“I’m a prisoner here.”

I just heard one of our patients say that.  He had been sitting in a chair outside my office for about an hour.  Quietly fuming inside.

About an hour earlier, he had pushed the elevator button when a therapist intervened.  It went something like this …

Where are you going?

Outside.

No, you can’t do that.

Why not?

You have to stay on your floor.

Oh, and why’s that?

Well, because we have to know where you are.  We’re responsible for your safety.

Ok.  I’ll tell you where I’m going.  Outside by the entrance.  I want to go outside.

No, you can’t leave this floor.  If something happens to you, we’ll get in a lot of trouble.

An hour later, his nurse and CNA both tried to get him to go to the dining room.  This time he was resolute.  He wouldn’t budge.  He called himself a prisoner b/c the staff wouldn’t let him leave.  I would’ve been the same way.  After a few back-and-forths about whether he would or would not go to dinner or even ever leave that chair, I stepped out of my office and said,

You want to go outside?

They won’t let me.

Who won’t let you?

The people here.

There must be some misunderstanding.  They probably meant that you needed to go with someone.

No.  They said, “You can’t leave this floor.”

Well … let me see what I can do.  [I went to the gym and asked the therapists about him.  They were thrilled with the idea of me escorting him outside.  They just didn’t want him to go alone as he still has a ways to go to get his strength back and is at risk for falling.  I came back with the good news.  He couldn’t believe it.]

We went down together and I pulled the bench into the sun.  Gorgeous day.  We talked for about 45 minutes.  WWII veteran.  married to a ‘saint’ for 60+ years.  A few kids.  He’s the last surviving child of 8 kids in his family.  He told me about his ‘crooked’ father in law who died with $500,000 in the bank.  We laughed.  I teased him.  He teased me back.  We talked about religion and faith and cashing in his chips after 92 years on the earth.  After a while, he said, “Well, is it time for dinner?”

Yeah, are you ready to go back in?

You bet.

He literally had a large smile on his face when he sat down to eat dinner (after everyone else had already eaten by this time).  It struck me as I sat back down in my office how differently that could’ve gone (and sadly too often does) … the nursing/therapy staff get frustrated by the patient’s “behavior” and start to treat him as an object more than as a person.  He becomes a problem.  Stubborn.  “Non-compliant.”  A pharmaceutical intervention is ordered and the man, the WWII veteran, loses a little bit of his identity and dignity and control.

As a facility leader, it’s my role to establish a culture within the facility where that latter scenario is avoided — when it’s avoidable.  We have to create a mission, a purpose for our staff that is larger than a paycheck or a task to constantly motivate them to SEE their brother, sister, mother, or father in the eyes of the patient sitting in that chair.  I saw the difference tonight in being task-driven/objectifying and human-driven/personalizing.

Our great challenge is to systematically enable our great staff to personalize their residents’ and patients’ experience …

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