I was recently re-reading an email exchange with Dr. Skip Durning, who at the time was director of Hospitalist services at North Adams Regional Hospital. He wrote to me following a presentation to hospital staff that included our video “Voices from the Lived World of Illness.” After the viewing, the discussion with attendees highlighted the challenges of healthcare communication, especially when someone is seriously ill.
“I hear a challenge from these patients to walk with the patient and be present,” Dr. Durning noted. “It is my experience that the patient who has accepted the serious nature of their illness still wants to live, to be heard, acknowledged and to be loved.”
As much as the Center for Communication in Medicine’s work emphasizes the role and responsibility of patients to open channels of communication with healthcare providers, we recognize that doctors and nurses have a hard job. Dr. Durning’s work as a hospitalist often placed him in a position of having to communicate to patients and their loved ones about the seriousness of the illness. In some instances, he might be the first person to open a conversation about end of life care.
In this time of COVID-19 hospital safety protocols, I’m trying to imagine what it’s like for doctors and nurses to be treating patients who are unable to speak and loved ones restricted from visiting. What makes it even more complicated for hospital-based clinicians is that they often find themselves in the position of not knowing the patient or family and critical decisions about care need to be made.
There is no simple solution to this communication nightmare. We’ve seen news accounts of a doctor or nurse holding up a phone and being an intermediary between a COVID patient and their loved ones, perhaps updating health status or sometimes facilitating a heartbreaking last goodbye.
In the “Voices” video, Pat Barr tells us, “We need to develop a partnership…a shared sense of not knowing—but a willingness to do the best we can.”
In his email Dr. Durning said, “Cure is no longer the issue, so neither is failure, except the failure to be compassionate and present. Every doctor and caregiver can offer these gifts and thereby help and heal”
His words were as true then as they are today.