Patient-centered TV: 24 hours a day

We love Grey’s Anatomy, E.R., Chicago Hope, St. Elsewhere, Marcus Welby MD, and all the others:  the drama of near-death experiences and rescue by wise, handsome doctors and beautiful nurses:  What’s not to like?

And hospitals love the publicity of real-life TV shows about their doctors and nurses as heroes, for it polishes their public image.  Some patients may like appearing on TV, too.

But not always.  Anita Chanko was horrified to see her husband’s death in an Emergency Room televised, without her consent, on ABC’s program, “NY Med.”  When her husband had been hit by a truck late one night and brought to the E.R., a doctor had blocked her from seeing him.  But they didn’t block the TV videographers who recorded the hospital’s treatment of patients 24 hours a day.  The hospital’s Vice President of Public Affairs explained that “you can’t buy this kind of publicity, an eight-part series on a major broadcast network.” 

If all patients formally consent beforehand to being broadcast, that is their choice.  But for me, if a hospital is concerned with my dignity and privacy, please don’t broadcast me at my most vulnerable and weakest moment for your viewers’ titillation.

Read a story about the Patients' Bill of Rights.  Thanks to Charles Ornstein of the New York Times for the story, “Dying in the E.R., and on TV,” and Dina Litovsky for the photo.

Ideal care in the Intensive Care Unit: You sleep well

Dr. Peter Pronovost's vision of care in the Intensive Care Unit:

Imagine your loved one is admitted to the ICU after cancer surgery, you are actively involved in his or her care at a level comfortable to you, providing information about symptoms and concerns, knowing what is going on and actively participating in decisions.  

Clinicians are using technology to predict what harms your loved one is at risk of suffering.  Using technology the clinicians have a checklist of the 200 therapies your loved one may need to receive on any given day, to prevent harm. You can see when they are due, when they have been done. And most are automated because the devices monitoring care are connected.  

You sleep well knowing the infusion pump would alert staff and shut off if your loved ones breathing slowed. You are confident that staff will have time to provide comfort for your loved one, listening to their concerns, holding their hand. You attend clinical rounds daily, or whenever you choose–sometimes by video conference sometimes in person.  

You are provided a daily report on how well your loved one’s symptoms were managed, how well the team performed those 200 things and the results it achieved. The staff continuously works to learn and improve. You can feel that the staff work as a team, and are joyful. You can feel you and your loved one are treated with respect and dignity. And amazingly, care is much less expensive.

All of this is possible today, technology is not a barrier. The engineers can do this now. The question is–do we believe and will we collaborate?

See another story about Dr. Pronovost.  Thanks to Dr. Pronovost for this excerpt from his speech on August 28 at the launch of the Gordon and Betty Moore Foundation's Patient Care Program. 

Bring a man's shirt: A recovery wear garment for mastectomy patients

Peg Feodoroff's story:
As a result of my and my youngest sister's cancer experiences, we were compelled to start a company that would improve the environment in which people are asked to heal and recover. We designed a Recovery Wear garment that we call the Original Healing Threads. This was our first project and we have many other ideas to further our mission. However, we need to be profitable before we can proceed.

Hospitals cannot afford to purchase our Healing Threads for their patients. We do have 4 hospitals throughout the USA that have forward-thinking decision makers who give our Healing Threads to their mastectomy patients before their surgery. They raise the money to pay for them via the medical institution's philanthropic arm. Wearing our Healing Threads allow women to recover and heal with their dignity and modesty intact. The patented break-away panels allow only the body parts that need to be exposed, to BE exposed. The interior pockets hold post-surgery drainage bulbs discreetly and comfortably. Did you know that the medical community has a common practice of preparing women for breast surgery by suggesting that they bring a MAN'S SHIRT to the hospital for their trip home? Now, your breast or 2 has been removed and now they confirm your feelings of inadequacy as a woman by advising you to bring in a man’s shirt! Not so subliminal a message there! Oh, and then they clip the drainage bulbs to said shirt where they constantly remind you that you no longer have a breast. The Hippocratic Oath states, "First, do no harm," and obviously is taken as an admonition against physical harm. The psychological harm being done is undeniable and endless.

Our garments provide our customers with dignity, modesty, and empowerment. Being able to say "no" to a hospital gown empowers a person to say "no" to other directives: to ask questions; to get 2nd or 3rd opinions; to dialogue with the doc re options, side effects, etc., etc.. To take control and ownership of their own health, their own illness or disease. To bring to the battle the mind, the body and the spirit. Without all 3 working together recovery is not possible.

Yes, you do have a choice, a choice that has won praise from many medical personnel who have worked with patients wearing it. Our Healing Threads are not only attractive, they are supremely functional.

Read a story about hospital gowns. Thanks to Peg Feodoroff, the president of Healing Threads, for the story.

Real Men Don't Wear Gowns

Ken's rant:
I like to look silly – once in a great while, at Halloween, and Purim. But even then, I don't cross-dress.

I don't do dresses. And not nightgowns, negligees, chemises, and not even aprons, either.

So, hospital nurse, don't give me a johnny – one of those ridiculous open-to-the-back gowns with a drawstring and little chotchke designs.

There are 5,000 other hospitals in the country, and if you hand me a johnny, I'll haul myself out of your hospital bed and find a hospital that doesn't make me wear one.

Advice to patient advocates: Tell your clients to bring their own bathrobe or favorite pajamas to the hospital.

Read a very different story about a patient’s dignity in the hospital.

We gave our own orders: Dignity in the hospital

Kathleen Kalt's story:

Patients have no obligation to the "health-care community." In fact, more patients need to know that they do not have to comply with every doctor’s request.

My daughter had leukemia at age 10 and clear-cell sarcoma at 17. She was treated by outstanding doctors, but we all knew she would not survive the second cancer. When she had to be admitted to a major teaching hospital for surgery, it seemed she was on all the grand rounds; everyone wanted to see this rare case and hear her medical history. We didn't think she needed to relive constantly the worst moments of her life. She needed dignity and control. We gave our own orders: "No one will touch her except her primary doctors. She won't answer any more questions. Read her chart for yourself." After seven years dealing with the medical establishment, we knew that the best patients were their own advocates.

Advice to parents: To preserve your child's dignity, you can give your own orders to guide the learning of interns and residents in the teaching hospital.

Read another of our stories about a death with dignity.