Post-it Sunday 6/12/22-scripting the OR

The post-it reads ‘using scripts with patients’.

This is something that healthcare has been doing for years. And not just at my hospital.

Scripting is when you use words that you did not write, even if you mean them.

Healthcare providers as a whole are not eloquent. We use jargon too much. We forget to dumb it down for non healthcare people. Not that non healthcare people, aka patients, are dumb, but they don’t know the lingo. And they sometimes feel they are drowning in the alphabet soup that healthcare uses as a shorthand to get a lot of information across to someone who knows and can interpret the lingo. So ixnay on the lingo in front of patients and families.

Sometimes the patients think they know the lingo. This can lead to misinterpretation of the facts when they try to be hip and cool like the healthcare personnel. And cause a headache for the healthcare provider trying to be clear and concise when they are speaking to a non healthcare type person.

The worst kinds of scripts are the ones that are tailored to the patient surveys they receive after care. These scripts use the exact words of the survey questions in order to trigger a memory when it comes time to fill out the surveys. These are not bad on their own merits but feels like cheating. In fact the hospital has told us not to use exact wording from the survey questions. It seems that patients are figuring out that is what’s going on and leading to a mild backlash. They know they are being programmed, in a way, to respond to a certain question in the manner the provider would like. And if there is anything that has been made absolutely clear in the last couple of years, patients do not like to be told what to do. Even if it will save their lives or someone else’s.

Scripting is in fact a programming language that is used to interpret and execute one command at a time. Kind of like healthcare worker trying to get through to their patient the importance of this one little thing. Like the dangers of smoking. Of taking their medication as prescribed. Or avoiding covid.

When I tell you that the patient is an LOL, NAD, CAD, DNR, that may mean nothing. Or it may mean that the patient is an elderly woman, in no apparent distress, with cardiac arterial disease who is a do not resuscitate. Or, where it is dangerous and misinterpreted, when the family decides that all of that means we do not care about the patient, that she should just die. And instead it means that we will treat the patient, take care of her ills, until the time that her heart stops. Because there is a lot of things that can be done until then to make her comfortable.

I’m not sure how I got on to the alphabet soup from scripting conversations that healthcare providers have with patients that mimic the survey questions they will fill out after their care but here we are.

If you get a survey, fill it out. Be honest.

Healthcare entities use these surveys to fine tune care. But don’t let a bad day or a bad experience that is outside of the care provided, such as you got cut off by a driver leaving the hospital, color the survey.

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