In the age of machines, bedside manner matters more than ever | Susan Cooley | TEDxTWU
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- เผยแพร่เมื่อ 9 มิ.ย. 2024
- The machines we invented to improve healing may actually be eroding real patient caring. To better facilitate healing, hospital nurses need to find ways to work with machines rather than for them. Have nurses become scribes for insurance companies?
Susan Cooley is a nurse practitioner with advanced degrees in public health and nursing. Dr. Cooley served on the faculty of the University of Texas Medical School for over 30 years where she taught medical student, nursing students and residents in clinics located in Houston’s barrios. After retiring from UT, she was medical director for RediClinic, a healthcare company with clinics located in grocery stores. Dr. Cooley works as a consultant, assisting healthcare organizations with a variety of strategic projects. Dr. Cooley’s first nursing job at the Hospital Albert Schweitzer in Haiti, prepared her for a career working with vulnerable families. She is proud of her roles in bringing Reach Out and Read, a national pediatric literacy program, to Texas and of her work during relief following Hurricane Katrina. I addition to her work in healthcare, Susan is a passionate photographer, with four grown children, a new beekeeping enterprise and a growing number of grandchildren.
This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at ted.com/tedx
My name is Phil, I am a retired RN and RPN, in emergency health, come to Canada, you will be so respected, and Canada will really welcome you.
Thank you for your comments and encouragement. Together, we can make a difference.
NURSING IS A VOCATION!!! WHERE HAVE ALL THESE NURSES GONE?
Susan Cooley you are right I have a friend who was a dedicated nurse and I have been a caregiver working from an agency until I ended up sick and needing surgery I am in and out of the doctor's office a lot beca I am an asthmatic i am glad and thank God you recovered from your illness
Susan Cooley the issue is taking on double the patient load since healthcare reform and changes. Yes we are scribes for insurance companies . we get fired for needless bs instead of how we perform as nurses... if I do care for my patients well (and I do) as you have described, I have 2 hours of charting to finish at the end of shift. I’ve tried a million ways of charting to manage time better and with 4-6 very ill patients it’s just not possible unless you do just treat them as an object...
As a soon-to-be graduate nurse, I found this extremely eye-opening & will help direct my care in the future. Thanks for the perspective
In my clinical practice over the years I have realized that paying attention to the patient helps you to intervene early even before the the monitors show changes.
thank you for the thought-provoking reminder🙏🏼🙏🏼🙏🏼
@@ellenpaul678 the same time
@@ellenpaul678 the same time
@@ellenpaul678 the same
As someone about to start her nursing degree this has been some powerful food for thought. On the occasions I've been unwell enough to be admitted to the ward in the last few years, the nurses that have stayed with me didn't spend much in the way of extra time with me, but they came and said hello during handover, and stuck their head in the room to say goodbye on their way out, the night nurse (bless their heart), remembered on my third night that I was getting migraines from the flurocent lights and rushed over to turn off the one closest to me at the enterance to the ward when they came on shift, and reminded the day nurse for the next day that the flicker of the old lights triggered migraines. And the day nurses were kind to me when I was overcome with hormonal tears and offered to get me a real cup of tea from the break room to help soothe my tears. Not one of these things was billable, but made me feel like a human instead of a number.
Now this is a real nurse...as I am. And I'm proud to say I do speak & touch & comfort my patients. I explain to them what's going on & ALWAYS provide them with food & drink. I'm often made to feel incompetent by younger nurses because I don't check everyones orders non-stop, having my eyes on computers more often than on the patients.
I do believe that paying attention to the patient is still a key aspect. While it does get busy, the still deserve to be listened to and extended compassion, even if it is for a quick second.
Yes, nurses are overworked and yes we are understaffed but I work on a med-surg floor and I talk to my patients, walk them to the bathroom, review plan of care, hold their hand when their upset, and help them have a better day. So as I agree that healthcare is broken I don't see nurses on the floor being as cold and uncaring as depicted in this video. Nurses are resilient and although the charting is ridiculous we have not given up the care of patients that makes nursing important.
I will attest that it definitely depends on the unit. I am also on a med/surg unit (as a care tech, in nursing school) and our nurses are fantastic and helpful as you've described yourself above. However, there are units I dread floating to in our hospital because there are nurses that are just as Susan describes in the video - spend the bare minimum amount of time in the patient's room, and then focus on their charting or socializing in the hall with other nurses. I think some of them have given up on patient care or at least solely rely on care techs to pick up that aspect but we can't comfort a patient when they're concerned about an upcoming procedure I have no knowledge of, or they're worried about a medication they're taking and all I can do is go ask the nurse to talk with the patient. Every single unit seems to offer a very different experience depending on which nurses are there.
@@haleighcole1712 I think it also might depend on how you are trained/ management. I'm lucky enough to have an amazing manager who taught me efficiency to be able to have the time for giving the care patients need. Sometimes I think we have to re-center and remember to focus on the purpose (patient) and not the tasks
Most hospitals are understaffed, nurses must discharge patients before noon and get new admissions right away, nurses do not even have time to eat or go to bathroom.
And yet I see many nurses still have time to check their phones ... frequently
Can’t judge everything by appearance. A lot of nurses use their personal phones to check information that could save lives and/or improve care. I have worked some hospitals where you cannot access the Internet and so we use our own phones. Also, there is good and bad in everything and I can say most nurses I have worked with are not diddly daddling on their phones.
@@alloftheaboveeunicesmith9625 that's because the resources on a personal phone are oftentimes better and easier to use than the ones provided by the hospital, resources we have to go all the way to the computer to use
Tell the administratiors we need more nurses in the floor. Our front line troops need more help.
As as nurse we are over worked with poor working environment. it is all about filling those empty bed to make more money. Too many patients but not enough nurses or nurse tech. I personally exhaust myself so I can provide good care to my patients. Greed for more money has cost public they health. thank you Susan enjoyed this clip.
It annoys me that all these solutions or suggestions or what is implied is that nurses need to do more. It always seems to be on the nurses shoulders. They want us to give more time but with less money, less support, and staff. No one is talking about nurses being over worked, abused, and bullied on a daily basis...but you need more bedside time...most nurses are so busy they don’t eat or get to get a pee break on 12 hour shift.
Thank you
What an important and timely thesis. As a nurse, I have had the same frustrations with the "system." I appreciate you setting the stage for REAL change. Your talk gives me hope for reform. I hope to hear more from Dr. Cooley, she is a pioneer and a real leader. Thank you for your honest portrayal of healthcare and your optimism for nursing's future!
by any chance do you work with respiratory therapists? whats your experience with them?
Truly inspirational!! A must for all the young nurses entering the profession
Thank you for sharing this heartfelt humanitarian message. I hope to bring light and hope to every patient i come across.
Thank you for the beautiful and well explained video.
I absolutely love this. I think in both Nursing and Pharmacy, the staff has been so overworked and underpaid that they get burnout and feel apathetic towards the job. Patients become tasks. Its a horrible problem in our healthcare system. Corporations have made it about the bottom line and not about care. It's all about metrics.
Amen Susan. Excellent presentation. Thank you for being a voice for this important concern.
BAM!!! I am an old school nurse. This is beyond true!
God Bless n thank you ❤️ my Dad died after 27 days in hospital first time my now wife ever went to a funeral then to the church with me didn't know her before that. Now there's a Dr. N two RN on her side the family. She's been a RN now for 37 yrs never missed a day of work are not make sure that all is well with Family's before I see her at night lol I know we're I stand in the pecking order but I'm so proud of her. Ur right Mam they don't make Nurse's like they used to. Amen to all nurses 🙏🏻
I'd like to hear some actual experiences of how older nurses provided care in their time because to newer nurses, the use of electronic health records and machinery has been all we've ever known. How else are we going to know when air is in a line or if an infusion is occluded unless our IV pumps beep? How do we provide critical care to a septic patient unless we closely monitor every number our vital machines give us, where a patient can show vital signs of decline in a matter of minutes? How can we manage to make a patient feel so pampered when we have hardly enough time to care for 5 patients on a day shift, 7 or more on nights? Do you think we are made of time? There are days where I try my hardest to see each patient in a timely manner, utilize all of my fellow staff, manage to barely get all of my patient care and charting in by the end of the shift, and I've probably not eaten, gone to the bathroom or even sat down, and you want what, MORE, from me? I'm keeping you alive, I'm doing the best I can, there is more responsibility thrust on a modern nurse today than I think a veteran nurse may realize. You probably had the luxury of time and good staffing when you practiced nursing 20 years ago. You probably never had to take care of 500lb patients with multiple wound cares in and isolation room with altered mental status every day with little to no help. If you were cognizant enough to be able to criticize how little the nurse pampered you, at least you were stable enough to realize it. Because we provide so much of our time, our backs, our sanity, to making sure people don't die, fall, or crash during our shift. I would appreciate solid, implementable solutions to your complaints rather than a patronizing criticism of modern nursing.
TheGingerInvasion 👏🏼 Thank you... You took the words from my brain and laid them out perfectly in this comment.
Made of time...seriously.. That was genius!
As if nurses don't leave their shifts feeling guilty they didn't do enough in 12 hours already?
The issue is here that computer charting is only one issue taking the nurse away from being able to extended a greater therapeutic relationship. I can't imagine expectations on the modern nurse being compared to the nurse in 1970-99 being a fair comparison in any realm.
I am truly sorry to hear she didn't feel cared for.. a shame indeed... But believe me..the nurses did care..and they care a lot..unfortunately most of the time they haven't got the time... and we're trying the best we can with the time and resources were given.
Well spoken.
TheGingerInvasion YES. YOU TOTALLY NAILED EVERYTHING I THOUGHT WHILE WATCHING THIS. I don't know what else to say but... I'm not here to give you great customer service... im here to make sure you walk out these doors alive and well. Sure I am extremely pleasant in the mean time but I am not here to spend time learning about your social life history while I have 20,000 other tasks I need to attend to. Nurses need downtime too in between the hours and we rarely get that alone... even if a patient is tubed and can't ask questions. I hate that we have turned to this "all about the customer service and satisfaction". They expect the best service and satisfaction when we don't even have it ourselves when we are working and running like a chicken with its head cut off. I respect her greatly as a nurse, but she clearly has not been a nurse in a busy hospital, ER, ICU, or floor in long time... Or ever.
This are your personal feelings, complaints, and frustration regarding current health care system. Thank you for sharing it as well! In fact all you say is correct we live in such reality that without technology is no way of survival and we must obey the rules and demands of modern nursing profession. However, what if there is for whatever reason you have no machines/no pumps??? So you say then it appears we are useless and we can't do much without charts and machines? The speaker is not asking us to be "nuns" /"waitresses" but be a human beings or the ones who make someone feel cared.That's is a main essence of nursing. Otherwise we are no different from "robots".I am sure there are already such "nurse-robots" are exist and I am sure they can take over us in few decades, and I am sure they can handle patient load much heavier than we do now, and save many more lives than we ever did in our practice... While I got only couple minutes just to change IV I would try to talk to my patient even tell her/him that" I do not remember when I used a bathroom, do not remember when last time I ate/drink" this could divert concerns and even bring a smile and reduce the fears that may exacerbate whatever condition our patient is...I am sure we can find ways to show our care even we are in a big hurry... I am sure in every nursing school , in almost every exam question, they tell us repeatedly "we must assess patients not machines!". I believe we had an entire course on "therapeutic communication" ! Let's don't let our education to be a waste of time
TheGingerInvasion very well said!!
Thank You so much for sharing this valuable experience and encouraging us to be, to do better, and be simply a human not an extension of the machines. I will try my very best and beyond to make someone feel cared! That's a very reason I went to become a nurse!
This is great. The issue is poor staffing ratio and nurses doing more /being responsible for more than ever before .
This made me laugh. I am a certified nurse's assistant who has been working for 2 years now. 1 in the hospital and applying to nursing school. I went into this job with the intentions of holding people's hands, making people laugh on their worst days, and wiping their tears away after a traumatic event... then I clocked in and have 12 patients. I truly want to stay and hang out with all of them, but if I stay in one room for too long someone else is being neglected. I either don't finish what is expected of me for my shift and neglect my other patients or I can spend extra time being a friend to the I'm patient with. I have done the latter numerous times but my coworkers, nurses and managers say I am slow, inefficient and not a hard worker. Idk what I'm getting myself into with nursing but my intentions are pure. I hope my patients can understand that when I have to run out of their room to get a bed alarm. I hope my bosses understand when I take too long in a room for the sake of being thorough with my patients.
I am so sorry that your cowokers are unkind to you. I just want to say that your kindness and selflessness is much appreciated by your current patients and the patients in the future. ♥
Excellent, Susan! Pete will agree with your every point about EMR -- I like your optimism and your saying that we need to find a way to incorporate the inevitable computers into patient care without losing sight of the the patient's humanity and basic needs.
Bravo, my friend!!!
Being a nurse these lectures are a good revision to keep up to date .And how to continue being a good care giver.
I believe rather than talking about computers we need to talk about nurse to patient ratios. I don’t work in a hospital anymore. I work in the primary care setting after years of ICU nursing. (17 years) What I noticed was an increase in the numbers of patients I was expected to care for with every computer abled ability to use my own senses. I couldn’t possibly say goodbye to my patients without robbing my young family of valuable time. I’d spent about 13-14 hours at work. I was tired. I wanted to pee and go home.
I was just thinking about giving up on my Nursing goal. :) Nevermind.
Dan!elle Razmataz I hope you’re a nurse now and being a front liner to change healthcare for the good! Good luck in your journey! ♥️
Thank you for reminding me why I thought I would make a good nurse in the beginning. Every obstacle has been thrown my way just to get into a Nursing program (I have my BA degree in anthropology). I keep thinking maybe this isn't my calling after all. Now I remember what I bring to the table that not every nurse does and that is true compassion, intuition, observant, empathetic, and cares about the little things that are helpful. I am not worried about working with people who are the patients. I am worried about working along side miserable individuals who do nothing but complain, criticize, gossip, and try to demoralize me and make me feel like a misfit. I'm not saying I can't handle it, but it is my biggest concern. Then again, I'll be dealing with that no matter what job I do, sadly. It is just more stressful when you have people suffering, in pain, or their life is on the line. I'm a passionate person. I do not have patience for people who are so selfish and uncaring when it comes to patient care. It truly is upsetting to me personally. I could work with people who are inspiring and the kind of nurse and person I want to emulate. I need to remember that too.
This is a great talk, I show it to my students in allied health sciences classes.
She spoke the truth, machine has taken over our duty.
Riveting talk; Ms. Cooley manages to graphically capture the world of the seriously infirmed. This is no easy task, as we feel each and every moment of her ER visit. Thank you for making this public Susan, as I suspect a void of the all-important personal health care interaction may be driving the human response to illness out of modern medicine ...!
RN BSN in DNP school working critical care and ER. I have listened to many TED talks. Thank you for this.
Hire more nurses, give us less patients and we'll give you more bedside time.
So true
This is an important talk about the nursing profession in the age of technology and "capturing charges" -- as seen from "both sides of the stethoscope"
Hey check it out: Med surg nurses don't have time for any of that these days. Ratios are out of control
James Cockerham exactly why we all (the people in the trenches) need to speak up! This must change. Our patients deserve it. Great point.
Yes we know it but asking “how do you feel? You need anything?” Takes 5 seconds and it makes a great change
Thank you!!! You are spot on!!
Well said! although this was 6 years ago, I can say as a nurse nothing has changed. In fact I think patient center care has gotten worse especially in regards to communication with our patients. As one who is unintentionally a sociable talker, I always talk to every pt or at least try. As we know some will let you know they don’t want to talk and that’s ok, but when I enter each room the goal I always have is to welcome the pt and try to make them feel comfortable and at ease that I will be taking care of them. Either way, what saddens me is that when I meet each pt I care for, repeatedly, I see that they are so grateful for my polite and simple mannerism; such as me asking them how are you today. Anytime I hear a pt thank me for this, I always get the same knot in my stomach and think how is this not a normal thing in patient care. Do clinicians really walk in to a room making no eye contact and treating a pt as if they are invisible? Then when giving report to the next nurse and discussing the pts, the question that I ask my self will be reminded and answered when I share a simple thing about the pts life whether it is related to their personal,professional or current condition. “Isn’t it sad that Poor Jane doe just lost her husband and has no one to help her? The next nurse; “wow Jane doe lost her husband and has no family? I did not know that…. And yes I know each person has a special gift and expression of compassion but I think when one has a job to help and care for people it is imperative to be taught simple gestures and communication styles like this nurse shares to help someone feel they are seen and someone cares. I pray one day this changes but until then I will
Always be a compassionate patient centered caring nurse.
This is wonderful.... I'm in the same page of you....I'm a PCA and we are having a lot of responsabilities
Susan Cooley makes some excellent points about what is happening in healthcare. I believe a large reason why medicine is headed in the direction it is as Susan talks about is the increasing bureaucracy. Healthcare professionals swear to uphold 4 principles of ethics which are beneficence, non-malfeasance, autonomy, and justice. With these increases in bureaucracy healthcare professionals are losing autonomy. I do agree that bureaucracy can provide a framework for ensuring medical practices are held to a certain standard and there is compliance with regulations. But this does come with a price. As Susan mentions more and more healthcare professions are more interested in what is on the computer rather than the actual patient. This is a result of the increase in regulations that are constantly being implanted. The saying goes that if it wasn’t documented it didn’t happen. This idea fosters the environment for healthcare professionals to spend more time on the computer screen. The priorities of healthcare are backwards. Bureaucracy in medicine seems to be putting more weight on what the computer says. This isn’t the healthcare professionals’ fault but rather as Susan alludes to the insurance companies and the business behind medicine. Healthcare professionals need to be allowed to focus more on the patient relationship and as a result all aspects of medicine will improve.
Thank you so much.I have taught students in large hospitals and the nurses that were in charge of the charting were overwhelmed with the new and additional information that was needed to be input. There was consequences as well. If something had not been entered within a period of time, the nurse could get written up. The list goes on. Some students could not believe what they went into.
i wish to meet you in person. I am in nursing school right now and wanted to be a nurse. So i can make a difference to what new nurses practice at the hospitals i have worked before.
Awesome touching reality things discussed..wake up healthcare provider's.
I've been an RN for 30 years, I see what she is seeing, too. I think God ain't happy about what is happening to the profession of nursing. I watch as society is shifting to individualization with our devices. Preserving human interaction is the job/calling of what professional nursing is now.
I think the issue is more to do with the TIME that nurses have. Most of us want to be able to give our patients this care, however, sometimes with the resources that we have its hard to do more than the the priorities medical/safety wise. I always leave work wishing I could have spent more time with my patients, but the reality is, unless we want to be out 2 hours late, its not always practical - This is where MORE nurses need to be employed and have less staff ratios, so that we can be the nurses we should and want to be. :'(
susan murdered this
The things she said are easier said than done.
Computers are not the problem, lady. Hospitals are the problem. Keep units staffed and we will have more time with the patients.
She is NOT blaming the nurses themselves, she is blaming the SYSTEM. She KNOWS nurses are understaffed and the ratios are unrealistic. She isnt ragging on nurses, she is addressing all that the administrative healthcare SYSTEM needs to correct. SOOOO many comments taking this personal when she isnt even attacking the nursing profession. Damn.
Preaching to the choir. Corporate entities need money for lavish lifestyles. Period. Nurses tolerate this so will never change.
This right here! 100%
I strongly agree what she depicted. On the otherside should be consider nurse-patient ratio which turns d fact upside down. More workload less humanity
Valid points but disappointed the video didn’t include solutions.
in other words, a profit driven model within a capitalist framework
In our city, the introductions and orientations are similar to those of flight attendants. Scripted. Checking the boxes. It’s the goal and meaning behind the words. It trickles down. If the ceo and doctors and cno don’t show this by example, it will always be lip service.
How bout an ER nurse doing her documentation (I can't see any patient in the ER)...but the nurse strictly told me "if you can wait, wait." I was experiencing pain on my side everytime I walk or even breath....
Yesterday, the triage nurse told why I just came on that time. She said they are already full....can you predict when you will be sick?
very true!
Wow.. Why only 7200 views..!?!? ALL of us will need the services of emergency healthcare providers at sometime, someday.. Well, at least the majority of us..
To study nursing it should be free to encourage more people to go into the field, especially with covid causing nurses to leave the industry as they are over worked.
Holistic nursing should be taught. ;)
I hope nurses have the luxury of time time providing nursing care at the bedside at times I can not even find time to pass urine or take my lunch...
To get the human experience you wand from nurses u need to work in an environment that mandates safe staffing and patient ratios.... and that is what is causing compassion fatigue. Nurses are overwhelmed at the bedside because of the "bottom Line" u a re discussing. Hospitals do no want to pay for extra nurses and when u have 6 to 7 patients u are running the whole day. I have been a nurse for 21 years and I am still working in the industry and the computers and the scanning are the least of the problems when concerning patient care. This nurse is obviously not understanding the day to day life of a nurse in the current health care environment. Nurses do not lack compassion in this day and age they lack resources because the hospitals bottom line is more important than having your hand held.
Her point is that the system is broken. She is not directly blaming nurses for being lazy. She keeps saying that the care was effective and professional but she felt like a product and not a human being. The United States should be screaming out for healthcare reform. We all deserve better than this!!! Upper management in hospitals keep getting the cash bonus and everyone else suffers .
Yes nurses are very busy and extremely understaffed. . We don’t have a lot of time to spend with our patients so we make those contacts count when we do an iv or give a drug. A quick chat assesses so much about a patient to a skilled nurse. Skilled nurses have incredible empathy and can say a lot with a touch or a word of advice. We are constantly prioritising and reprioritising . We also rely heavily on excellent HCA’s who are technically the ones providing nursing care. This woman seems bitter, cold, repeats herself, doesn’t understand the bigger picture of healthcare and population changing and is accusatory in her tone. Painful. I would not want her to be my nurse that’s for sure!
Yes and No. I question the place of a nurse who lets herself deteriorate so badly to criticise staff under pressure as they provided lifesaving care 'from her haze' then throw the whole profession under a bus.
As a childcare worker turned nurse, I could say the same thing about nurse parents not giving two ***** about their sick child infecting the other and us.
I see older nurses who very thinly disguise their contempt/jealousy of university trained nurses when it was their generation who insisted on being seen as professionals.
Most responses cite time constraints or stand up for themselves by saying 'we do demonstrate peraon-centred care'.
Yes, a good reminder, however also a slap in the face to kind colleagues under the pump.
There is a severe shortage of nurses across the nation. Unless this is addressed, things will get even worse!
But wht if the nurse gave a smile, a nodd heading towards the patient, make them seen? That is bedside manners for ladies and gentlemen....Yes, the system is broken idees. Caretaking is something we used to do.
Nurses...there are not the same
My wish is that the Board of Nursing will be replaced by robots that the underhanded lying deceitful will end up in a prison , and justice will then be served. ALL of this is null and void if you dont have a license , taken by a corrupt board. ARIZONA STATE BOARD OF NURSING CORRUPTION WATCHDOGS. I hope you all carry malpractive/ license protection !!!
they all want to be nps or crnas
Toxic
she is right but nurses are so overworked everywhere