Guest post by Darlene A. Cunha, R.N., a senior healthcare executive who focuses on population health management and the patient caregiver experience.
Recently, I attended an interdisciplinary team meeting. There was a knock on the door to the conference room. Before I could rise to open the door, it swung open and one of our attending physicians scanned the room, made eye contact with me and beckoned me to step outside.
The two of us made our way to my office, where this physician, visibly upset, explained to me her interaction with the wife of one of her patients. She described the spouse (whom I'll call as Mrs. Jones), as aggressive, unrelenting, and dare I say, hostile. I was taken aback, as the patient was admitted the day before. What could possibly have gone so wrong in such a short period of time?
The physician asked me to accompany her to the patient's room, as she wanted me to witness the interaction between the patient, Mrs. Jones and the staff. After quickly reviewing the patient's admission notes, I accompanied the physician to the patient care unit, where we came upon Mrs. Jones standing at the nurses' station. She was visibly upset, evidenced by her raised voice and demand to see someone in charge. As I approached the desk, I reach out my hand to introduce myself with a calm, low voice. The staff stood wide-eyed waiting to see what would happen next. The physician gave me the, 'I told you so look,' but I stayed focused on the family member.
Mrs. Jones shook my hand, and as she did, I gently steered her away from the nurses' station and toward her husband's room. The attending physician followed. Once inside her husband's room, she began to raise her voice and insisted on driving the patient's plan of care. She stated she was unhappy with the attending physician's orders and wanted her husband transferred immediately. Any attempt to interject was met with resistance and anger. At this point, I stayed silent while Mrs. Jones voiced her concerns. As she spoke, her voice quivered and she began to cry while she held her husband's hand. It was at that moment that I stepped forward and embraced her. I assured her we were all here to help both of them get through this difficult time.
Over the next hour, the attending physician and I learned Mrs. Jones was recently discharged from the hospital herself, and her husband was recently diagnosed with a terminal illness which prompted his readmission. Since we were not the hospital that initially diagnosed and treated Mr. Jones, Mrs. Jones was upset with the plan of care established by his new attending physician. It was different from the one initially established. The more she resisted the treatment plan for her husband, the more frustrated the attending physician became, until finally Mrs. Jones demanded her husband be transferred.