Attn all communications providers and tablet manufacturers - our patients need your help!
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We, the frontline healthcare workers, are used to dealing with stress. It’s what we do. We’re trained to be calm in the face of chaos. Some would go so far as to say that we’re adrenaline junkies. When our patients get sick fast, we thrive. Our primordial instincts kick into action. And we do what we do best. Smooth and fast. But this COVID pandemic is making us all experience stress in ways we never have before. The uncertainty of it all. The cognitive burden of keeping up to date. The ever-changing protocols. The fear of getting it wrong for our patients, for our colleagues and for ourselves is very real and palpable. We’re getting rattled. We’re afraid. And we’re feeling more vulnerable than ever before.
As challenging as this COVID-era of healthcare is for us all, the hardest part of patient care these days is watching patients suffer alone without family and friends at their bedside. We, the frontline healthcare workers, are looking to partner with private industry and anyone else who is interested to change this.
Hospitals everywhere have instituted strict “no visitor” policies. And while this is a necessary safety protocol, it is having a huge unintended impact on patient care. The care we provide is being forcibly dehumanized, and this is especially evident for our most sick and vulnerable patients. This is an area that we need help addressing for everyone’s benefit and well-being. For our patients, for their families, for ourselves, and for our society at large.
During the pre-COVID era, patient families were commonplace at the bedside, especially when their loved ones were very sick. Family and loved ones played an active role in goals-of-care discussions, especially when the patient lost the capacity to make their own decisions. Oftentimes, we would even perform resuscitations with family present at the patient bedside. It wasn’t always an easy conversation or an easy experience to be a part of, but we were able to both acknowledge human feelings and emotions whilst providing expert-level medical care.
But during the COVID-era, patients are alone. Families and loved ones are far away. And we healthcare providers sometimes don’t have the time, cognitive bandwidth and emotional strength to provide the care we would like to, and that our patients and their families deserve. Especially for those who are most sick.
Our conversations and interactions with patients are limited. Not just in time, as could be understood, but also on an interpersonal level. Our personal protective equipment, which importantly protects us from getting sick, also creates emotional distance. Talking through a mask and a shield without a visible smile or show of empathy just doesn’t allow for the same level of connection.
Some patients also speak very little English, and so we’re left trying to connect through apps (e.g Google translate). This is especially true when we do not have updated phone numbers for our patients' next of kin, or we are not able to reach them. And when we are able to either speak clearly with our patients or get a hold of patient family members, our limited nonverbal communication abilities (speaking over a phone) present significant barriers.
All of this is to say that effective patient communication is consistently challenging during the COVID-era. And this is most evident and painful to witness when we are treating our most sick and dying patients.
We should not be having goals-of-care discussions over a hospital landline outside of a patient isolation room. We should be having these discussions inside the patient room using video conferencing. Our patients and their families might not be able to be together in the hospital physically, but the least we could do is offer to let them see each other and talk to each other before getting put to sleep to be put onto a ventilator - sometimes until they succumb to their illness. And when we are resuscitating our patients, we should be able to offer families the opportunity to be there with their loved ones. Speaking to them. Loving them. Crying. Feeling connected. Being human.
For us, the healthcare providers, introducing an element of human interconnectedness back into the care we are providing is crucial. Physical distancing and personal protection measures are critical. But so is the human element of the care that we provide. And the two should not be mutually exclusive. Many of us are having to make difficult impersonal phone calls to newly bereaved family members and loved ones, and it sucks for everyone.
We have to find a better way. And solutions exist that are easy to implement.
If we had tablets or smartphones with the capacity for video calls in every critical care room, it would be a game-changer for all of us. Patients could talk to their loved ones and vice versa. Potentially final words could be shared ‘face to face’ and heart to heart. Goals-of-care discussions could become shared decisions with all parties ‘present’ and participating. Patients could be reassured that they’re not alone. Families and loved ones could be comforted knowing that the person they love is in good hands and receiving the best possible care. Healthcare providers could be afforded the opportunity to exhibit the human and empathic elements of healthcare that are so crucial to what we do. And we could all begin to mitigate the negative consequences of physical distancing with the restorative feeling of connection.
We invite telecommunications providers and tablet manufacturers to join us on the frontlines in this effort to provide the best care possible for our patients and their families during the COVID-era. We are asking for encased tablets with calling and data capabilities that we will use exclusively for the purposes of improving patient care.
If each hospital unit (e.g. ER, ICU, inpatient ward) received just 5-7 of these devices, patient care would change drastically for the better. We could sanitize them between uses and re-use them for each patient encounter. Just 40-50 devices could equip an entire mid-sized hospital. Changing the patient and family experience one interaction at a time, we can make a huge difference together.
Who is with us?
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