There is no real theme for the next Grand Rounds, but the host Jackie Fox of Dispatch From Second Base is hoping to get posts on doctor-patient communication in any of its forms. She adds that nurses play a critical role in communication.
I’ve had nurses explain what the doctor is talking about. One of my family doctor’s nurses let me know that the surgeon he recommended for my first-ever surgery was a great guy and that all his patients really like him. This was good to hear, and she was right.
Most of my experiences with nurses are similarly positive and I “love” the once-yearly visits to my endo-nurse, who just needs half a word to know how I’m doing.
But I also have some not so good or even bad experiences with nurses. Here are some serious, and less serious tips, merely based on my own experiences. I won’t deal with the normal etiquette: shake hands, listen etc, but most tips are pretty obvious anyway. At least in my view.
1. Never reprimand patients, and certainly not in front of others.
My worst experience dates from 11 years back, when I stayed at the hospital after a massive postpartum bleeding. I had all symptoms of an Addison crisis, but this was not recognized as such. The nurses at the pediatric department found I had to try harder to give milk (but lactation failure is one of the first symptoms after giving birth), or to nurse the baby (weakness is another symptom: I couldn’t hardly walk or stand on my feet). They started to take me serious when I vomited all over the place (vomiting and the absolute dislike of food are another sign). Another nurse saw it differently, and gave me a sermon about the importance to do my best and break the circle to eat, etcetera ….in the presence of a fellow-patient. I was so ashamed. It hurt very bad, because there was nothing I could do about it, but I felt like someone who faked it all.
Two other “rules” follow from this one:
2. Try not to judge patients and take them and their illness seriously (unless proven otherwise)
3. Don’t step into the doctor’s shoes (never mind how often you may be right)
Certain doctor’s receptionists also like to act like they are the doctor. I know one who asks things in a snappy way, like: “Why do you need those pills anyway?”
4. Respect the patients privacy.
5. And don’t go partying at the ICU (of all places).
Yeah this happened. It was just a small party: some cake, coffee and loud jolly conversations at appr. 07.00 am. I wouldn’t mind otherwise, but “parties” ain’t what you need after one night ICU, where you’re too weak to respond to signals like all kinds of beeps, voices, panic, intubations, and regular rough hawk-ups. Your damn ill, that’s why you are in the ICU.
6. Don’t offer technical solutions to non-technical problems
I had trouble feeding my first child because she was too small and didn’t have the power. A got “support” from a nurse who offered all kinds of technical solutions (all kind of exotic things, like nipple shields), that were not at all required. Everything went smoothly as soon as I was home, alone with my baby.
7. Don’t treat a child as an adult, even if it tries to act like one.
It is their way to cope. Just let them.
8. Try to be honest. Don’t say “it doesn’t hurt a bit”, when it does.
On the short term it may help to use a trick to get unpleasant things done, but in the long run people -and especially children- may no longer trust you or any of your colleagues in a similar situation. At least consider this.
9. Be open, nice & friendly
10. Always remain professional
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