Around mid-day at a busy urban academic medical center, the auditorium filled to capacity with 150 staff members representing a wide variety of disciplines from throughout the hospital. The Schwartz Center Rounds physician leader opened the session with a warm welcome followed by the facilitator who reviewed the usual ground rules of confidentiality, listening without judgment and silencing pagers, to focus on being together and creating a safe forum to share the challenges of caring for patients.
The physician leader provided a brief clinical overview of the patient case that had occurred nearly a year earlier, involving a middle-aged hospital transport worker known for his outgoing and playful interactions with staff and patients, who collapsed at home from a stroke and was brought to his own hospital’s emergency room. What ensued from the time of his stroke until his death only three days later touched the lives of hundreds of hospital staff members. The stage was set for an open and honest discussion focusing on the experience of caring for one of the hospital’s own, especially when the outcome was the loss of a cherished colleague. The panel included a fellow transport staff member, the hospital’s transport manager, and a nurse.
Panelists described the ways that Harold had endeared himself to everyone. He joked and teased and made it fun to come to work every day, while also opening up about his own life by sharing his joy and pride in his family. He made friends on every unit and was known for his ability to comfort patients as he accompanied them through the hospital.
The discussion revealed a hospital staff stricken with grief but determined to provide expert care to Harold and his family, and support for grieving coworkers who came to pay their final respects. After his death, Harold’s nurses volunteered to transport him to the morgue as his transport coworkers accompanied him on this final journey. Once there, the hospital chaplain conducted a brief service for them all.
The Schwartz Center Rounds session featured the physician who cared for Harold at the end, who described how much he had struggled to accept the fact that he would be unable to save such a beloved member of the hospital community. Another doctor offered support by sharing how haunted she remained by his death and how important it had been for her to share those feelings with others.
His closest colleagues talked about the sense of mortality his sudden death had engendered in them. A coworker commented that Harold’s death reminded him to approach every patient needing transport as if he or she were a friend or family member. The transport manager remarked that patient satisfaction scores for his department had risen after Harold’s death because it had reminded his staff of their common vulnerability and mortality.
During Schwartz Center Rounds, Harold’s coworkers eloquently conveyed the dignity and care they bring to their work with patients, giving the rest of the hospital community a chance to better understand the concerns, daily life and contributions of their transport colleagues. They are often the first staff members patients meet when they enter the hospital; they also accompany patients when they are discharged. At other times, they are the ones responsible for bringing patients who have died to the morgue.
“Often we are the only staff that patients know won’t poke or prod them,” said a member of the transport staff.
It became obvious to the audience that the time patients spend with transport staff between clinical interventions is often a welcome respite and a time to let down their guards. Physicians and nurses heard for the first time the kinds of questions patients ask transport staff, including whether they will survive whatever ailment or accident has brought them the hospital. When asked how they usually respond to such questions, the transport panelist said, “I tell them that we have wonderful doctors and nurses here who will take very good care of them.”
In life as well as in various commemorations after his death, Harold’s vibrant personality and gift in connecting with others came through. Panelists described bonding with Harold’s various family members who had heard as many stories about his coworkers as the coworkers had heard about his family. These conversations created a communal experience whereby staff members, regardless of position within the hospital, could share a similar sense of shock, loss and sadness as well as inspiration about what a loving person and coworker can contribute to the entire hospital community.
“I’m going to think more about letting people know how much I care about them while they are alive” said one physician who spoke. The Schwartz Center Rounds session reminded the group how much healing can occur even when no cure is possible and how much stronger all caregivers can be when they come together as a community to support one another.
Please note that names and some case details have been changed to protect patient confidentiality. Photo is representative only and does not depict the actual caregiver.