A patient’s perspective on bedside manner
Monday, February 29, 2016
A 55-year old female visits her primary care nurse practitioner due to severe pain in the lower back. She seems to think it is muscular, but wants to have a doctor look to ensure she is accurate. The NP wants to agree with the patient on the muscular diagnosis, but also wants to make sure it is not a kidney stone and issues an ultrasound.
After completion of the ultrasound, the NP discusses the results, which show fluid around the kidney but no sign of a kidney stone. That said, there could have been a kidney stone farther below where the ultrasound looked. The NP refers the patient to a urologist who can shed a better light on the ultrasound.
The urologist requests a CT scan and a second visit to go over the results. After completion, the patient returns for a second visit. During this time, the physician states that it must be a muscular issue since there was no kidney stone.
The patient is confused and mentions the ultrasound that showed her kidney enlarged with fluid around it. The urologist asks whether he knew about the ultrasound, which immediately irritates the patient since they both discussed it two days earlier.
What's lacking in this scenario? Compassion and knowledge of the patient. The disinterest of the urologist is apparent.
A recent study published in PLOS One showed that the clinician-patient relationship has an effect on healthcare outcomes. There's no denying that clinicians have a high-stress job atmosphere, but that shouldn't take away from the bedside manner given to patients.
Whether you're on the phone or in person, your tone, mannerisms and appearance all take a toll on the patient. That said, it can also take a toll on your professional career.
A healthcare professional's line of work is helping people, but with that comes a lot of responsibility. Your field shouldn't mean simply diagnosing a problem, giving a prescription and moving onto your next patient. It should mean much more.
Little does the urologist [from the scenario above] know, but that patient is now upset that she left the office with her needs not met. No accurate diagnosis was given, and the lack of compassion could inevitably hurt the clinician's practice.
The expectation of healthcare experiences vary, but most are seeking the same end result of meeting their needs — patient-centered care. The best way to achieve this is communication. Put yourself in your patients' shoes and show empathy. Remember that they want to feel comfortable, so be able to instill trust to make it easier to discuss their medical needs.
Patients want someone who will sit down and listen to everything we have to say without being interrupted. We want someone who will show interest in our lives and truly care to our health and well-being. If there's little interest or communication, then we will automatically assume we're not a priority and our needs won't be met.
The Sullivan Luallin Group created a helpful outline on how to deliver appropriate bedside manner. They call it C.L.E.A.R., and here's what it entails:
Connect with your patients. When you walk into the room, acknowledge them with manners. This includes maintaining eye contact and smiling. Ask how their day was and truly get to know about your patient's life. Do you know about their job, goals, family? This is your time to learn. The more you connect with your patient, the more you'll instill trust in them.
Listen to your patients and their needs. Let them tell you their reason for visiting and then discuss in depth. Even if you know their diagnosis could be serious, stay relaxed. The more calm you are, the more calm your patient will be. To ensure your listening tactics, repeat information they mentioned.
Explain what will happen next in the diagnosis process. Whether it's more tests or filling a prescription, speak clearly and concisely, so nothing can be misinterpreted. If there are going to be any lapse of days due to tests, make sure to mention it.
Ask your follow-up questions to ensure that everything has been taken care of. Have you answered all of your patient's questions? Does your patient understand your diagnosis?
Reconnect with your patient. During your explanation phase of the visit, you should have mentioned where your patients should go next. Follow up with them to make sure they were able to obtain the visit. Followups to check in how your patients are feeling is also a bonus. It shows compassion.
The healthcare industry is continuously facing changes, but a focus on patients will always be the heart of the profession. Patients want to have a close relationship with their healthcare professionals to ensure they're being treated in the best way possible.
A good relationship takes time, and trust can be earned after a couple of visits. Practice makes perfect, so remember to communicate.
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