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Let's see, it was about 9 o'clock at night when the nurse came into a semi-private hospital room where I was sitting with a patient I knew. The other patient, an elderly woman who was hard of hearing, was woken up so she could sign a consent form that would make it quicker for her doctor to review her
records. That, by itself, wasn't much of a problem (although it probably annoyed the woman who was woken up). What was a problem was the fact that the elderly woman had a hearing problem so the conversation went something like this -
"I just need you to sign this form so your doctor can see your records."
"What?!"
"I just need you to sign this form so your doctor can see your records."
"What?!"
You get the picture. Now it just so happens that every patient in this hospital has a portable TV that they can swing around in front of them to watch. A comfortability expert would quickly see the usefulness of this and say hey, stick a keyboard on that thing and type what you want to say to patients who can't hear very good. That way the person in the next bed can get some sleep.
I'm sure there are a lot of other things he or she would recommend too, like providing a comfortable set of headphones to block out all of the rest of the background noise that can keep the patient awake, and an eyemask to block off the lights that keep getting switched on and off as visitors come by to see your roommate.
ICU Psychosis
http://www.medicine...psychosis/page4.htm
"According to current estimates, one patient in every 3 who spends more than 5 days in an ICU experiences some form of psychotic reaction." [Klaatu, Jan 22 2005]
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Good. I hate being woken-up. [+] |
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Great idea. Most hospitals have their own station, where they advertise how great they are, 24/7. |
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It would be easy, I would think, to hook up the bed to the t.v., and when a message for you was gonna be aired, the bed would kind of vibrate a bit. The patient would turn to the station, and then read what is about to happen, or what needs signed, etc., enjoy a tiny muscle relaxing vibe, and not awaken the dead. + |
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A vibrating bed wouldn't do well in California, what with the earthquakes and all. |
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I normally say, "If I hear anything good I'll let you know" and dismiss the inquiry. |
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That assumes, of course, that no one mistook her hearing aid for a cashew today. |
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Mach, I worked at Santa Barbara Cottage Hospital during a small, (4.5) quake, early in my nursing career. Most of the folks, (I worked in the cancer department), found it, in some way, a nice diversion. |
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I can only thank any god that exists, that I was not about to insert an IV, since it would have been my first. Ouch. |
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Won't get a Comfortability Expert past the CFO of your HMO. Doesn't satisfy the Profit Motive (yes, that's in caps - we bow to it). End of life means no more customer loyalty = put your resources elsewhere. Pretty depressing. |
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Hey good idea. Did you know that elderly people are also often afflicted with poor sight as well? |
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Jung - It's surprising how things change. I'm working for a company in the healthcare field now and they've just hired someone whose job title is 'usability expert'. In this case his job is to make the gui interfaces on programs more user-friendly, but it's not such a great leap from there to hiring a 'comfortability expert'. The profit motive would even work in favor of hiring one. |
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Take the conversation in my example. It probably took the nurse at least 3 minutes to get the patient to understand what she wanted her to do and then get the form signed. Conveying the same message on a screen could have cut that time in half. Since any task that can be accomplished faster translates into a cost savings (decreased labor expense), it wouldn't take long for a comfortability expert to have a positive impact on a hospital's cash flow. The brighter CFO's in the health care field will recognize this. |
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As far as end of life meaning no more customer loyalty, that's only true if the patient dies on their first admission. I'd be willing to bet that the percentage of fatal outcomes on first time admissions is pretty low for most hospitals. |
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cuckoo - Yes, I'm aware that the elderly are often afflicted with poor sight as well. Which, since you brought it up, gives our 'comfortability expert' another chance to improve things and earn his keep. If the patients can't read the screen then they can't really be giving their 'informed consent' when they sign the form we're asking them to read either (insert lawsuit here). Our expert would realize that in cases like this the form itself should be shown on the screen, magnified several times, and a flip-down attachment added beneath the TV so they could electronically sign it (the same way we sign for credit card purchases at a lot of stores now). |
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Yet another way to strip the person from the patient, like wool from a sheep. Let the healing begin! |
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I wouldn't want to go to a hospital where the patients are dying left and right from medical errors, but everyone is comfortable. Hospitals have to set their priorities.
1. Don't make patients sicker than they already are (this is tough, with hospital-borne diseases so common)
2. Successfully treat their illness (medical errors due to mix-ups and oversights are common)
3. Keep patients comfortable |
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If a hospital was so good at 1 & 2, that they had surplus resources to devote to 3, then the hospital could hire comfortability experts and advertise that fact. That hospital would be in great demand. |
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Comfortability seems like it would be a field of Nursing. Lots of nurses have little techniques for making patients more comfortable, and the comfortability expert would gather these all together and then keep the whole nursing staff informed. |
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Having more nurses is the biggest comfortability aid of all. |
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That ICU psychosis link was amazing. My ICU room had a skylight, which really helped. |
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rob, you must have had a very serious ailment/injury. People like you, make people like me, feel cared about. |
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In a job that shows you the darkside of mankind, and the unbelievable grasp that nature has on how we do, or how we don't live, the prospect that you even care, is promising. |
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Reading this, it occurs to me that people visiting hospitalized folks should brings gifts of earplugs / headphones and sleeping eyemasks, rather than flowers and cards. |
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As regards ICU psychosis, think about the folks who spend more than 5 days in an ICU. 5 days, critically ill. I suspect the psychosis has less to do with where they are than with why they are there. My, what a tortured sentence that was! |
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bungston - Those would indeed be good gifts. |
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rob -
//I wouldn't want to go to a hospital where the patients are dying left and right from medical errors, but everyone is comfortable.// |
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This assumes that a choice has to be made between comfort and a successful treatment due to financial constraints. In reality that assumption is false - comfort and successful treatments are not mutually exclusive. A couple of more examples might help illustrate the point. |
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At the hospital I was visiting each patient had their own phone, each one with a long line attaching it to the phone jack so it could be used just about anywhere. The defect in this convenience? There was no place to hook the phone onto the bed. Because of this the patients either laid them on the bed or tried to tie them around the bed rails in an effort to keep them within easy reach, resulting in several collisions between the phones and the floor. Being plastic, the phones are going to break fairly often. Now weigh their replacement cost against the cost of a few pieces of velcro - one on the back of the handset and one on each of the railings. This would keep the phones off of the floor and within reach of whichever side of the bed that the patient felt like putting them on, making the patient more comfortable. The money saved by not having to replace broken phones could be put into the labor pool, increasing the percentage of successful treatments. |
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Another case in point. The respiratory mechanics of a difficult bowel movement are often overlooked. Ambulatory patients using oxygen have a choice, disconnect their breathing tube and take their chances in the bathroom, or hang onto the tube (assuming it's long enough) and bring it in with them. I saw examples of both. Those who left the tube on the bed could sue the hospital for not providing them with a longer tube if they lost consciousness during their trip to the bathroom and suffered an injury (resulting in less money available for successful treatments due to court costs), and those who took it with them sometimes dropped it on the bathroom floor requiring a replacement tube to be supplied (again reducing the money available for successful treatments). So what would our 'comfortability expert' suggest? I'm betting he'd say find the patient a convenient way to take the oxygen into the bathroom without risking the loss of the tube. It wouldn't be hard to find such a way either. Most of the time these same patients have to drag an IV stand with them into the bathroom too. The pole on that stand is hollow. Since we know how to make small, hand-sized cylinders that can hold about ten minutes worth of air (which we sell to people who don't want to risk smoke inhalation while trying to escape from a burning building) we could easily convert the hollow pole into a similar oxygen tank with maybe 15-20 minutes worth of air. The stand would have it's own tube too so when the patient wanted to go to the bathroom they'd just take off the air tube they were using on the bed and put on the one that came with their IV stand. Net result - no lawsuits and more comfort for the patient. This would also let patients who are now retricted to their beds due to their need for oxygen get up and walk around a little bit without having to cart around a heavy oxygen tank. (They do make tanks for the beds by the way, they just haven't thought to turn the IV stand poles into smaller versions of those tanks.) |
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It might be argued that these examples would only result in surplus pennies. With each new solution there would be more pennies though and pretty soon the cost of our comfortability expert would be far less than the amount money those solutions would be contributing toward better patient care. If nothing else, give it to the nurses. They deserve it. |
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Sounds like you'd be a good person for the job. You oould consult with hospital supply companies to innovate products. |
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This reminds me of when my dad was in the nursing home, and they lowered his bed to the ground so he COULDN'T get up and risk falling. That must have been planned by an uncomfortability expert. |
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As a question of ethics I have no issue with people dying comfortably over having their life saved uncomfortably. It's the reductionist approach to medicine. The greatest pleasure (comfort) for the greatest number! |
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In August I was hospitalized, and had a roommate come in the last night of my stay. It was about 2am, and I was attempting to fall asleep. The roommate had not turned off his T.V., which was quite loud, and he was snoring. The sound of the T.V was keeping me awake, so I called the nurse, and asked her to turn off the T.V. She awoke my snoring roommate and asked him if he would turn off his T.V. ?????? |
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longshot - I'd just like say that I admire your patience (everybody stop looking for puns for a moment), and your ideas. I need to keep my reactionism in check sometimes. Sorry if I steered us a little off topic. |
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Jung - Thanks. Like everyone else, I like hearing an 'attaboy' every now and then. |
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During some of my many hospital stays, I've seen patients woken up to be given sleeping tablets. |
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Elderly patients seem to have confused moments more during the night than duriong the day and I think the fact that the place is nosier and not as dark as their home is a major factor. |
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