Inside Duke Medicine
Team’s compassion fills a patient’s heart
posted January 15th, 2010In 22 years of treating cancer patients, Neil Spector, M.D., often encountered other people involved in patient care—food services, environmental services, patient transporters, technicians, nurses. (Watch videos highlighting each group by clicking on the links.)
Spector knew each job was important, but never fully appreciated how important until he received a heart transplant last summer at Duke University Hospital. The experience transformed his view of patient care.
It began on day one, barely 48 hours before the surgery, when an echo cardiology technician offered to say a prayer for him. “Imagine someone asking if they can pray for you. You don’t expect that,” says Spector, 53, whose heart was damaged by Lyme disease.
The food service workers followed suit in coping with Spector’s gluten allergy and other dietary requests. “They always said, ‘You let me know what you need and we’ll get it,’ ” he said. “It made all the difference.”
“Every patient is important,” said patient menu tech Pam Fowler, who cared for Spector. “The smallest thing could be the biggest thing to them. If you go in with a smile and sweet spirit, they can feel that.”
Nursing care on the 3200 and 3300 units was predictably professional, but with an almost spiritual quality that greatly comforted Spector, his wife and their family. “ ‘You’re going to be OK,’” he recalls the nurses saying. “This is a great place. The doctors will take good care of you.’”
They also were strong patient advocates. “If they felt something wasn’t being done, they would call the attending over, and let it be known,” said Spector. “That made me feel better emotionally, and fed into the healing process.”
RNs Tanya Bolton and Tonya Evans cared for Spector in the 3200 cardiothoracic ICU.
“I treat each individual patient with respect, dignity and how I would want to be treated,” Bolton said. “I think that is the spirit of Duke nursing.”
Likewise for Evans. “I always enter with a smile and introduce myself and as I leave I ask, ‘Is there anything else I can do for you?’ Professionalism is the norm at Duke.”
RNs Faryl Podolle, Melissa Smith and Jamie Tumbleson cared for Spector in the 3300 cardiothoracic stepdown unit.
“I always look at every patient as if they were my family,” Podolle says. “People and families are scared in the heart unit. I try to give them the strength to get them through.”
Added Smith, “We spend quite a bit of time educating our patients and their families regarding their post-operative care and preparing them for discharge. That time is also spent building a relationship.”
Tumbleson said nursing is more than charting and passing out medications. “It’s about caring for patients when they are at their very worst,” she said. “If you treat them like you would your mom or dad, it really helps make their stay a lot better.”
It took being a patient himself for Spector to comprehend first-hand how exceptionally DUH delivers care in its patient-centered culture.
“Good care—not just skillful, but compassionate, people doing the little extra things—makes you feel better emotionally and physically,” he says. “If you’re feeling better emotionally, you’re going to heal much quicker. It all fits together. If you feel better, you
heal better.” Many researchers agree.
The cardiac surgical team, led by Carmelo Milano, M.D., was top-notch. “I knew they were going to be the best anywhere,” Spector says. So was the cardiology transplant team, led by Joseph Rogers, M.D., and Michael Felker, M.D.
Spector recalls informal visits from cardiothoracic surgical fellow Edward Cantu, M.D., and cardiology fellow Connie Hess, M.D. “They would come into my room late at night and talk about science and things,” says Spector. “They just became good friends.”
All in a day’s work, said Cantu and Hess.
“Every member of the surgical team takes pride in providing the very best care to our patients,” said Cantu. “Achieving this Duke standard is not easy, but it is this extra effort which sets Duke cardiothoracic surgery apart.”
Hess chose Duke for her fellowship for its long tradition of outstanding medical care. “I was amazed by the degree of expertise of Spector’s medical providers and by the easy collaboration between the different specialties caring for him,” she says. “The whole process was seamless.”
Milano says heart transplantation is just one small piece of the multidisciplinary heart failure program. “We are the largest heart and lung transplant program in the state and region. Our thoracic transplant outcomes are better than the national average and our wait times are significantly lower than national averages due to aggressive utilization of donor organs,” he says.
Spector returned to his Hock Plaza office (his research focuses on mechanisms of resistance to targeted therapies in breast cancer) in early November and is writing a book about his experience.
“U.S. News & World Report ranks four hospitals higher than Duke. I worked in one of them [Harvard], and the care here was certainly much better,” he says. “That report needs to be amended. I can’t imagine having had better care from top to bottom.”
Watch videos highlighting many of the groups Spector credits for providing the best care at Duke.