Navigating today’s healthcare system requires one to be a self advocate—to speak up. Despite efforts of advocacy groups and other programs to empower patients, challenging a doctor or nurse about whether they are correctly doing their jobs is intimidating. I say this from experience—personally and professionally.
A year ago I expressed concern to my physician about a finding during a routine medical exam. She was not concerned. This year the finding persisted. I had to insist upon being treated, and essentially manage my medication regimen. If I were not medically savvy I would not have been treated at all, and my health placed at risk. After this personal experience I began to wonder about people unable to advocate for themselves.
How do people unfamiliar with medicine receive appropriate care?
Have you witnessed a physician begin to examine a patient without sanitizing their hands? I have. It is a conundrum. You don’t want to anger or embarrass the physician, but you don’t want to compromise your patient either. Years ago, I challenged a surgeon who failed to wash his hands before examining a patient. He responded, “My hands are sterile.” I ask, how does one respond to that? He was a great surgeon—but that was a dumb answer!
Many hospitals make use of the “speak up” campaign launched in 2002 by the Joint Commission. The program provides free brochures and posters to hospitals urging patients to take a role in preventing medical errors, infections and wrong patient procedures. In an effort to promote self advocacy for patients nurses now wear buttons that say, “Have you seen me wash my hands?” However, the most outspoken and assertive among us suddenly turn timid when we are hospitalized.
Traditionally patients are portrayed as passive individuals requiring healthcare workers to control their actions and responses, and as “good” patients we try to comply with expectations. Physicians and we as nurses don’t expect patients to challenge our practice.
How do you respond when a patient challenges your actions? Are you defensive, or seek retaliation? Are you sarcastic or gracious in your response?
Patient’s and families fear treatment may be sub-optimal if they antagonize the staff, so it’s all too common for patients to remain silent when they suspect something is wrong or improper in their care. The Joint Commission encourages hospitals to educate bedside clinicians about the importance of being receptive to patients who may fear speaking up. A pleasant, “Thank-you for reminding me to wash my hands,” or “Check your name band” is all that it would take to reassure a patient and help develop a collaborative relationship between patient and nurse.
Remember patients and families are very vulnerable when they seek medical care, so challenging a medical professional is very difficult. We should respect them for having the courage to speak up.