IT ALL STARTED WHEN...
She began her healthcare career in 2010 as a private Home Health Aide, providing home-care services to an elderly patient. It was then that a passion for healthcare was sparked. Following this Kistein became a Certified Nursing Assistant, subsequently landing her first position at a nursing home and rehabilitation center.
She recalls her experience there as being eye opening, "I realized that a significant portion of care provided, lacked empathy from the care providers that were administering care to patients". She continued "Administrators of that facility prioritized cost savings over the quality of care patients received. I remember my first night as a CNA working the overnight shift, with no nighttime orientation. I arrived on my assigned floor and received my assignment of 20 patients. Let's be clear here, I was responsible for ensuring the safety of all patients while performing activities of daily living, blood pressure monitoring twice during my shift and answering call bells in my assigned district. Knowing there was a nurse on the floor provided me with some form of relief. However, that nurse was responsible for medication distribution, wound care, documentation and other duties, for all 40 patients".
Despite this experience Kistein remembered her highlights from that position came from the expressed gratitude patients shared once they were treated humanely. She noted that the lack of resources compromised empathy in many of the more seasoned direct care staff. Further adding that this unfortunately is the dilemma of the modern day healthcare delivery system.
After parting ways with that facility she signed up for work-study at her college and elected to work in the health center. There she engaged with students, raising awareness on health issues faced in urban areas, while actively helping to coordinate the school’s annual health fair. During this time she also volunteered at a nearby hospital, completing both patient hospitality and clerical duties. Soon she had began working at that same hospital as a float-nursing assistant and remained there for 2.5 years. She described her experience in that hospital as being "imperative" to understanding patient's needs for better healthcare service delivery.
"During the nights I worked in the ED patients complained about the long hours they had spent waiting to be seen, and how inhumanly they were treated. A series of barriers, i.e. population density, language, cultural diversity, resources or lack thereof, heighten the complexities of the emergency department at this facility. Administrators seemed to not hear patient’s complaints, and this was proven by their inaction to change the culture of poor services. I believe that many of the barriers to providing patient centered care can simply be resolved by actively listening to what patients are saying, then framing policies around patients needs. Once patients begin feeling isolated in their need to be heard, naturally a breakdown of communication between the patient and the healthcare provider that is administering care commence. I've witness patients coming into the ED to be seen for urgent health issues, then after several hours of waiting, wanting to leave at all cost, the outcome of being frustrated".
She further pointed out the healthcare providers, faced real challenges also, from being on the receiving end of patient abuse, to working under confining policies.
"I do believe that healthcare workers become emotional numb due to the trauma of a constant heavy workload. On the other hand the healthcare environment being highly litigious, and uncertain due to current political climate presents unique challenges to healthcare providers and healthcare professionals. Thus, creating a trickle down effect of poor health outcomes for patients, further enhancing healthcare disparities".
Most recently Kistein filled position of a service coordinator, facilitating care for patients living with one or more mental illness diagnosis in a Supportive Housing-Single Room occupancy program. In accompanying two tenants of the SP-SRO to the hospital close by, she saw a dire need for better patient care at this facility.
"I could not believe how dysfunctional the emergency department and main entrance area were. The tenant that was seen at the facility did not receive a follow up call to be reminded of her upcoming appointment, a detrimental part of her after care and overall health. In my discussions with other care providers, the deplorable condition of this hospital had been normalized to residents in the neighborhood. In fact, poor health services has become socially acceptable, as residents in the area are mentally prepared to wait 7 hours plus in the ED should they need emergency healthcare services".
Kistein believes that patients hold enormous power to creating positive changes in both the healthcare setting and the community in which they live.
"Poor healthcare service delivery thrives in a hyper silo culture, patients must begin to combat this culture in order to end healthcare inequality. Health providers, and decision makers must advocate for sensible policy reform molded around patients needs in order to effectively improve public health outcomes. This is why I believe now more than ever, we must use technology to reach, teach, and inform the general public, creating an environment of patient empowerment and advocacy. I am hoping to change the way we think of patient centered care, through heighten civic engagement. Open dialogued will prove detrimental in filling the gap between patients, care providers and decision makers, hence, creating solutions to fixing the problems".