Sunday, June 6, 2010

Plane Ole Crashing

I was sitting on the plane with notebook and pen, jotting down thoughts I had for my book in progress. We had not yet taken off and the stewardess was going standing in the aisle showing us how to use our seat belts and where to find our flotation devices. She pointed above my head to where the oxygen masks would drop down in the case of decreased cabin pressure.

I was doing my best to tune her out and concentrate on my chapter on patient safety. After all, I had heard this so many times I could practically give the stewardess's shpeel myself. At that moment, a brain light bulb went off and I looked around the cabin at my fellow passengers.

She was saying things like "in the case of emergency..." and talking about "water landings." Wait a minute, she was talking about what would happen if we CRASHED. Why were the people around me not panicking? Why was everyone so calm? Why was I so calm?

Perhaps it is because we had been in enough planes to know an emergency like the ones being described was unlikely. Perhaps we were a group over very optimistic, positive thinkers. Perhaps, it was because what she was saying was nothing new.

We were desensitized to the stewardesses crash instructions because we had heard them over and over. We knew what to do. Did that mean we would not be scared out of our minds if the plane ever began to fall from the sky? Of course not, we would not be so calm then. Did it also mean that we had been trained sufficiently so that when the oxygen masks fell we would no to place the yellow mask over our nose and mouth and place it first on ourselves and then on children? Yes, I think so.

In healthcare we work hard to avoid the unpleasant topics. This is perfectly understandable, of course. Illness is intrinsically scary and we instinctively seek to not add to that emotional weight. While this approach may be helpful in the short term, it can be harmful in the long run.

What if we began educating our patients and families as soon as they got on board? What if, even before serious or chronic illness, we talked about advanced care planning? What if we starting training to be effective advocates before we went into the hospital or had a medical crisis? What if we were able to reach a place of preparedness long before we had to place the oxygen over our nose and mouth?

What if were were ready when illness hit?

This is my hope. This is where we are heading. This can happen if professionals and lay people agree to embrace the aviation model of safety.

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