Late one fall evening, Marcus Engel, a freshman in college, was on his way home from a hockey game. He never made it home. A drunk driver, traveling twice the legal speed limit, plowed into the side of the vehicle Marcus was in.
When he awoke to a world he would never again see, Marcus faced seemingly insurmountable obstacles: survive hundreds of hours of reconstructive facial surgery, adapt to blindness and find happiness in a world changed forever. It is our honor and privilege to talk with Marcus, author of I’m Here: Compassionate Communication in Patient Care, and amazing motivational speaker.
JNJ: Reading through your book, Marcus, it seems that there are two clear messages that you’d like to share with nurses. The first is that little things – gestures, conversations, a quiet moment — can mean so much. The second is really a call to remembrance: a directive to hold onto the fact that patients are people too.
Marcus: Absolutely. That’s my goal: to focus on the little things you can do to give your patients confidence in your care and return an element of compassion to the healing process.
JNJ: As an example, there were a few points in the book where you discussed orderlies who moved you without introducing themselves or explaining where you were going. That must have been a frightening experience. Was this an isolated incident, an exceptional sort of error?
Marcus: I wish that it would have been an uncommon sort of experience. Unfortunately, it’s not. I had surgery recently, ended up with a bowel obstruction and a resistant infection. After a five hour wait in the waiting room, I’m finally back in a room, and I’m being seen by someone. This person tells me he’s going to give me some dilaudid and ativan. He’s filling me up, and I have to ask him: “Are you a nurse? Are you a doctor? Who are you?”
He apologized immediately and let me know he was one of the ER RN’s. Now this may be my issue, being blind and not being able to see the lab coats, or see the color-coded scrubs…
JNJ: But there is the point that while you’re physically blind, patients can come to us with a blindness of inexperience. When we hear Ativan, we know what that’s for — but our patients may not know that.
Marcus: Exactly! When I speak to healthcare providers, I try to stress that the hospital is your work environment. You’re there every week for your 4 12-hour shifts. You’re used to it. But your patients don’t understand what’s going on. They don’t know the latin lingo that you use. Many times, people don’t understand the full range of medications they’ve been prescribed. I have to say I’ve learned as much about my medications from TV commercials as I have from my physicians.
JNJ: Don’t feel bad. That’s where they learn it too. Coming back to our mystery orderlies; how could that situation have been improved? Something in the nature of a best practice?
Marcus: We could look at the military model: name, rank, and serial number, and adapt it for health care. “I’m Susan, I’m your nurse, and I’m giving you Ativan for anxiety.” Your name, your title, what you’re doing, and why.
JNJ: And that’s another symptom of what’s wrong with our damaged health care system. We’re so overburdened that we go on automatic, full speed ahead, never able to stop and step into the patient’s shoes for a moment. Had that nurse had the ability to focus and truly be with you in that moment, it would be clear that he’d want to tell you what he’s doing. We’ve lost that human touch, that empathy, that vital connection to our patients.
Marcus: When I ask professionals why they went into health care, everyone says to help people. No one got into this to go go go all the time, with bureaucracy breathing down our necks, documenting everything under the sun, obligations coming from every side. It was about helping people, and we need to get back to that. If I could change one thing about health care, I’d love to give every nurse and doctor the amount of time they wanted and needed to spend with their patients. If everyone had the time to do the job they set out to do, I think we’d all be a lot happier.
JNJ: You write beautifully in the book about your doctor comforting your parents, about a group of nurses bending the visiting hour rules so you could spend time with friends who traveled a great distance to see you. Can you talk for a moment about the role nurses and other health care providers play in supporting your loved ones and by extension supporting you?
Marcus:After the accident, I went through over 300 hours of reconstructive surgery. There were years of rehab. People tell me that they can’t imagine what you went through, but I find myself thinking about my family during this time. The only thing worse than suffering yourself must be watching a child suffer. I didn’t come to this realization until after I married and acquired a couple of teenaged stepchildren: no one wants to be the parent standing there while their child is in the hospital bed.
So while you’re remembering that your patient is vulnerable, remember that their family is also out of their element and sick with worry. If you can treat them with compassion; with kindness — if I know the nurse and my wife have a good relationship, I’m going to trust that nurse more. That will help me heal. It’s not just the patient in the bed, it’s the family around it as well.
You can learn more about Marcus by visiting www.marcusengel.com His latest book is I’m Here – Compassionate Communication in Patient Care
