Why Communication Counts: A Patient Speaks

Brandelyn Bergstedt knows firsthand that communication is critical to good health care relationships. She’s had difficult encounters with health care providers as a patient. Twenty-three weeks into her pregnancy, Bergstedt was rushed to a hospital experiencing labor contractions. The admitting nurse performed a physical exam and told her that she was losing her baby. For 12 hours, Bergstedt waited to see a doctor in a labor and delivery room, declining to hasten labor because she knew that her baby could not survive outside the womb at such a young age. She struggled to convince her hospital team that she was not losing her baby after a fetal monitor detected a heartbeat and she felt her baby kicking.

Bergstedt perceived that her nurse stopped talking to her and considered her resistant, and staff told her throughout the day that the doctors were too busy to see her. Then 12 hours later—after the hospital finally performed an ultrasound that showed that the baby was, in fact, viable—the hospital transferred her to a medical center specializing in high-risk pregnancy.

Bergstedt delivered her daughter at 24 weeks, and her daughter spent the next four months in neonatal intensive care. During that time, a clinician hung the wrong bag for her daughter’s IV and she received the wrong medicine for 12 hours. Expecting to be shut out, Bergstedt says, “I was pleasantly surprised by their reaction. I expected more avoidance and conflict. Instead they told me they were holding a meeting that same afternoon to find out why it happened and that they wanted me there. They believed my daily observations of their process were going to be key in finding the solution. What was most important to me was helping to make sure an error like this couldn’t happen again.”

Bergstedt doesn’t believe the caregivers had malicious intentions in either setting. But their approaches to talking with her in the midst of a difficult patient care situation were strikingly different.

Several months later, Bergstedt approached the neonatologist of the first hospital and described her experience. “The doctor responded, ‘Why didn’t they call me?’” says Bergstedt. The physician next acted promptly with the hospital to begin an investigation. At a meeting with a hospital patient relations representative and the heads of Neonatology and Women’s Health, the hospital reported every step in the process where its standard of care was not followed. The leaders apologized to Bergstedt and gave her the opportunity to talk to her obstetrician about her experience. They also gave their recommendations for how the hospital would improve its care and asked Bergstedt if she believed the changes would be effective or if she had other ideas.

“That hospital generally provides excellent care,” Bergstedt says. “Unfortunately, mistakes will happen. There will always be the perfect storm. But when hospitals get into a difficult situation, patients deserve transparency, honesty, and an apology.”