Communication in the hospital

I have been away from the blog for a longer period than normal for a very difficult reason. My dad was in a serious motorcycle accident on August 3. He will recover but faces a very long recovery and rehabilitation.

I flew out to Portland the day I found out about the accident. I spent a little over a week with my mom at my Dad's bedside and witnessed physician communication, not in theory, but in practice. Two thoughts have stayed in my mind.

1. Be accessible. Perhaps I am naive, or perhaps it is because I work with primary care providers, but I was shocked, and at times annoyed, at how long we would go without even seeing a doctor. Now, I know the doctors are getting reports from nurses and residents and are aware of what is going on. I am also aware that if there was an immediate problem, the doctor would be right there. But I also know what a difficult situation my mother and I were in, and how many questions we had, and it was upsetting, at best, that we often had to chase down a physician to talk to someone about my dad's condition.

2. Be aware of timing when delivering difficult news. There has been some research on how physicians should break bad news, but I am talking more about timing and delivery. When we finally managed to get some face time with one particular doctor, a day after my dad had been transferred to a new facility, the doctor launched into a litany of possible problems and then dropped the bomb, "Oh yeah and he might be paralyzed. But we don't know yet." Paralysis is a very difficult thing for a love one to think about, especially a week after the accident when no one else has mentioned this possibility before. To just drop that into conversation, and try to say, "oh, but we don't know yet," is insensitive. But beyond that, it is ineffective communication because I can tell you my mom didn't hear much of the rest of what the doctor said after that. And I'm not saying he was wrong to say it. If that is a possibility, it should be discussed. But it could have been handled and communicated better.

Hospitals are there own world. Communication in this world is a particular challenge, given the anxieties, emotions and uncertainties. And as I have now seen firsthand, there is still room for improvement.