Why do we miss cauda equina syndrome? Part I: Decreases in patient interaction; computerized chartin
I have practiced as a Registered Respiratory Therapist since 2005, back in the “good old days” of paper charting*. Back in the days when we charted what was relevant, that we were there, and what we did. This giving us the time to spend with the patient, building rapport, trust, communication, and noticing what the patient isn’t telling us, the subtle nuances of assessment. Now as a chronic patient myself, I see the failings of healthcare since computerized charting. What a tragic loss.
I have chronic cauda equina syndrome (C-CES), a rare spinal nerve root injury within the lumbar spinal canal causing a multitude of symptoms and co-morbidities resulting in loss of quality of life, social relationships, and independence.
This year alone I have had multiple hospital stays and over 1,000 doctor’s visits over the years since being diagnosed with cauda equina syndrome (CES) in 2012. I have noticed less and less interaction between my healthcare practitioners and myself. I no longer see their eyes, and in many cases I see the backs of their heads while they are buried in computer charting. They ask questions while facing a screen and inputting answers; missing facial expressions, tells, and opportunities to ask follow-up questions based off clinical observations of body language. They have become automatons and data entry specialist. Sure, they still touch me and provide treatment, but as soon as they do them move on to the computer to input their findings.
While concentrating on computerized charting, they can’t concentrate on patient communications and questions. I can’t tell you how many times I have been cut off by someone from my healthcare team due to computerized charting because quote, “let me finish inputting this.” I have a chronic illness, by the time you finish, I may forget what I was going to say due to the brain fog associated with chronic illness. You just missed an opportunity to help me, maybe even save my life.
This isn’t your fault. More and more administrators and government officials wanting to “improve” healthcare write policies that are out of touch with reality of direct patient care. They don’t practice physical patient contact and interaction, how can they know about the effects of their policies?
It is through us, the providers and the patients to advocate for our needs. We must take back the patient-provider interaction. We must be allowed to properly care for our patients, not be glorified data entry specialist. We don’t go to college for years, going literally through blood, sweat, and tears, getting bodily fluids on us (that don’t even belong to us), to lose the reason we went into healthcare in the first place; to improve quality of life for our patients and to provide empathy and compassion.
Don’t miss your opportunity to diagnose acute cauda equina syndrome because you had too many things to click on, many of which aren’t even relevant to the reason your patient is being seen. Such as, “Do you wear glasses?” What does that have to do with my back hurting me right this second?
Acute cauda equina syndrome is a medical emergency where minutes count! Asking pointless questions not relevant to the patient’s chief complaint ticks down that time clock. Again, not your fault. The more time spent with your back turned to the patient clicking boxes not relevant to the patient’s complaint, the more opportunity to miss important diagnosis that are time sensitive, such as acute cauda equina syndrome.
Help us improve the quality of life and care for individuals living with cauda equina syndrome. Cauda Equina Foundation and its members that suffer with chronic cauda equina syndrome, many times due to misdiagnosis and delays in care, ask that you call and write your legislators and healthcare system administrator(s) to let them know how computerized charting has affected your ability to give the best care to your patients. Offer suggestions for improvements and change. Put the care back in healthcare.
Serving to improve the quality of life and care for individuals living with cauda equina syndrome.
We are looking for qualified healthcare practitioners to join our Medical Advisory and Review Board, learn more here.
*Due to cauda equina syndrome diagnosis, I no longer work as a Registered Respiratory Therapist.