Communication in the Hospital

The care rendered in hospitals is of a much greater intensity and more complex than in the past. It is not unusual for two or more physicians to be involved along with therapists, nursing staff, social workers and others on the care team. The sum total of this may be a greater degree of confusion on the part of the patient and family with regard to all that is taking place.

An even more distressing outcome may be unintentional injury or poor treatment decisions if there is not a thematic nature to the process that is understood by all. As a consequence, the value of good communication is elevated with the onus on the physicians first and then on other members of the health care team. There should be no unanswered questions.

There are several signs of good doctor-patient communication that are all reasonable expectations on the part of patients and families:

• Any physician involved in the care plan clearly provides an introduction and a brief description of their care-giving role.
• If they are covering for another doctor, they should say so and give some indication that they understand your particular situation.
• Upon entering the hospital room, they acknowledge the presence of all assembled and look for a place to sit down before beginning to speak, especially if the news is complicated and emotionally charged.
• They speak clearly and slowly and pause to ask if you understand what is being said - some may even ask the patient or family member to re-state what they believe the treatment issue is in their own words.
• They will tell you the time during which they make hospital rounds so that other family members can be present if so desired.
• A lead doctor may ask that one family member be designated as a key contact and make an effort to provide a daily update to that person if unavailable at the time the physician makes rounds.
• In particularly grave situations, they may schedule a family conference to allow more time to review a treatment plan.

On occasion and even with the best of physicians, the whole process may appear to be fragmented and poorly coordinated. Here are some suggestions in the event that clarity is needed:

• It is entirely reasonable to be respectfully assertive and to ask for explanations or make requests that any of the aforementioned issues be addressed if there is a concern that the full picture is unclear.
• The nurses and other members of the care-giving team are often good resources for additional care-related information and often can provide support in getting better communication from the physicians.
• If the care-giving process seems to be eroding and concerns about safety and health arise, hospitals have patient advocates available that are charged with addressing these issues and can be contacted through the nurse or social worker.

Regardless of the circumstances and even the outcome, having the peace of mind of knowing that care was delivered professionally and competently is a goal that has both immediate and long-term benefits. Knowing that you were able to take full advantage of the expertise available during a hospitalization is empowering and sets the stage for a healthy working relationship for any future issues that arise.

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