It was a typical Friday night: The trauma bay was full, patients were lined up in hallway beds 1 through 6, and we were 50 deep in the waiting room. Within an hour of starting my shift, I had a chest pain in Room 4, a pregnant vaginal bleeder in Room 6, an old lady with belly pain in the neighboring room, and a colostomy malfunction in Room 13. These descriptions were exactly how I attempted to remember them. I had systematically hit all the right questions for each patient and put in the necessary orders, imaging was obtained, charts were being typed up, and the attending physician had been notified and had agreed with all my plans. Feeling like I had things under control, I called over to the nurse, “Hey, can you please check on the vaginal bleeder to see how she’s doing?” The nurse stared at me blankly and responded, “You know she has a name, right?”
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ACEP Now: Vol 36 – No 02 – February 2017I was immediately taken aback. To me, she was “Room 6,” 35-year-old female G3 P 0111, newly pregnant with a few days of spotting, mild abdominal cramping, no rebound or guarding, rule out ectopic, and confirm a live intrauterine pregnancy. My face immediately became flushed and warm, and my voice stuttered. I was unsure how to respond. I had been so consumed with everything else, I honestly hadn’t even glanced at her name. Like a good resident, I had checked on her a couple of times to ensure her abdominal cramping had resolved. I gave her ice water and updated her on the wait time for her ultrasound. Once those items were marked off my checklist, I went on my way. The nurse proceeded to ask me, “Did you know she and her husband have been trying for a year? That she’s had a prior miscarriage and is worried it might happen again?” My face was now beet red and my heart thumping out of my chest from my embarrassment from the unintentional reprimand.
I walked back in, this time more aware, noticing more than just the vital signs. In front of me was a woman not much older than me, clearly worried. Her lips were pressed together nervously, hands clutched tightly, and eyes wide in anticipation of bad news. This was someone seeking reassurance, not just lab values and test results. She was more than just “vaginal bleeder in Room 6.”
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One Response to “Opinion: Connecting with Patients Can Help You Become a Better Doctor”
March 5, 2017
Gregory BowermanDr. Hsiao,
Your nurse’s put down was not unintentional, but the information that followed was, of course, very valuable to you and her. We made a conscious effort to call patients by their names about 20 years ago, until HIPAA and now we’re back to the handy way we used before and you were using now. If you just say “the patient in room 6”, their identity may have changed once or twice since you last saw them. Metrics are presently a god to administration, making it more difficult to get to know your patients. It’s great to be reminded of it’s importance often. But if you feel bad after an encounter with a nurse, that’s because s/he was hoping you would feel that way. Address him or her by their name, thank them for the information they conveyed, confirm that you knew and were concerned or didn’t and are glad they brought it up. Remind them in this way that you too are human, as are they. Good luck