Healthcare, Humanity

The Human Factor at Emergency Department

Hola a tod@s, my dear friends.

Something is changing in the hospital, specially at Emergency Department of the Hospital Universitario San Juan de Alicante. Montserrat Soler, auxiliary nurse, has edited “The Human Factor at Emergency Department,” a guide to humanize care of patients and families in this area of the hospital.

In her own words, “Humanize care requires interaction between the knowledge of Science and Human values to establish a quality assistance.”

“Since many years I have been working in the care of patients in the Emergency Room and I have learned many things, but the most important is the great role that we have to do in a human level in critical situations where already nothing technical can be done,” explains Montserrat Soler. A quote from Doctor Marañón, “Only with dignity we can be physicians (nurses, assistants or healthcare providers) with the idea stuck in the heart that we work with imperfect tools and media of uncertain utility, but with the awareness that where Knowledge can not reach, always gets Love.”

The guide presents strategies to promote the humanization of the intervention of nursing in each one of the different steps comprising the process of care in the Emergency Department.

Also, the guide talks about the importance of the first contact with the patient (greeting with kindness, asking the name, listening carefully the reason for consultation, demonstrating interest in helping it, explaining the procedure to be followed, and the likely waiting time for medical care); on respect and privacy during the stay in the service; what is the relevant information to patient and family and emphasizes the use of a language adapted to the receiver.

It also discusses some environmental factors, that can help to rest and tranquility: change of sheets, the position, temperature, or the facilitation of the night’s rest.

The Guide also covers the information and explanations to discharge, or the handling of acute resuscitation situations.

For the moment, the publication is available for members of the Emergency Department and also will be available to the rest of the staff of the Department. The IC-HU Project will contact with Montserrat to try to broadcast from this platform, because we consider this is an excellent project of general interest.

Congratulations and thank you!

By Dr. Gabi Heras, ICU Physician
*Re-posted with permission
Original can be found at:
Humanity, ICU

What do they want to tell?

Hola a tod@s, my dear friends.

Rather than anything, thanks everybody for the response given to “Human tools.” We knew that it is a great film, but with the fire in Networks and more than 2000 visits in the first 24 hours our expectations have been beyond!

Keep helping us do this trending Topic in your day to day: BE SWEET, BE HUMAN.

And following this way, today we want to share an article recently published in the advance online of the Revista de Calidad Asistencial (Quality of Care Journal) by one of the components of the IC-HU Research Project, Dra. Ángela Alonso, and her team from the ICU of the Hospital Universitario de Fuenlabrada.

The authors raised as target to know the expectations, needs and experiences of families in relation to the information that we give them and the degree of understanding, to find that magic receipt that will make us improve in this difficult task.

They carried out a qualitative research through ten semi-structured interviews to family members of critical patients, finding that there are differences between what they expect from the information and what we give them.

In the analysis, they highlight several points:

1. The subjective position of the family: waiting, anticipated grief and anguish.

2. What represents the ICU for family.

3. The perceived care.

4. The four phases of the information: first information and first visit; following information and following visits, information from the withdrawal of support measures and the discharge information.

The article includes a table with recommendations on aspects unwanted and undesirable to inform family members, which it is for us an indispensable guide.

We have to understand that families are also our patients; we need to move them from the passive state of “waiting” and paternalism; the information we give them is vital and fundamental how we inform; we have to be truthful, honest, sincere, compassionate, and caring; they require a custom time and information needs vary along the income.

ICUs of the 21st century want to put people at the centre. This is an excellent way.

Congratulations colleagues! And thank you so much.

By Dr. Gabi Heras-ICU Physician

*re-posted with permission from:

Humanity, ICU

Noise Pollution in the ICU

Hola a tod@s, my dear friends.

Who and what generates noise in the ICU? Mainly people.Today, we talk about this interesting subject thanks to the article Noise pollution in the ICU: time to look into the mirror published in Critical Care in August 2014 and yesterday shared by our friend Carles Calaf in his social networks.Noise can have harmful effects on our patients, already vulnerable.

The study shows that more than half of all the acoustic energy in an ICU is due to the expression and human activities, and is potentially modifiable.

Strategies involving the adaptation of human behavior which can be very effective to reduce noise pollution in the ICU.

The contribution of each noise category for (A) the acoustic energy and 
(B) the number of predicted loudness peaks. Noise generated by or involving patients is excluded.

Immediately comes to my mind, is the first time my father was operated in a long history of cancer that began in 1996.

I remember that I was starting Medicine studies and I knew absolutely nothing. I went to the hospital to visit him the day after his first night at ICU, and I asked him: “How was the night, daddy? Have you got pain?” He replied me, staring with his deep blue eyes: “The pain is bearable, they gave me painkillers. What I could not fight was a rude conversation about football that two workers had at 2 AM. Sincerely I can´t understand: one is here died of fear, not knowing if I will live or die, and it seems that it doesn´t matter to the people. This is incredible.”

As on other occasions, I insist: the most important thing is to be aware of things. If we make them aware, we will be able to modify them.

We can lower the voice. We can customize alarms.
By Gabi Heras, ICU Physician
*Re-posted with permission from:
Career/Job Advice, Social Work/Helping Profession/Mental Health

Demand the Best of Yourself

Set your own standard of elite performance and rise to meet it each and every day, with each person you interact with. Give it your very best. Set the bar. Excel in your workplace whether anyone is around to witness what you do or not.

Do you personally have a standard of work that you demand of yourself? The very best employees do and they do it without being reminded of it by their boss. It’s as if their ethical work compass is set at north all the time, but the symbol ‘N’ on their compass stands for, “Nothing less than the best.” And here’s the interesting thing about being around such people; they tend to bring out the very best in others. So instead of lording over others, you find that just being around them causes you yourself to raise your performance to another level you may not have been aware you could achieve.

The really great employees do this. They have an internal work ethic that can’t be taught, but which they themselves learned from observation of others and making a conscious decision at some point to internalize. They treat others as they would wish to be treated themselves. They do their work without compromise and they do it consistently, not just every so often or when the spotlight is on them. Even when they are working independently and no one is around to pour on the accolades they go about their business with the same high personal expectations they have for themselves.

And on top of all the above, they can acknowledge their superior performance, but do it in a way that is humble, sharing credit with others when that credit is due, and when they are solely responsible for something truly outstanding, they don’t necessarily draw attention to themselves, but point to the outcome, not themselves as the focus.

Now you may or may not feel some kind of jealousy around these folks, but their humbleness and consistency of performance at a high level will, if you admit it, have you admiring their work ethic and abilities. Small people will always wish others worked down to their level instead of demanding more of themselves and rising up to higher levels of personal performance. If we worked harder and smarter with more personal accountability, we too could be more than we are. Can we – could we – do better as we go about our daily jobs?

You know you’ll often find that even outside the workplace these same people have this internal compass for high personal expectations and working to do their best. So you’ll see some parents coming home mentally spent because they gave it their all in the workplace, but they find new-found energy to spend time with their kids playing outside, they invest their interest genuinely in finding out how their spouses day has been, and they contribute around the home with a sense of responsibility.

Now do these people have times where they don’t achieve the results they’d like? Most certainly they do. Despite their best efforts, things don’t always turn out the way they’d hope. But the good ones, the one’s of which I speak find lessons in these moments. They make no excuses, step up to take the responsibility rather than blaming others, and take great pains to not repeat whatever they did previously that resulted in anything less than what they come to expect as the best result possible.

And yes these people do exist. If you are a sports enthusiast, you’ll likely recall a very few who in your opinion and in the minds of others who play that sport, stand out above the rest. Just this past week the world of North American hockey mourned the passing and celebrated the life of Mr. Jean Beliveau of the Montreal Canadiens. He epitomized class and excellence. Not only did the man have his name on the championship trophy 17 times, he did as much off the ice as he did on it. He turned down the Governor General position of Canada because he wanted to put his own family first after all those years they gave up so much for him and allowed him to play the game he loved.

But this article is not about Mr. Beliveau. It’s about you; you and me. Are we the very best we can be on a consistent day-to-day basis? Do you even want to raise your level of personal expectations to the point where your personal accountability and the results you achieve are greater than they are today? Maybe you do and maybe you don’t.

When we say, “Well, at least I gave it my best shot” is that the truth? What might we have done differently or better to achieve an overall result that would be more satisfying? Does every customer we deal with leave having got an exceptional experience from us that leaves them feeling satisfied and happy to return?

If you are up for it, take this challenge to raise your standard of performance this one day. Start with a single person, a co-worker, a client, a customer – anyone – just start. Push yourself in that single interaction to look them in the eye as you speak with them, give them your full attention and make their need your own. Leave them better for having spoke with you. When you’re done, repeat.

Demand your best of yourself.

By Kelly Mitchell

*Re-posted with permission from:

Healthcare, Humanity, ICU

Miracles Exist

Yes,  “miracles” exist. 

And I put it in quotes because the real miracle is not to lose hope nowadays and you should fight for what you want.

But, don’t miss it! Because if you don’t, you’ll find the job you were looking for or what you desire. If you read the post I wrote for my application to Editor, you know what I said to my last chief. 

I set out to vacuum, I devoted myself to that project that had to abandoned, and I felt happy for the first time in a long time. AND… VOILA, the “miracle” happened. After seek it with all my strength, not to be still drowning me in despair, and calling every door with much of effrontery, finally I will work as a nurse in the special service I wanted: The Intensive Care Unit. 

I know that it is not easy to follow with mood on many occasions. Nursing has suffered a great abuse in recent years. But do not be conformed. 

Visualize what you want, how you want it to be your public health, and fight for it. Position yourself where you want to be in this game. 

Really, believe me, if you want it, everything comes. 

Nurse in distress sends lots of positive energy for all nurses. 
Because we are awesome!

Recommendation: read “The Secret.”

by Ana Polegre

*Re-posted with permission from Gabi Heras, ICU Physician. First posted at:
Healthcare, ICU

José Carlos Bermejo and the Listening Center, Listening Award 2014

José Carlos Bermejo and the Listening Center, Listening Award 2014

 Hola a tod@s, my dear Friends.

From IC-HU Project, we add and celebrate the Listening Award 2014  to our Friends of Centro de Humanización para la Salud (Center of Humanization of Health).Teléfono de la Esperanza (The Hope Phone) has  awarded to José Carlos Bermejo, Director of the Center and Centro de Escucha (Listening Center),  with the Listening Award 2014. The award will be delivered in Granada next 15th of November, coinciding with the Listening National Day, to be a recognition for the free help provided by Bermejo and the team of volunteers whom help people in situations of crisis in their lives or suffering (mourning for the loss of a loved one, loneliness, disease).

Mobile Unit of intervention in duel Centre,
one of the services of the Listening Centre
Several of the goals and values of the Hope phone are similar with the Listening Center:

•Assisting to raise awareness in society of the importance of the “culture of listening” and its impact on all areas of social life.

• Encouraging parents and educators to promote the culture of listening, respect for the other, and people who think “different.”

• Remember that many people around us need to be heard and may be going through difficult situations (duels by sentimental tears, diseases, death).Our most sincere appreciation to all volunteers and collaborators! You make this world a much better place.

by Gabi Heras, ICU Physician
Aging/Gerontology, Healthcare

I Am Old: Can You See Me?

I am old, can you see me?

 Hola a tod@s, my dear friends.

Adding to collaborate with IC-HU Project two new friends, Vera Santos y Estefanía Martín of the Spanish Association of Psychogerontology. We invite you to navigate through their website, full of resources and training, projects, courses, news, and even  job offers! 
It is essential to continue to build networks that contribute to create awareness and collaboration. As all of you know, more than 45% of people admitted to the ICU are over 65 years old. So I asked them to write a post about our elders, and here it is. I am convinced that you’ll be pleased and that will make you think. Thank you and welcome to IC-HU Project.

“Youth, as social value predominantly in our society attached to the force and extension of the stereotypes about old age, can guide us as healthcare providers to see only a body crumpled and aged that we should cure or which we have to wait because there is nothing to do. But what about the person? Are we accompanying and serving people who live in aged and sick bodies?

The person is not the body. The person feels and lives here and now. His/her life story continues to write at this very moment and the quality will depend largely on the relationship we establish with them. The human being is scheduled for emotional contact and emotional bonding from birth to death. However, when old age knocks at our door, culture, stained myths, and false beliefs, contradicts the nature of our species.

“He is so old that he can´t feel or suffer.” “Do not complicate, she is very old and hardly feels.” “I don’t think that the family is too affected. He is very old.” “The best is admitting on the guard, because of his age there is little to do.” “The patient and the family know largely that she is so old that we can do nothing more than wait.”

All these thoughts make that as professionals and citizens, we deploy a series of biased actions or omissions that contribute to the older person to increase their volume of suffering by identification with these messages: “I have no right to feel, I am old. I am a nuisance.” “I don’t want to bother.” “Too much work I’m giving.” “I’m a burden.” “Now, why complain.” “Nobody worries.” “Nobody cares as I am.”

To remove all this, it is necessary from others, emotional embrace because it is what pushes us to be free, and thus feel reality as it comes. It makes us free to live and die with dignity, away from loneliness.

Emotional embrace should be essential ingredients empathy, tuning, involvement, the presence, communication skills, and flexibility of the time. Embrace emotional, generous, should be extended to families, because they also need us and if we are able to accommodate them we can promote both the care they give to their dear ill relative.

Let us make the sense of our profession depend on the sense of the lives of the people we serve and not only of their bodies (aged or not) or diseases. Let us make our profession an opportunity of relationship and meaning.

Is there something more beautiful than being treated “as we are” until the end of our days?

*Re-posted with permission from Gabi Heras, Intensive Care Physician from: