Making Your Medical School Commencement More Memorable, Use the Voice of the Patient

No doubt you were attracted to the field of medicine because they have a deep caring and interest in helping humankind. From the time you entered nursing or medical school until you begin to work in a healthcare setting -- learning the ins and outs of illness,

medicine as a means to a hopeful recovery -- is your primary focus. Later the demands of your work increase and too often, the patient – the reason you chose this profession to begin with -- seems to fade away.

Commencements are a time of celebration, reflection – a new beginning or start. What better time that to hear directly from the source – a patient – who has had first-hand experience of being ill as well as treated by those of you who have worked so hard and studied so diligently. A patient is someone who is painfully and/or blissfully aware of the impact a nurse or many nurses have in helping to heal her illness. Imagine hearing from a patient(s) before entering fully into the profession, perhaps at your commencement. We all remember a compelling story about how someone’s words or actions have impacted someone else. Not only would this be of benefit to you as a graduating nurse, but also to the friends and family members in attendance.

Rosalyn Carter put is so perfectly when she said

"There are only four kinds of people in the world:

those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers."

How true.

As graduation and future caregivers as nurses, who better to hear from than a patient with a story (or a few) to tell about the impact you have the ability to make in your patient’s healing process.

As a patient myself, and one who is nothing but grateful for my medical team of physicians and nurses (who I saw the most frequently), I think it would be hugely beneficial to let graduates know of the impact they will have on the ill as well as patient’s family members and friends who, like them, are also caregivers.

When I speak to audiences of health care professionals, I’ve been told that I am “generously poignant” in sharing the ups and downs of my life before, during and after my emergency liver transplant (2005) that was wrought with complications. I share my story from my heart because I want future medical professionals to know the true difference that they make in the lives of their patients.

I speak with first-hand authority of what it’s like to be on the receiving end of medical treatments and how small things had such a big impact on me . . . and my family members. The narratives and stories we share with others are what people remember. The vision that can be described by the person who has experienced something is more powerful than imagining what it “might have been like” for that individual.

Here’s a sneak peek at what I share with graduating nurses that they might not have heard in nursing school and has recently been published in my book, Patient Speak, 7 Communication Practices to Improve Patient and Family Experience.

Words Matter

What you say to a patient has power. The manner in which you say it, through your tone of voice and intonation has power and

meaning to a patient. Never forget the impact you have and please don’t underestimate offering hope to someone who’s ill. There is a clear connection between emotional and mental well- being and your ability to heal. I know.

At my absolute lowest – after being discharged after six consecutive months of hospitalization – I was at my doctor’s office where my medication had to be adjusted. My surgeon left the room and my nurse practitioner Erin had her back facing me as she was writing instructions down related to my new medication. I was at my absolute lowest – having not showered for days, wearing the same sweat suit from Target, with suicidal thoughts coming in and out of my consciousness. “Erin,” I asked her, “will I ever get better?”

Erin slowly turned around to me and looked me in the eye and said very steadily and with a strong voice, “Yes. Yes, you will get better.” I know now that Erin had no idea if I really would get better – after a six-month hospitalization, I was in the midst of being readmitted to the hospital 11 times during the following six months that I was in the midst of when I saw Erin this time. It was truly a touch and go situation. I held onto her words because I needed to believe that if Erin thought I could get through this, then maybe – just maybe I would. What you say matters and never underestimate the power of giving someone hope.

Compassion is Key

Showing your compassion can be said in words, or expressed in gestures, a gentle touch, a caring glance and direct eye contact and acknowledgement of your patient and what he or she might be going through. It can be expressed in the way that Erin so graciously did when she gave me the belief that I could and would get better.

A light touch of your hand, offering direct eye contact and a caring tone of voice all reinforce compassion and respect of your patient as an individual and we feel your caring.

Delivering unfortunate news to a patient or family member that they don’t want to hear is not easy. It can be done in a way that leaves the patient or caregiver with a feeling that you, as a health care professional, is concerned and understands the disappointment that less than positive, or devastating news is always difficult to hear.

Relating on a Human to Human Level

When I first arrived in ICU, the nurse who was assigned to me was Frank. I’ve written about Frank extensively because he made such a positive impression on me from day one. Within an hour of arriving to the ICU via ambulance from my local ER, Frank inquired about my manicure and asked me “what is that on your nails?” I replied it was a French Manicure. He also noted that my toes had been painted the same way and I said, “yes, that’s a French pedicure.”

He mentioned something about being from Maine and not having seen that before, but he did say – “It looks like you take good care of yourself, and I’m going to take good care of you too.” I was sold. Although I don’t believe the benchmark of taking care of oneself is having a French mani/pedi -- but Frank took the time to relate to me on a very personal, human to human level with the conversation about something as simple as my finger and toe nails. His effort to make a connection and strike up a conversation with me – knowing I was as ill as I was when I entered ICU – helped me to believe that he had my best interest at heart and really would “take good care of me.”

Little Things Mean a Lot

Sometimes, the seemingly small things you do – perhaps even big things you do by going above and beyond -- will be remembered and talked about for years to come. You may never know it and it almost always won’t be acknowledged in the moment because your customer – your patient – is sick. That doesn’t mean we won’t forget what you did. We remember.

I’ll never forget the time my nurse Frank (same guy, same place) showed up early for his shift to take me for a CT scan one afternoon in August. On what I thought was the way back to my room post scan, Frank pushed my gurney into unchartered hallways. As we cruised down the basement of the hospital, I saw two large black double doors that Frank opened . . . onto the loading dock of the hospital. I was in ICU for nearly three months and had been expressing (by mouthing out the words because I couldn’t speak) my desire to go outside. I was continuously told that I was too immune suppressed and it wouldn’t be allowed.

But on that glorious August day, my nurse Frank had made an executive decision with compassion and courage I needed -- to bring some sunlight into my life. He pushed me into the sunlight on those docks, lifted my Johnny up and stood beside me for about five minutes. It was the most memorable act of kindness I experienced while in ICU and I haven’t stopped sharing the story.

Put Situations or Circumstances in Context

Context is so important and sharing the reason behind asking a series of questions or doing things a particular way is critical in building trust and credibility between people. When context is provided, a patient doesn’t personalize everything that’s happening to and around them.

I participated in an intake role-playing exercise where I had to dress in a Johnny and get into a hospital bed and “act as if” I was entering the hospital with the same conditions of my illness when I first entered ICU.

Within in seconds of my explaining my symptoms, she asked two questions – both necessary to have the answers to when you enter a SICU. She asked me if I had a health care proxy and if I had an end of life plan. Although they are questions that need answers to, I shared my feedback and suggested that they could have been phrased differently if more context had been established. Here’s how I’d suggest those questions be asked.

“We have to ask everyone who comes through our doors a couple of questions because we need to know the answers to them. Do I have your permission to do that?” If context had been established from the get go – and had been set up like this, a patient would have thought that these are questions that need answers to them – and it’s not unique to me because of how ill I am. They need to know and I’m happy to tell them. Without that context, increased anxiety for patients is the result.

Above All, Treat Patients as Humans with Lives Beyond Being Ill

Patients are people too. Always remember that we have lives beyond our illness. We have careers, families, relationships, interests, etc. that need to be acknowledged. Connecting with people on a human to human level is the ultimate way of caring for someone.

And for that we, I – your patients – thank you.

So, who else would you want to hear from at the commencement of your nursing education than someone who can personally

share their experience of the impact that you will make on someone – but more likely, many people?

If you haven’t yet chosen your roster of commencement speakers I hope you’ll consider asking a patient to share their experience with the graduating class so you can hear the difference you have the ability to make in someone’s life by choosing this profession.

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