Hospital observations

I spent several hours at the hospital yesterday. It is something that I do fairly often and there is nothing particularly uncomfortable about being at the hospital when I am not a patient. They don’t poke or prod me and my presence is accepted by the staff, who are polite and helpful. The experience, however reminded me of some bits of hospital practice and culture that are distinct and different from other parts of my life.

You’d think that technical language and jargon might be a barrier in a hospital dedicated to scientific and evidence-based medicine. However, I’ve found that almost everyone in the hospital, from doctors to nurses to aides to technicians, is pleased to explain things to you if you ask a question. Most of them are very good at explaining things in terms that can be understood. Actually, I think that they are used to bridging the gap between medical technical language and common lay language.

There are, however, some things about hospital culture that stand out as I reflect on the day. Here are a few observations.

Hospital staff have been trained to avoid apologies. I suppose this has something to do with the fear of lawsuits, but they have learned to be very natural without using the words, “I’m sorry,” or even “excuse me.” Instead they listen carefully, repeat what you have told them, and use euphemisms such as “I could do this another way,” or “lets try again,” when they are communicating that they will be changing their behavior. I don’t think that this is a conscious effort for those who have been working at the hospital. It seems to simply be ingrained in their culture.

I, coming from a culture and a tradition of confession, am constantly apologizing. When I stand in a place that is blocking another, I apologize for being in the way. I apologize for not remembering some detail that I am asked by a hospital employee. I say “excuse me,” and “I’m sorry” enough that several times yesterday I was told, “You don’t need to be sorry,” or “No need to apologize,” and even “You’re good.” I actually think that if I made a point of offering a apology for each time I was even slightly in the wrong place or in the way of hospital activity, I would end up making others uncomfortable. Then I’d have to apologize for that.

I don’t have any complaints about the hospital or the way I was treated, but I did notice the difference between the culture of the hospital and the culture of the church where I work every day.

Another difference that I’ve noticed is that people don’t make reference to shortages of staff. In a hospital the phrase “shortage of beds” is almost always a reference to a staffing shortage, not an actual problem with a lack of furniture. I don’t think I heard that particular phrase yesterday, but I’ve often heard it in reference to behavioral health patients and the lack of services available. If you listened to what is said about Regional Behavioral Health, South Dakota Developmental Center, Northeastern Mental Health Center, or The South Dakota Human Services Center in our community, it would be easy to come to the conclusion that there was some kind of a strange furniture shortage in our state. One might even be encouraged to go into the business of manufacturing hospital beds to address the acute shortage. But “shortage of beds” doesn’t mean a furniture problem in our state. It means a lack of staffing and sometimes it means a lack of funding.

The phase I did hear yesterday was “the hospital is full.” It didn’t mean the same thing as that phrase means during the motorcycle rally, when they sometimes have to have patients in the hallways or double up in some treatment areas separating patients with curtains. What it meant yesterday is something that you often encounter in a motel if you arrive too early. The room is not prepared. The hospital, like a motel, has a limited amount of cleaning staff, who work diligently but can only be one place at a time. As they work through the rooms, preparing them with fresh linen, cleaning out bathrooms and making sure that all surfaces have been disinfected, it take time. When a patient is dismissed from the hospital or transferred to another area in the hospital, it takes time for the cleaning staff to get to the room and make sure that it is fully prepared for the next patient. You won’t however, hear anyone at the hospital go into detail. They’ll just comment on how busy the hospital is and use terms like “We’re full.” I suspect that staff have been told not to make references to staffing shortages in any of their conversations with patients or families.

Actually, as my experience yesterday illustrates, much of medical care involves waiting. A patient literally has to be a patient person. The hospital moves a significant amount of people through their triage, treatment and patient care rooms and the system works in many ways that are very efficient, but there is a reason why every doctor’s office, every treatment area in the hospital and every floor of the institution has a “waiting room.” Being a patient or a family member involves quite a bit of waiting. The hospital has invested significant resources is making those waiting areas comfortable. They are kept very clean. They have comfortable furniture. There are television sets everywhere in the hospital. And there are quite a few volunteers and staff who try to ease discomfort and keep patients and families informed. I don’t know how many times I was offered a cup of coffee yesterday, but it was a lot. As one who doesn’t drink coffee, I was aware that with all of the potential health effects of caffeine, the hospital might want to consider revising its beverage offerings for those who occupy the waiting rooms.

I have no conclusions about hospital culture today, just observations. It’s probably a good thing that I spend some time at the hospital so that I learn more about the culture of a place that is devoted to healing and caring for people.

Copyright (c) 2019 by Ted E. Huffman. I wrote this. If you would like to share it, please direct your friends to my web site. If you'd like permission to copy, please send me an email. Thanks!