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Friday, August 26, 2016

The Waiting Game

The Waiting Game

Did you ever wonder how doctor’s appointments are made? It seems like everyone has the same appointment time but no one's time is honored.  Recently, I had my three-month checkup with my Hematologists. My appointment was made for 9:20 am on a Tuesday. As we were going to Miami, we took a chance and made a second appointment while we were in the area for 11:30 am. We thought this was a safe bet, but unfortunately, our plan was derailed due to a delay in the patient flow clinic schedule.

To ensure we were on time, we left our house at 7:45 am as you never know how the traffic will be going to Miami. Luckily, traffic was light, and we sailed down to Miami arriving at 8:30 am. We registered and went to the 2nd floor where the Oncology/Hematology clinic was located. We were greeted by a familiar face and told that the clinic was closed for renovation, and all patients were being seen across the hall. We took our seats at 8:45 am and I thought we might get seen early, but the waiting room was filled so I started to have my doubts.

As we waited, the nurses were calling people in but as my appointed time came and went, my name was not called.  Time passed, and we waited and waited. At 10:30 the nurse called me. My husband and I started toward the door but stopped us. She said she was just bringing me in to take my vital signs and I would be right out, so my husband could wait till I came out. 

After returning to the waiting room, we continued to wait and were finally called at 11:00 am. The nurse who put us in the room said that the doctor would be in soon. I asked where the Nurse Practitioner was as she usually came in first and did a preliminary interview and got the electronic health record ready for the doctor. The nurse said she is no longer with Dr. L, but he did have a new NP with him which was why things were a little slow. 

The doctor made his way to our room about 20 minutes later. We realized we would be late for our second appointment; so my husband stepped out of the room to call the office and let them know we would be there as soon as possible.  The doctor came in, said hello, examined me and then went to the computer to document his findings.  I could tell he was not up for small talk, so I did not say anything so he could concentrate on what he was doing. Once he finished documenting, he turned to me and asked me how I was and did I have any questions for him. I told him I was doing well. I did have a few questions, and we reviewed them. He answered all my questions, told me he would see me in three months and that I was stable and doing well. I thanked him, and we went to the checkout desk.

As most cancer patients know our check-ups inspire fear, anticipation and a bit of apprehension. As a result, my husband and I are always on edge as we are fearful a problem will pop up. I am thankful that I continue to be blessed with good check-ups, but that little bit of fear is always there.  Waiting adds to fear and anxiety. 

As I sat there, I wondered why people who came after me were going in ahead of me. There seemed to be no rhyme or rhythm to the process. I wondered when I would be called as no one provided an update, the reason for the delay or an estimated time of when I would be taken. I thought how ironic it was that the TV kept playing an infomercial that talked about how the clinic is committed to providing a high level of customer service, but as I sat in the waiting room, I wondered what they meant by high levels of customer service since no one took the time to explain why I was waiting. In my mind, a simple explanation would go a long way in decreasing my anxiety and help me understand the delay.

Most of us know that when we go to a doctor’s office we will have to wait. We bring books, our cell phones and other things to keep us occupied. The frustration mount when the wait times grow longer, and no one tells you why you are waiting or how much longer the wait will be. I actually wrote a blog post on this topic that was called What to do When Waiting. 

Hospitals, clinics, doctors’ offices, and other settings that service patients have to do a better job of keeping their customers updated and informed. Their survival depends on it especially when revenue is based on the outcomes of patient satisfaction surveys.

As a frequent airline passenger, I recall after some horrendous delays where passengers were held on planes for hours instead of letting them deplane, the Department of Transportation put consumer rules into place that limits airline tarmac delays which provided the passenger with protection. Today, if there is a delay on a plane, the pilot comes on the intercom and informs the passengers what is going on and how long they anticipate the delay will be. They do this frequently throughout the delay to keep customers up to date. Although delays are still frustrating, the pilots messages help to keep the passengers up to date on the delays in their flight which decreases passengers anxiety.  

Today, with the focus on improving the patient experience, keeping patients and their caregivers informed and updated regarding delays is something that should be done in every setting.  As a patient, I appreciate information that keeps me updated on delays from the staff who has control over the patient flow. Updates show that the staff values my time and is a show of respect for their customer.  

I hope this post was helpful and provides some food for thought for the providers we depend on for our care. 

Thank you for reading Nurse Advocate. If you have a comment or would like to share your experience that has impacted your life, please note in the comment section.

Have a good week!

Saturday, August 13, 2016

Going for the Gold

This post is short, but I wanted to take the time to recognize the 2016 Olympics!  Every four years, the world comes together to highlight their athletes in various events. My summer favorite events are swimming, diving, gymnastics and track and field. This year, I have watched some of the other events which might not be as popular but are just as exciting. Two that come to mind were badminton and table tennis. I caught two exciting matches in these events and was in awe of the players as they volleyed back and forth with skills that have made them the best in their sport.   

As the world watches the Olympics, we are reminded that hard work, perseverance and talent allow us to excel beyond our expectations. The Games are a reminder to all of us that there is good in the world, and everyone has a chance to win when they work hard and push past what they think they can do. 

As I watched the parade of athletes during the opening night ceremonies, I was impressed how each country sent their athletes to Rio to represent their country in the name of sports. As the list of countries was read, it was evident to me that as a world we are united, and CAN come together to celebrate in peace and spirit.

As the reporters share personal stories on the athletes as part of the coverage, we learned about the challenges many athletes overcome through determination and support of family and friends. As I thought about this, I realize there is a lot of good in our everyday lives. It is is important that we stop and recognize it when it occurs and pay if forward when we can.

To illustrate this, I wanted to share a story a friend shared on an experience she had when she went grocery shopping after work one day. Here is what she shared on Facebook: “I picked up my little lovebug and headed to the grocery store after work. We walked outside after checking out and it was POURING. A little rain never hurt anyone so we decided to make a run for it and leave the cart right there next to the doors soon to return little one was giggling as we ran to the car because rain is funny. I buckled her into the car, planning to drive up to the sidewalk and load the groceries. Just as I was getting into the car, I look up and an elderly man in a suit, who had just finished loading his car,  was walking towards me with our cart...I thanked him as I opened the trunk and we loaded my groceries. He said it had been a long time since his kids were that young, now he had grand-kids, and he hoped someone would help his daughter out in the same situation as he helped me. I thanked him again as I noticed his leather shoes and suit were almost soaked through.”

This story made me think of the many experiences I have had in my life. I realized how lucky I have been to be blessed with a beautiful family, good friends and the ability to have a career that has allowed me to grow personally and professionally.

I hope this post inspires you to think about the experiences you have had in your life and encourages you to do something nice for someone who crosses your path! If you have an experience you would like to share, please share in the comment box or email me directly at

Have a good week and enjoy week two of the Olympics!

Saturday, August 6, 2016

The Last Dance: Encountering Death and Dying

Recently, I visited a long-time friend, Kathy, who was having a party for her husband, John, who recently retired from the U.S. Air Force. We have known each other since the early 1980's when we both worked in the Respiratory ICU in Philadelphia.  We have kept in touch over the years, and I was able to visit her in many of the places she and her husband traveled as part of his career in the Air Force.  Currently, they are in Tampa FL, so when I got the invite for the retirement party, I was anxious to go. My friend's mother (Mrs. Z) also moved to Tampa from Philadelphia a few years ago, and I was looking forward to seeing her. 

The party was fun, and my husband and I had a good time visiting with those who came for the celebration. Unfortunately, Mrs. Z did not attend as she does not like to go out after dinner. I was disappointed but understood. I asked Kathy to give her mother a hug for me and wish her well.

A few days later, I got a text from Kathy, telling me that her mother had a major brain hemorrhage, and was in ICU. The bleed was so massive there was nothing to do so she was put on Hospice and was receiving comfort care per her advance directives. Her children were on their way to Tampa from various parts of the United States to be with her as transitioned to the next stage of her life.

Mrs. Z is a very religious woman and has lived a long and joyful life. Her husband passed a few years ago, and she looked forward to being with him when her time came. When Kathy found her mother; she said, "don't worry, God is getting me ready to go to heaven". I am praying for Mrs Z, my friend Kathy and her brothers and sisters as I know they are all going through an agonizing time as they lose their mother. 

As I was processing this news, I was introduced to Sam Simon. Sam produced a one-man play called the Actual Dance. The play explores illness and end of life through the eyes of the caregiver. In the email introducing Sam, there was a link to view a portion of the one-man play. I found it very moving and relevant to what I was experiencing. In my mind, Sam’s storytelling helps to share the experiences many go through when they or someone they love is told they have a complex medical condition or faced with an end of life experience. 

I wanted to share the video as it is a good follow-up from last week’s post; Caring for the Caregiver; The Unsung Heroes of the Healthcare System. Take a few minutes to watch this short clip of the play. I am sure it will move you and give you pause to think about your mortality as well as those you love.

In closing, I want to tell each person who reads this post; please do not be afraid to think about your own death, but do take the time to make sure you have your advance directives in order. Also, make sure your family is aware of your wishes so they can be followed. Doing so will be a tremendous help for those who have to handle things when you can no longer express your wishes. I know Mrs. Z helped her children by having her wishes know. For now, please say a prayer for my friend, her mother and the family as they have their last dance. 

Thank you for reading Nurse Advocate. If you have a comment on the video or an experience you went through when you lost a loved one, please feel free to share in the comment section.

Have a good weekend.