From her time as a patient, she can see nurses are overworked enough

  March 27, 2012

AS A woman hospitalized three times between July and September 2011, I feel qualified to comment on the article “Nurses balk at bid to guide dealings with patients’’ (Page A1, March 21). Once again, the medical community is focusing on the wrong thing by urging nurses to follow scripts when communicating with patients. Could hospital officials be diverting our attention from what’s really important?

As a practicality, nurses do not have time to repeat phrases and questions. They are too busy racing from room to room managing patients’ care. There are not enough nurses to staff patients’ needs.

The only time I felt I had appropriate attention was when I was in the ICU or other special units, and I never again want to be sick enough to require that kind of care. The rest of the time I was placed on the “floor’’ with too many sick patients for the few nurses and support staff assigned to adequately care for them or to respond to their call buttons. The staff who worked with me were courteous, caring, smart – and overworked.

It seems as if the savings gleaned from holding down staffing goes into the bottom line of hospitals and to executives’ pockets. Let’s pay attention to meaningful information and criteria when discussing what’s important for patients’ care.

Gail Trubow

Southborough

letters | a push for nurses to stick to the script

Mandated courtesy could be prescription for dangerouly poor communication

  March 27, 2012

RE “NURSES balk at bid to guide dealings with patients’’ (Page A1, March 21): As someone who has taught interpersonal skills to health professionals for almost 30 years, I was unsurprised, but further discouraged, to see that the creep of mandated fake courtesy has reached local hospitals. Nurses unions are right to object. But the real problem is that some of the consultants’ advice offered in the scripts you reprinted is incorrect.

Any credible instructor of health care communication skills knows that it is important to limit closed-ended questions. Yet one example advocated starting an interaction with: “Do you mind if I review these instructions?’’ The implication is that if patients do mind, then they will be holding up progress through the to-do list.

The phrasing should start with something more like “Just to make sure I have explained things clearly enough, would you mind telling me your understanding of the instructions?’’ The open-ended prompt to the patient will elicit an authentic answer and a genuine reality check to prevent problems. The rephrasing may seem minor, but it has the potential to prevent tragedies.

Time needs to be dedicated to train health care professionals in interpersonal skills that go beyond the types of pseudo-social recipes cited in the article. This would go further toward the goal of keeping patients psychologically comfortable and safe from medical errors.

I hate to see hospitalization devolving into a situation where patients will get follow-up surveys with checklists similar to the quizzes I receive each time I take my car in for an oil change.

Dr. Helen Meldrum

Waltham

The writer is associate professor of psychology in the Program in Health Sciences and Industry at Bentley University.

letters | a push for nurses to stick to the script

Money for staff is wasted on consultants

YOUR STORY about how hospitals are pushing nurses to speak to patients in certain ways was distressing (“Nurses balk at bid to guide dealings with patients,’’ Page A1, March 21). Why aren’t hospital administrators asking the nurses what they need instead of hiring consultants?

I would like to have learned how much the hospitals pay to groups such as Disney to help them boost their scores on patient-satisfaction surveys. Hospitals say they can’t afford to hire more nurses to improve nurse-patient ratios, yet they are eager to pay who knows how much to consultants.

My husband tells me “the expert is always someone from out of town,’’ but I feel like Mickey Mouse is not someone to ask about health care.

Kathy McDonald

Milton

The writer is a registered nurse.