Wednesday, September 19, 2012

Patients and Self-Advocacy

Several recent studies have brought to light some disturbing issues regarding patients, medical providers, and the relationships between them. These studies underscore the importance of positive relationships between patients and providers, and how important it is that healthcare consumers feel empowered to advocate for themselves.

In a study cited in the Archives of Internal Medicine, one third of doctors and nurses reported unwillingness to be reminded by patients to wash their hands, and would not agree to wear a badge encouraging patients to do so.

Yet another article details that more than 70% of patients experience worry regarding the likelihood of medical errors. Recently, when I posted a link to this article on the Nurse Keith Coaching Facebook page, a reader commented, in essence, that 100% of patients should be worried about medical errors, and I must admit that she’s correct in that assertion.

With nosocomial infections and other medical complications all too common—and let’s not forget MRSA and those pesky antibiotic-resistant microbes—consumers would be smart to channel their worry into self-advocacy. 

Speaking of patient advocacy, author Martine Ehrenclou recently wrote on her blog about communication strategies for patients to utilize when interacting with their medical providers. She states: 
You might wonder why you need to consider these communication strategies. After all, shouldn’t doctors and nurses wash their hands anyway? Yes, but we are dealing with reality, not what should be. If health care providers are already resistant to the idea of patients asking them to wash their hands, why not simply deal with that fact and use techniques that can better your chances of getting more of what you want? Which is to leave the hospital infection-free.

As patients we need to learn to work with what is until doctors and nurses are more accustomed to working in partnership with patients. Some may never accept the notion of patient centered care and the role of patient as partner but there is growing evidence that more and more are welcoming their patient’s participation in their care.
As a growing number of healthcare facilities get on the bandwagon of aggressive combat against medical errors and hospital-born infections, consumers must be invited into the conversation and given a role in the implementation of such practices. And if they're not invited to the party, patients simply need to make their presence (loudly)  known and advocate for a place at the healthcare table.

Personally, if I was employed in a hospital, I would readily agree to wear a badge asking my patients to remind me to wash my hands, and I would not take offense when asked. Hand-washing is a well-known and important tool i the battle against the spread of infection. Patients have every right to make sure that the hands touching them are clean, and any medical provider unwilling to be reminded or encouraged by patients is suffering from a generous overdose of hubris.

(And while we’re at it, why don’t we ask patients to remind us to clean those nasty stethoscopes, as well? How often are those things cleaned?)

Healthcare reform comes in many guises, and patients standing up for themselves and the quality of their care is yet another piece of the puzzle. The medical profession, nursing profession and other allied medical personnel are, like it or not, in the customer service business. And since the business in which we are employed holds the lives of its consumers in its very hands, then those consumers have a right to make their needs, desires and standards known.


Lisa said...

Wow, washing hands and wearing name badges are the empowerment issues? I struggling with issues about being allowed to choose the doctor in the practice that I go to after my doctor leaves. Or being included in on the discussion of what my diagnosis is if there is one and what the plan is, or if there is on and if there isn't why am I being asked to come back in six months...I should be focusing on if the guy washed his hands?

Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

No, Lisa, washing hands are not the only empowerment issues for patients. They are simply the issues addressed in these recently published studies, and those were the impetus for me to write this particular post.

I've covered many patient advocacy issues during the seven years of this blog's existence (and in my 16-year practice as a nurse), and this is one snapshot about something very specific based on recent scientific findings.

Covering every issue salient to every issue within one blog post is not possible. I apologize if my post engendered anger in you vis-a-vis your current situation with your personal medical care. I wish you the best and hope your providers do include you in important conversations and decisions.