Jan 16 2012
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Living the Dream: How We Care Matters

Debra A. Toney, PhD, RN, FAAN, is founder of TLC Health Care Services of Las Vegas, and the immediate past president of the National Black Nurses Association. She is an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program. Toney is the keynote speaker at Vanderbilt University Medical Center’s annual Martin Luther King Jr. lecture on Monday.

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Today, on this national day of service, people across the country are honoring the legacy of Dr. Martin Luther King, Jr. by making a difference in their communities. They’re picking up trash, making meals at food banks, cleaning up parks and caring for the less fortunate. But this shouldn’t be a once a year occurrence; it is my dream that a sense of caring and greater purpose will someday be ingrained into our everyday lives. As a health care professional, I try to carry this calling with me every day.

Health care is becoming increasingly complex. Our population is aging and becoming more diverse. Patients come to us with multiple chronic diseases and a bag full of medications for refills, often not knowing why they are taking them. The waiting room is packed and everyone wants to be seen now. And the health professional is wondering how to get through the day.

All of this comes with a cost. Not a monetary cost but a human caring cost – the lack of touch, caring and compassion. We call patients by their disease; “the gallbladder in room 232” or “the COPDer in 476.” We order test, tests, and more tests to avoid lawsuits, a form of defensive medicine. Health care costs are out of control and millions of people are without health insurance. Access to quality health care is lacking. Provider salaries are on the decline.

These are the real challenges of health care today. Yet amidst these many challenges, we must not lose sight of patients, who literally put their lives in our hands. Patients look to us to provide them with quality health care. We must continue to provide personalized care and teach the next generation of health professionals how to do so.

My first nursing job was in the ICU. The first thing I did after report was to clean my patients up and make them as comfortable as I could. I would change the wrinkled sheets they laid on all day in a hard bed. I got them up and out of the bed if they were able to do so. I brushed their teeth and combed their hair. I wanted my patients to feel someone cared for them. I made sure their room was clean and then I would let them visit with their family. I know that doesn’t sound like much, but have you been in a hospital as a patient lately? All these little things add up. It makes a big difference if it’s you lying in the hard bed. And if it’s your mother or father, a grandparent or child, it makes all the difference in the world.

Patients don't live their lives in hospitals. Lives are built in the communities where people live and work – the same place they are today planting trees or serving food at the soup kitchen. And that’s where patients want to return.

More than 15 years ago, I started a home health care agency to care for an underserved minority community. Care in the home is an extension of where you left off in the hospital or clinic. It comes with its own challenges: confronting family dynamics, coordinating with caregivers and educating patients so they feel confident in their care when you leave. But that same sense of caring for each individual carries through no matter what the setting.

Report after report tells us that patients want to be cared for in a humanistic manner. They want to see professionals who look like them, who honor and understand their culture, and speak their language. Members of ethnic and racial groups do not lose their individuality when they come to our health care organizations.

As our nation navigates the uncertain future of health care, one of our greatest needs will be to increase the number of health professionals and to make sure that they can practice to the best of their skills and knowledge – no matter what the setting. Health care is both a science and an art, and providers should be able to deliver both.

Tags: Barriers to care: cultural, gender and racial, Disparities, Diversity, Executive Nurse Fellows, Health & Health Care Policy, Home health care, Human Capital, Nurses, Nursing, Voices from the Field