Last time, I wrote about Brene Brown and how she stresses that clear is kind. I related it to my own experiences surrounding death and dying and, while using language like passed on to a better place may feel more comfortable, it isn’t clear. And it isn’t kind.
Thinking about all that reminded me of another incident in which being clear would have been much kinder.
I was working at a smaller community hospital, not a large trauma or academic medical center, when a patient who’d had multiple cardiac arrests on the floor was moved to the Intensive Care Unit with a significant decrease in brain function. The family was understandably upset and wanted answers about how this happened.
We needed to have a family conference but there were no conference rooms available at that moment. We did the next best thing and gathered in the empty patient room next to his while the team of physicians and nurses spoke with the family about what had happened and what the plan was, moving forward.
In hindsight, it’s easy now to see where we went wrong. We allowed to family to remain in that empty patient room after the conference. We thought we were being sensitive and accommodating, but over the next several days, they had multiple family members round the clock, sleeping in sleeping bags on the floor of that room. They brought in coolers filled with water and juice and even plugged in a crock pot for pulled pork sandwiches.
We thought that by not setting any boundaries, we were being nice but it was the worst thing we could have done. By not telling them at 9pm that it was time to go home, we gave them the message that they shouldn’t leave. They stayed and didn’t get the rest they needed. They even asked if they could use the patient showers so they could clean up.
It also put an undue burden on the staff. There was a window between the two rooms so anytime a nurse went into his room to provide care, the family was watching. It was very hard for the nurses to focus and concentrate, knowing that there were people looking at them. People who, quite frankly, didn’t really know what they were looking at.
This went on for over a week before the patient was transferred to a hospital that could offer a higher level of care. That place, I knew, had very clear boundaries about how many visitors could be there at any given time, very clear visiting hours, and a very strict no crock pot policy.
It’s important to remember that the things we say or do when we try to be sensitive or accommodating aren’t always the kindest. Families need to know it’s okay to go home. To sleep in their own bed. To shower in their own bathroom. Or if they live out of town, at least at a hotel. Somewhere that isn’t the hospital so they can recharge, refresh, and be ready to support the patient and each other.
This is where being a patient experience professional can get a little tricky. For those of us who have a hard time saying no, saying yes to every request seems like the kind thing to do. It isn’t. Not always. We have to stress the importance of downtime, of rest, and we have to be sure we’ve earned their trust, so they know they can leave the room and their loved one will still be safe.
I wish we’d done things differently for that family. I wish I’d known of Brene Brown and her clear is kind message at that point in my career. It would have been a much kinder situation for everyone.