Hearing the Gentry’s story about patient safety today was quite striking. I think it is a message of hope and conveys a message about how a disclosure and post-harm conversation should occur. I also remain wondering what the same scenario looks like for folks who not only “aren’t as lucky” but who may be from disadvantaged backgrounds or who go to county hospitals, or folks who are just different, or patients who are might be “a little rough around the edges.”
One of my most precious clinical encounters was with a difficult patient and his family. The patient was a young man who did not act his age, and some might say that the family dynamics were pretty dysfunctional at times. But I saw and worked with that patient every day for over a month, and despite our differences and challenges in communication, we found a way to connect. Of all things we connected through horses. This patient was from a rural part of a different state and he yearned to be back on the open prairie with his farm and his horses and his freedom. My dad’s side of the family are outdoorsmen/women, and I was familiar with farming, hunting, horses and the sort. One day I sat on the patient’s bed and he and his family regaled me with stories of western local rodeos and the sporting events. After that we had a connection. We still struggled with communication and finding common ground in acceptable medical plans on a daily basis, but every day we worked together on it. This was not the kindest, nor the happiest, nor the most “well behaved” patient by any definition. And he gave me a run for my money, but boy were we glad to have had each other by the end of the 51 days that he was hospitalized and then finally discharged.
On my last day the family gifted me a magnet purchased from the hospital gift shop that had a picture of an elderly lady that captioned “Who says this job is stressful? I’m 28 and I feel great.” It just about perfectly summed up our relationship – I aged probably 5+ years in my dealings with that family and the patient but we found a way to build a relationship and trust, and keep him safe during his tenuous and prolonged hospital course.
I imagine that patient safety is even more difficult to achieve with patients with whom it is difficult to relate connect or communicate, and I wonder what we as a growing community of patient safety leaders can do to champion patient safety for all.