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INTRODUCTION

As Radha Samson was making her way to meet with Dr. Garcia about his staff problems, she passed the new long-term care building and remembered one of her first experiences with The Exchange. It was two years ago, during the final stages of the building's construction, when everyone was stressed with the noise and delays. She had been contacted by the Vice President (VP) of Ambulatory Services, Dr. Gunther Samuels, about an issue that had come up between Nursing Duty Night Supervisor Kim Brown and a patient, Marvin Yee. Dr. Samuels was new to St. Sonia's Hospital and had called Radha for advice. His concern was that Mr. Yee was one of St. Sonia's Hospital's major financial contributors and Kim Brown was one of the most important members of his staff. It pleased Radha to think of how well the situation had worked out. This was the same Kim Brown, now a trained Exchange facilitator herself and promoted to a new position as well, who had just used The Exchange that very day.

USING THE EXCHANGE TO DEAL WITH PATIENT EXPECTATIONS OF HOSPITAL STAFF

To deal with the conflict between Mr. Yee and Kim Brown, Radha first spoke with Dr. Samuels and then decided to try out The Exchange. It seemed like a perfect opportunity: the issues, she had heard, showed that there was a misunderstanding and the patient's expectations about the role of hospital staff were unmet. She remembered being happy that it would also be a good opportunity for Marvin Yee, as both a patient and a donor, to find out how The Exchange actually worked.

The situation involved Mr. Yee's request for a room transfer. He had been in the hospital for over a month with complications following abdominal surgery. He had not asked for special treatment and had had several roommates during his stay in the outmoded long-term care wing. He was keenly aware that the new building, when finished, would prevent other patients from having to endure the overcrowding that prevented him from having a private room and forcing him now to share space with an "impossible" roommate. But he felt that his "understandable" request for a room transfer was being deliberately ignored. He was convinced that the roommate was suffering from dementia because he spent a lot of time arguing loudly with someone who wasn't there. Mr. Yee knew that Dr. Samuels had endorsed his room change request, so he wondered why the nurses hadn't moved him by now. He was exhausted from a lack of sleep and he was angry. He wanted to be acknowledged.

STAGE ONE: RADHA SAMSON'S PRIVATE MEETINGS WITH PATIENT MARVIN YEE AND NURSING DUTY NIGHT SUPERVISOR KIM BROWN

In her first conversation with him, Radha learned that ...

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