Medical Sloppiness and the Need to Micromanage Health Care: Day 1 Part 2

By: Loolwa Khazzoom, Founder, Dancing with Pain

February 15th, 2009 • Patient AdvocacyPrint Print

By 10:00 p.m. on Thursday night, my mother’s personality had returned, and she was able to speak again.  Although I was tired and felt myself on the verge of getting sick, I stuck around until she had gotten all of her medications — which she had been refusing up until then, given her conviction that the hospital staff was trying to kill her. 

I was especially eager to be there when she got her shot in the stomach with a blood thinner medication (to prevent her from getting blood clots — given that, once again, she was immobile in bed). It looked like a nasty shot, and I didn’t want her going it alone.

While the nurse had on gloves while giving my mom the shot and doing the initial steps of reinserting the IV, the nurse began fiddling around with her cell phone and some paperwork, before returning to the IV business. I asked her to change gloves, in the interest of hygiene. She said she only wears the gloves for her protection, and that I shouldn’t worry about it.

I said that might be the case, but I was concerned about my mother’s protection as well, and that it didn’t seem hygienic for her to go back to the IV without changing her gloves. She said that what she was doing didn’t require being especially hygienic. I said I would like her to change her gloves anyhow. She didn’t answer. I asked her again. Still no answer.

I pointed to a sign on the wall that said, “It’s OK to ask about washing hands. Your hygiene is our concern.” “It says you can ask,” I asserted. I had to say it twice before she responded – by throwing out the gloves and then using her bare hands – which may or may not have been sanitized before entering the room.

How much do we push on something? Was it true that the things she was doing didn’t require super hygiene? I said nothing for a minute, despite my anxiety. Then I pushed her to put on new gloves, which involved another round of arguments and being ignored. At the end of it all, she put on just one glove. It was unbelievable. She was almost done, so I said nothing and hoped for the best.

Which battles to pick? That’s always the overarching concern: On the one hand, patients and patient advocates need to be assertive about our rights.  On the other hand, specifically because our lives are in the hands of medical professionals, it seems important not to alienate those individuals. The missing pieces of this puzzle, of course, are adequate training and supervision in bedside manner, hygiene, diligence monitoring patients, and deference to patient needs. 

In other words, if you’re in the medical profession, you are in the service industry.  Just as the customer is always right, so must the patient always come first. Although things are slowly changing, the medical profession still has the patient-doctor relationship bassackwards.

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