Hard Cases: What Losing My Mom Taught Me about Communication

This article is part of LinkedIn's Hard Cases series, where medical professionals share the toughest challenges they've faced in their careers. You can read more about it here and follow along using hashtag #HardCases.

?Many healthcare professionals are the only healthcare professional in the family. At this point, I am the only one in my immediate family licensed as a registered nurse (RN) and a PhD in Nursing Research. My mother, who had a high school education and was licensed as a practical nurse, died when she was sixty years old from a hospital-acquired staph infection. I put her there right after Christmas with gastric bleeding (throwing up blood) and she died there in May. In the past, I felt incredibly guilty about it, convincing her to leave her home for the hospital. It took me years to reconcile it. Writing this piece will continue to help with that healing.

According to the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (https://psnet.ahrq.gov/glossary/failuretorescue), “Failure to rescue is shorthand for failure to rescue (i.e., prevent a clinically important deterioration, such as death or permanent disability) from a complication of an underlying illness (e.g., cardiac arrest in a patient with acute myocardial infarction) or a complication of medical care (e.g., major hemorrhage after thrombolysis for acute myocardial infarction).” I felt like I had somehow failed to rescue my mother by not being the attentive daughter (who was the RN of the family). Of course, I lived 365 miles away, in graduate school for a Master’s in Nursing Administration, and many other things were happening in my life, some in my control, others outside my control. But I had been taught well as an RN in taking responsibility even when it was out of my control.

My mother had severe rheumatoid arthritis. Medical professionals assumed she knew her medications, what she should and should not do, and how to keep active to prevent joint pain and stiffening. My mother did not know. Her baseline of understanding was never assessed. One major assumption was that she knew her medications and what the effects were, especially when combined with prednisone or another steroid. My mother did not know she could not take her anti-inflammatory while on a steroid. The consequence for mixing of the two medications created the GI bleed that placed her in the hospital, leading to her exposure to the hospital-acquired staph infection. I pushed her into the hospital then drove back to home two days later. I had no choice but to go back to work and school.

The experience of losing my mom is not lost to me. As healthcare professionals, we do not always see the aftermath of poor education on our patients’ lives. Any time I am in a position to educate patients or clients on medication interaction, I do because I don’t want them to land in the Emergency Room with low potassium because of the Lasix-caused diarrhea along with loss of potassium. I want my patient to know that short-term use of narcotics will cause constipation and to use a stool softener. I educate every man and woman on the signs of sleep apnea because undiagnosed and untreated, sleep apnea in most cases causes hypertension, hyperlipidemia, and Type 2 diabetes.

Patient education is foundational. Many consequences could be averted by gently asking what they do know about their medications, even if taken for years. Not everyone has basic anatomy and physiology. My mom did not know that after a hysterectomy, I could not have any more children even though she was a licensed practical nurse. And, for some patients, it takes more than handing them a brochure. Patients may not be able to read even to a sixth grade level. 

Knowing the issues with my mom’s illness and death has made me a better healthcare professional in educating patients and clients. Hopefully, reading this story will help you step up your communication skills with your patients, clients, or residents. As G.I. Joe use to say “Knowing is half the battle.” Apply what you learn.

Peggy Ann Berry, PhD, RN, COHN-S, SHRM-SCP, PLNC received her doctorate from University of Cincinnati in 2015. She is a past NIOSH Education and Resource Grant recipient and American Nurses Foundation Scholar. She is a Founding Fellow with the U. S. Academy of Workplace Bullying, Mobbing, and Abuse and a past Graduate Nurse Intern to OSHA and Malcolm Baldrige Examiner. She can be contacted through:

Website and blog: https://thrive-at-life.com/

Twitter:         @PBerryRN

LinkedIn:    https://www.dhirubhai.net/in/peggy-ann-berry-phd-msn-rn-cohn-s-sphr-9049898

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