This Week on #MedTwitter: Compassion. How Small Gestures Put “Care” Back Into “Healthcare”

This week, we’re looking at the humanity of healthcare. As per Maya Angelou, patients may not remember exactly what you say, but they’ll remember the way you make them feel.

The small gesture that made a patient feel special

Amber Soucy, a registered nurse from Boston, recently had a patient with a history of stroke and residual weakness. He had difficulty walking and required a leg brace, assistive devices, and multiple healthcare professionals to move him out of bed.

Noticing he looked uncomfortable and knowing her coworkers had busy and demanding patient assignments, she focused on what she could accomplish by herself to increase his comfort. She noted that his hair was thick with oil and riddled with dandruff, she promised to shampoo it by the end of her shift.

“You should have seen him light up; his smile took over his entire face,” Soucy told Figure 1 in an email. “The minute I started washing and massaging his scalp, I could feel my patient’s tension melting away. I lathered, rinsed and repeated for about three successions of washing. I combed out as much dandruff as I possibly could, and then fluffed and buffed and styled.”

“I felt amazing [afterwards] because my patient said he felt amazing; his level of happiness directly correlated with mine. The little things truly make the biggest difference.”

Replying to Soucy’s tweet, Joshua Hardy, a Kansas-based nurse, chimed in saying, “I feel this so much!! As nurses, we sometimes get caught up in the technical skills of nursing. We forget that nursing is to take care of someone as a whole. We need reminding of that sometimes.”

Healthcare professionals need care, too

As a general medicine advanced trainee admitted for a minor procedure, Dr. Ashleigh Witt didn’t get the usual after-care package. Apparently, her surgeon assumed that as a physician, she could get the post-operation dressings herself. Dr. Neela Janakiramanan, a Melbourne-based reconstructive plastic and hand surgeon, said this implies Dr. Witt is expected to “just head into work on your sick leave and steal the dressings.” In Dr. Witt’s words to her colleagues: “Please don’t do this.”

Good clinical care alone is not enough. Patients need to feel “seen”

As long as a patient receives perfect clinical care, that’s good enough. That’s what Dr. Rana Awdish—a Detroit-based critical care physician and bestselling author of In Shock, a memoir about her critical illness—previously believed.

This all changed when she became a patient. In a conversation with Melbourne intensivist Dr. Andrew Davies on his podcast, Mastering Intensive Care, Dr. Awdish said that what she had been trained to believe — staying emotionally distant from patients and not empathizing with a patient’s feelings to avoid feeling depleted— was upended when she experienced healthcare from the other side.

“As a patient, I truly had these moments where I felt ‘unseen’ and believed if I wasn’t being seen by my care team that they wouldn’t do what it would take to help me survive,” said Dr. Awdish.

In one instance, she was sent to the obstetrical triage to check the health of her baby. The resident had trouble reading the ultrasound, but Dr. Awdish realized there was no heartbeat. When she told the resident this, he asked, “Can you show me where you see that?” She felt he was more focused on treating their appointment as a learning opportunity than actually treating her. He failed to notice that Dr. Awdish had just lost a pregnancy and was suffering herself from hemorrhagic shock. In her words, “I truly felt that he had to see me for me to survive.”

The case doctors are talking about this week

This incidental finding was found in a 36-year-old male who presented to the emergency department with epigastric pain. After a clinical evaluation and initial management, an ultrasound was performed. No abnormality was noted with the exception of this cystic lesion revealed by color Doppler. See the answer here.

Published April 2019

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