Tuesday, September 18, 2007
By Jeffery Kurz, Record-Journal staff

MERIDEN - Last De­cember, staff at MidState Medical Center gathered in the Horwitz Conference Room to talk about a patient who was driving everybody crazy. The troublemaking was so bad, people were heading home from work crying.

This was not a one-time complaint session, but the first in a formalized program that addresses what often gets overlooked in health care: how do you take care of the people entrusted with taking care of others?

This is not a topic placed high on the medical-school priority list. People who work in health care are trained to focus on patients. It may not be easy to get them to talk about their own problems, but it’s worth it, said Doreen Bottone, Mid­State’s chaplain.

“It really helps build a stronger community among caregivers,” she said.

During the past decade, the program, called the Schwartz Rounds, has spread throughout much of the northeast. Managed by the Kenneth B. Schwartz Center, in Boston, it’s named for a health-care lawyer who died of lung cancer in 1995. Impressed with his treat­ment, he established in his will a center to benefit the patient-caregiver relation­ship. The Schwartz Rounds started at Massachusetts General Hospital.

Bottone first heard about the Schwartz Rounds during an ethics committee meeting at the Connecticut Hospital Asso­ciation, in Wallingford, and at­tended a session at Saint Fran­cis Hospital and Medical Center, in Hartford, before de­ciding to bring it to MidState.

The center provides hospi­tals with grants to cover the cost of meals and an independ­ent moderator to run the ses­sions. MidState offers sessions during lunch; some hospitals hold it at breakfast.

The program also requires a local physician to champion the cause, a role filled at MidState by Dr. Harold Kaplan, the hos­pital’s director of medical af­fairs.
MidState holds the one-hour sessions every other month, though the program has proven so successful during the first year it may expand to monthly sessions, Kaplan said.

“I thought it would catch on,” Kaplan said. “I was won­dering when it would start to tail off - but it hasn’t tailed off.”

Some hospitals focus the program on cancer care, but at MidState it’s open to anyone in­volved with patients, which is just about everyone.

The sessions give staff the opportunity to talk about the personal, emotional and human side of what they’re doing, said Bud Wassell, director of Solu­tions EAP (which stands for employee assistance program), who serves as the independent moderator.

“I see it almost like a safety valve, an accepted way for peo­ple to come together, which in the long run will help them in terms of their own humanity,” he said.

“It’s hard for me to say there’s a direct benefit, because I’m not on the floors,” Wassell said. “But it seems to be greatly appreciated by the staff to have a forum to speak in this way. We get this incredible feed­back. It seems to me there’s ab­solutely a benefit. I think it’s going to make better care­givers.”

Since that first talk, about dealing with an obnoxious pa­tient, sessions have dealt with a variety of topics. One focused on treating patients whose reli­gious convictions keep them from making choices recom­mended from a medical point

Schwartz Rounds are now held in 100 hospitals in 25 states. At MidState, they typically draw anywhere from 80 to 100 participants.

of view. Another dealt with families that might not have the best interests of a loved one in mind, focusing, say, more on in­heritance than wellbeing.

One session involved Mid­State’s emergency department, which, like emergency depart­ments across the nation, is fac­ing increasing pressures and demands.

MidState is at the threshold of a major emergency depart­ment expansion, but in the meantime the hospital routine­ly contends with overcrowd­ing. There have been letters to the editor in this newspaper, critical of the department. They have not escaped the at­tention of the people who work there.

“We knew that it had been tough for them,” Bottone said. “These are dedicated people who perform extremely well under difficult circumstances.”

Schwartz Rounds are now held in 100 hospitals in 25 states, said Kaplan. At Mid­State, they typically draw any­where from 80 to 100 partici­pants, he said. The next session, in October, will cover the emotional as­pects of dealing with patients who Kaplan described as “fre­quent fliers who crash and burn.” In other words, patients who are brought back from the edge of serious ailment or ad­diction only to return to the hospital later on with the same issue. The December session will focus on treating a cowork­er as a patient.

“The presentations have as­tonished me,” Kaplan said. “We’ve had physicians and nurses give these emotional presentations, and I didn’t know they had it in them.”

“I thought it would be well received,” he said. “I did not ex­pect the level of enthusiasm and the participation.”

“It’s clearly a great catharsis for the people involved,” he said.