“Be kinder than necessary, for everyone you meet is fighting some kind of battle”
Not long after joining the renal team in Dumfries and Galloway I met Audrey, a peritoneal dialysis patient in Stranraer. She was quite a character, “larger than life”, and whenever she came to clinic she brought her Husband, Paul. They were inseparable, soul mates, and made most decisions together.
Sadly, a few years ago, Audrey’s health declined and despite all our efforts it became clear she was approaching the end of her life. The conversations we had around stopping dialysis were difficult but more so for Paul who couldn’t bear to let her go. As is often the case Audrey had come to terms with things some months before and was clear about her decision to stop dialysis.
She was transferred from Dumfries to Stranraer where she passed away peacefully two weeks later. I heard the news on a Monday morning and was saddened at her passing but glad that it had been peaceful. She was 51.
The next day I was doing my ward round when I did a double take. Paul was sitting in a four bedded bay looking a little lost. I approached him and asked why he was here. It transpired that he had had a small heart attack three days before Audrey died. The team in Stranraer had kept him there until she passed away but then, on that day, he had been transferred for Cardiology review. He was now sitting in a bed that was directly opposite the room his wife had occupied just a few weeks before.
This man was in torment. He said to me “Ken, I’ve been told I need an angiogram. I just need to get it over and done with. I need to sort out Audrey’s funeral and a number of things.”
I approached the team looking after him. He had been seen by two junior doctors. I asked what the plan was and told that he would have a treadmill test and echocardiogram and then see the Consultant on Thursdays round. I asked if they were aware of his current circumstances and was astonished to find that they were not aware that his wife had died the day before. There had been no mention at the morning huddle and the consultation had left no opening for Paul to bring this up.
In the end I spoke to the Cardiology Consultant and he had an angiogram the next day and got home. Paul was able to arrange the funeral, organise the family and say goodbye to his wife.
So why am I telling this story? It’s not to offer any criticism of the teams involved but to raise the concept of empathy. When times are tough and we are all busy it’s often the first thing to go. Not because we can’t empathise but because we are so busy we never get the chance to ask simple questions like “What matters to you?”
The Francis Report into the failings at Mid-Staffordshire is a lengthy tome with several hundred recommendations but it has been said that, at its heart, there was a failure of empathy.
I recently saw a short video on you tube that was made by the Cleveland Clinic in America that highlights this subject beautifully. It’s just over 4 minutes and you can watch it here. I am aware it is a little ‘American’ but I firmly believe anybody working in healthcare today should be able to identify with the message.
On September 6th we shall be running our second Enhanced Patient Experience event. Throughout the day we will discuss patient stories like the one above, exploring values and asking ourselves what we need to do to enhance the patient experience. The pilot in November last year worked well and I would encourage you to consider coming along to the second outing. For more information about how the day runs you can click here to see a poster with a little more detail. If you are interested then please discuss with your line manager about putting a team together, the more ‘multi-disciplinary’ the better. You can also discuss with Peter Bryden, Risk, Feedback and Improvement Facilitator Tel: 01387 241739 (ext 33739)
Let’s try and take some steps in our patients’ shoes, see life from their side, ask the question “What matters to you?” After all this is not a new concept…
“It is more important to know what sort of person has a disease than to know what sort of disease a person has.”
(The names of the patients have been changed)
Ken Donaldson is a Consultant Physician at Dumfries and Galloway Royal Infirmary
Next weeks blog will be by Sam Johnston (@YeWeeStoater) from the Patients Support and Advice Service