Wednesday, November 23, 2011

What to do?

Year ago (I'm not saying how many!) when I was a teenager, I had a doctor's appointment where something happened that I will likely never forget. I was reminded of it recently.

At that appointment, I was instructed to undress and put on a gown. The nurse left the room while I did so. Then, she came back, and at some point, the doctor came in, and did the exam. The doctor left. The nurse left.

And there I sat.
What was I supposed to do now? Were they done? Was I waiting for something more?
I didn't know. No one had told me what I was supposed to do.
So I waited.
And waited.
And waited.
Naked, except for a gown.
Cold and alone.
I was 16.

Eventually, after about an hour or so, a nurse came in the door, and was shocked to see me there.
THEN, and only then, she told me that she thought I had left an hour before, that I SHOULD HAVE left.

No one ever told me they were finished and I should dress and leave. Not one word.
They just walked out the door and left me there.
How was I supposed to know what to do?

We had a call recently with a lovely, sweet elderly lady.
She was very cooperative, if a little confused.
Happy to do whatever I asked.
She gave me her wrist so I could take her pulse.
Held up her arm for the blood pressure cuff.
Smiled for me.
Held out both arms.
She couldn't have been more pleasant to work with or to be around.

The interesting part, though, was that she did ONLY what I asked.
It didn't occur to her to put her arms down, or to relax her arm once the blood pressure cuff was on it.
I needed to ask her to do the things I needed her to do, and then tell her when to STOP doing those things. She needed both.

It's a simple thing, but it's so important.
People, especially people who are not feeling well, who may be scared, or confused, and who suddenly have a houseful of strangers, can't be expected to know what we want them to do, how and when. We need to tell them, and not leave any of it to chance, or assume they'll just know. They may not.

It's not fair to expect more of them than they are capable of, and it's not fair to leave them hanging (sometimes literally!)  while discussing things with a partner, or even while getting information from the patient herself.

So now, I have another thing to add to my presence, in addition to introducing myself and the medics.
Now, I ask my patient to do the things I need from them, and then I remember to thank them for doing so, and to let them know when they can stop, when they can relax. Since part of my goal is to help them be as comfortable as possible, this can be an important part of it.

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