The Compassionate Use of a Clipboard

Posted on May 6, 2014 by Oren Mason MD — 2 Comments

Patients can’t often measure high-quality care, but absolutely can recognize high-compassion care. Tuesday, May 6 begins National Nurses Week in the US.

A prospective patient was interviewing me to see if I was a good fit to be her physician. She was visibly relieved when I told her that I had admitting privileges at the hospital she favored. She seemed compelled to explain why she would only use that hospital and no other:

“It was the worst day of my life. My ex-husband had beaten me for the last time. I was covered with blood and still bleeding. The pain wasn’t nearly as bad as the confusion and sense of lostness. I couldn’t cry, I was just dazed and in shock. I literally couldn’t figure out what to do other than get in my car and get away from him. As I was driving, my head cleared enough to realize I needed medical attention, so I drove myself to the emergency room.

“When I got inside, the hospital overwhelmed me, and I froze. Who do you talk to first? Where do you start? There was a waiting room full of people staring at me. Medical people were rushing around, clearly busy. I was standing under bright lights, still feeling lost, and couldn’t imagine what to do next.

“A nurse was walking by, absorbed in something she was doing on her clipboard. She looked at me and stopped in her tracks. ‘Oh, no! What happened?’ she asked.

”’My husband beat me,’ was the only thing I could blurt out.

“This nurse dropped her clipboard in the middle of the busy hallway, threw her arms around me, hugged me right there and said, ‘I am so, so sorry.'”

“I finally just sobbed while she held me. My blood was staining her white dress and it didn’t stop her. I’ve never felt more cared for.

“Now I tell everybody to use that hospital. It’s the best hospital in the world! It’s been 12 years since that day, and I send everyone I can there.”

Now there’s a marketing lesson for hospital executives. Yes, they need to keep working to lower costs, inefficiencies and infection rates, but that is not why patients choose one hospital over another. Patients can’t often measure high-quality care, but absolutely can recognize high-compassion care.

How many hospital board and executive committee meetings focused on finding more nurses like this one and fostering her kind of compassion in their sterile hallways? When the people in charge meet, is it ever to discuss the spirit of the care they deliver, or do profits and reimbursement take all their energy?

Every day, almost 4 million US nurses go to work and graciously accept the ever-rising demands for efficiency and operationally-defined quality. Few, if any, are concretely rewarded for their compassion. They are paid to write on their clipboards–or iPads more recently–in the service of yours and my health status, and most do it very well.

So here is where nurses can amaze me. Despite every economic pressure, the best nurses still sneak compassion into our broken healthcare system.

Blending compassion and efficiency requires a fine balancing act. Great nurses know when to stop writing on their clipboard and look their patients in the eye. They know when to set aside the clipboard and pull their chair closer. And they know when the rare time has come to drop the clipboard and bloody their white uniform.

If you owe a nurse a thank you, today is the day.

Today’s post celebrates National Nurses Day, May 6, with a special thank-you to my own extra-ordinary staff!