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Five-Star: Doctors Showing Compassion

June 3, 2011Doug Wojcieszak, Founder & Spokesperson Contact phone/e-mail address: 618-559-8168; doug@sorryworks.net

FIVE-STAR: DOCTORS SHOWING COMPASSION A good friend sent a recent PIAA newsletter with a news article on how doctors struggle with compassion - see directly below:

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Doctors Often Struggle to Show Compassion While Dealing With Patients Upon learning from his doctor that he had less than six months to live, Mike Venata said he wanted to reach across and slap the doctor. He said it wasn't the news that made him angry; it was the way it was delivered. The specialist had pulled out a piece of paper with his test results on it and said, "Well this isn't very good. This is terminal." He didn't talk to Mr. Venata, he talked to the piece of paper. "I have a guy sitting there reading a piece of paper telling me I am going to die and then walking out the door. That was not well executed," said Venata. To him the doctor's heartless presentation was as painful as the news. In research conducted at five medical schools, researchers studied two sets of faculty members on their skills at being compassionate as evaluated by their medical students and residents. One faculty group underwent a two- year program that combined experiential learning of skills such as role modeling along with reflective exploration of values through writing narratives and other activities. The other group had no intervention. The compassion-trained group was rated significantly more compassionate or humanist with their patients, demonstrating that compassionate can be taught. Another study of medical students showed that empathy scores declined among students at the end of the third year, when they had begun regular exposure to patients during clinical rotations-exactly when they need more empathy. In an editorial for the Washington Post, Manoj Jain, MD said, "The art of medicine is not just choosing the right medicine, but gauging the needs and providing reassurance and comfort to the patient." He said he believes that healthcare providers are genuinely compassionate and that is often what has steered them toward medicine in the first place. However, with the uncertainties in healthcare, increased workload and limited time, for many the joy in the work is lost, and this comes across in doctor-patient interactions. (Washington Post, 5/16)

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You know, only half (or less) of medicine deals with biology, chemistry, math, etc....the other half is all about relationships, emotions, communication, etc...yet medical schools have traditionally focused on the science. It's a shame, but we have a lot of great technical people who have trouble emotionally connecting with the customers! This is article is exhibit A.

In our Five-Star courses, this is what we teach --- and the docs actually eat it up! Docs know they are often lacking in this area, but many don't how to make it happen, especially in their pressure- packed, overbooked professional lives. So, we teach them simple things that don't consume time or cost money....the importance of hello, using someone's name, sitting down and looking a person in the eye, avoiding the temptation to interrupt and actually listen, body language, and so on. It's actually a small investment that a) can provide nice dividends and b) avoid big headaches and losses, including litigation. There's so many little things docs can do that mean the world to patients and families.

This compassion stuff is big part of it. Taking a few minutes to talk through a difficult situation, appropriate contact such a holding a patient's hand or gently touching a shoulder, appropriately relating ("You know I lost my own mother a year ago...."), even crying with them, etc. I know this is foreign to some docs because you're taught to heal and save lives and admitting defeat is not part of your DNA, but, we all die some day. Patients and families know this....and we also know despite your best efforts you can't fix every problem, cure every disease, etc. So, sometimes showing us you care is enough....but you have to do it! And to do it, you need to be trained.

Below is a great story of a Cincinnati hospital that developed a compassion training program after a family complained about how they were notified about their daughter's death during surgery. See below.

To learn more about Five-Star training from the Sorry Works!-Stevens & Lee Team, give us a call at 618-559-8168 or e-mail doug@sorryworks.net.

Sincerely,

- Doug

Doug Wojcieszak, Founder Sorry Works! 618-559-8168 (direct dial) PO Box 531 Glen Carbon, IL 62034

Ohio Hospital Trains Staff On Death Notifications By Associated Press May 19, 2011

CINCINNATI - Seated in an audience of doctors, nurses and faculty at University Hospital's amphitheater on a recent morning in May, Michael and Stefania Urbisci of Green Township held hands and listened attentively to a presentation about the hospital's new training on death notification.

It's a process the Urbiscis care greatly about because of the manner in which they were told of their daughter's passing roughly a year ago.

Melissa Urbisci - a spunky 22-year-old on her way to becoming a nurse herself - died in surgery at University Hospital last March after she was injured in an automobile accident.

Not only do the Urbiscis feel the doctor who delivered them the irreversible news did so in a terse and compassionless manner, but another staff member told their 20-year-old son Alessandro - who had been driving and was also injured - while he lay alone in a separate hospital room.

Over the course of the last year, hospital officials say they listened to the Urbiscis' complaints and developed unique training they hope will ensure professionalism and respect for patients and their loved ones.

Dr. Jay Johannigman, director of the Division of Trauma and Surgical Critical Care at University Hospital, said the Urbiscis' experience brought him to a realization.

"We simply weren't meeting patients' needs," Johannigman said. "None of us have really ever had the preparation (to notify loved ones of an individual's passing) in a fashion anything akin to how we are prepared to practice operations or diagnose medical diseases."

'Italian Hippie' Melissa Urbisci was a combination of old soul and jubilant youth. Her friends and family describe her as charming, full of energy and compassion for others.

She dreamed of working as a nurse in Third World countries, friends say, and in the months before her death she completed the nursing program at Cincinnati State Technical and Community College as well as Red Cross disaster volunteer training.

In an effort to continue the good work his daughter didn't get to fully realize, her father, Michael Urbisci, said he owed it to her and other families to press University Hospital to re-evaluate its process of death notification.

"As long as I live, I will never forget that instant," Michael Urbisci said of learning of his daughter's death. "It was not a pretty time.....I just hope they are sincere in their efforts to improve their skills in this."

Her friends hope so too.

"Hospitals don't usually change their actions because of one person - but when her family puts their mind to something, they're going to do it," said one of Melissa's best friends, 31-year-old Karen Walter.

Walter is happy that the training can honor "one of the most amazing friends that you could possibly ever have;" the young woman who she called her "Italian hippie" because of her love of nature and peaceful way with people.

"I always told her she was more beautiful on the inside than the outside," said Brian Young of Green Township, who had been dating Melissa for nearly four years at the time of her death.

Her confidence and ability not to take herself too seriously drew people in, they said.

Her cousin, Tracy Oliverio of Fairfield, said many members of their family came to the United States from Italy. Oliverio has fond memories of conversations she had with her cousin while doing dishes after weekly dinners at their grandmother's home in West Chester Township.

Melissa always seemed to carry a camera, Oliverio said.

"She wanted to capture any moment, even if it was nothing. Because of her we have a billion pictures," Oliverio said. "I thank God for those moments that she took pictures, because that's what left, beside memories."

Melissa's Time On average, three people die every day at University Hospital, Jaylene Schaefer, social worker and field service instructor at University of Cincinnati's School of Social Work, told University Hospital staff as she led the recent session of training, called "Melissa's Time."

Schaefer said the person who informs family members of the death of a loved one plays a vital role.

"That voice, that memory, becomes so critical - it is the beginning of a journey for that family," Schaefer reminded the doctors and nurses.

Now when a patient dies, the physician is advised to act as a team with a hospital chaplain and social worker when breaking the news to loved ones.

The training has been shared with everyone in the Social Work Department and Trauma Division and will now be integrated into curriculum for all medical students and resident doctors. It includes information about what words to use and how to handle survivors' reactions. The new model also reminds hospital employees not to ignore their own grief in losing a patient but to reach out to the hospital's network of social workers and chaplains.

"As physicians and trauma surgeons we have this self-imposed unrealistic expectation that we don't let someone die," Johannigman said. "That's why I think these slides (in the presentation) are so wonderful for our young doctors, because they say, 'It's OK; you will have these feelings.'"

Third-year resident Dr. Jonathan Thompson, of Fort Thomas, said he thought the idea of having a team of three experts break the news to loved ones is a good one.

"It is a very emotional thing and I think trying to make that emotional connection with family makes all the difference," Thompson said.

Melissa's friends and family say her brother Alessandro, to whom she was very close, has recovered from his physical wounds, but still struggles emotionally.

It's a reality all of Melissa's loved ones are learning to live with.

Her father says his next goal will be talking to other local hospitals about implementing Melissa's Time for their staff.

Johannigman knows executing the training at University Hospital is a start.

"There's nothing I can do (to bring back Melissa) for the Urbiscis," Johannigman said. "But if somehow, some of that (pain) can be softened by the legacy Melissa has brought to this huge hulking monolith of an institution - that doesn't change very readily - if Melissa's Time changes this place, that in of itself will be a fitting tribute to a young lady I never got to know."

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