“It’s such a beautiful day today!” My preceptor brisked into the room with a huge smile and a cheery greeting.
“Really? I wouldn’t know.” The patient turned away, despondent. On his bedside table was a picture of him with a beautiful woman and two children – the wife who had left him when he got sick and the kids he never got to see anymore.
It was the first time I witnessed the prisoner-like depression that patients can experience being disconnected from the world.
We were cautioned about this in nursing school, but it seemed so unreal. Then, suddenly, you’re looking into someone’s eyes while they grapple with such overwhelming odds in their weakest physical state, and you wish you hadn’t mentioned the weather.
They told us: Be careful with comments about the outside world because patients are not part of it.
When my grandparents were recovering in a nursing home, they went for walks together every day. “If the postal workers can walk in it, then so can we,” they explained to the nursing staff as they headed out toward the garden on frigid days and icy sidewalks. It was certainly dangerous, but so was sitting inside and doing nothing.
Grandpa pushed Grandma in the wheelchair, then when they turned to go back, they would switch, and Grandma would push Grandpa on the return trip. In this way, they formed a routine with something to look forward to, and someone to care about.
When we think about quality in healthcare, we all have opinions and ideas about what that means. I know infection control ranks high on my list, but someone else might say safe surgeries, or knowledgeable staff.
Usually, no one thinks of access to the outdoors as a critical part of healthcare quality.
By Gayle Porter
