Finding Out What Went Wrong
What did you do the last time a patient asked to read the chart? Traditionally, you uttered an authoritative “tsk,” turned abruptly on white-heeled shoes, and walked briskly away. Who ever heard of such nerve? A patient asking to read a chart! Today, there is the “patient’s bill of rights.” One of its mandates is that the patient has the right to read his or her own medical record. Experience,
Health and Illness in Modern Health Care ■ 195
however, demonstrates that this right is still not always granted; and in cer- tain situations 2 records are kept. Suppose one enters the hospital for what is deemed to be a simple medical or surgical problem. All is well if everything goes according to routine. However, what happens when complications de- velop? The more determined the patient is to discover what the problem is or why there are complications, the more he or she believes that the health care providers are trying to hide something. The cycle perpetuates itself, and a tre- mendous schism develops between provider and consumer. Quite often, “the conspiracy of silence” tends to grow as more questions are asked. This unpleas- ant situation may continue until the patient is locked inside his or her subjec- tive world. It is rare for a person to truly understand unforeseen complications. Nurses all too often enter into this collusion and play the role of a silent partner with the physician and the institution.