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the importance of being nice....


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So, I recently had a pt with a large pleural effusion requiring thoracentesis. I got in and started getting fluid, but after 10-20 cc it stopped flowing and I could not get it to go again with adjusting catheter, positioning, etc. I apologized and asked one of my partners to give it a try. they did and were rapidly successful. I later heard there was a complaint from the patient....about my partner because they were "gruff and uncaring".

so let me get this straight, I can stick a roofing nail through your back and fail to achieve the desired result, but if I am nice about it that's better than being successful if my attitude sucks.....think about that....

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I agree and have heard much the same in my 4 years. The lawyer for my small company was in risk management at a big corp. hospital x 14 years and she has told me the same. She also told me the likelihood of a provider being sued is much lower if the patient "likes you" or "things you are nice" which says much about patient care. Think about it, this is no different in other professions (mechanic, plumber, heating/air, etc). Good comment and is worth it's weight in gold for everyone in medicine.  

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Everything is about the "PATIENT EXPERIENCE" these days.

At the hospital I work at the priority of service excellence standards are:

1- Safety 2- Courtesy 3- Accountability 4- Efficiency 5- Innovation

(I'm not saying I agree with the order)

But in the example of above with the thoracentesis, your friend was great at #4 but not so much #2 in the eyes of the patient. Not defending the patient's comments, but it is just the world we live in these days...patient experience seems to trump everything.

 

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21 minutes ago, majetito said:

Everything is about the "PATIENT EXPERIENCE" these days.

At the hospital I work at the priority of service excellence standards are:

1- Safety 2- Courtesy 3- Accountability 4- Efficiency 5- Innovation

(I'm not saying I agree with the order)

But in the example of above with the thoracentesis, your friend was great at #4 but not so much #2 in the eyes of the patient. Not defending the patient's comments, but it is just the world we live in these days...patient experience seems to trump everything.

 

Shouldn't they at least give a passing mention of "quality care"?

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3 minutes ago, majetito said:

The HR department didn't ask me what I thought either during the mandatory training...

My guess is they try to lump that under "accountability" : apply expertise and commit to the highest level of patient care and accept responsibility for the result.

If I have learned anything since my recent move back into corporate medicine it's that the admin drones really aren't interested in the opinions of the people who actually deliver care. My people tend to treat a policy like an old man with a long beard came down a mountain and delivered it to us poor ignorant mortals.

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Ideally, the perfect questionnaire: did you die?  Yes.  No.  

If no, then why the &$@( do you care if the provider was nice?

In 3 weeks, I am leaving my "give me my antibiotics or I'll tell on you" job for something else. Moving to a civilian corporate job biggest mistake of my life, and every minute of every day I regret the move.  

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Not so sure that being nice is the vaccination that prevents being sued.  Once a decision is made to sue, for any reason, pretty much any provider whose name appears on the chart will show up on the initial defendant list.  Remember the goal of the plaintiff's attorney is to find as many pots of money or malpractice insurance to try to tap.

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one of my best mentors ever (taught me IR) told me "people don't sue the people they like"

 

I try very hard to perform my job with a very non-confrontational disposition

When I move off this mark I find that my life only gets harder (IE having to defend myself against complaints)

 

never been sued, but seems to hold true for complaints....

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For myself, this didn't hold true since my only involvement was initial triage of a known tip/fib break from soccer in an adult while in the ED.  Confirmed distal NV function, ordered x-ray and pain med, and then handed pt. off to ED doc since I was leaving shortly.  Hours later pt. developed compartment sx. which was exacerbated by ortho missing a vascular injury at some point during transfer from ED bed to OR table after time on the ortho floor.  During the depo you would've thought it was a planned assassination attempt on my part with this guy.  Yes, he ended up with a BKA after months of complications.  He never knew me from Adam.

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