Magazine article American Nurse Today

Say It Isn't So: Eradicating the Fear of Retaliation

Magazine article American Nurse Today

Say It Isn't So: Eradicating the Fear of Retaliation

Article excerpt

ONE OF MY LEAST FAVORITE ACTIVITIES as a chief nursing officer was reading and responding to patient and family complaint letters describing a disturbing event or significant gap in meeting their expectations. Following due diligence to gain insight about each situation, I found some reconciliation was always necessary. Once I'd addressed specific issues, I typically concluded my letter with something like this: "Thank you for your willingness to let us know how we could have provided a better experience for you. We take these issues seriously and work to improve care." I was sincere and truly valued their willingness to take the risk of sharing their complaints.

But sharing complaints shouldn't be risky for patients in the first place. All too often, patients tell us they feel too intimidated to ask a healthcare provider about their care, and fear retaliation if they're perceived as confrontational or complaining. As protectors, we can't imperil patients by reacting poorly to negative feedback. As providers, we're expected to check any dour attitudes at the door and find a way to deal with having a bad day.

A colleague with extensive expertise in patient education and engagement recently shared a disturbing family healthcare experience where she felt helpless and compromised. Her octogenarian aunt fell down a flight of stairs; in the emergency department, she was diagnosed with a foot fracture and received a temporary cast. Discharged to a skilled nursing facility, she didn't improve--and she fell again. After a great deal of wrangling, the family obtained her medical records and learned to their horror that the temporary cast had been placed on the wrong foot. When she returned to the same hospital after her second fall, her blood work revealed elevated cardiac enzyme levels. Although she lacked symptoms and had no history of cardiovascular disease, she underwent a cardiac catheterization and an intensive care unit stay without being diagnosed with a cardiac problem. My colleague's most distressing comment was her admission that her family was evaluating what steps to take with the hospital but feared caregivers might retaliate.

Say it isn't so--that this is an isolated and unfounded fear. Unfortunately, though, the blogosphere and other reports confirm otherwise. On an "I hate dialysis message board" (http://ihatedialysis.com/forum/index. …

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