Latest / Banter At The Bedside / You’re Not Difficult, You’re Advocating | How Patients Can Speak Up in Healthcare, Views from the Healthcare Team

Transcript

You’re Not Difficult, You’re Advocating | How Patients Can Speak Up in Healthcare, Views from the Healthcare Team · Banter At The Bedside

• 0:06
  SPEAKER_00: Hey everyone, and welcome back to Banter at the Bedside.
• 0:09
  SPEAKER_00: We have a bit of a different episode for you today.
• 0:13
  SPEAKER_00: I'm just here with Kaylee, our other main co-hosts.
• 0:17
  SPEAKER_00: Hey guys.
• 0:18
  SPEAKER_00: And we're going to take a little bit of a sidestep, I guess, from our normal kind of format, as it's just Kaylee and I.
• 0:26
  SPEAKER_00: We had a request from a listener or an idea submitted from a listener to talk about how can patients or those who aren't familiar with the healthcare system haven't navigated it too much, how can they take some of the things that we talk about and use it to help them navigate the system or advocate for themselves better.
• 0:48
  SPEAKER_00: So we thought we'd do just some short mini-series episodes on how do you advocate.
• 0:54
  SPEAKER_00: And we're going to be breaking these down into different steps.
• 0:57
  SPEAKER_00: So today we're just going to be talking about kind of basics of how you advocate.
• 1:02
  SPEAKER_00: And this is also good for our healthcare professionals because it might show why what your patients are going through and how we, as healthcare professionals, healthcare workers can navigate and help our patients advocate for themselves.
• 1:17
  SPEAKER_00: Because we might not always be there.
• 1:19
  SPEAKER_00: We know all our listeners are great advocates for our patients, but not all of them are.
• 1:24
  SPEAKER_00: And so we have to help them help themselves sometimes.
• 1:29
  SPEAKER_00: As always, this is for entertainment purposes only.
• 1:33
  SPEAKER_00: Everything we say here is our own opinions.
• 1:35
  SPEAKER_00: We don't represent any entity, and you should always seek the medical advice of your healthcare professional.
• 1:42
  SPEAKER_00: So how are you doing, Kaylee?
• 1:43
  SPEAKER_00: Doing good.
• 1:44
  SPEAKER_00: What about you?
• 1:45
  SPEAKER_00: I'm doing good.
• 1:46
  SPEAKER_00: Um, coming off a busy weekend, but I'm excited to kind of be here to talk about this.
• 1:52
  SPEAKER_00: And I think it's kind of cool because it's our first kind of topic submitted by a listener.
• 1:58
  SPEAKER_01: I know that that was really exciting.
• 2:00
  SPEAKER_01: I'm like, they listened and they want us to do something for them.
• 2:05
  SPEAKER_00: Oh my gosh.
• 2:06
  SPEAKER_01: I love it.
• 2:07
  SPEAKER_00: I I really liked it, and I think it's a a good idea and probably not one we would have thought to tackle.
• 2:14
  SPEAKER_00: So, our listener out there, thank you for submitting this.
• 2:17
  SPEAKER_00: And our other listeners, I hope this proves to you that we when we say we want to hear from you, we really do want to hear from you, and we're going to take what you say and probably bring it on here at some point.
• 2:29
  SPEAKER_00: Maybe not as quite as quick as this one, but we will probably bring it on at some point.
• 2:34
  SPEAKER_00: So patients advocating for themselves, I feel like that's hard for them.
• 2:41
  SPEAKER_00: Um I know we've both been patients ourselves.
• 2:46
  SPEAKER_00: And even as a medical professional, sometimes I get the fear of like, I don't want to say anything because I know how frustrating it can be, or I feel like I'm frustrating them.
• 3:00
  SPEAKER_00: Even though when patients ask me questions or advocate for themselves in calm ways, it doesn't frustrate or annoy me at all.
• 3:09
  SPEAKER_00: What's kind of your experience?
• 3:11
  SPEAKER_01: Yeah, it's the same thing.
• 3:12
  SPEAKER_01: I feel like a lot of us experience this.
• 3:14
  SPEAKER_01: Um, whether it's at the doctor's office or just in our life, where I can't do that.
• 3:21
  SPEAKER_01: That would be a problem.
• 3:22
  SPEAKER_01: But if you did it, it's completely fine and acceptable.
• 3:24
  SPEAKER_01: Yeah.
• 3:25
  SPEAKER_01: Um, and I think it's even worse for me because I'm like, oh God, they're so busy.
• 3:30
  SPEAKER_01: I'll I'll no, it's fine.
• 3:32
  SPEAKER_01: I'll just, I'll just figure this out on my own.
• 3:34
  SPEAKER_01: But you know, that's not that's not good.
• 3:38
  SPEAKER_01: If you're going somewhere and you have a problem and you're talking to the person that you trust that's supposed to be helping you, you should and you deserve to ask all your questions and have them answered.
• 3:50
  SPEAKER_01: And it doesn't matter how busy they are.
• 3:53
  SPEAKER_01: That's not your fault that they are booked up.
• 3:55
  SPEAKER_01: It's not and it's not their fault either.
• 3:57
  SPEAKER_01: Um, and that's your time, and you know, you need to take that time while you have them face to face.
• 4:03
  SPEAKER_00: So yeah, absolutely.
• 4:05
  SPEAKER_00: It is that like you can do it, I won't do it, but you can do it.
• 4:09
  SPEAKER_01: Yeah.
• 4:10
  SPEAKER_01: It's like it's like when I get a gift, I'm like, I I don't deserve this.
• 4:14
  SPEAKER_01: Why would you give me a present?
• 4:15
  SPEAKER_01: But if I give a gift, I'm like, no, it's just because I I love you.
• 4:18
  SPEAKER_01: Like this is not a big deal.
• 4:19
  SPEAKER_01: It's the same with my love.
• 4:21
  SPEAKER_01: Yeah.
• 4:23
  SPEAKER_00: Yeah.
• 4:23
  SPEAKER_00: And I think there's a lot of like myths, like, and I think you touched on them, like they're too busy, it's annoying.
• 4:31
  SPEAKER_00: I think there's also like the fear of being labeled as difficult.
• 4:35
  SPEAKER_00: I was speaking to a family member and they had filed uh what I thought was a valid complaint about people coming into the room and not introducing themselves.
• 4:45
  SPEAKER_00: So they had no idea who was touching them, what they were doing, um, what their role was, should they even be doing it.
• 4:51
  SPEAKER_00: You know, it sounded like there weren't even safety checks, the normal ones, like what's your name, what's your date of birth?
• 4:56
  SPEAKER_00: And I was like, Yeah, they, yeah, that's no good.
• 5:01
  SPEAKER_00: And then they were concerned that it was like put in the chart.
• 5:06
  SPEAKER_00: Because then the next time they went, they're like, everyone's introducing themselves to me.
• 5:12
  SPEAKER_00: And like, she's like, I feel like they're making a point of it, they're introducing themselves.
• 5:18
  SPEAKER_00: They must have put something in the chart that I put this complaint.
• 5:21
  SPEAKER_00: I was like, no.
• 5:22
  SPEAKER_01: No, we don't put things in the medical record like that.
• 5:27
  SPEAKER_00: Um, just ignore that.
• 5:30
  SPEAKER_00: Yeah.
• 5:30
  SPEAKER_00: And I think that's a big myth that I wanted to debunk that we don't label you in charts as difficult.
• 5:38
  SPEAKER_00: The only thing that gets put in a chart is medical non-compliance.
• 5:44
  SPEAKER_00: And that usually takes a long history before a provider will put that in.
• 5:51
  SPEAKER_00: Because taking medicines is or following medical interventions, it's a change in habits.
• 5:58
  SPEAKER_00: It's time consuming.
• 5:59
  SPEAKER_00: Sometimes there's money barriers, sometimes there's getting it barriers.
• 6:04
  SPEAKER_00: If you forget or you couldn't afford your meds, that's not medical noncompliance.
• 6:09
  SPEAKER_00: That's we have a financial barrier we have to address.
• 6:13
  SPEAKER_00: Yes.
• 6:13
  SPEAKER_00: We have a memory barrier that we have to address.
• 6:17
  SPEAKER_00: So the only thing that patients will get labeled is the medical noncompliance, but that will take a while.
• 6:23
  SPEAKER_00: It only comes really into play when we're talking about needing advanced life-sustaining therapies for long term that you would take a lot of medical management at home.
• 6:37
  SPEAKER_01: Yeah, I mean, I would document if somebody refused something, but it's not it's not because it's not uh this person's difficult and they refuse.
• 6:44
  SPEAKER_01: That's just I have to document that to cover myself.
• 6:46
  SPEAKER_01: And it's a black and light.
• 6:53
  SPEAKER_01: Really, for the most part.
• 6:54
  SPEAKER_01: But no, we we don't put stuff like that.
• 6:57
  SPEAKER_01: I mean, charts are not notes for us to complain.
• 7:02
  SPEAKER_01: Like it is a medical record.
• 7:04
  SPEAKER_01: We have to document enough.
• 7:05
  SPEAKER_01: We're not going in there and taking the time to put extra stuff in there.
• 7:08
  SPEAKER_00: I'm not.
• 7:09
  SPEAKER_00: No, I don't know anyone like that.
• 7:11
  SPEAKER_00: If you have a concern or if there was a complaint, and it sounds like that was passed along and people were complying, but then she felt bad because she was like, Oh, now they're really doing it, so they must be yeah, and she was convinced that there was like something in her chart, like, make sure you s introduce yourself.
• 7:32
  SPEAKER_00: And I was like, No, no one's doing that.
• 7:34
  SPEAKER_00: I was like, that's just there, you're experiencing what should be done.
• 7:38
  SPEAKER_00: People should come in, introduce themselves, introduce their role, yeah, and check who you are, because that's a safety checkline.
• 7:49
  SPEAKER_01: If you're going to anybody's work, like hey, I'm so I'm gonna be helping you today.
• 7:54
  SPEAKER_01: That's just part of being like a normal adult.
• 7:57
  SPEAKER_01: I don't know who's not doing that.
• 7:59
  SPEAKER_01: I'm sure it's probably just slipped their mind it wasn't on purpose.
• 8:02
  SPEAKER_01: But we should introduce ourselves and we should put ourselves on the whiteboard.
• 8:06
  SPEAKER_01: I know everybody jokes on the whiteboard, but if you're a patient or a family member and you're seeing 25 plus people coming into the room and you don't know who they are, definitely ask.
• 8:17
  SPEAKER_01: And you know, it's it's not unheard of.
• 8:20
  SPEAKER_01: Just be like, would you write your name on this board and like who you were with?
• 8:22
  SPEAKER_01: Or you can come back and ask the nurse and I'll be happy to tell you.
• 8:26
  SPEAKER_01: Um, because sometimes people slip in and I don't know and I can find out.
• 8:29
  SPEAKER_01: But I have every intention of updating the board in the morning and writing all of the things, but then, oh, there's not a marker in here.
• 8:38
  SPEAKER_01: I gotta go get one.
• 8:39
  SPEAKER_01: I got caught up in my other room.
• 8:41
  SPEAKER_01: Next thing you know, it's noon, and I haven't done it.
• 8:44
  SPEAKER_01: So if that's you as a patient or a family member, it's okay to just say, hey, what do you mind just like when you get a chance?
• 8:51
  SPEAKER_01: Will you write it up here?
• 8:52
  SPEAKER_01: Because uh, I just um I want to keep up with who's who and blah, blah, blah.
• 8:56
  SPEAKER_01: And that's completely fine.
• 8:58
  SPEAKER_01: Yeah.
• 8:58
  SPEAKER_01: I feel bad.
• 9:00
  SPEAKER_00: For me, the solution has always been easy to this problem.
• 9:03
  SPEAKER_00: Oh, we have the mini permanent markers for our badges.
• 9:06
  SPEAKER_00: Why has no one made the mini dry erase markers for us for our badges?
• 9:12
  SPEAKER_01: Hmm.
• 9:14
  SPEAKER_01: It's a good idea.
• 9:16
  SPEAKER_01: Well, some people just write it in permanent marker.
• 9:17
  SPEAKER_01: I'm like, okay, cool.
• 9:18
  SPEAKER_00: Like we don't do.
• 9:20
  SPEAKER_00: We can't do it.
• 9:24
  SPEAKER_00: Forever, this is the room you are working in.
• 9:28
  unknown: Yeah.
• 9:29
  SPEAKER_01: And I've told people too on the same thing, like, if I'm not in here and you think of something, this was maybe a little bit before people would have like um their phones on everything, but you can write a question on that board or you know, write your information if you want to.
• 9:45
  SPEAKER_01: Um that way when I come back in, like you can say, oh, I thought of this like and I didn't want to forget.
• 9:52
  SPEAKER_01: It's good for them to use too if they want.
• 9:54
  SPEAKER_00: Yeah.
• 9:55
  SPEAKER_00: It's for full communication.
• 9:57
  SPEAKER_00: I love when families this is a pro tip.
• 10:00
  SPEAKER_00: I love when families write their phone number on the dry erase board, because if something happens, it's right there.
• 10:07
  SPEAKER_00: I do not have to try and open up the chart and because that can take sometimes like a solid five minutes, depending on how good that computer is.
• 10:17
  SPEAKER_00: Yeah.
• 10:18
  SPEAKER_01: I like it when they write it up there too.
• 10:20
  SPEAKER_01: Write it up there.
• 10:21
  SPEAKER_01: That's completely fine if you don't want to put all your stuff up there.
• 10:24
  SPEAKER_01: Also, not a problem.
• 10:25
  SPEAKER_01: We will have it somewhere.
• 10:26
  SPEAKER_01: Yeah.
• 10:27
  SPEAKER_00: I also feel like there's maybe not for us in our region that we work in, but there is also a level of, well, they must know what they're doing.
• 10:38
  SPEAKER_00: So I'm just not going to say anything.
• 10:41
  SPEAKER_00: So, like if they have a a question or a concern.
• 10:44
  SPEAKER_00: A question or concern, or even like, oh, like they mentioned this antibiotic, but I'm allergic to it, but they must know what they're like, they're a doctor or they're a medical professional, so I'm not going to say anything.
• 11:00
  SPEAKER_00: And I've run into that, and then I'm like, no, I'm a human.
• 11:04
  SPEAKER_00: Yeah, I'm a human.
• 11:06
  SPEAKER_00: Why didn't you say something?
• 11:08
  SPEAKER_01: There's lots of checks that that would go through, but if yes, if that's the stance that everybody has taken and it's never made it in your chart.
• 11:18
  SPEAKER_01: Yeah.
• 11:19
  SPEAKER_01: Stuff like that, that's your that's your body.
• 11:22
  SPEAKER_01: Like, that's your health.
• 11:23
  SPEAKER_01: Like, absolutely feel free to verify what are you giving me and what's that for?
• 11:29
  SPEAKER_01: And if it is something like that, where you have um an actual allergy, or some people have quote unquote allergies where they've had side effects.
• 11:39
  SPEAKER_01: Um sometimes we do have to give you something that maybe you have a side effect that you don't like or an intolerance to because it's like our only option, and that's just our job to educate you on why.
• 11:55
  SPEAKER_01: Um yeah, don't you I love that you trust the people taking care of you if if you are one of those people, but don't be afraid to ask the question if something doesn't seem right.
• 12:08
  SPEAKER_01: Right.
• 12:09
  SPEAKER_00: Cause we have a lot of checks and balances, so stuff like that typically gets caught.
• 12:16
  SPEAKER_00: But some what if it didn't make it in the chart?
• 12:19
  SPEAKER_00: You know, there's still technology issues, things don't get saved properly.
• 12:24
  SPEAKER_00: There's times the system accidentally creates a second chart for you, and your original chart is over here.
• 12:32
  SPEAKER_00: So it's always okay to say it.
• 12:35
  SPEAKER_00: I think one of the big things to talk about in saying it is it's the way you say it that's important.
• 12:44
  SPEAKER_00: And one of the big things is we have a lot of aggression towards healthcare workers.
• 12:52
  SPEAKER_00: We experience a lot of violence, and a lot of us have been in very dangerous situations, whether it's because of a medical issue, a mental health issue, or people getting upset.
• 13:07
  SPEAKER_00: There's a whole spectrum of reasons, but it is the way that you say it too, that's going to change the response.
• 13:14
  SPEAKER_00: You can advocate from yours for yourself, be stern, set a boundary without being aggressive towards the staff.
• 13:24
  SPEAKER_01: And I think it's important to note that the patient or the family is bringing their past experiences and their trauma, and the staff is bringing their past experiences and their trauma.
• 13:36
  SPEAKER_01: So it's in the way that you say things and it's in the way that we say things that make communication better or worse.
• 13:42
  SPEAKER_01: And obviously, everybody can have a bad day or something can come off in a way, but I truly think what you're saying, like you could ask um a question or make a statement in a very aggressive, demeaning way, or you could say it in a polite, hey, I'm just confused sort of way, and you would get a much different response.
• 14:02
  SPEAKER_01: And, you know, I think that's very, very important.
• 14:06
  SPEAKER_01: Because if I'm just showing up to work and I'm just walking in the door and you're hitting me with this attitude first thing in the morning, I mean, I'm not gonna be as receptive.
• 14:16
  SPEAKER_01: And I I'm just a human being, and like you said, I'm just gonna sit here and be like, this is how it's gonna feel and you can be completely justified, but I'm not gonna yes.
• 14:28
  SPEAKER_01: I mean, I'm sorry, I'm not gonna make me feel a type of way when I just got there and I haven't even had a chance to talk to you.
• 14:36
  SPEAKER_00: Yeah.
• 14:37
  SPEAKER_00: And I think we've we touched on it in our kind of grief palliative episode, how grief can bring out anger, and we can understand that to an extent, but we also have to feel safe and remember that we're humans.
• 14:54
  SPEAKER_00: And we are the vast majority of us, there's always going to be an exception, but the vast majority of us are here because we want to help people, we want to take care of people.
• 15:05
  SPEAKER_00: So just remember that.
• 15:06
  SPEAKER_00: I don't choose to work night shift for 17 years because I love making up at 3 a.m.
• 15:14
  SPEAKER_00: I choose to work, I choose to work it because I love taking care of patients, and that's the schedule that's required for the patient population that I want to take care of.
• 15:24
  SPEAKER_00: Just as a patient, as a family, remember that we are all here.
• 15:28
  SPEAKER_00: If you had one bad experience with one healthcare person, it's not all of us.
• 15:34
  SPEAKER_00: Yes.
• 15:35
  SPEAKER_00: And people just don't vibe sometimes.
• 15:37
  SPEAKER_00: Sometimes that is not your person.
• 15:39
  SPEAKER_00: Yeah.
• 15:40
  SPEAKER_01: And that's okay.
• 15:41
  SPEAKER_01: You know, we may not vibe, but hopefully you still can see that they're taking good care of the patient.
• 15:46
  SPEAKER_01: Right.
• 15:47
  SPEAKER_01: Um, like and that's okay.
• 15:49
  unknown: Yeah.
• 15:50
  SPEAKER_00: I love a cranky old man.
• 15:52
  SPEAKER_00: Me too.
• 15:54
  SPEAKER_01: I do.
• 15:55
  SPEAKER_01: I do.
• 15:56
  SPEAKER_01: I'm like, let's put it right right off the bat, cantankerous.
• 16:00
  SPEAKER_01: Like cotchety.
• 16:02
  SPEAKER_01: Give it to me.
• 16:05
  SPEAKER_01: I ain't gotta worry about my face or my attitude.
• 16:09
  SPEAKER_00: As long as you as long as you let me be a little sassy at the end of the day that male man's going to be proposing to me, I promise you.
• 16:17
  SPEAKER_01: They always love it.
• 16:19
  SPEAKER_01: Oh, yeah, you thought you were getting some 22.
• 16:22
  SPEAKER_01: No.
• 16:25
  SPEAKER_00: But I think my point in saying that is like you will find the people that vibe with you.
• 16:30
  SPEAKER_00: We just sometimes have to sort out who that is on shift.
• 16:33
  SPEAKER_00: And sometimes we pass that on.
• 16:35
  SPEAKER_00: Like, even as providers, when we're assigning patients in the morning, the night person will be like, This is a patient for Abby.
• 16:44
  SPEAKER_00: Abby will love them.
• 16:46
  SPEAKER_00: So he's the cranky old man.
• 16:51
  SPEAKER_00: I love that.
• 16:52
  SPEAKER_00: Um, I do.
• 16:53
  SPEAKER_00: So but I think the other in talking about like how you say it or even what you say, some of the things that I thought of that I've heard patients say that I've thought were nice were when you don't understand something, I've had them say, like, can you explain it to me in a different way?
• 17:14
  SPEAKER_00: We absolutely need that, uh especially providers.
• 17:18
  SPEAKER_00: Absolutely need to explain things in a different way because we have a habit of talking up here in our language, and we need to bring it down.
• 17:32
  SPEAKER_00: And just not this isn't to say that patients aren't as intelligent, they absolutely are, but when you're that sick, we don't need to be talking that graduate level medicine.
• 17:45
  unknown: Right.
• 17:45
  SPEAKER_01: Or I mean, like just a simple basic um example is our patient population.
• 17:51
  SPEAKER_01: They come in and they have STEMI, so SD elevated MI, and somebody's gonna come in there and be like, this myocardial infarction, and blah blah blah.
• 17:59
  SPEAKER_01: And I'm like, boo, he had you're having a heart attack.
• 18:02
  SPEAKER_01: You don't and they're like, oh.
• 18:05
  SPEAKER_01: It's like nobody has said the word heart attack to this person.
• 18:08
  SPEAKER_01: I'm like, just say it in basic terms.
• 18:09
  SPEAKER_01: They're not stupid.
• 18:11
  SPEAKER_01: They don't have time to Google what a myocardial infarction is.
• 18:14
  SPEAKER_01: Like, and that's the kind of stuff that I'm sure as a provider, nurse, doctor, um, you think that you've explained it fully or simply and they didn't get it and they didn't ask, and then later on they're like, what do you mean I had a heart attack?
• 18:29
  SPEAKER_01: Nobody told me that.
• 18:31
  SPEAKER_01: And nobody did.
• 18:33
  SPEAKER_01: And I think it's important for the nurses who are with these patients all day long, maybe multiple shifts in a row, who kind of have gotten to know their personality or with the families, and they've talked to them a lot.
• 18:44
  SPEAKER_01: If the provider's going in there, maybe it's a new doctor or a consulting group.
• 18:48
  SPEAKER_01: If you can, you know, you may not always be able to go in there with them because, you know, you might get a five group, five doctor group who's gonna go in there and talk to them and say a bunch of information and maybe, you know, they have a heavy accent or something, any of those things, right?
• 19:03
  SPEAKER_01: The patients, they're gonna say, Okay, are you good?
• 19:05
  SPEAKER_01: And they're gonna be like, Yeah.
• 19:07
  SPEAKER_01: And I'm like, No, they're not.
• 19:08
  SPEAKER_01: They don't they don't understand.
• 19:10
  SPEAKER_01: Like, well, do you understand what they're saying about this?
• 19:14
  SPEAKER_01: And you can kind of be like that go-between or that mediator to make sure that they get their questions answered.
• 19:19
  SPEAKER_01: Like, they didn't even know that they needed you to advocate for them, but you didn't right.
• 19:24
  SPEAKER_01: Because then what happens?
• 19:25
  SPEAKER_01: They walk out the door, the patient's like, I might ask, like, do you have any questions?
• 19:29
  SPEAKER_01: Or did you understand what they said?
• 19:30
  SPEAKER_01: And they're like, No, I don't know what they said.
• 19:32
  SPEAKER_01: Like, I couldn't, I couldn't understand that doctor the whole time.
• 19:35
  SPEAKER_01: I'm like, that's okay.
• 19:36
  SPEAKER_01: Like, I'm gonna tell you.
• 19:38
  SPEAKER_01: Like, and if if I need to get back, I can.
• 19:40
  SPEAKER_00: That's not a problem.
• 19:42
  SPEAKER_00: I love that, and I think that's great because the relationship that the nurse and the patient can build can help that.
• 19:48
  SPEAKER_00: I think it helped me grow as a nurse when I did go in, and I'm like, oh, okay, now I kind of understand this physiology a little bit more, even as a new nurse.
• 19:57
  SPEAKER_00: But as providers, we all need to be working, and this is really anyone in healthcare.
• 20:03
  SPEAKER_00: We really need to work on our our emotional intelligence because the largest part of emotional intelligence I'm about, okay?
• 20:14
  SPEAKER_01: I'm sorry, I just I heard the one free therapy.
• 20:17
  SPEAKER_00: A little bit, but it's like a huge part because a big part of emotional intelligence is being able to understand the emotions and quote unquote read people and understand what you're seeing.
• 20:28
  SPEAKER_00: And so if you lack that as a provider, most of the time when I'm interacting with a patient and I'm explaining something, I can see that they're not getting it.
• 20:39
  SPEAKER_00: You see the glossover, you see the confused look, you look over at the family, you see the confused look.
• 20:44
  SPEAKER_00: And it can just be as simple as being like, you look confused.
• 20:49
  SPEAKER_00: What what aren't we understanding?
• 20:52
  SPEAKER_01: And and even saying, like, I'm here, this is my time.
• 20:57
  SPEAKER_01: I want you to ask me when I don't want to leave here until I know that you feel good and that you understand.
• 21:02
  SPEAKER_01: Because, like you said, sometimes that people will worry if you don't have enough time.
• 21:07
  SPEAKER_01: But you do, and you need to make time.
• 21:09
  SPEAKER_01: And if you're going in there, you know, patients should feel comfortable knowing that they've got your early time.
• 21:17
  SPEAKER_01: They're the one laying in the bed.
• 21:18
  SPEAKER_01: And if they're on our unit, they're sick.
• 21:21
  SPEAKER_01: They're sick.
• 21:22
  SPEAKER_01: And if they're able to participate, we want that.
• 21:25
  SPEAKER_01: And if you are somebody who has trouble understanding medical terms, or you get really overwhelmed and you have a support person and they can't be with you, you can say, Hey, would it be okay if I just call my daughter real quick and get her on speakerphone so she can hear this conversation?
• 21:41
  SPEAKER_01: Like, yeah, that that would be great because that's gonna save another phone call later.
• 21:47
  SPEAKER_01: The game of telephone having to redirect, and it's just so much nicer.
• 21:51
  SPEAKER_01: And I think it's great.
• 21:52
  SPEAKER_00: I don't know about I love it too, because often what happens is that person did want to hear.
• 22:00
  SPEAKER_00: Where they needed to hear, and then they call frustrated, and then I'm talking to someone that's frustrated and angry, and then we're tiptoeing into we almost pulled them into that aggressive phase because now they feel like they've been lied to, the family member maybe because they didn't understand, didn't communicate it properly.
• 22:21
  SPEAKER_00: Like there was one time, you know, we were doing a central line, which, you know, a big IV in the neck or groin, which is a normal procedure we do.
• 22:34
  SPEAKER_00: The patient agreed to it, called his daughter, and said, We're going down to the OR, and made it seem like he was having some big invasive surgery, and she called, understandably upset, because she was like, I'm at work.
• 22:50
  SPEAKER_00: I thought he was okay.
• 22:51
  SPEAKER_00: What are we going to surgery for?
• 22:53
  SPEAKER_00: And it's like, no, no, no, no surgery, no surgery.
• 22:57
  SPEAKER_00: It was just a procedure at the bedside.
• 23:00
  SPEAKER_00: He's not even going to leave his bed.
• 23:02
  SPEAKER_00: We just can't get a normal IV access because of their disease process.
• 23:08
  SPEAKER_00: But I could see then where it's like me relying on that patient.
• 23:13
  SPEAKER_00: So now what I do is I will say, Do you want me to call if that support person isn't there and I know it?
• 23:18
  SPEAKER_00: I say, Do you want me to call and explain this to so-and-so for you?
• 23:22
  SPEAKER_00: Or let's just get them on the phone and only have to do it once.
• 23:26
  SPEAKER_01: Yeah.
• 23:26
  SPEAKER_01: Yeah.
• 23:26
  SPEAKER_00: I'm just so nice.
• 23:28
  SPEAKER_01: All right.
• 23:28
  SPEAKER_01: Like we have the technology, we should use it if we can.
• 23:31
  SPEAKER_01: Yes.
• 23:32
  SPEAKER_00: FaceTime, you want to FaceTime in?
• 23:34
  SPEAKER_00: I'll hold the phone.
• 23:36
  SPEAKER_00: That's fine.
• 23:38
  SPEAKER_01: And also, I would say this, and this is where we live.
• 23:43
  SPEAKER_01: I think a lot of people have very big families.
• 23:47
  SPEAKER_01: Okay.
• 23:48
  SPEAKER_01: And your family is who you say is your family.
• 23:50
  SPEAKER_01: So maybe it is like some distant relative or even someone who's not blood related, but you want them to know what's going on or you want their opinion.
• 24:00
  SPEAKER_01: So whoever that person is to you is who we want to talk to if that's what you want.
• 24:06
  SPEAKER_01: However, probably be mindful of having a large quantity of people involved in these conversations.
• 24:18
  SPEAKER_01: Just because at that point it does get to a different level.
• 24:23
  SPEAKER_01: So too many people.
• 24:26
  SPEAKER_00: Too many cooks in the kitchen.
• 24:28
  SPEAKER_01: Yes.
• 24:28
  SPEAKER_01: Like it can muddy the waters.
• 24:30
  SPEAKER_01: And so you know, if you're lucky enough to be blessed with people who you have 10 people who you talk to every day and who are your close people, you know, I think that's great.
• 24:41
  SPEAKER_01: But that's probably too much.
• 24:43
  SPEAKER_01: And I think that's part of the problem that we can run into sometimes, where like you said, it's too many cooks in the kitchen and too many hands, and it sort of can spiral into a place where okay, let's recenter on the patient.
• 24:56
  SPEAKER_01: This not well, your experience here and your experience here and all of this.
• 25:01
  SPEAKER_01: If that makes sense, I don't think that people mean to make it about them, but sometimes that's the direction that it goes.
• 25:06
  SPEAKER_00: Yeah.
• 25:07
  SPEAKER_00: Or it it definitely does.
• 25:09
  SPEAKER_00: I think we've all been there where it's the conversation of well, my cousin's girlfriend's son had the same thing, and this is what they did.
• 25:20
  SPEAKER_00: And that's always nice, I think, for the patient, but I don't have access to their chart, and there are a lot of caveats.
• 25:30
  SPEAKER_00: There are a lot of different approaches in medicine.
• 25:34
  SPEAKER_00: And so when you start getting those people, it can be telling all these stories.
• 25:41
  SPEAKER_00: One, it can muddy the water for the patient, and it can put your provider and even your nurse in a weird position because sometimes it maybe wasn't what should have been done.
• 25:55
  SPEAKER_00: Um, or at least with the information that you're telling, they're telling you, you're like, ooh, uh, and so you don't want to put that down because you don't know all the ins and outs of that situation.
• 26:08
  SPEAKER_00: But it's also putting you in a weird pos you're putting them in a weird position of, okay, how do I like, how do I tiptoe around this?
• 26:15
  SPEAKER_00: Because there's a lot, there can be a lot of caveats in medicine why we might choose one drug or or another.
• 26:23
  SPEAKER_00: Always always ask, you know, oh, so and so I think had something similar, and they were put on this drug, why this one?
• 26:32
  unknown: Yeah.
• 26:33
  SPEAKER_01: And so question.
• 26:35
  SPEAKER_00: Yeah.
• 26:35
  SPEAKER_00: And sometimes yeah, and sometimes it's you know, facilities we we can't keep stock of every medicine.
• 26:43
  SPEAKER_00: So sometimes it's just that's the only one we have here.
• 26:46
  SPEAKER_00: But if you want to try that one outpatient, we can talk about that.
• 26:52
  SPEAKER_00: So sometimes the answer is that simple.
• 26:54
  SPEAKER_00: Sometimes it's more complex, but always ask.
• 26:57
  SPEAKER_00: I think another good one, and I think you kind of touched on it, but that I've had patients and families ask is when you do get overwhelmed, you were talking about like it's so overwhelming, and there's a lot of information to take, saying, Can we pause for a minute?
• 27:15
  SPEAKER_00: Because sometimes you do need to process things before you even know what questions to ask for to even know what you're feeling in that moment.
• 27:25
  SPEAKER_01: Absolutely.
• 27:27
  SPEAKER_01: I mean, we deliver a lot of hard information or we have to break stuff to people and we have to put things to them like risks and benefits for procedures and the outcomes if you don't do it versus you know, it's tough.
• 27:42
  SPEAKER_01: And I think it's so appropriate to just be like, hey, I need a second to like absorb this.
• 27:47
  SPEAKER_01: And you can even say, like, do you mind just giving me a few minutes and then come back if you have time, or can I ask the nurse to get you when I'm ready to talk again?
• 27:56
  SPEAKER_01: Like that's so that's completely fine.
• 27:59
  SPEAKER_01: And no, it may not happen in the exact minute that you request for them to come back because things happen, but if you're not in the space to hear anything else, then we don't waste of the time.
• 28:11
  SPEAKER_01: Yes.
• 28:12
  SPEAKER_01: Absolutely.
• 28:14
  SPEAKER_00: And this this can apply in all settings too, because a lot of healthcare is and you're even in the clinic, they're giving out bad news.
• 28:24
  SPEAKER_00: You're getting diag lifelong diagnoses of hypertension or high blood pressure or high cholesterol, and that still sucks.
• 28:35
  SPEAKER_00: Yeah, you're not in the ICU, but there's still a lifestyle change that you have to make.
• 28:41
  SPEAKER_00: There's still medicines now that you have to make.
• 28:44
  SPEAKER_00: There's long-term illnesses that they might talk to you about that could develop if we don't control it.
• 28:50
  SPEAKER_00: So this can be used in any setting, not just if you're unfortunately in the ICU.
• 28:58
  SPEAKER_00: You can say, you just got a diagnosis of hypertension, you weren't anticipating that, or of diagnose of high blood pressure and you weren't anticipating that.
• 29:07
  SPEAKER_00: You can say, I need a pause.
• 29:09
  SPEAKER_00: Yeah.
• 29:10
  SPEAKER_00: Uh I need a pause.
• 29:12
  SPEAKER_00: And you can always do, well, I don't know, outpatient.
• 29:15
  SPEAKER_00: I was gonna say you can always rebook an appointment, but I think that can take a long time.
• 29:19
  SPEAKER_00: Unfortunately.
• 29:20
  SPEAKER_00: Unfortunately.
• 29:21
  SPEAKER_01: You know, a lot of places too, they have that the messaging back and forth where you can send a message and maybe the provider checks them in a couple of days, which I think is great.
• 29:29
  SPEAKER_01: Um, I would say use those appropriately.
• 29:31
  SPEAKER_01: Yeah.
• 29:32
  SPEAKER_01: You know, you don't you don't need to text them like they're your bestie, like every complaint you have.
• 29:38
  SPEAKER_01: But yeah.
• 29:38
  SPEAKER_01: No.
• 29:39
  SPEAKER_01: In the hospital, we can get up with pretty much anybody at any time.
• 29:42
  SPEAKER_01: And you can't get up with that person, we can get up with somebody else that's related to them.
• 29:46
  SPEAKER_01: Um, maybe you don't have the physical time to spend at the bedside right then, but somebody's gonna be there or their counterparts gonna be there that can get to you at some point.
• 29:57
  SPEAKER_01: So and it's a 24-hour place in the hospital, so there's no really reason that you can't get your questions answered by somebody in some fashion at some point or something.
• 30:07
  SPEAKER_00: Yeah.
• 30:08
  SPEAKER_00: I think kind of for this first little mini episode.
• 30:13
  SPEAKER_00: I hope you understand that advocating in a non-aggressive way for yourself or your family members.
• 30:20
  SPEAKER_00: It's about how you say it.
• 30:22
  SPEAKER_00: Maybe some of the words don't curse at us, but and just kind of stating what you understand, don't understand, just taking that time.
• 30:33
  SPEAKER_00: And I don't I hope the nurses don't get me for this, but at the end of the day, your nurse is going to be your biggest ally in this.
• 30:45
  SPEAKER_00: If if you are very intimidated by the providers, by the white coats, talk to your nurse and they will almost always gladly help advocate for you or explain.
• 30:58
  SPEAKER_00: Or to go and tell the doctor, hey, you need to go and explain that again.
• 31:04
  SPEAKER_01: Okay, if the nurses are coming after you for that, then I don't think they should be nurses.
• 31:09
  SPEAKER_01: They can come after me.
• 31:11
  SPEAKER_01: That's our job.
• 31:12
  SPEAKER_01: Taking care of our patients, and as many times as the nurses, including myself, want to complain about a bad provider or a bad physician, quote unquote bad.
• 31:20
  SPEAKER_01: Don't get mad if a patient or a family member has the same feeling because they're the ones that are in the bed.
• 31:27
  SPEAKER_01: Yeah.
• 31:27
  SPEAKER_01: It's all in how you say things.
• 31:29
  SPEAKER_01: You can get a long way in life by just being open and you know, kind.
• 31:36
  SPEAKER_01: We all need to remember that.
• 31:37
  SPEAKER_01: Right.
• 31:38
  SPEAKER_00: And just remember you're not being difficult if you're advocating for yourself.
• 31:42
  SPEAKER_00: No, you're not.
• 31:43
  SPEAKER_00: Not at all.
• 31:44
  SPEAKER_00: I think this was a great first mini episode.
• 31:47
  SPEAKER_00: From if you like this, please leave us a comment, review.
• 31:51
  SPEAKER_00: If there's other parts of advocating you want us to talk about, let us know what else you want to cover or any other topics you want to see here at Banter at the Bedside.
• 31:59
  SPEAKER_00: But from all of us shift talkers here, we'll see you next time.
• 32:03
  SPEAKER_00: Bye.
• 32:03
  SPEAKER_00: If this felt your kind of conversation, make sure you're following, leave us a review, and we'll see you back here soon.
• 32:10
  SPEAKER_00: Bye.
• 32:11
  SPEAKER_02: Step into the light where the stories come.