Monday, 14 September 2020

CAREGIVING: THE DIFFERENCE WE MAKE IN HOSPITALS

 FROM THE PEN OF A CRITICAL CARE DOCTOR: THE DIFFERENCE THAT CAREGIVERS (ESSENTIAL PARTNERS IN CARE) MAKE IN THE HOSPITAL.

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“It was a tenet of my critical care training. Family members were an integral part of the care that we delivered. They keep us accountable and remind us that our patients had rich lives outside the hospital. But more than that, it was often the relative who would clock a subtle change, alert us to a medication allergy, bring in the blanket from home or the food that would spark our patient to start eating again. The attending physicians who trained me taught me to recognize the way my agitated patients calmed when a loved one entered the room, the way a hand on a shoulder could cause a rapid heart rate to slow, or how a delirious patient would smile when they heard a relative calling their name. All of that has changed. It has been nearly six months since visitor bans went into effect in hospitals throughout the country. Just last month, a new fleet of interns joined us. They are learning how to be good doctors in a world of masks and distance and isolation. They do not know what it is like for the hospital to feel alive with family members in our hallways, cafeterias and waiting rooms. I want to teach them how much it matters, but as the months go by, I am already feeling a shift in myself. Our language has grown more casual. We talk about how a patient ‘acted up’ or ‘gave us trouble,’ phrases I would never use if that patient’s husband or wife were standing in front of me. The cost of this policy has gone far beyond those with the virus. It is that moment overnight when I did not think to call the family. It is in the many quiet hours my patients spend alone, the extubations that happen now without a loved one at the bedside, our patients waking from the nightmare of intubation to find themselves surrounded by the masked faces of strangers. It was nearly 4 a.m. by the time we called the family on that recent overnight, but they came quickly, hair still mussed from sleep, surgical masks in place. Security verbally screened them for COVID-19 and let them up even though it was outside visiting hours, because we were worried that our patient would not make it through the night. The nurse set up two folding chairs for them next to the patient’s bed. They held his hand and talked to him in ways that we never could. And slowly, as the carbon dioxide cleared from his blood, my patient started to open his eyes. And when he did, he was not alone.”
— Daniela J. Lamas, writing in The New York Times, is a critical
care doctor at Brigham and Women’s Hospital in Boston.

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