By GLYNIS HART
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Crisis in the health care system – Part 2
CLAREMONT — There is a crisis in the health care system, but it is not just on the economic side. While the national debate swings from Medicare for All to repealing the Affordable Care Act, patients complain that a for-profit health care system leaves one critical thing out: compassion for those suffering from pain and disease. In the second story in our three-part series the Eagle Times looks at the need for compassion in health care.
Suicidal depression after stroke
“I’m really on a mission about people not getting the care they need,” said Diane Foster, who lives in Charlestown. On Dec. 29, 2018, Foster had a stroke. She doesn’t remember much of the event: she went to bed and the next morning found her on an emergency flight to the hospital in Burlington, Vermont.
She spent a few days there. The stroke affected her memory and her reflexes, her speech.
It also turned her life upside down. Before the stroke, Foster drove a bus for children with special needs. After, she could no longer drive.
Foster also suffered debilitating depression after the stroke. Always an upbeat person before, she found herself crying uncontrollably when her family left the hospital.
“The nurse said, ‘You’re crying? I’m sorry,’ then out the door she goes and that’s that,” said Foster.
Foster was transferred to Mount Ascutney Hospital for rehab and speech therapy, and then they sent her home with a referral to someone at Dartmouth Hitchcock Medical Center — or at least she thought so.
Instead she curled up on the recliner in her living room and stayed there for days.
“Nobody called. Nobody cared. I wasn’t seeing any doctors. I couldn’t understand it. I just kept getting worse with depression.” Foster said she’d never had depression before and it was terrifying.
“It gets to the point where you do not fear death,” she said. “It would be so easy to end it.”
Stroke patients often suffer personality changes, and Foster feels different. “The old Diane is gone. Done.”
She gets upset and angry more than she used to, and oddly, she spends a lot of time drawing. Her drawings use intense clusters of lines to depict flowers, animals, leaves, and other natural subjects. Since the stroke, she’s filled notebooks with drawings.
“Before, I couldn’t even draw stick figures,” she said.
She called her doctor to get help with her depression, but she got the receptionist, who told her to put a cold washcloth on her face.
“She told me to take a deep breath and call my daughter,” said Foster.
“Now I understand why kids are cutting themselves,” she said. “I come from a place in Connecticut where a teenager 16 years old jumped to her death. I used to judge people like that, but these kids don’t have anything to hold onto. It’s because you don’t know what to do anymore. They say it’ll take time and you’ll get better, but what do I do in between? It’s like you died, but you’re not dead.”
Teaching compassion
Although each patient’s experience is unique, feeling pushed aside and dismissed by the health care system is something most patients can relate to. Whether you’ve waited an hour to see a doctor who spent most of your allotted 15 minutes looking at a computer screen, or you’ve sat in an emergency room for hours waiting for treatment, getting the message that your problems are not important is part of the modern health care experience. But, does it have to be?
“The whole way they treat people is not compassionate,” said Melanie Sears. Sears retired from nursing after 35 years and has written a book, “Humanizing Health Care; Creating Cultures of Compassion with Nonviolent Communication.” She believes teaching health care professionals to communicate better and behave more humanely toward their patients could revolutionize health care.
“I sure got to see the system up close and personal,” said Sears. “At first when you’re a new nurse you have a lot of compassion, but then you get burned out. It’s a moral dilemma because you want to take care of people and the system doesn’t encourage it.”
Sears promotes nonviolent communication, which requires providers to observe their patients and themselves, read feelings, express needs, and make requests (not demands). She makes the case that a top-down system that rewards “tough” people with status and power squelches collaboration and communication. For instance, if a nurse or doctor makes a mistake, they feel pressured to cover it up or deny it, instead of talking about it and figuring out how to avoid similar mistakes.
While many practitioners believe that empathizing with their patients will compromise their effectiveness, Sears writes that the opposite is true: “You cannot give what you don’t have. If you don’t have empathy for yourself, you cannot give it to others.”
“I don’t see it that much that practitioners will sit down and deal with emotions,” said Sears. “I think it’s necessary for a person to heal to have empathy.”
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