Whilst on the orthopaedic inpatients ward on my last prac I had an experience with a patient and doctor which really reinforced for me the importance of communication in terms of respect for the patient as a person and their right to know what is happening in terms of their management. I had just introduced myself to the patient, an elderly man with a stable Cx fracture who also had a mild hearing impairment, though no significant cognitive deficit. I was almost finished my subjective examination when an intern came in and read the patient's drug chart. Then, without even apologising/asking/acknowledging that I was speaking to him he interrupted and told the patient that one of his medications would need to be changed. He spoke very quietly and I told him that the patient had a mild hearing impairment. Again he spoke to the patient very quietly, and was not heard.
I ended up "interpreting" for the patient by repeating everything the doctor said louder, which seemed very silly to me. He asked several questions about his new bowel condition that was preventing his transfer from the hospital as well as the changes to his medication. After twice not being heard (at a volume that I was stuggling to hear!) the doctor seemed to decide that it wasn't worth explaining things to this man as he wasn't going to understand/hear him. He continued to read the chart, when the patient asked him if he was a pharmacist. The doctor's reply was simply to hold his ID card up (which had his name, photo and the word "Doctor" on it) without so much as a glance up from the chart. To be honest I was quite appalled at this lack of any effort to communicate with the patient and explain things to him simply because he had a minor difficulty. Unsurprisingly the doctor left again without a word to myself or the patient.
For me this experience really reinforced the importance of considering the patient as a whole, and adjusting things, be they communication methods, treatment, management, education etc to suit the patient. In some cases it is extremely difficult to communicate with some patients and effectively get your message across, however more often that not it is a simple change that can make a huge difference, such as the volume of your voice. I also experienced first hand that health professionals do not always consider the patient's understanding of their situation to be important, as demonstrated by a complete lack of effort to provide him with this information.
I think if something like this happened again I would like to constuctively and respectfully suggest things to the person to help them, as part of the team, to communicate their message and answer the patient's questions. I think my surprise at being interrupted and still thinking about what I was doing prevented me really reacting to the situation, instead doing little more than standing there observing. I felt very sorry for the patient, who had no idea why he had the new bowel problems, (despite asking) so would not like to witness this again when it could be so easily avoided.
Subscribe to:
Post Comments (Atom)
1 comment:
This year, besides refining our practical skills, by far the biggest thing I have learned is how to communicate in different ways. We can never be sure of how another health professional or patient is going to interprete what we say, write or express in our body language, therefore I have found that it is crucial to be aware of this at all times. I'm sure most of us have been in awkward situations such as this at least a few times this year!
Post a Comment