[Originally published by Hospital Impact]
I recently had the opportunity to visit a number of well-respected healthcare organizations and meet with amazing servant leaders who are all striving to bring healthCARING back into the healthcare system.
Today I would like to share one of those experiences and what I learned.
At a critical access hospital in the Midwest, I met a chief nursing officer (CNO) who has worked throughout the country to implement systems to better position nurses to be successful and again find joy in their work, and improve the care of patients and their families. We had the opportunity to share stories, best practices and barriers to optimal care provision. And during this time I shared the story that I have shared on many occasions in many forums of the impact of childhood abuse on the health of adult patients.
I explained how I’ve witnessed firsthand far too many patients being declared “non-compliant” because they did not adhere to treatment protocols when in fact we healthcare leaders have not created care models that allow for time, relationship, trust and for the patient’s whole story to be told and heard. These patients were not positioned to share their whole story, and clinicians were not positioned to hear their whole story, e.g., how sexual abuse in patients’ past had led them to form an unhealthy relationship to food or how abuse from a coach during their childhood has led to an aversion to exercise. And thus we healthcare leaders have not created systems that allow both patient and clinician to identify and address the root cause of “non-compliance” but rather, we have given up on patients who truly needed us.
As I was sharing this information, I made note that this CNO was shaking his head and leaning in as I spoke. And when I stopped to take a breath he shared …
“Yes. This is so true. I have seen this same occurrence throughout my own journey as a healthcare leader and am appalled that to date we have not made the necessary improvements to allow for such critical information to be shared. We have failed our patients and our clinicians in many ways and must do better.”
The confirmation of what I have seen and the need to improve was one thing–but then he continued with a story that actually caught me off guard …
“Some years ago, I was working in a rural community as an Interim CNO. I was getting to know my team and developing my plan to improve the nursing systems currently in place, and yet something was gnawing at me. At first I could not put my finger on it, but something was wrong. Something was truly wrong with my nursing team. I looked in the mirror. I looked at our aim, the plans we were creating, our pathway to improvement, and all were in line with successful endeavors in my past. But here something was very wrong.
After much processing I made my way to Human Resources and there, without consciously thinking about it, I shared, ‘my nursing team … they act as if they have all been victims of abuse.’
Tom, I was blown away when the response I received was, ‘Don’t you know? This county has the highest rate of childhood abuse in the state. Many of the people on your team were victims of childhood abuse.’
Not only was I shocked to hear this, I was also so very disappointed in myself that I did not know the stats and more importantly did not recognize more quickly the challenges many members of my nursing team were facing.
The next day I brought my team together and I apologized. I apologized for my behavior and for my lack of awareness. And together, slowly at first, we began to develop a relationship. We began to share and to develop trust as you referenced. We began to share stories and connect at a much deeper and a much more important level. And together we began to ensure they (our team) were healing while they also ensured our patients were healing.”
Childhood abuse impacts our patients and their families. It may also be affecting members of our organizations and of our teams (and perhaps some of us). As healthcare leaders, it is incumbent upon us to be aware, to develop healthCARING models for both our patients and families and our team members and ourselves that allow for time, relationship, trust and for whole stories to be told, heard and together acted upon as appropriate. Only when we have invested the time and energy to do so will we truly be honoring those we are blessed to serve, improving patient and clinician experience, improving patient safety and providing optimal care while optimizing limited resources.
It is not too late but long overdue.