forced to tend to more patients than they can truly handle well. Call bells go unanswered, patients receive less personalized care, and frustration reigns for all concerned.
Reasonable nurse-patient ratios help, but only California has mandated them. When we leave ratios up to each facility, the outcomes are generally less than stellar.
Putting humanity first in a people-based, people-powered delivery system shouldn’t be rocket science, but the ability to successfully rehumanize healthcare often appears beyond our ken.
Human Connection is Key
In a system that often reduces patients to faceless, nameless numbers and diagnoses, there remains an urgent need to restore the humanity of the patients who are the reason for our work. As robotics and AI infiltrate healthcare more and more, we’ll need to keep an eye on how patients and staff react to certain tasks losing the human touch and being mechanized.
Nurses and other providers can also feel dehumanized within that same system, forced to work harder than is healthy, surviving long shifts without meals, hydration, or bathroom breaks.
Meanwhile, nurse-to-nurse bullying is a scourge on the profession, and many institutions are either unaware of the problem or turn a blind eye. And if a third of new nurses leaves the profession within the first few years of practice, what does that tell us about the conditions within our facility walls?
Human connection is one key to successful healthcare delivery and its rehumanization. Many strategies exist — this is just a sample of possible solutions and initiatives:
- Staffing systems that allow for nurses to actually take breaks and care for themselves (some facilities utilize “resource nurses” whose only job is to relieve tired nurses in need of a meal or a break)
- Keeping a finger on the pulse of care as robotics and AI are increasingly integrated
- Mandatory training in emotional intelligence and relational intelligence (including physicians, surgeons, managers, and executives)
- The utilization of "medical improv" techniques that improve communication, relationships, and teamwork
- A return to truly patient- and family-centered care
- Unit redesign allowing for improved physical flow and enhanced communication
- Creating an inclusive, tolerant, compassionate, communicative workplace culture reflecting the human values of most importance to the organization and its staff
The Human Bottom Line
When we turn our focus back to our individual and collective humanity within the healthcare space, we reintroduce the notion of care for both patients and caregivers.
The old paradigm that the financial bottom line is most important no longer applies — we also need the human and emotional bottom lines to receive their due.
Healthcare is about many things, but it truly comes down to promoting health, providing cures when possible, community service, and caring for everyone who is party to the industry. It’s time to rehumanize healthcare from the ground floor.
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