Sharing difficult stories

We discussed several topics today, however, two of the most powerful were transparency and shared decision making. After reviewing the story of Michael Skolnik, my heart ached for families that have suffered similar loss. For the Skolnik family, the loss was intensified by the lack of transparency and shared decision making. As an advanced practice nursing student, I witnessed a situation in which transparency and shared decision making was present in an otherwise unfortunate event. A patient arrived to the hospital in the midst of his second heart attack. After stabilization, options were presented with one being coronary artery bypass surgery. The patient chose bypass surgery, however, his surgery was on hold for coagulation issues. When it was time for the patient to have surgery, an emergent patient arrived necessitating a potential delay in the first patient’s bypass. Transparent communication occurred between the patient and provider detailing the situation and the options. Totally involved in shared decision making, the patient and family decided to postpone surgery to the next day. Unfortunately, he died before the next day’s surgical procedure. Although the family suffered a tragic and unexpected loss, they had confidence that the right decisions had been made with full knowledge of risks and benefits. As I reflect on the differences in the two scenarios, both had unexpected outcomes, but transparency was an important variable. Including the patient in every conversation ensures the opportunity to voice concerns related to their care and builds a trusting relationship. We connect as humans, and are invested in the outcomes of the patient. When we are transparent, the difficult stories shared above have very different endings.