Embedding Hope in the Culture of Cork University Hospital Mar 21, 2018 -
J. A. McNamara
Cork University Hospital (CUH) is a very busy acute teaching hospital that has c. 500,000 different patient interactions each year ranging from the provision of cardiac surgery to general medical services. It provides over 40 different medical specialties and is one of eight cancer centres in Ireland and has recently been designated as one of two trauma centres in Ireland.
This profile of services brings particular challenges to delivering comprehensive patient care in many different settings and circumstances in the hospital. One of the key challenges in delivering that care is to give hope to every patient and their families and to do so in a way that embeds hope in the culture of the hospital. At the extreme, the opposite of hope is hopelessness that borders on nihilism, a state of being that is alien to most humans and which has no place in a caring health service.
Hospital leadership in CUH at every level work incessantly to shape the culture of the hospital in a way that nurtures values such as empathy, respect, inclusion and hope.
We expect and believe that these values are reflected in the daily behaviours of our staff who, through empathising with patients, gain an understanding of what each patient desires from their journey of illness and how our staff can help them achieve maximum quality of life (however that is defined) during that journey. In this regard, it may be that for a terminally ill patient with a relatively short life expectancy that honest disclosure may empower the patient to have a quality of life for this period of their illness or that patients diagnosed with life changing medical conditions with a full life expectancy are supported in their journey. It is important to remember that as professionals we should not be judgemental in superimposing our own values and expectations on patients or their families or in making assumptions as to what constitutes “quality of life”.
Giving hope in a hospital setting is not about giving false expectation to patients or communicating a misplaced feeling that outcomes are likely to be better than perhaps the presenting medical evidence suggests. I think that it is much more about empathising with the patient and their family in genuinely trying to connect with them and supporting them in that journey. Indeed, one of the observations on the practice of medicine might be that all too often there is insufficient divulgence of likely poor outcomes to patients leaving them with a misplaced sense of hope. I believe that it is vitally important that patients are communicated with in an honest way mindful that there may often be personal, professional or financial matters to be concluded in circumstances for example of terminal illness.
What does Cork University Hospital do to give practical expression to the belief that engagement, empathy and hope are at the core of the culture we want in the hospital? Increasingly staff are being employed in professions such as Clinical Nurse Specialists for example in respect of cancer care, neurological conditions and specialist children’s services. These specialists intermediate on a personal level between patients (their families) and services in the hospital to provide continuity of care in to the home setting. In addition, specialist care programmes such as those for stroke patients, provide patients with access to specialist therapy and other, staff whose focus is on maximising the quality of life of patients living with life changing conditions and giving them hope.
At another level CUH is one of the largest contributors to the national kidney donor programme with 11 organ donations in 2017 and this results in untold hope for those many patients who live in hope of a life changing transplant. At times of great grief and stress the ability of our staff to explain to the families of dying patients in our Intensive Care Unit and in other Departments in the hospital, that patients elsewhere will potentially benefit from the donation of the organs of a loved one is a great privilege notwithstanding the difficulty of those conversations.
Embedding hope in the culture of the hospital together with respect, empathy and inclusion will I hope help to differentiate Cork University Hospital from other hospitals. Our staff passionately believe that it is our responsibility to support patients on their journey and that our services should be developed in support of this endeavour at all times. We will be measured in terms of the extent to which the hospital “lives” these values in the way that we are perceived by patients and their families.
Chief Executive Officer