How Can We Make It Okay To Question Caregivers?

A loved one was recently hospitalized for surgery in a nearby town.  During the experience there were several moments when I had to decide whether or not I would say something to nurses about hand washing and cleanliness. To my great surprise, I was too intimidated to say anything!  The one time I did speak up went something like this:

”¢    Hey, is that nurse filling my loved one’s water pitcher?
”¢    She’s trying to make the water not too cold or hot, that’s good.
”¢    Oh, no, she is letting the water run over her hands and into the pitcher!  Should I say something?
”¢    She’s probably going to dump out that water and fill it up with water her hands haven’t been in.
”¢    Nope, she’s turning off the water.  Do I say something?

”¢    Me: “Hey, that water ran over your hands!”
”¢    Nurse: “Don’t worry, I wash my hands all the time.”
”¢    Me: “No, I don’t think we should take that chance.”
”¢    Nurse: ”˜I’m really hurt that you would think I’d do something like that.”

This was a personal seminal moment.  I could not believe that after working with physicians and nurses in healthcare for 25 years that I would be intimidated about saying something about cleanliness.  I was worried about the potential impact that my questioning would have on the care of my loved one.  That made me hesitate about saying something until a situation came up where I could not keep quiet.  I could not suppress my concern based on the possible impact to my loved one.

What about the nurse’s reaction?  It was defensive, and she was telling me in essence “I can’t believe you’d question my decision-making.”  In discussing the situation later with my husband (not the patient), he assured me that I had done the right thing.  He asked me if I saw the waiter in a restaurant washing his hands at my table, would I then let him dip his hands in my soup?

This hospital experience was 99% wonderful. I thought the hospital paid excellent attention to the needs of the patient and the family.  I thought it was clean, the caregivers were very good, and I would recommend the hospital.  But the wall is still up about questioning at this hospital and probably every hospital across the US.  It is a hard call to tell the professionals that they are doing something wrong.  A cleanliness episode can happen so fast that you don’t have time to debate yourself about saying something.

How can we make it okay to question caregivers for the benefit of the patient?