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The Patient Experience 2a

Mark Finley Des Cummings

Conference

Recorded

  • November 1, 2013
    9:30 AM
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there are seven different unspoken requests in the heart in mind the patient was in when you analyze the encounter that Jesus had at the well systematically Jesus met every one of her unspoken requests so before Disney ever did the research for Florida Hospital two thousand years ago Jesus ministered an answer those questions that have your Bibles let's go to John chapter four and were going to compare the methodology of Jesus in John four would be unspoken requests of the woman and were going to take a look at how they apply to the research is being done today and then guess is going to come on and share with you how that relates to practice we begin in John the fourth chapter we recall last evening that we noted the expression we spent the first twenty five minutes on it in John four verse four Jesus needed to go through Samaria we pointed out that he did not need to Goodridge Samaria geographically neither did he need to go through Samaria because it was the quickest way to Dowling neither did he go through Samaria because he divinely knew he was good we meet the woman that were not sure about that he needed to do through Samaria because based on John three verse thirty four for he whom God sent speaks the words of God is Jesus had this purpose driven life Jesus had this sense that he was sent to Samaria by God Jesus had to sense inside that the Holy Spirit was leading him to Samaria and he could not get hi that your fiction of the spirit he could not deny that interleaving that you are prompting of the spirit as you when I get up in the morning what keeps us from burnout in a people profession what keeps us from exhaustion what keeps us when the waiting room is full and were already thirty minutes behind in the schedule what keeps us from mental physical emotional exhaustion there is one thing that helps to contribute to keeping us from that and it is this inner sense that we are here by the divine decree of God it is that inner sense that the work of a physician the work of the dentist the work of a healthcare provider is not a profession but it's a calling that inner sense of purpose direction and calling Jesus must need to go through Samaria he was divinely some GE you are divinely summoned for sacred work now let's look at a clinical analysis of Jesus interaction with the woman at the well and attempt to discover the seven unspoken requests in the part of every patient John four we're looking fair beginning at John for verse seven Jesus is sitting by the side of the well he's wearied a stranger shows up working at the back and look at verse six in the last session of the day intentionally and in verse seven it says a woman of Samaria came to draw water and Jesus said to her give me a drink notice the expression Jesus said often in the Bible very short expressions are pregnant and loaded with meaning the Scripture says and Jesus said it was not simply what Jesus said it was the fact that he said nothing about it was not only his content but it was his comment and Jesus said a good attention to her issued under she was a Gentile Samaritans he was a Jew she was a woman he was a man she was a woman of elder ill repute it was a religious teacher and Jesus said what flowed through her heart when Jesus said something to it wasn't only what he said it was her surprise it was saying anything at all he was speaking to her he was paying attention to her she was not unknown he was recognizing her Jesus noticed her when your patients are sitting in the waiting room is anybody paying attention to the other a merely a statistic on a daily chart when they walk in to the inner sanctum of your office and your nurse has been sitting there do they feel like their statistical human being when you come in and you're already seeing thirty thirty five forty patients a day in some disciplines if you are in other disciplines that I know that will remain unnamed you may be seeing ninety patients you know who one disciplinarian some of you may do a few surgeries but others of you may have shorter encounters with patients how they feel that they feel you notice they feel that you commit a safe now I looked at the chart and this was the problem is the remember the Disney study that has brought out last night the first thing that the Disney said that a patient longs for his attention that is exactly what Jesus gave this woman and Jesus sent the notice of intention I'm reminded that an old country-western song that goes like this I want someone to notice the little things that make me who I am more than anything I do not want to be unknown the refrain haunts me more than anything I don't want to be a new and old country-western song I want somebody to notice little things that I am more than anything I don't want to be unknown human beings do not want to be considered to be a cosmic zero they don't want to be considered a blurb on the radar screen they don't want to be considered as a non- entity Jesus did not treat the woman as a patient he treated her as a person Jesus did not treat her as a commodity he treated her as a child of God in Piersall injurious biography of John Kennedy saw one juror in talking about John Kennedy makes this interesting observation he says that Kennedy would get his list of appointments that day that you can imagine the large number of people will the president of the United States would have to see anything Kennedy would get his large it is list of payout of people that day but he had to stay in Salinger says in his biography of Kennedy that one of Kennedy 's unique abilities was not to say to people please let me I only have a few minutes for you even if you only had a few minutes if Kennedy had this ability to focus if you spend three minutes with you would spend what it felt like he was spending three hours is not the quantity of time it is the quality of the experience in the Kennedy had this ability to spend five minutes with a person then simply put his hand on his shoulder or look directly in his eyes and smile and say you know this was really engaging conversation I appreciate so much the opportunity of spending a little time with you today thank you so much his aide would answer the person out of the room and they would feel like they were walking on air because the precedent set watch and engaging conversation the conversation might've been three minutes it might informants the desire of the patient's heart initially before they receive treatment according to the research is that somebody pays attention to know as we continue through this narrative Jesus proceeds from the attention level and he makes a request you will notice that in the last part of verse seven Jesus said to her give me a drink it appears in the English translation of the text that this is a command give me to drink it almost seems a little harsh it almost seems a little direct the original language places it in a little different context and the culture places it in a little different context the original language puts it in the context of a gentle request it would be more like saying May I have the drink it's more like asking for a favor Alan White makes quite a insightful comment I'm always amazed at the insightful comments that Ellen White made not knowing the culture never having traveled to Israel and not knowing the original language I wonder why she gets it right all the time if she never traveled to Israel and she doesn't know the Greek I can't explain those of us who believe it has installation at no difficulty in explaining those who believe that the writings of Ellen White where human influence struggle over those questions but notice she comments on what Jesus said and she says as the liturgical way Jesus asked her for a drink in other words he startled her he noticed her he paid attention to her such a favor no Oriental with Witt would withhold in the East water was called to get God to offer a drink to a thirsty traveler was held to be such a sacred duty but the Arabs of the desert would go out of the way to perform wow what is Jesus doing here is saying to her not only do I recognize you but I respect you I respect you he was saying to her here is common ground I need a drink of water and I will not allow the kiss between the Jews and the Samaritans to keep me from respecting you enough to ask you for a favor what is the second great quality in the heart of every patient what are they long for first I want somebody to my attention to second they want their hearts and there needs to be respected they want somebody to say I respect you I can really understand where you're coming from I can really understand why this is troubling you will concept of respect verse ten Jesus goes on and what I want you to see is that there are seven basic steps that the Disney research has discovered they come in the water and the seven steps are in water in the text of John for it's rather amazing to me that when the leading researchers research the attitude of patients they simply come back red rock fundamental eternal principles in Scripture let's look at the third great need for the great recognition that Jesus at this one universe ten Jesus answered the center if you knew the gift of God and who it is who says to you give me a drink you would have asked me and he would've given you living water what was Jesus saying to her here what what's the psychological principle Jesus was saying I have sympathy for you you are looking for something more than simply coming to this while getting a drink of water your woman who is a woman was craving in our heart I sympathize with you I sense that you're looking for something more I says that you have a deep longing in your soul I sense that there's an emptiness in your heart I was interested in a rewritten version of the Hippocratic oath it was written by the then academic Dean of medicine at Tufts University Louise lasagna and human rights a colonic version of the boat that really harmonizes with the sympathy that Jesus is giving this woman he says here's how he writes it for for his physicians in forty students as medical students at spots he says I will hi the benefit of the sick all the measures that are required avoiding those twin traps of overtreatment and therapeutic nihilism I will remember there is an art to medicine as well as a science and that warmth and sympathy and in understanding may outweigh the surgeons knife in the chemist run bets on charges at some time so what was Jesus seen here he was saying to the woman warm I'm paying attention to somebody's listening he was saying to the woman I respect you it was saying to the woman I know that you have a deeper longing I see in your eyes it's written on your face you are I sympathize with you you want something more than the water of this well I have the sympathy that compassion for you your unspoken needs I love this sentence I will remember modern Hippocratic oath that there is an art to medicine as well as science and that warmth and sympathy and understanding may outweigh the surgeons knife in the chemist wrote medical missionaries in the twenty first century recognize that there's something beyond surgery and something beyond the dispensing of drugs to their patients that there is any element of sympathy care and concern when you look at verses thirteen and fourteen Jesus himself comes to those passages any offers the greatest thing that after three patient desires he offers the woman whole verse thirteen and fourteen Jesus answered and said to her Weber drinks of this water will verse again so you think I have something more for you yes I noticed you yes I did attention to you yes I respect you yes I've had sympathy for you but ma'am do something beyond Madam there's something beyond whoever drinks of this water will thirst again whoever drinks of the water that I shall give him will never thirst but the water that I shall give him will become in him a fountain of water springing up into everlasting life what did Jesus say there is singular your inner longing longs for hope you want more than five broken relationships you want more than a life that's emotionally shattered you want something beyond your guilt something beyond your shame I am giving you hope may I suggest to you that the heart cry of every one of your patients who committed that office is that there are crimes if they have been diagnosed with a coronary artery disease that they won't promote if they been diagnosed with a cancerous malignancy they long for hope if they come in with a common cold they law what ever they come to you for there is that inner inner longing for hope I know that from a patient's perspective for sixty seven years I don't think I went to a doctor if I can avoid it more than two or three times I mean I I I was and if you asked me how long he will live I would've told you at least to a healthy hundred with my friend is coming soon we go beyond that Desi is the father of the healthy hundred and I would so get least I'm going to healthy under until as many of you know I have this freak accident I break one red and another crazy accident that they need only plug in my computer and I drink another remnant and pretty seeing my general conference physicians make appointments with the top positions of the University of Maryland they send me that I have rehearsed that litany of medical tests I will not bore you with that again today but I will tell you when you see it with anonymous and may draw sixteen choose a blood you begin to wonder if you have any left I have enjoyed with 3-D formula takes six mean you and you sit there and say how many more you can take in the phlebotomist says all for today that's a wall I remember sitting with Doctor Manger professor at the University of Maryland in internal medicine and he says I analyze the statistics and brings out about seven pieces of paper with a little tiny lines on the singlespaced with numbers after every line but I never heard off and he begins going over seven pages on singers and what what's up to what halfway intelligent ion and so I'm looking at things what in the world is his name talking about any explains it explains it he did a great job hunting thank God is going on as unconcerned about this number concerned about this number after we went through that icicle what we can do and he said well I think I need to send you to the oncologist in my secretary my administrative assistant just made an appointment with the oncologist and he was very gracious very kind I left his office as as walking along in his office in the unconscious awesome oncology but that's not going to have you had your oncologist I know what that means not pathologic Nelson using yes recession but that that's what he said and this fear grips with one of my wife you what what about my kids what about those sermons preach what about all those appointments for the next three months when I walked into the oncologist 's office what did I want more than anything else I wanted to become a little incidentally just so you don't get nervous than a faint halfway through the sermon I'm doing great they backed up my diagnosis to a pre- myeloma multiple myeloma as the oncologist originally anticipated so I I'm doing a lot better now but here's my point Jesus met a woman and he sensed the need of her heart was whole and he said I will give you I will give you something beyond what you can possibly imagine the fifth thing that every patient longs for is the truth Jesus said to the woman verse seventeen verse seventy patients want truth telling verse seventeen the woman answered the center said I have no husband Jesus said there you have well said I have no husband we have had five husbands and the one you have now is not your husband in that you spoke truly what patients want they want somebody in a attention they want to be respected the one sympathy and understanding and compassion they want to be given hope for their hopelessness encouragement for their despair but I want to be told the truth Jesus could have avoided saying anything about marital or nonmarital situation but Jesus knew the deceiving their and not revealing to her the truth would not be helpful for her ultimate healing so we told the truth or because he knew that Ruth Kelly Austin is the doorway to healing as you share with your patients the truth about their condition in a gentle kind sympathetic loving way it promised them to decide our lifestyle change of the six thing that Jesus did was he made a transition into the spiritual which is very very fascinating you find that verses twenty one to twenty four verse twenty one to twenty four Jesus said to her woman believe me the hour is coming when you're neither worship on this mountain nor in Jerusalem she and try to change the topic but Jesus talks about worship you worship what you don't know we know that we worship or so for the salvation is of the Jews the artist coming when the true worshipers worship the father in spirit and truth it's it it's quite interesting what cases do he pays attention to these shows of respects he begins bringing science of the barriers by showing sympathy to her he offers hope for her hopelessness he then begins sharing with her the truth about herself that truth about herself causes her to feel this sorrow district engines inside because the certainly a desire to change in her experience with this place they have this discussion on worship now they're talking about the eternal and then in the second part of the narrative you come and Jesus then offers the ultimate solution to the alternates that the ultimate solution must certainly deal with the physical needs of your patient it must certainly deal with the care the immediate cause of the disease of the patient or the immediate results of the disease the ultimate solution is much more than that because here you come to Jesus and God is the ultimate solution what is the first twenty six Jesus says there are I speak you would be in other words I am the Messiah I'm the ultimate solution to your loneliness the ultimate solution to your deal the ultimate solution to your fear the ultimate solution to the conflict of your heart what does this now can say to us today in a 21st-century setting it says seven things first it says however busy you are whatever the frantic pace of the practice pay attention to patients consciously remind yourself to notice the second offer respect every patient deserves our utmost respect sympathy and compassion thirdly shown sympathy for being an inspirer of hope when they have little hope you must be there hope tell them the truth tell them the truth at one appropriate transition to the spiritual and present the ultimate solution of the treatment that you will give them in the context of Christian faith how you apply this new twenty first century in a modern practice of hospitals and thank you Marco first thing is done they took away my leveler microphone and you demoted me to him always a lot of things from last night but the first thing is basically story listening is the bridge by which you come into another person 's life and understand in a different way so you listen to the words that they say that reveals the thought process of their mind you listen to the stories that they tell revealed the memories of her heart stories are what are the memories of the heart is the window to the heart sister so I would just ask you do this as part of the session would ask you to work in groups of twos and threes so find a learning partner beside you you got it if you need for you can make it across speak across four but go ahead and decided to be aware of all right here's what I hope your assignment Mark is just told your story if you told you that story in your in your office he told the story of walking across there and he experiencing and realizing that he was going to the oncologist and those associated how would you respond to that story what would be the next question that would invite a bridge into the deeper conversations of the heart what would you said how would you respond what do you about three minutes ago first thought what if you hear him say what was he really saying the ones the deeper message that the story brought one more minute ten seconds RIAA what did you hear as the story or what would you said is the follow-up anybody for money or drugs when majority what do you hear what you said anybody all actually the stage and give you an opportunity with the market wants me want to mail acknowledges here simply just recognizing that fear so give me a statement of how you would do that that must be pretty scary I remember when or how I felt that way myself it was very traumatizing what is that kind of language it felt very scary I jump into the identity with the person when I say I felt that way myself and I can tell you it was a life-changing moment or one that I don't want to revisit very often under the effect you you now open the door to another deeper conversation the other request is very stable do your same how could this happen to me everything I have been said that without any that was great because you heard them say sixty seven years yet is how it has happened to me so what does this imply I don't deserve it I know you do something bad is there any guilt factor behind this is something I should be feeling guilty about what's the Lord trying to tell me in those responses are right I should've seen a doctor for office allotment of a citizen of Doctor Moreau actually this was discovered it are an executive physical at a celebration where in we just had another founder of one of national football on national basketball league franchises to found his multi- myeloma and is because the panels that we run he just had him months before a physician 's eight exam so you can continue to come when they told him from the team that they had come for his physical and sell it it was it was really not that kind moment senior positions a good thing so but as you as we talk about this kind of thing are basically saying why did this happen to me is very easy to it it's very natural to come back and say it I hear you saying this happened what what what what what is this and I I got it to left field next this is too busy this is an interruption so basically what might be your next next what you think God is along this interruption in your ministry is opening the doors that that discussion someone says to you if you're it it's yes the sort of say that there were seven pages of results and pass the first three his mind was already listening to editing saying so I are there you must have a lot of questions that I think you have any questions about material any questions great great any questions in some respects many times you might be able to actually have someone in your office he specializes in answering this question either so I have a person that's on my step as the president of our foundation have many medical questions so I hired an ICU nurse and I basically said to the person you I've got a full ICU nurse whose rate capable of understanding this with you and knowing absolutely personal for see you can ask anything you want to our friendship I value and I want to be will to respond but you might have some deeper issues that you are discussed was Simeon Mark more privately some voracious nurse to beat your disposal here's her number and she if you release your information or shall sit down can talk through said designating some younger team has the ability to be able to do that kind of thing see you might be tied up but the acknowledgment the seven pages write off overwhelming so he said seven pages you said immediately that feels overwhelming and you feel overwhelmed and you feel like you need some kind of navigation through this process or the other question you have any resources to help you understand this help you navigate so that you begin to explore resources as opposed to taking it all back on yourself you begin to empower the person to explore resource was one of the problems of being faced with the status of patient set become very vulnerable and immediately you don't quite a while people call themselves the patients are at I'm amazed that we as providers call everybody patients when I go out with visiting with the other folks interviewed they don't call himself patients they when they refer to the doctor they will send a patient of this Doctor was a patient of this hospital other than that I don't use the term patient to describe himself why don't you think these in turn patient describes a patient is sick that is a very insightful because you're my father had a six way bypass sitting in a hospital ICU three weeks in the hospital and his doctor told me cardiologist said he got a convincing he has he has some heart disease and he has got cardiovascular disease I walked in my father he's an outlier we spent thousands of dollars take care of him and he is is it will run through insurance we've been his bad for him it's got to the hospital that the government spent for a buddy and so I'm saying him as a walk-in bad I feel similar Jan had this condition for some time to placement if you have got cardiovascular disease you can just use easier to me and said the day I let you call me a disease is the day I lose my personality for health some disease or condition he never change the vocabulary to the data because he knew the power of the labeling and when she wants you to call a person a patient one of the things my dad always love to do was be a provider as a difference this equation the provider patient who's got the power the provider I take away your ability to provide I put you into us into his own were you going be healed and now during that period of time you are an object that we do things to take things out of wood put things in the prescribed we do it we wake you up with it we can put you to sleep we do it on our timetable at part-time regime so what we have to do is recognize it if were going to co- create a story we have to have collaboration and basically a hospital was built for incarceration meringue exactly what it will look at the vocabulary what is a wonder they call a person who is in the jail when we call the people are in a bad information I rest my case I can go through a whole litany on this I will not I will not but simply the point is you've got to find a way to empower them because when they lose a sense of power they lose a sense it was built in them in creation remember when God made humans if you want to understand how to bring the best on people understand how God made them he gave him dominion dominion is the power over a certain territory a certain responsibility today we would call it in the computer world a domain it is described as the point at which all of the roots of your files reside so it is the point in which you leverage the power the memory and of your capability so if we can give patients a domain in which they can be expert because they feel so disempowered by all this information by all this emotion I was not someone has just have you have you plan through how you're going to deliver bad news and heavy scenario that through with your staff so they know how you're going to deliver bad news to a person can I invite you to do that think that through how you're going to actually deliver the bad news to a person in different occasions so I thought oncology physician friend who is just fantastic she's incredible and one of the things that she does the best is the patient will inevitably spills and slaughter women with breast cancer until one of the stories about one of the women and in my book it secrets of healthy one hundred this woman's image Sheila Sheila sat down in front of the oncologist got the bad news that she had breast cancer stage three and it was bordering toward stage for Chris Sheikh Doctor said to them you must have hope you're not a statistic I give you statistics but you must have hope Sheila 's response was this I'm too afraid to hope hope she sang at praise popular with the person next to you and say what you would've sent back and forth on video couple minutes so what did you say responses what makes you say that a big yes I can tell you're very concerned tell me more about what he afraid of it specific but would be the worst thing that happened yet this could be the best thing that could happen to get this tell me about your fear so basically the other question is are you afraid to help why are you afraid to help you what the woman said because I don't want to be disappointed I don't want to build things up pray and hope and get all my network of friends rallied around me and then have my wife and I just don't do that she said I was too afraid hope the doctor said back love this phrase you can borrow from me you may not have hope that you and borrow from me start with me now tell me who are the other people you could borrow from regular people in your circle let's sit down and begin to list how you are going to construct hoping to your life even though you're afraid to help so the first thing he did was sent to redefine what charcoal was most people say I want to be a cancer survivor Sheila says I want to be a cancer driver not survive and she took as her text more than a conqueror more than conquer and became her text she went on her on near what the doctor sat and wrote in permanent marker these passages of texts of things that start her life of a give her hope she began to go through her chemotherapy she started waking up at three a.m. in the morning intense fear because it was dark she was alone she would check her husband and asked this question but even if I die chit for boisterous homeschooling but even if I die concept to her to take care of new non-native vascular boys and he reassured her in violation they cry for she cried herself back to sleep happened three nights in a row fourth night he wakes up she wakes up when using he says after her wedding and if you live that's what you say said Sheila the real question is what he can do if you live you're not dead yet what was anyone in the next morning she got up and she said I'm going back to medical school and the doctor she taken premed today she is a second year medical school yet a student at the University of Florida page forty six I asked her that when she applied this holder hereto all that most medical schools she said not to plant lived on hundred Kurt goal is in her statements beautiful our essay of why she wants to be a doctor she wants to deliver care to women who cannot afford care for breast cancer see will be oncologist she has a husband this is a pet lawyers use very well on provided for as far as that goes because the electric property law practice 's there is just an example of how you can become what I call the stethoscope of the spirit and explain it to you healing the whole person we've talked about is really the genius of what we have is Christian healers and when Florida Hospital does it right when we get it right we actually sent this intersect between them this spirit the body and the mind and what you find in Scripture is when God reason Adam 's body is spirit is mine are ignited and becomes fully alive Edwards sold me for me my translation is fully alive is what Jesus was referring to when he said to have life more abundantly so there's different qualities of air that you breathe you can live by respiration to thrive by inspiration you are designed for inspiration the tragedy of what happens in human experiences at sea and always attacks your inspiration to see this to take take away your worth and diminish your vitality happened to the disciples at the time of the resurrection where Jesus Feynman that evening at the time the resurrection Sunday evening walk in the upper room what you what was his first act upon he breathed upon what was his act to bring humans to life he breathed in the new begin living self he breathed the second window salvation into the hearts these people so that they can become a living soul basically that is what you have the opportunity do we heal the whole person is if you have the opportunity take and provide physical cure or physical healing for the moment you have the opportunity to understand and engage the mind of the opportunity to inspire the spirit and that is the inspiration process this thing this many many times you'll you'll be telling patient patients of the breathing exercise write some breathing exercise or something you have to do to make sure that you breathe properly with your surgeon getting them back whether able to function get on the hospital whether you're dealing with somebody with COPD when you're dealing with somebody who is elderly and experience some respiratory issues if you often talking about leaving back reads a great conversation because it's got conversation in the Holy Spirit is all about breathing so this is that this is a great opportunity to actually take what would be a very normal Monday and function of an HMO requirement that you check check waiting I asked about the rest asked about smoking check it off and you take the Monday evening and begin to turn it towards the divine and ask how could I take any of those Monday and questions and begin to cause them to reach a different point and is there a place at which my staff might help me do that so that it's not all on me to do that at work and how can I help you take an craft those moments so one of the things that I can't people and reading I learned when I had brought ruptured disc in my back couldn't move but I learned how my prayer process around breathing exercise because that's the one thing I can do and I think Lord I do not have surgery but I did have to strengthen my core to be able to get back someday I'll try after surgery but I didn't have to right now so what I learned in my still do it every morning is that I have my prayer process in the breathing exercises all the same time it's a way to simply take the common exercising you would give people and actually show them away to live differently in other ways to give them harmonic and tell them to play because it's the same as purse lip breathing and they can learn to play under favored him but basically you have different ways of turning your practice into a spiritual journey for people that goes into whole person healing last night we talked about the three dimensions that the folks at Disney defined when they look to limit question one Florida Hospital heals people holistic way I happens when we really do it right may save you touch them but the body mind and spirit and I was six when at last I soon will not review that but here's one of the things I want to point out you how important a metal portion is on communication communication is to my mind what prayer is my spirit believe that if I need to know the plan I need to understand where we are in the journey I don't expect you know everything I need answers but I need answers changes are okay if there explained silence destroys trust so what happens is this whole ability to communicate is often exercised in the mine in the discussion these opportunities with the seven pages is a great opportunity to communicate a crackpot about what's been happening up overwhelming situation where information is coming at you how are you going to process how you going to get that help cure some things we've done our practice field provide your situation the science of medicine has been remarkably advanced to an increase of technologies for diagnosis and treatment these advances provide clinicians with objective and comparative information for your planning harbor most of these tools are focused on the physical view cognitive and an psychological test probe the mind and emotions but there virtually no technologies for the spirit you can image the spirit that day that they had an MRI that will actually image love or hate or violence and that's the day that we have been basically long talk about sums I don't know that will overcome for actually that is the part of life that is the mystery aspect and basically what you think what I would say is a statement of opportunity under the situation because there is an absence of objective technologies for treating the spirit of the patient the dimension of care remains an art yet it is key difference in our presidency difference in her practice years ago least Doctor 's building medical one medical arts building you may remember back as far as the medical arts building why hospital is a science doctor 's office was the art the art is the process of interacting with the mind and the spirit of your member when from the research last night what percentage of the patient's whole journey is wrapped up in the mental eighty percent eighty percent and eighty percent of their memories wrapped up the spiritual care planning is an area of great opportunity you are called to be the stethoscope of the spirit so you are an instrument by which God uses to hear the spirit and can hear the language of the spirit as people begin to share their stories how do we enhance the ability of our caregivers to practice whole person healing while I want to want to show you where that starts on a spiritual level this is the number one patient experienced driver and now I didn't write this the Disney team wrote this human connection compassion overwhelmingly reported as the most important not medicine technology on farm medical outcome is separate and distinct from the hospital experience in the mind of the patient this weekend we will sign an agreement with a woman who lost her husband in a hospital and she wants to give two million dollars to develop a transplant house for patients who need kind of support her memory is not the memory of that loss it's the memories she had three extra years with her husband and he was able to see their granddaughters and he was able to do some things that it hope to do so the end-of-life is not so much the issue the bad news is not so much the issue it is the way you create meaning that is the issue if there is no meaning than individuals feel totally lost they feel lost in the infant in the body they feel lost in the mine and they felt they could in the spirit and that cause will be calling for C sinkholes of the spirit it means that the water of life is not floating between many that the structure of it that is about as a result things dry up a new sentencing so what happens here is height a high standard of medical care and treatment is a given it's a cost of doing business they expect us to be good expects not know if we walk in and say we don't kill many people they say was so what's so great about that that's what you're supposed to do many patients want to it to recognize their humanity as all times is market said earlier in the woman at the well in all encounters invite everyone this is the part was the hardest for doctors to hear the doctors the doctor is often viewed as a commodity alongside medical technology and procedures what do you think that is what you think I made that statement is loss of the personal how have we allowed ourselves as a profession to use a commodity that journey if you want to be commoditized do what computers can do if you think you can beat them good luck if you want to be differentiated do it only humans can you will have an ongoing significant differentiation that will have value over time above and beyond technology brick-and-mortar equipment and capital resources are available through all kinds of different companies and for-profit hospitals but the spiritual and mental care of the individual is where God has called us to be able to have excellence now it doesn't mean that we have more quality on the other side it means the we have excellence that goes beyond the physical embraces the whole person we might inspire people and they may become living cells so it is with a set is a caregiver circle in the this made up the patient nurse family member the doctor can get in the circle cosmos the patient they want the doctor and they just don't feel like the doctor wanting to communicate at by the fact that there always in a hurry but always rushing the rushing in rushing out and as a result of the time spent and we have this range from eight to fourteen minutes time I wish a little bit about how to cope with that because there is a whole class rough time that people are not a letting patients in to understand if we let them understand that it will be a remarkable difference so here's the difference between the whole area of soft science and art science subjective artist on me so yes I'm subjective art is subjective the disease specific science focuses on the disease specific art focus on individual uniqueness a caregiver driven is the science side it cocreated is the art side where you work together back and forth with the interaction for a science is protocol practice artist permission -based when the great things that I learned in witness training was always let people always ask people if they were anyway you to go next would you like me to talk to you about that would you like me to pray for you about would you like to understand that deeper so that there is a kind of a code that we've be adopted which is invite all force nine makes sense invite all force not in the way you invite is my questions the Lord was just fantastic question Jesus was incredible it questions somehow bridges of income becoming credible statements advising him and him really Jesus opens people 's minds often opens our hearts up with questions so we have the opportunity to invite him with questions about the permission site in science intervention in arts and interaction in science is most commoditized it's most customized sodas of the differences between where you can try to put your emphasis on to be scientifically excellent but won't tell you you will be differentiated benefactors mentally and spiritually in tune with the patient in it we go back to the three dimensions of story now the question is how we set the stage for this encounter in your practice so we talked about the interaction or talk about the plot next Thursday it mentions a story the interaction the plot and the stage so let's take a look at the at the plot one hundred the time to look at the video so let me go to this we found that there were five plots that people come to the hospital with my guess is there I may be a similar number in your practice you need to look at your practice what are the five what are the areas of people come with a different plots that they come with so the first one is celebration were coming emanating as a great deal you have made it high expectation as Pfizer such a deep crash when their baby is is born compromised or is threatened life-threatening tonight it will tell a story for our leadership group with a live feed from the hospitals and ICU unit of a young woman who was raped women want to let part of the story that she was raped and she became pregnant and she had no one no family here nothing here went into the doctor and realize that the baby was having some serious issues and went to the beach and thought should I keep this baby she said she is not a spiritual person has not had a lot of spiritual background all she said on the beach I felt on impressing me that I should keep the baby came into our unit neonatologist and found that the baby was highly compromised from a cardiovascular issue so spiking great arrhythmias and not being able to control as she is immediately brought in the care of any of the so she came and went through the experience of baby being born frankly maybe should I frankly than it was miraculous that he lived a limb to the hospital in Tampa that's our partner than a specialty services in certain subspecialty open-heart procedures she said I felt the clinical impact place there were very good clinically she said they didn't feel like family and I didn't feel God I asked that he be transferred back this is a finished transfer him back the date I interviewed her two weeks ago she had just seen his star for the first time if you see the scar and a little baby for these procedures of cracking the chest it is just so much pain that chose gone through and she was weeping when we begin to talk and she said I looked at that scarring realize how much pain he or she so can you become an talk to Sally took a shower she is living in hospital so she took a shower she came back she said then in the shower I realized they had taken early in me and I have a C-section scar is horizontal he has a heart to open just start is vertical there is meaning in pain together they are across and those to come together to form across here's young woman who you say she has never family with her she has no husband to debate would take to raise this child she said you are my family you are my church you are my sanctuary in your my healers and we say that would affect distinct opportunity trashy that this society has has devolved to the correct place in which we find ourselves forty children live in homes where the woman is this is a single caregiver and not completing so you have this kind of thing happening and yet what happens in those moments is it's important we stand beside him tonight she will talk about that will and with the whole group singing a lullaby Jesus launches his wife and her chaplain praying a prayer over them so young so we have a bedtime routine so the next one is emergency it's a surprise if the trauma it suddenly hit me and its unexpected the third plot is renewal this will get me back to health anemone replaced background was the fourth one is maintenance I just can stop the sliding on one who assist have a few more good years on a stop disliking I know I'm getting this point my life sliding in the final one is legacy this is approaching the end is very easy we can teach this chart transporters because the transporters know whether you wanted to join the patient is assigned to a floor they know where they came to emergency they know what floor they're going to ending of the docket is the admitting doctor and my what's more they're going to the probably guess which which plot therein or where they are but with a few easy questions they could find out as they are traveling down the hallway something deeper than just simply telling them undertaking this floor they now can go deeper into their heart they can become comfort giver and that something is use a picture practice my question is what are the plots that people come in with you and your practice just as you understand their plot you you suddenly can guess where they are in almost feels to them as if you've been reading their mind is if you've ever heard someone as a patient sex what you said was meant exactly for me that's what the classroom talking the ability to read into the heart of the individual and unlocks all so here's what we found that happens your constructing a drama in your practice were constructing the drama in the hospital albeit a hospital dramas much more intense perhaps but the drama is still you have an episode that dramatists key so that we founder three acts in this drama and my guess is those three acts working your practice so here they are drafted out at one is the point at which there is the stress begins and you'll see peeking and that she contact one for us where the stresses going up here on that piece is the point at which the person is told by the doctor there going be admitted their stress goes way up act one is the point from which used your toll you're going to be admitted to the time you get into your room that's Act I I told you that there are sixteen different apartments twenty six different individuals the planes on I will be leaving the slides with Bacchus and you'll be able to happen we will be leaving a book for you are on the patient experience as a monograph relapse in this information as well so what happens in Act I our goal is to build trust take away fear build trust why do we do that I'll show you in just a little bit like where we got this model from object the second act act two is from the time a person is in the hospital in the room as the nurse start admitting them to the floor and H&P and so forth associated with getting into the floor through their treatment process to the point which there think that can be rating on say start anticipating going home that's at to recall that the treatment act and the goal of that act is to help people feel like they belong a part of our family that they belong to this process that they are interacting with us in part of the family and then there's actually actually is a point at which people begin to think I'm can be discharged we thought the Act III would and would discharge the people really anxious to discharge the site I have all the support around me now you send me home and I don't often have the support I don't always take care of me I don't know what's happened here plus you get me all the things I got up by an opinion drugstore and I got to and the equipment identifying and always has to come together in some place houses can happen in their anxiety actually goes up to things that provoke their anxiety at Act II anxiety is provoked if the care plan changes we say we had some year not to get out as quickly thinking the exactly right with that plan for them surgery yet this convocation so forth if you don't explain that anxiety goes up frustration goes up if you explain that you can drop that anxiety and it's receiving on the lines of explanation not when you go into the next area of act three of them the goal of there is to build hope in the place where the people want you as they want you to be with them all the way to recovery not just discharge if you're their discharge than they feel kind of resentful of the system that they dropped them in your on your own so they want to plan all the way to recover so one of the things were working with right now is planning all the way to recovery so that we can actually provide people with the best process of getting all the way to recovery that's also been held not to have readmissions working on a concept of health warranties which your car 's warranty your iPad is guaranteed what's the difference you can do anything to help your iPad I mean I can at least my car I have to bring it in any do my part to bring it in and have it serviced and so forth as a warranty because I do something so and health what we do healing is often cute warranty process so what if we said what we had the best way to get you back with it with a knee surgery our knee replacement we planned this all the way is it for treating you as a world-class athlete so we get you with the best ideas of how to recover your home and on back in the short recovery time and work with you throughout the process so working on some of those kinds of ideas so as we as we take a look at the next item within these acts we have to understand the role so if we had time I would ask you to figure out what are the acts in your office fact I'll start you with that distal bit orders act one began as a beginning your office a set to telephone appointment referral website Yellow Pages these are where the identity of your and and word-of-mouth stories the people that your brand is really the stories of people tell about you right is that you bring so your friends the stories so Act I begins with the stories about you so I is there is a guy that we refer on people to and when we refer and take his top drawer clinically sick guys doctors when I go diesel little bit rough but but he's really good so put up with the roughness with you because the guy really knows is doing so they go in with an expectation because it already stories that accompany them over that brand of his referral process so here we have the opportunity now to look at how missed the plot expresses itself in the roles people play so that was the star patient -isms that if you treat them as the star they are centerstage they actually the villain is the disease of the problem and heroes of the caregivers so your hero in one of the things we have not really captured to in our patient in our and identification of patient satisfaction is the way we introduce nurses nurses are heroes why don't we been reduce in like heroes Disney would never SLI walk on stage without a dramatic introduction of blowing the trumpets all in snow white system uniform but not out the back and backstage she could be anybody but they will always bring him on was some kind of introduction of importance why because it says to the individuals take this is a great event we made it just for you it's very important if you can bring your nurse 's and your post into an understanding that as they move into the room they are actually entering into a drama and as they enter into that drama they most accelerate that drama when they get that drama their best attention and their full bar force under total mind body and spirit so I would suggest you get to practice that would just before you enter the room you take a moment beside that room to breathe and prayer and then as you enter the room and her wistful attention the question is how do you enter what is your entry procedure will talk with one of time to talk about that overthrew us I just looked at the time I cannot give you on TG one final question one one of the question what is your story is very important for going to make stories come together for you to express your story in all that you do and for your employees to see your story is partially my credentials but most people expect to see that credentials your story is really the answer to some of these questions will cause you to choose to be a caregiver what is your vision for health and healing how is the organizer practice to achieve this vision and what is your commitment each patient and what is your design day don't have time to go through that with you but with time that would be a worthwhile workshop but neglect to this enclose those three are model or models for trust the longing and hope which we send the three things that we try to bring whole person care where they come from it came from the seventh day of the creation week so when God created the Sabbath he embedded it with three things in the power these three things is example is exemplified and amplified in Hebrew because in the Sabbath commandment in the Sabbath verse of Genesis to it is made up of thirty five words thirty five a derivative of sevens thirty five words three phrases three phrases of seven words each those three phrases actually punctuate three core words and concepts rest bless was the third one sanctified restless sanctifying we translated those in the trust along and hope those three things are so powerful that when Satan attacked this world with sin and suffering and death for the first six days of creation he focused on sin suffering and death but the seventh day he attacked it with his greatest and enemies of the spirit get traffic back to trust the arrest was at the initiate he attacked blessing when shame and they cover themselves he attacked the sanctification with blame and they fractured their unity set apart to grow together they were now at odds with each other and as a result we are rebuilding the spirit through the actual original plan because when God did his creation story when he built the world using the quality didn't write the first is so because you get it right the first time if we study how we did it we can actually use that to construct his your way of reconnecting an individual mind body and spirit experiencing total health and complete healing I really people to be born new and despite their journey despite where they are they can look up to tonight the young woman that I will be interviewing name is Katrina said to me I don't know if you will live or how long he will did this I know pain will have purpose for it did on the cross if you the gift your patience with the perspective that makes pain purposeful you are a healer for eternity and God bless you that healing touch let's turn our attention to JoJo of Cilicia specialty I'm a guest neurologist in Greenville Tennessee what does Augustine I'll just do relate people like me or you probably think of me as the type person have to go to them you turn fifty and have to have a colonoscopy of you have integrated it into your hair some spiritual modalities of how he done it out medicine find anything fun for me I started practicing and probably fairly traditional way where people come in with complaints and I see we can do something about the complaints and get into the door and out and I was really not fun because pretty soon they come back medications and going to heaven help wanted worse and you know I was aware of our information on health was for prophecy but you know it's my opinion identity came aware that we actually have the scientific studies to back up everything that we preach in fact although so far say now I filter everything through that and if it doesn't match I know they haven't quite gotten it right as one person said if you have the Bible you have truth if you don't have the Bible need to scientific study you start approaching and so what I do is I just when patients come in and build on what they said I really try to start I listened to say I'm listening to tell me what's going on needless to discover and a lot smarter when I listen to my patients when you remember that logo back home still need to remember that a little smarter Alyssa so basically what I do is I'm listening to people and then I basically don't know I'm against Toronto so dealing with digestive tract and what happens is I tell them no what we eat is once we swallow whatever whether it takes whatever it tasted like or smelled it look like a cost to our body at least monthly swallow Tokyo and he put the wrong fuel in it's like if you have a car that runs on premium therein subnetwork or if it runs on these people gassing and one patient committed that he's advertising up he said so I tell them you're really makes a difference next thing I tell Ms. you know what you have to do is you want to know what you weakness it I struggled after longtime and function of the simple concept simple concept is the way we know how foods good for you is whatever food has the most nutrition in a few listens are harmful to you as was the so now I tell them we know what that is the most nutritious foods and planet are greens vegetables fruits beans whole grains nuts and seeds I felt unless you take those very foods group around once the amount of rendered of the people he owned a factory it is not good for you and equally important if you take those foods anything into an animal young processes them in there whatever causes the animal exposed to whatever you're not getting as good nutrition you're losing it or subject it to be an animal or if the analects greeted us with a dairy or the egg on your losing nutrition source is very simple you look at a food if it's a group around very good with the factory not as good with my animal not as good I'm getting to answer your question with enough features are you kidding that basically then I tell them now let me tell you what's persuasive to me to go along with this and that's why transitions are trusted but I have it right I've been told I can get decidedly stripping of told you but let me tell you what's most persuasive for me to do this and I do that and I asked them permission for the sake of me is okay most of it they don't want the simplest most precisely as I pay where I come from I believe we have a God who created us and reveal himself whose word the Bible that was okay I live in East Tennessee and most people belong nicely well think about regarding our first parents Adam Neve he put them in the perfect ideal location Burnaby and if you think about it he read the first chapter Genesis a specific just one thing I told us we didn't eat this fruits grains nuts seeds the true vine but one man sin now the garden of Eden no longer had access the tree of life he saying but now you can eat the plant to the Romeo Kristen Bell who say goodbye and painter children but he also did a few recent docs the greens the vegetables basically the specialist levels at the diet I said but here's the problem in those days including nine hundred plus years on that type they could have the most atrocious and tree of life that God gave him the second-most aggressions which is a great inventions but think about if you look over one hundred years and you reject God have a long time to get really evil kind of Hitler religion I have years of that idea so that's what if I came about twenty millimeters from his last one the ways I did was listen the only way for God said you know that's what got perceived man permission starting animals and animal products and guess what it worked to deliver managers or do anything other don't you know how fast forgers may knew of the minority are done so that you guys figure that this is ideal that before I give up the future to the closer you get to eating away the closer you get to eating the way were designed to each you're basically falling manufactures have and outside of them I'm embarrassed to say how long it took me to figure this one out you went through college and med school and residency and fellowship on board I finally tumbled to this he smarter time so I followed he says works as an accountant and the whole point of this isn't just so we can have the next for years of healthy life you the placement is so that you can actually have a clear mind to have relationship with this being who loves us so much you want to die to come down and allows have eternal life and hang out for eternity and local things with him and we had that discussion so that's the way it is with most locations at the end I quickly asked them may I pregnancy you should find that takes more time than you have is over waiting room because what you just said probably in an explanation Freeman note it's interesting how cool guys not everyone is can be opened I'm talking about that everyone but generally when someone is interested it's amazing how the next patient didn't show up or something and it still works out it's amazing how that works I decided you know if you let God be in charge of the schedule he managed to work it out it's really cool how that works this is helpful lessons for a fair Doctor Chris fire just out of areas with me father thank you for godly physicians who are here thank you for Doctor Kretschmann who heart is a great burden to share tactfully lovingly eternal principles in his office I pray that this coming week as he goes back to his office that they would be divine appointments and divine opportunities for him to share even more in Christ and this media was gone audio errors in website dedicated to spreading God 's word reading sermon audio and much more to know more about our universe the more so than in www. audio verse .org

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