Solitary Confinement: We must put an end to it everywhere!

Posted by Joel Friedlander | No Comments

I represented a nurse the other day in a matter at a hospital.  The case is not important here, but something that came out before the hearing is; apparently, the hospital in question, a very old established independent hospital located at the Nassau County Seat, has rules limiting the interaction that its nurses can have with the patients that they are treating.  In the case I was involved in that issue never came up, but I wonder at the sanity of such a rule.

Today, in the Health Section of the Times under the heading of Case, “Comforter and Comforted in an Unfolding Mystery,” written by By NELL BURGER KIRST, a fourth year medical student.  In the article she discusses two case histories in which the presence of what is called sitter made a tremendous difference in the way the patient felt about their treatment.  The sitter in both stories is the same, in the first instance he sits by his “girlfriend,” and stays her as she dies of an unnamed terminal illness.  The presence of such a person to be a contact for the terminal patient with the real world makes the hospital a human experience.  In the second part of the story the same sitter, now working for the hospital helps a 25 year old fellow cope with his treatment and hopefully recover.

My case and this story got me thinking about the ways hospitals often operate.  They are completely in charge of every aspect of the patients existence and some of them are so cold and remote that it just makes me shudder to think of anyone being treated there.  In the instance that I handled the nurse had been admonished for being too chatty, even though she did complete all of the work which she was assigned.  What the hospital in that instance seems to have forgotten is that patients are human and human beings are social people who need interactions.  To deny them contact with someone who is interested in their condition and well being, because of some arcane rules that prohibit nurses from being too chatty, causes real injury to the recovering patient and may result in permanent injuries of a psychological or psychiatric nature.  Patients in a hospital are at the mercy of the hospital and knowing that there is someone there that cares about them is a positive thing that hospitals should encourage.  No nurse is too chatty when she interacts with patients, she is humane and a benefit to the patient.

I think that all hospitals should have people who go around talking to the patients so that they can feel human.  They should not be isolated, for isolation can have disastrous affects upon a patient, just as it has on a POW or a Prisoner.  In connection please take a look at the affects that isolation has on prisoners in last weeks New Yorker: “Annals of Human Rights
Hellhole,” “The United States holds tens of thousands of inmates in long-term solitary confinement. Is this torture?” by Atul Gawande.  I think that a patient in a hospital where no one connects with his social needs is also at risk of psychological destruction.

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