One of the things I used to hear way back when was to treat a patient with respect. Listen to them and give them some dignity. Hear them for what they're saying, not just to hear them for the sounds they make. I don't hear any of those things too often these days.
Why?
Have things changed so much in just a couple generations that dignity and respect are not taught? Are they not a paramount issue on each and every patient? Do people just not think about those things anymore? I'm not saying that those things don't happen because they do or they're practiced, just sometimes I see it not to the level it should be or not practiced at all.
Each patient tells us different things about themselves, their condition, their surroundings, what they feel like, et all. Do we listen? Not always or not every detail is taken it. Sometimes those details get in to the ad nauseum and mundane that have absolutely no bearing on what's going on. Other times those minute things could be leading up to a bigger problem or could tell a story about something else that's not being voiced or give clues to what might be going on.
Go back a minute here,...
I had a run this weekend with an Alzheimer's patient. Very nice patient who can't remember a whole lot of anything. Usually upset due to the lack of memory and not knowing what's going on about the present condition or anything else around her. She's still at home being cared for by her devoted spouse. This time she fell and hurt her neck. She had had a syncopal episode which lead to the fall and the following 911 call.
After we got her packaged up and in the back of the truck she was still upset. One of the crew members began taking her blood pressure. The patient could not turn her head to see what was going on with her right arm. All she knew was someone was grabbing it, touching it, and there was something squeezing her upper arm. I stopped the process and spoke to the patient and then to the crew member. Being in the position the patient was in, c-spined and on a board, she could not see to her sides. All she could do is look up and count the specks on the ceiling of the truck's box. I slowly told her what was going on and why we were doing it. I told her who was doing it. I then told the other crew member to always make sure we tell each and every patient exactly what we're doing.
Telling our patients what we're doing helps build trust. It initiates conversation. It calms them so they know what to expect, especially if they're in a position they cannot see what's going on, like this woman was. Something simple as telling a patient that I'm putting on electrodes helps. Some people might wonder just why I'm sticking my hands under a woman's shirt, so I explain it to them. Why I'm doing it, what I'm trying to accomplish, and that it won't hurt at all, or if it will hurt, I tell them.
We all know that cervical collars and spine boards aren't built for comfort but we need to verbalize these things to patients. Let them know these things are being done for their safety since we're not human x-ray machines. It always seemed like an oxymoron that sometimes we hurt people to make them feel better or protect them.
But we need to tell these people what we're doing and why. Even for those, like this woman, who don't always understand, comprehend, or remember what happened, we still need to let them know what and why we're doing things. Let them see your face.
Talk to them in terms they can understand. I see a lot of doctors come out and spew medical terms to people who then become totally dumbfounded about their medical condition. They are now more confused about why they're sick then before. Understand that most people don't have a thorough understanding of medical terminology. Try to explain things to people where they're understand easier. It let's them know what's wrong which in turn helps to reassure them. And for those Alzheimer's patients who can't remember much? Repeat yourself. I've had patients who forget 5 minutes after I've told them what I'm doing and why. They get upset, they calm down after I tell them. 5 minutes later they get upset again so I have to tell them again and they calm down,... again. It's a vicious cycle but sometimes it needs to be done.
Finally we all have those patients who just want human contact. They've been left by family at nursing homes, they have no family left, they live at home with no outside companionship; those people. They're the ones who just like seeing people, anyone to talk to, just to have contact with the outside world.
Talk to your patients. Find out the details. Gather them all in and then toss out the ones that have no bearing on the present condition or problem. Let them tell you what's wrong. Even those who don't speak can tell you what's wrong. Sometimes the silence speaks volumes. Are you listening?
No comments:
Post a Comment