Wow! What a year it has been! I hope everyone is staying safe and taking some time to reflect.
At the Society of Critical Care Medicine annual congress in 2019, I had the pleasure of hearing Dr. Rana Awdish speak about her book, “In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope.” After the conference, I read Dr. Awdish's story for myself, which I now highly recommend to all clinicians. In the book, Dr. Awdish recounts her day-to-day feelings about her own near-death ICU experience, recovery, and her return to work several months later. She discusses the language we, as healthcare professionals, use when speaking about our patients—whether on rounds, one-on-one with our patients, or to colleagues when patients are present in the room.
This made me stop and reflect on my own habits. Do I use phrases like, “She's circling the drain,” or, “We almost lost him overnight?” These statements can be very unsettling to the patient and family if they happen to be listening. Remembering that the patient can still hear us talking when sedated or not fully conscious is very important. The patient may not know or understand how sick they are until they hear our candid conversations.
The book also discusses nurse-patient interactions. These are easy when patients can tell you things about themselves; but getting to know a patient who is intubated and sedated is certainly more difficult. How do you get to know your patients? Do you introduce yourself when you enter a patient's room? Do you tell patients what you are doing or that they may feel a prick when you administer a heparin injection or test their blood glucose?
This reminded me of talking to my mother while she was sedated in the ICU. I know she heard me because she would try moving her head in my direction. Her healthcare team took the time to get to know her. One nurse would even sing to my mother while she received dialysis. My mother loved music and served as the choir director at our church. It gave me such comfort that this nurse took the time to get to know my mother even though she was in a medically-induced coma.
As we move forward in this unsettling time, let's try to be more conscientious of how we speak about patients when rounding, updating the attending physician, or giving handoff during shift change. Take a moment to reflect on how you speak to your patient or about them with others. Does your language need to change?
Carrie L. Griffiths, PharmD, BCCCP, FCCM
Associate professor, Wingate University School of Pharmacy, Wingate, N.C. Clinical Pharmacy Specialist Atrium Health-Virtual Critical Care, Mint Hill, N.C.