Posts tagged “hospital”

Elaine’s War Story: They call me Mister

Elaine Fukuda (@elaine_fukuda) is a design research consultant from California.

I admit I don’t have a lot of experience with children but the opportunity to shadow a patient through an entire day’s hospital visit was one to not pass up. The patient being 13 years old added another layer of consent and assent, a mythical ethnographic research unicorn of sorts.

The goal of shadowing was to understand the experience of the entire visit from start to finish, through multiple provider visits, labs, tests, and the waiting times in between. I met the patient and her mother as they were pulling into the parking garage and started the day with a scan. During the next two hours she patiently laid in a claustrophobic tunnel, and did everything as asked, from changing positions ever so slightly, holding her breath for 30 seconds at a time, and breathing at a specific pace.

Having fasted since the previous evening, she was ready for lunch but wanting to get everything done before their provider visit, she and her mom decided to get a blood test done before lunch.

We arrived in the pediatrics department and her mother stood in line to check in while I joined the patient in the waiting area. After a few minutes, a volunteer came over for what I felt was a break in our somewhat awkward small talk.

The volunteer was a kind elderly man with a book cart offering free books for patients to take home. The patient, tired from the scan and possibly feeling out of place in the bright and cheerful pediatrics environment shrugged and said there wasn’t anything she liked. Determined, the volunteer took out a “magical coloring book” which colored itself with a flip of a page. She was still not impressed.

Then came the pièce de résistance. From the cart the volunteer pulled out a heavy woven rope and introduced the patient to his friend, Mr. Stick. Mr. Stick had a magic ability you see, with a grand gesture he could become taut. In order to turn back into a rope, the patient was instructed to ask, “Mr. Stick, will you go down?”

The shade of red across the teen’s face had long passed lobster and she and I stared at each other in disbelief. Her mother was still in line across the way, and as the adult I felt responsible but conflicted on what to do. Surely the man had no idea what he was implying? Being a very good sport, she complied and sure enough Mr. Stick fell limp.

But the volunteer didn’t stop there. He turned to me, holding the middle of Mr. Stick, now back in its rigid state. He asked me to tell Mr. Stick to go down, which I did. Nothing happened. The volunteer said I must say “please”, which I did. And again nothing happened. He then said, “I guess Mr. Stick doesn’t go down if you’re not a child.”

“Hey, I think they’re calling your name,” I quickly said to the patient. And with that we escaped the somewhat creepy, but good intentioned volunteer.

“That was awkward,” she said.

It wasn’t until after the blood test and during lunch that we were able to debrief and talk about the encounter with the volunteer. I was afraid the mother would be upset that I hadn’t intervened sooner. She was shocked but laughed, wondering if someone could really be that clueless. As I started to explain what had happened, the patient (who been sitting right next to the volunteer) interjected:

“No, its name was Mr. Stiff, not Stick.”

Me: “Oooh, that’s even weirder.”

Mother: “I’m really curious how you’re going to write this up.”

Priya’s War Story: Taking empathy to a whole new level

Design Researcher Priya Sohoni has a very personal experience in the field and reflects on the challenge in order to find deeper insight about her users.

I’ve never been too comfortable with hospital environments–the smells, sounds, sense of urgency–it makes me nervous. Yet, as an ethnographer should, I’ve attempted to conquer my queasiness and conduct research in medical facilities several times.

In October 2010, I was conducting research in a hospital in the SF Bay Area. I was almost 8 months pregnant with my first child. I was given a choice between spending a day in the ICU, emergency, or the maternity department. I picked maternity – I was excited to be among so many about-to-pop mothers and so many who had just delivered. I thought to myself that for the first time I wasn’t feeling so queasy, I could hear babies in nurseries, we shadowed some nurses as they took the babies for their first immunizations, observed visitors greeting happy families with flowers, balloons, gifts…it seemed so odd that this was a part of a “hospital” environment.

On one of the shadowing sessions, I sat in on a nurse shift change. The nurses went around the table sharing information about the newborns and their mothers and taking careful notes of the patients’ needs and requests. On one of the nurse’s share-outs, she turned to the nursing manager and said: “Baby girl in room 203, born vaginally at 8:02am, had trouble breathing, survived for 53 seconds and then died. Should I register her as a live birth or a still birth?” I felt as if someone had stabbed me in my stomach. So much pain that I clenched my tummy, sat down on the floor and broke into tears. I was expecting a baby girl too, in just over a month. Why was the nurse so unemotional around a baby’s death? The nursing manager noticed me sitting in the corner, brought me a glass of water and apologized that I had to sit through that. She suggested I take some rest in the nurses’ break room. But I wiped my tears away and stuck around.

In a few more minutes, the shift change was over and the nurses dispersed. The nurse from 203 then walked over to another room to check in on another Mother and her baby. I continued shadowing her. She entered the room with a big smile on her face, congratulated the parents and commented on what a beautiful baby they had. She changed the baby, swaddled her, gave the mom her meds and assured her that she could call for help whenever she felt like it. It then struck me that the nurse was concerned about her patients. Deeply concerned. She too had felt the pain that the family in room 203 had gone through. But she had made a commitment to hundreds of other patients, a commitment to take care of them and make them feel better. She could not have done that if she had carried the sorrow with her, out of room 203.

As ethnographers, we get trained to empathize with our respondents. To speak their language, to make them comfortable, to be one of them. I had just witnessed a remarkable new level of empathy that the nurse had. Where I had failed, she carried out each one of her roles with respect and propriety.

I went home that day with a new appreciation for the nursing profession.

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