Assuming the Patient Can’t Hear

Hola a tod@s, my dear rogue:

Going further, online International Cooperation, today I would like to invite you to spend some time with the protagonist of that video that changed our ways of working: Kathy Torpie from New Zealand.

“In most work places gossip
happens over the water cooler. In the hospital, it’s often the patient’s bed. Have you ever found yourself assuming
that a patient whose eyes are closed is asleep and can’t hear you? This common assumption
is made world-wide where doctors, nurses, and even family members talk freely
about patients as though they are not present. Even when a patient’s eyes are open, when it is obvious that they can hear, if they are unable (or
unwilling) to speak up for themselves they can easily be excluded from
conversations about them or have to endure private conversations that shouldn’t
be taking place in their presence.

There
is always a risk of adding to the patient’s fear and disorientation by
assuming the patient can’t hear you.

Personal conversations – or
worse, conversations about me – held in my presence as though I wasn’t
there – were as uncomfortable for me as an ICU patient as they would be for
anyone under any circumstances. Only more so because I couldn’t get up and walk
away! Being
talked about as if you aren’t present can demoralize a patient who already
feels diminished by virtue of his or her illness or injury. And a demoralized,
anxious patient isn’t a good team mate.

You’d be amazed at some of the
things I heard as a patient in ICU! In recovery from a 12 hour surgery to piece
the fragmented bones of my facial skeleton together with metal plates and
screws – my second 12 hour surgery in a week – I woke in a place I instantly
felt to be unfamiliar. This wasn’t the ICU ward I had been in prior to surgery.
Two female voices were having an animated personal conversation about people I
didn’t know. Struggling to cross the divide between my drug induced sleep and
consciousness, I felt like an invisible presence in the room listening to two
strangers sharing in a conversation that was completely outside of the context
of what I was experiencing. That frightened and disoriented me. It didn’t make
sense. Who were these people and where was I?
I remember thinking that I was a hostage and that these were my captors.

Many would call this classic ‘ICU
psychoses. And, perhaps it was. But it wasn’t the drugs alone that triggered
the paranoia. It was the combination of feeling so disoriented and vulnerable
as I emerged from 12 hours under anaesthetic, together with the terrifying
distance between what I needed and what was actually happening around me. I
woke, not to the sense of someone carefully watching over me at my bedside, but
to two women chatting with each other as if they weren’t even aware that a
terrified, critically ill patient, who had just emerged from having the skin of
her face peeled away to piece together the fragments of her facial skeleton,
was lying a few feet away from them and needed much more than their technical
skills.

It would be wrong to say that
these were ‘bad’ nurses. They were doing what they were hired and trained to do; to
monitor my vitals and be present in the event of a clinical problem during my
recovery from surgery. As long as the system continues to train and employ
healthcare professionals to be skilled clinical technicians, that may be all we
can expect, or hope for…..Until the day that we, or someone we love, becomes the
vulnerable patient in desperate need of compassionate human connection.”

Guest blog by Kathy Torpie
–
Patient, Psychologist, Author and International Healthcare Speaker-