This incident happens in Social Security Hospital Lahore on my clinical day on 20th Feb 2014 in medical ward. A 58yrs old lady was sitting on the bed no 08. She was looking very tense and worried. She presented with complaint of chest burning and pain, her medical diagnose was Gastroesopheagel reflux disease (is a condition in which the stomach contents leak backwards from the stomach into the esophagus). She came here after getting treatment from different hospitals. This hospital was of her last hope. At 9am consultant came and checked her and discharged her for endoscopy (Endoscopy is a nonsurgical procedure used to examine a person's digestive tract) which she already had. Doctor in charge of that patient did not properly communicate to the patient why he wanted repetition of the test. That test was expensive and patient was poor. She cannot afford such expensive test again. The patient and her family members were very worried and tense. Even the nurse on duty misbehaved them and did not listen them when the patient and her family member asked for help.
I feel very bad as no one educate and counsell the patient that why she had to repeat the same test. She was thinking that her disease is cureless and doctors want to let her out. I feel sympathy for the patient and her family members as they were very innocent and uneducated. . They were belong to a very poor family and did not afford more expensive test.
Communicating effectively with patients and families is a keystone of providing quality health care. Patients, who understand their providers are not accepting their health problems, do not understand their treatment option feel increas...
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...ot only the psychological, but also socio-cultural, environmental and politico-economic features of a disease and its treatment and its impact on patients and their families. (McCabe & Timmins, 2006).
If a patient does not understand the implications of her diagnosis and prevention or treatment
plans, an untoward event may occur. The same is true if the treating physician does not understand the patient or the cultural context within which
the patient receives critical information. In fact, communication breakdowns, between care providers and patient is the root cause of this incidence.
Frank, J., & Frank, J. (1991). Persuasion and healing a comparative study of psychotherapy (3rded.).Baltimore: John Hopkins University Press.
McCabe, C., & Timmins,F.(2006).Communication Skills for Nursing Practice. Palgrav: MacMillan.
Communication is cited as a contributing factor in 70% of healthcare mistakes, leading to many initiatives across the healthcare settings to improve the way healthcare professionals communicate. (Kohn, 2000.)
Some of these problems may be financial, psychological or medical. The economic challenges include incurring extra expenses on the solving issues that arise from the social aspects. Such issues could have been solved if the social aspects of minimizing trauma had been integrated into the medical model. Psychological challenges include stress and depression. Possible medical problems that may befall the patient include ill health and chronic diseases. In some instances, the body may develop an immunity system that is resistant to drugs. For this reason, the patient develops a condition whereby they have to be put on constant medication (Cheeseman,
Communication encompasses a wide range of processes such as the exchange of information, listening, posing of questions (Fleischer et al., 2009) or use of body language. In a healthcare environment where there are constant interactions among nurses, doctors, patients and other health professionals, professional and effective communication is important in ensuring high quality healthcare standards and meeting the individual needs of patients.
Understanding that all patients needed to be treated justly and given the opportunity to make decisions in their care is important. Not causing harm and preventing them from harm is also the duty of health care workers. These ethical principles are essential to keep in mind with interdisciplinary communication. Ineffective communication has been associated with medical errors, patient harm, and increase length of stay. Failure to communicate properly has been associated with 79% of sentinel events (Dingley, Daugherty, Derieg & Persing, 2008). Good communication has been shown to improve patient satisfaction, increase in patient safety, as well as a decrease in health care costs (Paget et al.,
In conclusion, doctors have a moral obligation to tell patients the truth about their illnesses, unless the patient clearly states that he or she does not want to know. Medicine is a field that works to treat the patient. This means that physicians are there for guidance, using expertise and years of education to guide them to a cure. This does not mean that a physician should make decisions about the patients without proper consent. Believing that patients will misunderstand the diagnosis, or assuming that they won’t want to know are not valid reasons for keeping information from the person. Communication is important in a medical setting, and is especially important when talking about the health of an individual. With relevant, appropriate and humanistic communication, telling a patient their diagnosis can and should be done in a caring way.
On my third day of clinical course I had an African America patient age 72, female, a retired high school teacher who was admitted for an Acute Diverticulitis with Perforation. She is diabetic and had a medical and surgical history of diverticulitis, High Cholesterol, Non-Insulin-Dependent Diabetes Mellitus (NIDDM), Hysterectomy, and Scoliosis. She has been on clear liquid diet since she was admitted then she was Nothing by Mouth NPO for the CT scan for that day. When I got the assignment that I was going to be taking care of a patient with an acute diverticulitis, the first thing on my mind was that she will be in a severe abdominal pain, high fever due to infection because my aunty had same disease. To my surprise, she claimed a 0 /10 on a 0-10 pain scale. Her blood sugar and vital signs were normal except for respiratory that was 22. All her laboratory test results were normal including WBC. Patient concern was that she couldn’t have a bowel movement. She was medicated on Colace- a stool softener, morphine for pain, sulfran for nausea, and azactam an antibiotics.
... becoming malnourished. Medically related subjects are effected by cultural in all areas on the world for the wide cultural diversity.
At the time, I was unable to mentally get past the fact that she was refusing blood products to potentially save her life. This was information that I did not know the answer to. I immediately called the doctor to see if there was we could do to help her. The doctor discussed with the patient if she was willing to receive intravenous iron. Intravenous iron has been shown to be helpful for patients in restoring red blood cell and hemoglobin levels. However, the effects are not immediate (Posluszny & Napolitano, 2014). I continued to do more research and found that by educating this patient on her diet as well as safety precautions to take when ambulating were other ways in which I could help this patient recover.
These differences in origin accounts for diversity in socio-cultural backgrounds and nurses must develop the knowledge and the skills to engage patients from different cultures and to understand the beliefs and the values of those cultures (Jarvis, 2012). If healthcare professionals focus only on a narrowly defined biomedical approach to the treatment of disease, they will often misunderstand their patients, miss valuable diagnostic cues, and experience higher rates of patient noncompliance with therapies. Thus, it is important for a nurse to know what sociocultural background a patient is coming from in order to deliver safe an effective
In an interview with a staff nurse (S.N), the main problem within patient communication included lack of patient’s (and family) involvement/willingness in planning cares. The staff nurse emphasized how “Patients often feel overwhelmed and do not want to participate. But, it is important for patients to be involved in their care for better outcomes” (S.N., personal communication, February 5, 2014). The staff nurse’s statement is supported by Evans (2013) whom remarked “better-informed patients avoid unnecessary care and frustration”.
The problem of poor communication stems from an environment of high stress levels. After a consulting company scrutinized processes throughout the hospital related to care coordination and patient flow, the evidence was clear. The company identified areas for improvement around communication at many different levels. In order for patients to have a seamless transition from admission to discharge, the lines of communication needed to change. Daily face-to-face meetings were productive for the staff, hospital and overall satisfaction. The consulting firm worked for the hospital for several months, but as they departed, the prior culture of poor communication started to engulf...
The health care provider should ensure that they communicate effectively with the patient/client.
University of Phoenix. (2014). Syllabus. Retrieved from University of Phoenix, HCS/320 Health Care Communication Strategies website.
Patient profile: Heterosexual Muslim Woman who has been in the United Stated for three years. She came from Pakistan. She is 42 forty-two years old, from low socioeconomic standing, English language barrier, and is Muslim rituals and practices. She came to emergency department with her husband due to shortness of breathing, high fever, severe cough. She was dignosed with new onset of pneumonia and currently on antibiotic. she also has history of Vitamin D deficiencies and diabetes mellitus type II. She admitted to medical-surgical floor for observation...
Street, Richard, MD. (1992). “Analyzing Communication in Medical Consultations: Do Behavioral Measures Correspond to Patient’s Perceptions?”. Medical Care, 30, 976 - 987