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Tuesday, July 20, 2010


Dignity in healthcare can mean a lot of things. But right now, to me, it means respecting your patients as human beings with the same amount of worth as you (or even more in some cases).

They are not unpleasant tasks to complete.

They are not lumps on stretchers to be shunted between hospital departments like a life size game of pong.

They are not there for you to resent when you get off from work late.

Most importantly, they have the right to bed educated on their condition and participate in their own care. They have this right regardless of what language they speak, or their psychiatric diagnosis (within reason, of course), or their ability to speak at all. A patient trapped in their own body after a stroke is just as capable of communicating their wants and needs and opinions if you take the time to ask.

If you find yourself unable to take the time to ask your patients if they're comfortable and doing okay (or as okay as you can be in a hospital), please, remove yourself from your current career path. That vitals machine above their bed doesn't tell you that they would feel...

...slightly more human if they had an extra pillow to support their bad back.

...slightly less terrified if you gave them a quick summary of what would be happening to them in the next few hours.

...slightly less embarrassed if you gave them a diaper instead of just leaving them on a chuck.


Dignity in health care should mean that when I walk in to an ER to bring a patient back to another facility, they should not be covered in their own blood while lying in a urine puddle that's expanded across half of the stretcher.

Dignity means that regardless of the facts that this patient only speaks Spanish and can barely move on their own after the stroke, they deserve the same respect and care that you would want to receive yourself.

When this patient proceeds to tell me that they're in severe pain, and I can see them still actively bleeding despite stitches, due to the fact that their extremely productive pneumonia related cough keeps tugging at the wound, you should not involve yourself in an hour long standoff with EMS over the transfer decision.

The correct bare minimum answer would be to properly clean up this patient, apologize, and apply gauze and an icepack.

When you haphazardly clean this patient, leaving them in their stained gown with clots still gurgling in their mouth and dried blood on their face and chest, and order me to transport them, that is an acute deprivation of dignity.

When you bounce into the hallway where you've left me attempting to mop up the ongoing flow of bloody sputum and announce that you've "won" because you called the receiving facility and they agreed to the transfer, I'm probably just going to stare at you.

Because I thought we were talking about patient care, and this patient's right to properly receive it.

I would've continued telling dispatch that I refused to transport due to the patient being unstable, but at that point I concluded that it was in the patient's interest to get as far away from you as physically possible. Even if that meant going via the receiving facility, where they refused to accept the patient once they realized that you had inaccurately described the patient's condition over the phone.

Because we transported the patient to another ER after that. And the first thing they did was far more effective than what I was able to do with a towel, saline and 4x4's in the back of my ambulance.

They asked how you were doing, did your interview in Spanish, and offered to get you a diaper.

When I saw how your face lit up with relief, I almost hugged the nurse.

Because dignity will always be a critical component of patient care.

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