It used to be that patients and families would look forward to having me come back the next night. Since moving to Seattle, I have not had that same experience. I have had patients and families tell me “Oh nice to see you again.” I have had a few thank you’s and a few hugs- but I haven’t felt the closeness to my patients families that I have in every other city I have worked in. What’s worse, is that I have been asked twice by two different patient’s families not to take the patient back in the last 6 months. Is it me? Is it the culture of this city? Is it me in this city? Whatever it is; it’s troubling to me.
Recently, I had a very sick patient that had spinal surgery and had >4L EBL in the OR and had a loss of motor function in the OR-which he regained overnight. I worked very hard on him throughout my night shift with fluid resuscitation, monitoring his neuro exam, motor function, labs, electrolytes, s/s perfusion, pain, sedation, oxygenation, ventilator management, and skin care. I didn’t really leave the room and I didn’t really sit down- he did well and the next day was off the ventilator and heading out of the ICU. Speaking about my interactions with the patient; I left and we were fine- we had a good night, he shook my hand, and I told him how proud of him I was about how hard he worked.
From the beginning however, I did not hit it off with his family, the amount of family as well as their dynamics and energy got overwhelming and I was abrupt and short with them on more than 1 instance. (I would never profess to be perfect and I was not that night) They kept addressing me as “lady” even though I kept telling them my name and after the third or fourth time of it I asked them to stop. While I was trying to wake him up through sedation and get them to move and follow commands I tend to sound a little sargeanty and I have heard that before- they were bothered by that. There were a few other small situations. I apologized to his wife for my abruptness and to his sister- but apparently that wasn’t enough.
I know that there is definitely something I should have changed, my approach or my tone. I admit my approach was not correct and I should have done damage control on myself earlier. You never want to be the one negative part of someone’s hospitalization- or their negative association with an instituton. I have been around long enough to know that almost every patient has one staff member they don’t jive with, like that much, or remember for a negative event that happened. It’s a heartbreaking thing to me for the family in this instance not to be able to look past the interactions early in the shift to see the care and hard work that went into the night. Even more so, its hard to know there is a family member out there that’s glad I wasn’t back the next night.