What Happens When We Ignore the Patient Priority

So we’ve talked about the importance of identifying and acting to accomplish the patient priority,  but what does it look like when we don’t?

A story to illustrate: a young mom takes her barely five year old son to have surgery to reconstruct his right ear. Born with microtia (an outer ear deformity),  the surgery was to take cartilage from his ribs to begin to build a new outer ear.  In an attempt to help, the surgeon tells mom, “I’ll do my very best to make it look more like an ear than a bar of soap.”

After surgery, the mom notices the young boy is not opening his right eye. In fact, it’s red and swollen, like he ran into a doorknob. He complains of light and won’t let anyone open the window shades. The more he comes out of the anesthesia, the more he complains of pain; not at any of the surgery sites, but in his eye.

The mom knows something is not right. Her son went into surgery to fix his ear, and now he can’t open his eye. She asks the nurse to take a look.

“O my gosh! I bet the surgical soap got in there. That stuff is like 100x’s stronger than any other antibacterial soap. That is not good.”

The next day, the boy still can’t open his eye. The surgical site swelling is going down, but the swelling around his eye is even more prominent. The mom talks with the doctor. He confirms they probably didn’t shield the boy’s eyes well enough during surgery, and that it most likely was the surgical soap that is causing all the irritation.

“Will there be permanent damage?” the mom asks. The surgery was six hours long. Six hours of that soap soaking in her son’s eye. Even now that he’s awake, he won’t let anyone go near it to try and flush it out.

“We don’t know.”

Mom’s anxiety is through the roof. It was hard enough to make the decision to have her son go through surgery to hopefully come out with an ear that didn’t look like a bar of soap; her son already had hearing issues, was he now going to suffer from vision problems as well?

And here’s where the road could have gone a completely different direction: instead of an honest apology and asking the mom what they could do to make things right, the doctor and the nurses stopped talking about it and acted like it never happened.

But for the mom, getting her son’s eye checked out by an eye doctor, understanding if there was any damage, was the only thing on her mind. I know because this mama is me.

Ethan right before surgery

Waiting to wake up

Four days later

How differently my week would have gone had the doctor or nurse been able to recognize how much additional suffering my son and I were going through because this issue was not being addressed. What a different story I would be telling now if they would have owned their mistake and asked what they could do to ease my mind.

Ethan couldn’t open his eye for five days.  For five days I thought he may have lost sight in his right eye because of their mistake, and no one cared.

This is what it looks like when we don’t listen to patients and then act to accomplish what matters to them.

This was all well before I knew the in’s and out’s of patient experience surveys, but it probably doesn’t surprise you how I answered the survey when it showed up in my mailbox about a month later.

I reamed that hospital. I showed no mercy. All the feelings of frustration, anxiety, and disappointment in their care flowed from the tip of my pencil onto that survey.  And here’s the rub: that team took excellent care of my son for the purpose that he was there for. The surgery to begin reconstruction on his ear was a complete success. But none of that mattered to me because of the complications with his eye that went unaddressed. The fact that his eye was still reddish looking at the time I took the survey didn’t help.

I look back now and think maybe I over-reacted. One of those “difficult” parents who wouldn’t stop asking questions and just shut up and go with the program. But then again, what loving mama would?

Our work is to listen. Meet them where they are. Apologize without hesitation. And then do what we can to accomplish what matters to them, reducing their overall suffering, not adding to it.

My call to action today is to listen for the priority of the people you are caring for and do what you can to help them accomplish it. By doing so, everyone wins.