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Cultural and Social Diversity in Health Care Conclusion
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The ability of a medical practitioner to elicit a sound and thorough chief complaint and history is essential in treating patients. During the first encounter with the patient, medical practitioners should be able to treat based on the information the patient provides. On December 13, 2013, the Physician Associate class of 2015 had the opportunity to interview standardized patients. This encounter was videotaped for self-analysis. I was able to reflect and improve on interviewing skills from watching my own patient interview. My critiques and thoughts are delineated in this essay from which I hope to improve upon.
The patient whom I encountered during the standardized patient interview was Phil. Despite my failure to inquire how to address the patient, my initial encounter with Phil started smoothly with proper introductions, negotiating priorities, and agenda setting. Within minutes of greeting Phil, I was able to demonstrative active listening by nodding my head and keeping direct eye contact with the patient to ensure comfort. While Phil was informing me of his concerns, I leaned forward to show that I was listening and encouraged the patient to continue discussing the matter with open body language and appropriate hand gestures. Overall, I tried my best to stay engaged with the patient and believe that I built a rapport with Phil.
Although I was able to build a professional patient-physician relationship with Phil, I did struggle in characterizing the symptoms related to the main concern in addition to the patient and emotional story. Phil’s chief complaint was his inability to hear out of his left ear. He also wanted to discuss his lightheadedness. I began by asking Phil an open-ended question, and it was not until a minute a...
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...ns that are more open-ended and responding with the NURS model. Reflecting on the patient’s emotions by asking more questions that are open-ended would help in the interview as it shows a mutual understanding of the patient’s feelings. I also want to pay closer attention to emotional cues that could help explain the patient’s diagnosis. These components can carry the patient interview forward.
Overall, I feel that the interview went well, but there can be definite improvements. After watching the video a few times, I noticed weaknesses in the interview including callousness and brevity. With practice, I hope to improve on these aspects and utilize supportive comments to demonstrate empathy and obtain a thorough patient interview. These features of a patient interview are essential as the patient is providing the necessary information to form an accurate diagnosis.
In her personal essay, Dr. Grant writes that she learned that most cases involving her patients should not be only handled from a doctor’s point of view but also from personal experience that can help her relate to each patient regardless of their background; Dr. Grant was taught this lesson when she came face to face with a unique patient. Throughout her essay, Dr. Grant writes about how she came to contact with a patient she had nicknamed Mr. G. According to Dr. Grant, “Mr. G is the personification of the irate, belligerent patient that you always dread dealing with because he is usually implacable” (181). It is evident that Dr. Grant lets her position as a doctor greatly impact her judgement placed on her patients, this is supported as she nicknamed the current patient Mr.G . To deal with Mr. G, Dr. Grant resorts to using all the skills she
When we see patients, we must remember that we are not simply treating a disease. We are caring for people with lives, hobbies, jobs, families, and friends, who are likely in a very vulnerable position. We must ensure that we use the status of physicians to benefit patients first and foremost, and do what we promised to when we entered the profession: provide care and improve quality of life, and hopefully leave the world a little better than it was
Truth in medicine is a big discussion among many medical professionals about how doctors handle the truth. Truth to a patient can be presented in many ways and different doctors have different ways of handling it. Many often believe that patient’s being fully aware of their health; such as a bad diagnosis, could lead to depression compared to not knowing the diagnosis. In today’s society doctor’s are expected to deliver patient’s the whole truth in order for patients to actively make their own health decisions. Shelly K. Schwartz discusses the truth in her essay, Is It Ever Ok to Lie to Patients?. Schwartz argument is that patients should be told the truth about their health and presented and addressed in a way most comfortable to the patient.
Effective communication between patient and clinician is an important aspect to patient care. Proper communication has a direct positive impact on patient care and adversely poor communication has a direct negative impact on patient care. I will define the seven principles of patient-clinician communication and how I apply these communications with my patients. I will also describe the three methods currently being used to improve interdisciplinary communication and the one method that my area of practice currently uses. Then, I will explain the ethical principles that can be applied to issues in patient-clinician communication. And Lastly, the importance of ethics in communication and how patient safety is influenced by good or bad team communication.
To start implementing this framework, one need to understand and acknowledge that every patient is not only different from one another, but a unique individual. Assumptions and stereotypes about a specific cultural group must be avoided, along with personal biases (Murphy, 2011). Furthermore, actively listening and fully engaging patients’ can improve nurse-patient communication and enhance patient outcome.
In the medical community there appears to be a divide between disease-centered care and patient-centered care. Both Charon and Garden, readily acknowledge this. Charon explains how although doctors can boast in their “impressive technical progress,” and “their ability to eradicate once fatal infections,” doctors often lack the abilities to recognize the pain of their patients and to extend empathy (3). Charon further adds that “medicine practiced without a genuine and obligating awareness of what patients go through [empathy] may fulfill its technical goals, but it is an empty medicine, or, at best, half a medicine” (5). Often, doctors fail to remember that their patients are more than just a person with cancer or a congenital heart defect — they are human, a whole person with dreams, aspirations, and fears. According to Charon, “scientifically competent medicine alone cannot help a patient grapple w...
The purpose of this essay is to reflect and critically study an incident from a clinical setting whilst using a model of reflection. This will allow me to analyse and make sense of the incident and draw conclusions relating to personal learning outcomes. The significance of critical analysis and critical incidents will briefly be discussed followed by the process of reflection using the chosen model. The incident will then be described and analysed and the people involved introduced. (The names of the people involved have been changed to protect their privacy) and then I will examine issues raised in light of the recent literature relating to the incident. My essay will include a discussion of communication, interpersonal skills used in the incident, and finally evidence based practice. I will conclude with explaining what I have learned from the experience and how it will change my future actions.
Does your head hurt, does your body ache, and how are your bowl movements? After a head to toe assessments, touching and prodding, the physician writes up a prescription and explains in a medical jargon the treatment plan. As the short consultation comes to a close, it’s wrapped up with the routine “Please schedule an appointment if there are no signs of improvement”. This specific experience often leaves the patient feeling the “medical gaze” of the physicians. Defined by good and good, the medical gaze is the physicians mentality of objectifying their patient to nothing more than a biological entity. Therefore it is believed that the medical gaze moves away from compassionate and empathetic care, thus leaving patients feeling disconnected from their physicians. In order to understand how the medical gaze has stemmed into patient care, I begin with observations of a Grand Round, lectures for the progress of continuing medical education of physicians. There are expectations of physicians to be informed of cutting edge medical procedures and biotechnology since it can result in a less aggressive and more efficient treatment plan of patients. As I witness the resident physician’s maturation of medical competence in during a Surgical Grand Round at UC Irvine Medical Center, it has shifted the paradigm of the medical gaze and explains how competence is a form of compassion and empathy in patient care.
Listening requires active participation to development a shared understanding and minimize misinterpretation. Some physicians possess conversational skills that would be considered downright rude. They constantly interrupt their
Listening can be defined as empathy, silent, attention to both verbal and nonverbal communication and the ability to be nonjudgmental and accepting (Shipley 2010). Observing a patient’s non-verbal cues, for example, shaking or trembling may interpret as an underlying heart condition that may not have been addressed (Catto & Mahmud 2012). Empathy is defined as being mindful of and emotional to the feelings, opinions, and encounters of another (Merriam-Webster Online Dictionary 2009 as cited in Shipley 2010). Providing an environment conducive to nonjudgmental restraints allows the patient to feel respected and trusted whereby the patient can share information without fear of negativity (Shipley 2010). For example, a patient who trusts a nurse builds rapport enabling open communication advocating a positive outcome (Baker et al. 2013). Subsequently, repeating and paraphrasing a question displays effective listening skills of knowledge learned (Shipley 2010). Adopting a therapeutic approach to listening potentially increases the patient’s emotional and physical healing outcomes (Shipley 2010). Nonetheless, patients who felt they were genuinely heard reported feelings of fulfilment and harmony (Jonas- Simpson et al. 2006 as cited in Shipley 2010). Likewise, patients may provide
As a result, I always felt that I am actively participating in patients’ care. She allowed me to perform patient examinations most of the time and encouraged me to build up a good rapport with the patients. I think my past experience and medical knowledge was helped me lot during the history taking because I was able to go through history taking in a systematic manner and at the same time I could think of possible differential diagnosis. Furthermore, working in a medical clinic as a physician assistant also helped me a lot because one of the responsibilities delegated to me is taking patients history, however, this time it was different that I had to work out and actively think about a possible cause for patient concerns. The weakness I observe during history taking was sometimes I am little quick that might hurt the doctor-patient relationship, So, I am planning to improve my listening skill with less interruption to patients, I believe that might help the patient to express their concerns freely. Also, I am determined to listen to patients concerns in a non- judgemental manner to get the unbiased clinical
The first part of the history-taking process is creating an appropriate environment. Ideally, the interview takes place in an area that is safe, accessible, and free from distractions and interruptions. During this initial process, the interviewer introduces themselves and states their purpose and obtains consent to proceed with the health history interview. Additionally, the initial part of the interview is the time to establish the patient’s identity, age, and preferred way of being addressed. A relationship built on trust and respect for the patient’s privacy is necessary to developing a good rapport. It is important to remain unbiased and professional and furthermore, to treat the client with dignity. After introductions are made, the patient should be given time to tell their story in their own words. Active listening is a must during this interaction and involves both verba...
We found a person to interview without much hardship since Sasha had a friend who is currently working as a session assistant. Yoonhee was yet familiar with neither unit secretary nor session assistant while Sasha had a few years of working experience as a session assistant and had the most experience in the hospital and subsequently with unit secretaries. Sasha provided a lot of personal experience and information in addition to the content of the interview. Because of this, we were all able to be on the same page and understand what we were working on as the project progressed. While our presentation was informative, there are things we could have
One key aspect that I learned from my patient interview relative to chronic care management is, the value in utilizing the 4 components of motivational interviewing. When I began my interview, my patient by sharing a list of diagnosis and dates. He also read a list of his medications. Rather than merely reading a problem list on his medical record, I wanted to capture the emotional essence of living with chronic heart disease and heart failure on my patient’s life. It can be challenging to get a patient to open up to a health care provider and share deeper emotions. I utilized the 4 components of motivational interviewing which included, open ended questions, reflection, affirmation and summarizing. Using these interview skills helped my patient
By demonstrating sincere caring for my patients, I illicit their trust and most of the time receive honest answers to my questions. This is important in order to collect accurate information about an individual. Genuinely caring for others also helps form trusting relationships, which allows for full disclosure of information and enhances my ability to be a patient advocate. I also am a very social individual, so maintaining the flow of conversation was easy most of the time during the interview. One thing that was difficult for me was continuing to maintain the direction of the conversation towards the topic at hand. Sometimes I feel like I get caught up in carrying on the conversation with my patient or interviewee and fall away from my original topic of assessment. However, at times this can be beneficial because it allows me to gain further information on a subject I may not have thought to bring up later in the interview. I plan to improve on this weakness by learning to distinguish between what is a good topic to continue to pursue and what areas of the conversation will lead away from the health