Hi,
I would like to ask an opinion about an incident that comes to mind regarding 'communication'. It was on my first placement, and I was asked to do a full subjective report on an elderly lady who had a fractured NOF. In liasing with the team earlier in the day, there was confusion as to the social status of this particular patient. Determining this information from any patient was critical in determining where to head for discharge (eg. home or LDU etc..).
So, when it came time for me to see this particular patient, I had this in mind. I was also told this patient was quite temperamental, and had upset quite a few nurses, but I thought I could handle that!
I made my way into her room, and it was quite obvious from her expression that she wasn't impressed with my cheerful disposition. I proceeded to ask the usual subjective questions, and was finding it quite difficult to build a fair rapport with this lady. I turned my attention to flowers that were on her bedside table, and after I had commented on them, I asked if they were from a friend. she replied with "Yes, I have heaps of friends thankyou." I then stayed on the same line of the conversation, and asked if she was married, or had been married in the past. She took great offence to this question, and commented that I was being very nosy. She was not compliant from then on with any of my questioning, and was not willing to come for a walk with me, or do any work in the PT gym. I was a little disappointed after I left her room, that my questioning had stirred her up, and I had not been able to complete my assessment, or do any treatment for her that day.
Has anybody else been in a similar situation, and not known how to deal with asking more personal questions relating to social status?Or does anybody have any tips on how I could have handled the situation better, or asked in a more tactful way?
I am aware that on gerentology placements, there are a lot of co-morbidities going on, but what do people think?
Ange.
1 comment:
Hi ange
I went through this experience several times on my gerontology placement when at first no matter how hard i tried my patients would not cooperate and i felt really defeated. I had one old lady cry the minute i said the word "walk" but i later found out that anytime an OT, nurse etc asked her to do anything she would get teary. But i think patient compliance comes with experience on a placement like that. Its really a process of trial and error and eventually somewhere towards the end of the placement you realise your patients are beginning to work with you because you develop your sense of adaptability. I tried numerous strategies; if a saw a forgeign surname i would ask questions about their nationality, heritage, hobbies, sports etc rather than personal qs about friends and family. One lady was only compliant when i talked about food so i would spend a whole treatment session asking her what she ate in that day...brought a smile to her face and she listened to everything i said. After you get the rapport with irrelevant convo...the important stuff comes to surface
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