We\'ve all observed patients who were far beyond the reach of medical treatment suddenly defy the odds and recover. We\'ve also observed patients who had been well on the road to recovery, take a turn for the worse for seemingly no reason at all. No matter what the technology or how terrific we are at our jobs, oftentimes medicine just isn\'t enough.
Case in point, a few years ago, my Grandma, in her mid-sixties at the time, had a moderate CVA. No matter what her doctors did for her, she wasn\'t regaining consciousness, defying explanation. My mom and I were living and working in Los Angeles and Grandma was two thousand miles away in Chicago. When the physician called to tell us about the stroke, he not only said that Grandma may possibly not live through the night, but that she could possibly not last the few hours it would take us to fly to her side. Mom and I both felt pretty strongly that we had to talk to her for what might be the last time, prior to we got on the plane. Hearing our voices and knowing that a person was with her, had normally created a tremendous distinction in any difficulty she faced. So Mom got the head nurse on the phone and asked if she could get a phone to Grandma. Asking quickly turned to pleading - we necessary to tell Grandma to hold on and that we were coming. The nurse essentially dismissed the notion - what achievable beneficial could THAT do? It took a though, but Mom finally convinced the nurse to put a phone up to Grandma\'s ear. We were able to tell her how much we loved her, that she was going to be fine and that we had been on our way. By the time the nurse came back on the phone, she was speechless. Evidently the moment Grandma heard our voices her eyelids began to flutter. Her vitals stabilized, her eyes opened for the 1st time since she\'d been in the hospital and she looked straight up at the nurse and then around the room searching for us. Two weeks later, she was out of the hospital and on her way to rehab.
That\'s the miracle of communication.
Regardless of whether it is a family member, a friend or just a familiar face, patients need to have to have the many people they really like surrounding them, when they\'re ill, in pain, or afraid. As caregivers, it's component of the job to realize that patients may possibly be too ill or physically unable to initiate the contact they so desperately need, on their own.
I wish that were the end of the story. A couple of years later, Grandma who had recovered fully, badly injured her leg and her jaw soon after falling in the bathroom at home. She was unable to speak but was in stable condition, when admitted to a numerous hospital. She was supposed to have gone on vacation so we hadn\'t expected to hear from her and had no notion she was in the hospital. A few days later she began spiraling into critical condition. By the time the hospital referred to as us, she was in the ICU, unconscious and critical. Though I was on 1 phone attempting to get a flight, my mom was on the other phone with the physician who happened to be standing right outside Grandma\'s room. She begged him and then the nursing staff, to get a phone into her, so she could talk to her, for what looked like it would be the last time.
But at this hospital, the doctor and the nurses refused. While the physician was on the phone with mom, Grandma, who had been unconscious just a few minutes before, unexpectedly opened her eyes and began to look around. The doctor told Mom what happened and took this as a sign that she her condition was turning around. Even so, Mom still pleaded with him to get a phone to Grandma. He told her there was no way to get a phone to an ICU patient. \"We\'ll try and figure some thing out in the morning,\" he said, hanging up the phone. But Grandma didn\'t have until morning. She died just a few hours later, just before we could get to her and we lost our opportunity to tell her we loved her - our chance to say goodbye.
Searching back on that time reminds me of that scripture, \"without having a vision, the men and women perish\". Some many people, even even though facing severe illness or death are so self-motivated that just the possibility of dying makes them muster each and every ounce of strength they have, to fight it. But most people today aren\'t that way. Most consumers will need to use the strength of others - the folks they appreciate - to give the strength they can not discover.
Patients want connection. They need vision - the vision to \"see\" themselves obtaining through the darkness and fear that they\'re facing. They need support \"seeing\" the next day or the next week. Seeing themselves powerful and well once more. And without that strength and that support they so desperately require from the consumers they love, there is no vision. And without having that vision, they perish.
Simply put, at that moment, Grandma required us. She required to hear our voices that night and the especially persons who were there to be her advocates and to assist her make that connection happen, didn\'t do it. And that night, Grandma perished, with out knowing that we had been proper there at the other end of that phone and on our way to be with her.
The good news is, the same thing that happened to us, doesn\'t have to take place at your facility. With just a couple of easy steps created to support communication-impaired patients, you can not only make a enormous difference in their lives, you could even save them.
With just a couple of easy actions created to support communication-impaired patients, you can make a substantial difference in their lives.
Assessing Your Patient\'s Capacity To Communicate
The next time you\'re caring for a patient with compromised communication capacity, take a moment to see your patient\'s surroundings from her perspective. If your patient\'s family and pals are not at the hospital with her or can\'t come frequently, are there tools you can give your patient that will facilitate communication with the outside world?
Mobility Limitations
o If your patient can speak, is the telephone close enough to her for her to use?
o Does she require support dialing? Is she able to see well sufficient to read a number off a piece of paper or out of her address book?
o If your patient is unable to hold a telephone, would she benefit from a speakerphone or a cell phone?
Hearing/Speech Limitations
If your patient can\'t speak, ask her to indicate if she would like to have an individual called for her, and task a patient representative or volunteer to hold the phone up to her ear and facilitate their communication.
If your patient is deaf, make positive that your facility has TTY telephones to connect with family members. If your patient is blind, make sure that she has Braille writers or other devices to support her communicate.
o Take a moment to call the department in your facility that deals with hearing or vision-impaired patients. They may have extra tools or ideas that can bridge difficulties and improve communication.
o One more idea for patients who can\'t speak, is patient Online access. If your hospital has it offered, it can be a real lifesaver, permitting a patient to sort an email, a text message or to supervise though a message is typed for them. If your facility doesn\'t have Web access for patients, either you or yet another team member can use a smart phone or cell phone to send an email or text a message for them, facilitating emergency communication with a loved 1.
o For patients who have a temporary physically impairment, like a broken jaw, encourage them to use patient Net access or their cell or smart phones (if allowed) to e-mail, text and maintain in touch with family or kids who could possibly not be able to visit in person.
If you work with seriously ill pediatric or adult patients who require to communicate updates about their patient to a entire team of family and friends, there is a terrific service referred to as Care Pages. It was created by a family with a seriously ill child and no time to continually email everybody who wanted to know how the child was performing.
Critical Care/End of Life
Considering that numerous hospitals still don\'t have a means of patient communication in the ICU, you might possibly have to get a bit even more creative for patients in critical care units.
There are now low emission wireless phones, like those manufactured by Spectralink, which can be used safely in crucial care units. Wireless internet pads also work well, or if those aren\'t available, you can always order an extension phone, like those used in regular patient rooms and maintain it at the nurses\' station. When it is required, it can be plugged into a phone jack in a patient\'s room.
And don't forget that technology is producing tremendous strides in facilitating patient communication. As unusual as it sounds, surgeons are now employing Twitter to maintain families apprised of patient\'s progress during surgery, though families who are apart during emergencies, are utilizing Facebook and MySpace to keep every other up to date. You can use that very same technologies to assist a critically ill or dying patient communicate with family members who could not make it to the hospital in time to be with them.
How? With your smart phone!
Most smart phones have the capability to record video, audio and take photos, all of which can be sent or received via email proper from the phone. Let\'s say you have a patient who could possibly not make it by means of the night. His family is about to board a plane, but won\'t arrive for 3 or four hours. Even if you aren\'t allowed to turn your individual cell phone on to obtain calls in the ICU, the family can record a video or audio message on their own phone and email it to you, so you can play it for the patient - something you can do without the phone truly being on. Or they can e-mail you a photo of themselves to show to the patient or an email that your patient can read for himself.
You can do the exact same factor at your end. Let\'s say that your patient is alert and oriented now, but you both realize that he could not live. By employing your smart or cell phone with video or audio recording capability, he can record a final message to a loved 1, that can later be emailed to the family. I don\'t feel I have to tell anybody, how significantly that bit of video can mean to a family.
Or let\'s say that your patient is a John Doe or that she was a part of a mass casualty and even although you're fairly positive you have the ideal name with the proper person, the family member is still in transit. You can snap a fast photo and e-mail it to the family, hastening the identification.
Communication isn\'t just a patient\'s appropriate - for countless it can be their only link to the outside world, or a life-renewing source of strength and adore. Combine that with outstanding medical care and watch the miracles flow.
