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Patient Care Experience Beyond the Medicine

Integrating Support Services and Families for Psychosocial Care

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He is that family member we all know, regrettably often looked upon as bothersome, annoying or cantankerous. Throughout my career in home health, skilled nursing and acute care, these family members are at every level – anywhere that involves caring for vulnerable patients.

One doesn’t even have to be in patient care – simply working in healthcare means each of us will likely deal with these troublesome family members at one time or another.

I was still a teenager when I first encountered “the husband” as we came to know him. Little did I know that those few days with him would have an impact upon my entire future, and that of my very role as a healthcare leader.

Interacting with patients’ families while working both in dietary as a dishwasher/server and facilities as housekeeping/maintenance taught me the importance of both support services and family members within the patient care experience – beyond the medicine.

A normal evening shift, I was working in housekeeping, simply emptying the trash in his wife’s room when we first met. He looked to be an older man (by teenager standards), in his late 50s or early 60s. He smelled like the local refinery, and was clearly a laborer as his hands were not dirty, but rather discolored from many years of working with asphalt, oil or dirt.

Later I learned that he was there every night as soon as he got off work, leaving his wife’s side only when going home to get cleaned-up for his next shift.

I’m not going to lie. To this shy and timid teenager, the glare in his eyes was a bit intimidating. But at the same time, he seemed very familiar.

It was almost 9 p.m. when he asked where he could get some supper and a cup of coffee. Regrettably, I had to explain to him that the kitchen was closed, and at this time of night, the coffee had likely been poured out.

Hearing that certainly did not help his mood. Though he said not a word, the news was visibly disheartening. I must have looked distraught coming out of that room, for the nurses quickly took me aside and explained to me how the husband was one of those family members, and I should not let it bother me. The nurses were wonderful, reassuring me that I had done nothing wrong.

I went home that night, school the next day, and other than wrestling practice (some things require complete focus), he was always in the back of my mind. I found myself worrying about him.

My next shift was working in the kitchen. Before pouring out the coffee to clean the pots, I made certain to set aside two big cups for the husband. When packing up from the evening meal, I wrapped him a plate. Plenty of meat, a slice of bread and two different servings of vegetables – just the way my dad would want it. It was then that I had the epiphany. The smell of the local refinery and those stained calloused hands from years of hard work was much like my own father. No wonder I felt a sense of obligation to care for this man. Doing what little I could to help him, as he was doing what he could to care for his wife.

Looking back, the husband was simply like the majority of the folks in my small rural town and communities all across the country. Whether they be farmers, ranchers, mechanics, truck drivers or waitresses, they all have that element of being the provider – working day in and out, doing what is needing to be done to care for their family.

It was almost 8 p.m. when I took the meal tray and coffee to his wife’s room. He had just gotten off of work, and of course was right there by her side. As I rolled the bedside table over to him and set the tray down - as a man of few words - he simply said, well thank you. But his body language spoke a great deal. He seemed to have a brief moment of relief. It had not yet occurred to me, but likely it had been several days since he had a full meal. Everything he did - his only concern - was to be there for his wife. Affording little regard to care for himself.

Before leaving, I asked if there was anything else he needed. Hesitantly, he asked for a glass of milk. “Of course,” I said with a smile. Walking down the corridor, I began wondering to myself, how could I have forgotten the milk? For that is precisely what my dad would drink with his supper (as he called it) every night.

The next day was Friday, with a wrestling tournament on Saturday, so I would not be back until Monday evening. I left a very specific note for the weekend kitchen staff on how to take care of the husband. I wanted assurance that he would get his glass of milk with his supper. I needed to know that he would be well taken care of, so that he could help take care of his wife.

When I came back Monday night, his wife had been discharged and they had both finally gone home. While I was cleaning the room, the nurses were talking, and this bothersome, annoying and cantankerous husband had apparently become quite charming, engaging and apparently even funny.

This husband did not mean to be difficult to deal with. No, he was a good man and supportive husband that had worked hard for many years. Suddenly finding himself unable to care for his wife. Experiencing a newfound sense of powerlessness and sitting in a hospital was not at all within his comfort zone. It was not intensity I saw in his eyes, but rather stress, concern and fatigue.

Psychosocial healthcare addresses the mind, body and spirit of a patient – and their families.

Working collaboratively, the nurses, doctors and therapist were able to treat this woman’s medical needs.

Likewise, myself and other support staff – even in a non-patient care capacity – was able to help care for the husband, enabling him to be there and continue providing the emotional support for his wife.

In the months following, I realized that I wanted to go to college - something no one in my family had ever done - so that I could have greater impact in caring for others.

As my career led me to ever increasing leadership roles within healthcare, I find myself thinking of the husband often. He is a reminder that I need to support everyone within the facility. For no matter their role, everything that everyone does everyday is a part of patient and family care.

As leaders, we need to establish a culture that supports the physicians, nurses and allied health, without losing sight of the invaluable contributions also made by housekeeping, food service, clerical staff and so many others. Each is integral in effective operations, ensuring quality care for our shared communities.