An open love letter to healthcare professionals

TL;DR

• Personal Journey and Resilience: Having undergone 22 surgeries due to a congenital urinary tract abnormality, the author expresses gratitude for the 62 years of remarkable healing and support from multi-disciplinary teams.

• Healthcare Impact and Competence: The author reminds healthcare workers to communicate clearly, include patients in their care, and learn from both positive and adverse experiences.

• Compassion and Patient Care: Compassionate care has been a source of hope and healing for the author. Whether through everyday interactions or during critical moments, the kindness and empathy of healthcare professionals have made a significant difference.

As a lifelong beneficiary, it’s a privilege to contribute to healthcare improvements. I seek to encourage students, mentors, and educators with my wholehearted gratitude and affirmation that your work is sacred. We hope conversations with patient partners strengthen your devotion to caring for people. In turn, we receive fulfillment and purpose, and our sufferings are assuaged.

I’ve had 22 surgeries after being born with a congenital abnormality of my urinary tract. I’m grateful for the remarkable healing and support from multi-disciplinary teams for 62 years. Functions you deem basic require my assistance. Different sources of pain and vomiting are unpredictable. I carry Ziplock bags in my purse which are superior to airplane bags. I persevere in making plans. Recently, I’ve only missed lunch with my out-laws. When I am overcome with pain, I practice gratitude by scanning my body from head to toe, grateful for what still works. Then I circle my perimeter, thanking all those who have loved me into being. But here’s the perspective: When I was a girl, there was concern that I would not be able to carry a pregnancy. However, thanks to medical science I delivered three children. Most days, nothing else matters.

Thank you for choosing to work in healthcare, especially students in it for the long game. You are the trustees of a future that will give my grandsons the best chance of flourishing and make me less afraid of my next birthday.

“What Matters Most?” is an endeavor to encourage conversations with people about their fears, hopes, needs, and idiosyncrasies. This includes asking staff to contribute their priorities. These glimpses of individuality in both the receiving and giving of healthcare can be found on health authority websites, posters in the hallways, and even interactive games with prizes.

To me, what matters most is threefold: 

1. Competence

I am grateful you are trained to be proficient through an evidence-based curriculum with mentorship in practicums. You are curious and engaged in lifelong learning with a passion for excellence. Here’s the rub. Time tightens with the added responsibilities accompanying experience. Also, resource issues ask you to do more with less. When under pressure, slow down. Check, double-check, and confer with others. 

My 9.5 lb. daughter was delivered with midforceps at shift change. Her heart rate was concerning, and I had a fever. The room was full, yet everyone forgot to catheterize my bladder. I tell my story so it may make a difference to someone else. 

An adverse outcome may not be anyone’s fault. It may be a system issue that can be prevented with a checklist. Healthcare professionals (HCPs) are anxious about the possibility of unexpected outcomes. They are vigilant and prepared to respond with the oversight of supervisors and risk management. 

2. Communication

Use the simplest words. Define the terms. Ask what we understand. Include us in the lesson plan. “Hello, my name is..” is an international endeavor to encourage HCPs to introduce themselves, pioneered by a UK oncologist living with cancer. Introduce yourself more than once, bringing your picture and name on your badge closer, especially if you have a mask. My husband was recently in hospital after complications from surgery. When there were no introductions or name badges, it felt like HCPs were evading responsibility for their work. Nevertheless, we received exemplary care from a sometimes–faceless team.

I am still a pediatric patient in an adult body. I am fearful and cooperative to a fault. Making certain I am liked precludes being assertive. I may not speak up if something hurts or I don’t understand. I may be reluctant to use my call bell unless it’s urgent. You may need to ask how you can make me more comfortable. Many Indigenous people were abused and experimented on as children in sanitariums and residential schools. They may continue to fear and avoid healthcare. With the help of indigenous navigators, trust may be built.

Patients have a right to know what happened, why, and especially how investigations will prevent it from happening to other patients. No one is perfect despite good intentions, so forgiveness comes easily. However, patients suffer unfairly when lied to and abandoned. BC Supreme Court Apology Act 2016 allows the expression of regret and apology by the HCP without it being a confession of responsibility.

Here is an example of supported decision-making during informed consent. I had recurrent gallbladder attacks requiring emergency surgery, a situation that didn’t require consent. Nevertheless, the surgeon and resident gathered with an ER nurse at my bedside. The nurse repeated the information to me and my husband when he returned. Even though I was drowsy with pain medications, they helped me recall the details of the conversation. The nurse was my witness, my memory keeper, and my advocate.

3. Compassion

“Hope is the bird that feels the light and sings while the dawn is still dark.” — Rabindranath Tagore

I have experienced healing and hope through the compassion of HCPs. A bowel obstruction was not resolving. The cluster of surgeons and residents stopped entering my room, only whispering outside the door. Nevertheless, I was buoyed by housekeepers and my daily x-ray sessions by cheerful porters who greeted everyone on the way.  A nurse took me arm in arm for a shower of hope, washing away worry and scaffolding my weakness.

After my son was born by elective c-section, he had wet lungs from not being squeezed in the birth canal. In his early hours, he was taken away from me to the special nursery. I was running on half a tank of blood, tearful and itchy from the epidural morphine. A nurse took me arm in arm, speaking hope with every step we took towards where he was being observed until he came home with us.

“Sorrows are almost always easier to bear when you can tell a story about them.” — Isak Dinesen

A woman on the sidewalk with exposed sores is shaking and crying, clutching bottles of hand sanitizer and Listerine. As a little girl, she never imagined herself homeless and suffering from withdrawal. It might have been me. I’m a recovered alcoholic 17 years sober. A blessed nurse extended hope by saying, “You have a disease for which there is a cure.” “You deserve a better life than this.” I hope you will remember me when patients are inebriated, vomiting, and combative. I asked an elder about an eagle skull I found on the beach. Eagles can inadvertently seize salmon that are too heavy to carry from the ocean surface. The predator plummets into the depths locked to its prey because their talons cannot be released, a metaphor for substance use. Somehow, sometimes, there is a way out. There but for grace go I.

Thank you for being present in our time of vulnerability. Thank you for asking what matters most to us. And especially, thank you for your expert care.

May you find me:

• Undefined by disability
• Adapting to acceptance
• Realizing resilience 
• Outshining stigma 
  

Because you willingly care for me, your joy affirms my worthiness and trounces my sense of being burdensome. Healthcare is love.