martedì, settembre 20, 2005
:: self reflection required ::over the weekends, i watched hong2yi1shou3ji4, a drama about the lives of nursing students in this hospital in hk. one of the scenes hit me really hard...
a young woman had just been warded for acute renal failure, from an autoimmune cause and has to undergo renal dialysis thrice daily...
enter consultant with many pple in white coats (i swear, they look exactly like US! only they have long sleeves)...
consultant: hello ms, these are my students, i hope you don't mind that we discuss your condition?
patient: ok...
consultant: students, this is a young woman who presents with acute renal failure... produced autoantibodies.... rare case... in the younger people...
student1: hi, ms, can u tell us a bit more about your symptoms? how did you first feel?
patient: er... felt like vomitting a lot, tired, bruising, go to the toilet often... (looking very bewildered)
student2: can you tell us whether there's any change to the colour of yr urine?
patient: (looking embarrassed and harrassed) er... brownish?
student3: you said you went to the toilet a lot, but each time there's only a little urine passed right?
patient: (showing obvious signs of discomfort and tears in her eyes...) yes... only a bit.
~~~
at this point, i was reminded by all our bedside tutorials... and scenarios where we 'clerked' patients in bigger groups. and i feel that...
1. doctors and students alike (also nurses) should never discuss the patient's condition in front of them, regardless of how severe/inconsequential the discussion might be... and whether what we say is correct/merely hypothetical.
2. we should not clerk is groups bigger than 2. especially since patients have to answer some more personal questions. and also, to avoid making the patient feel like he/she is before a firing squad.
3. i feel that no matter how rare/interesting/'good' patient's case is ie. usually this signifies very bad news to patients... we shouldn't clerk these patients unless they are very willing to talk.
this scenario reminded me a lot of certain people in the faculty, who are only concerned about getting a good history from the patient and don't put into consideration the feelings of a patient. to them, a patient is just a source of info to benefit themselves, they seem to have ceased thinking of the patient as a person, who has feelings and needs time to grapple with the new-found ill news.
i believe that at some point or another, all of us have been excited to clerk a fantastic case (for presentation) and unknowingly expressed our joy while clerking the patient. i guess we all need more control, in order not to look as though we're gleeful over a person's illness...
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francesca chiu
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1 Comments:
Well-said, Dopey! I couldn't agree more.
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