Hi, and welcome to my blog! I'm Susan E. Mazer -- a knowledge expert and thought leader on how the environment of care impacts the patient experience. Topics I write about include safety, satisfaction, hospital noise, nursing, care at the bedside, and much more. Subscribe below to get email notices so you won't miss any great content.
March 25, 2016
My mother hated the word tolerance, especially when it came to race. She would say, “To tolerate is not to respect. It is ‘to put up with.’”
I am in Mumbai, India, the place of many tolerances. The culture itself tolerates abject poverty next to untold wealth.
It tolerates unlivable low wages next to high income dynasties.
It tolerates whole families sleeping in the streets, on the pavement, visible from five-star hotels and thousands of cars driving past.
It tolerates shanty slums constructed of used corrugated aluminum, with stolen electricity and no running water.
In fact, it tolerates whole neighborhoods of slums that fill in the gaps between industrial buildings and apartment houses.
While this is not my first trip to India, these past nine days in Mumbai have allowed me to see what I could not see before. In some ways, it feels as though this is my first time in this amazing country.
The patient experience movement in the United States has been measured by our willingness and skill in raising the standards of patient care where the human condition meets the clinical diagnosis.
Given where I am today, I suggest that we turn the patient experience on its head and look at the bottom line tolerances we have in this arena.
In truth, what is the worst a patient can expect inside our hospitals? Inside our culture?
Are we willing to have an infant die because the mother cannot afford transportation to the hospital? Are we willing to have nurses live with memories of those they could not save because they just had too many patients to care for?
Are we willing to discharge a patient who is clearly too ill to go home because their insurance company said so? Are we willing to turn away a wounded person because they are not in our “system”?
What are we willing to tolerate? What is the poorest experience a patient can have that is still within our levels of acceptance?
This is a tough question because none of us wants to measure how we treat a patient by the “least bad” scenario. At the same time, it is a question that can show us what is real in our progress about optimizing each patient’s experience.
We do have tolerances, each of us. And as a universal truth, what we tolerate, we promote. Worth thinking about. Worth doing something about?
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