At Fast-Paced Hospital, Patients Need Patience; Volunteer Learns Importance of Taking Time
by Cathy Lickteig Makofski special to The Washington Post  April 25, 2002

“Good morning, my name is Cathy and I’m an Emergency Department volunteer, not a medical person,” I say to Mr. J’s wife and son. Mr. J, a big man in his mid-fifties, is lying blood-spattered and pale on a gurney in a tiny examining room at Howard County General Hospital. The medical team is beginning an examination, and they want Mrs. J and her son to leave.

“Let me show you to the waiting room, where you will be more comfortable,” I say.

“Cathy, bring the cell phone to Exam Room 5,” calls a nurse from the back of the Emergency Department (ED).

The 38-year-old female patient in Room 5 is shaking from a high fever and wants me to call her daughter to come and stay with her.

I love the challenge of the ED and, for more than a year, I’ve kept up with the pace of patients and with the medical teams who treat them. My job is to offer nonmedical attention to patients and their families — compassion, warm blankets, coffee, newspapers, a telephone — anything that frees the staff to handle medical problems more quickly.

I thought I was pretty good at this until one day when I was pushing an old man in a wheelchair to his son’s car. He reached for my hand, looked at me and said, “Thanks for letting this old man ramble on and on.”

I smiled and said, “Glad it helped.”

Despite my casual response, his comment caught me off guard. I didn’t remember listening to him or even having a conversation with him. Did he just wish I had talked with him? Was he confused? Yes, maybe that was it. He must have mistaken me for someone else.

For a while, I put the encounter out of my mind. A man in another examining room moaned. It was a deep, deliberate and frightening sound. He vomited violently several times before the tech could get to him with a basin. Housekeeping rushed to clean up. I brought him a cool towel for his head and another to wrap around the back of his neck to reduce the nausea.

Suddenly beepers sounded, doctors and nurses responded, and an ambulance crew wheeled a new patient into an examining room.

“Cathy, can you help comfort this patient?” asked one of the doctors.

The image of the old man returns. A red plaid jacket covers his frail body, but his eyes are clear and strong and so is his voice. If only I could figure out the meaning of his message. I feel the warmth of his stale breath as he leans close to my face and looks me right in the eye.

Why am I obsessing on this? Did I forget something he asked for? Guilt is setting in.

Another ambulance screams in with two patients from an auto accident — a 29-year-old man in a heavy parka and his 18-month-old son strapped to backboards. We put both patients in the same room and place the backboards as close as possible so they can see and touch each other.

The father explains that they were on their way to the hospital to see his wife and new son, who was born the night before. I am dispatched to the Maternal Child Unit to get the mother. The charge nurse calls ahead, and the mother’s nurse is telling her about the accident when I arrive. The woman is understandably hysterical. The mother, her nurse and I return to the ED, where we learn that her husband and son’s injuries are not life-threatening.

Meanwhile, the woman who wanted me to call her daughter awakens as I enter her room. We make another unsuccessful try to reach the daughter, then she drifts off to sleep and I rush out of her room to Mrs. J, who is standing in her husband’s room.

“Sorry I didn’t get back to you as I promised,” I tell her. Mrs. J explains that the nurse came to the waiting room as soon as they were finished examining her husband.

In front of the nurses’ station, Mr. L is shouting at anyone who will listen. “Just how much longer are you going to keep me waiting?” he demands.

“Until we get all of your test results back and the doctors can review them,” I explain, escorting him back into his room.

Thoughts of the encounter with the man in the wheelchair play over and over in my mind like a bad melody. Whose needs am I meeting? The medical teams’, the patients’ or mine? Am I just another person hurrying patients up and out of the hospital as fast as possible?

The energy and culture in the ED is all about speed. When I work at top speed assisting families or running to the pharmacy, the lab or kitchen for special meals, I feel productive because I’m helping the doctors and nurses do their work more quickly and efficiently. When the medical teams work fast, patients can be seen more quickly. Isn’t that what everyone, including the patient, wants?

But is that always the case? Maybe the old man’s thank you was his way of making the point that most of us don’t realize how badly patients need someone with the patience and the willingness just to be with them.

Friends who are physicians, psychologists and hospital clergy tell me that one of the difficulties of treating ED patients is that seldom is anyone available to console or sit quietly with them; or to give them space to absorb frightening information about a diagnosis or treatment; or to listen to their fear, anger or frustration.

ED volunteers are in the best position to provide this kind of attention. Because I was caught up in the all-important speed, I had missed a special opportunity we volunteers have to care for patients in tiny, meaningful and unhurried ways.

Patients deserve someone who can help make them feel human in the very dehumanizing environment of an ED. That’s why I became an ED volunteer. My good intentions and my love of the fast-paced, high- stakes environment drew me into the maelstrom that is the ED, but when I got there I discovered that working as fast as I can only gives me the sense that I am in control. By trying to be so in control, I missed some important personal things that ED volunteers can do to make a difference.

We all have to do what we can to help the medical teams — particularly the nurses, whose workload is beyond belief. Now, however, whenever I work in the ED, I will try to remember how important it is to preserve some of my time and patience just for my patients.

Thanks, Old Man.