Developing the Skill of Gracious Caregiving

Health care professionals are taught to use many tools in our medical training-phlebotomy, nebulizer administration, blood pressure measurements, and how to roll a stretcher through a doorway without scraping the paint (a skill that eluded me as a candy striper, but didn't thwart me from the pinnacle of doctorhood). However, we oftentimes overlook an important tool in our medical arsenal-the skill of gracious caregiving.

One of my greatest role models in medical school was a junior faculty from physical diagnosis class, the first course that we actually touched live patients. He insisted that we treat our patients with graciousness, giving them ownership of their hospital rooms and their bodies.

"You can afford to be gracious," he said. "You are fully clothed, your butt is not exposed, you got a good night's sleep, ate what you wanted for breakfast, and you're not in pain or frightened."

"So be gracious. Knock on their door, and ask for permission to enter. Introduce yourself, and state your purpose. Explain what you are going to do to them. Ask for permission to examine them. Explain what you found. Describe the tests that they are going to have and what they will show. Bring them on board as a partner in their own heath care."

"When you leave, say goodbye. Thank them. And lastly, ask them if they would like their door opened or shut. It's the little controls you can give back to your patients that restore power and relieve their feelings of helplessness."

The lesson I learned that day provided me with the tool of gracious caregiving. The definition of 'gracious', according to the American Heritage® Dictionary of the English Language, includes kindness and warm courtesy, tact and propriety, and a merciful or compassionate nature. We generally think of gracious in association with a party's host. You know how to be gracious; you do it all the time when you entertain guests (although not necessarily close personal friends; they are left to scrounge up food for themselves).

So, how do you become a gracious caregiver? Follow these simple tips with your ill 'guests', gleaned from rules of hosting parties and adapted to medical caregiving:

Eight tips for being a gracious caregiver:

• Greet your guests with enthusiasm

• Introduce yourself each time you see them until they greet you by name. Remember your advantage-their name is on their wrist, on the chart, and on the door. Offer to give them your card or write down your name. The recurrent hospital guest may have a guest book for you to sign.

• Explain your role in their care; do not assume that they are medically savvy. Then, explain in a detailed fashion what they are about to experience.

• Introduce them to any HCP who enters the room while you are there, giving your guest the advantage. Say, "Mrs. Guest, may I introduce Dr. Pulmonary?"

• Never talk over or around your guest without involving them in the conversation. Excuse yourself if medically appropriate to discuss another guest's personal business.

• Give able guests small tasks to carry out, such as self-care, carrying their record during transport, even assisting in monitoring their own vital signs and I/Os.

• Always ask permission to touch or adjust unless it is an actual emergency. We flick back covers with a casual air, but ferociously guard our own modesty.

• Give your guest governance in their room-over bed position, their door, and their possessions.

Ask permission to enter. Remember our advantage. You ate breakfast; your butt is not exposed. We take much for granted in our treatment of our guests. You can afford to be gracious.