Effective bedside communication
THE thing about illness is that we never know when it will strike us. Sickness takes us way outside of our normal life routine, whether or not we are gainfully employed. In bygone days it would either mean months for recovery from an ailment, or else in short order the sickness would usher us into that last room to meet our Maker, if a cure was not found. Fortunately, modern medicine has developed by leaps and bounds and allowed for those with access a speedy return to wellness.
I am not sure how many of us are aware of a syndrome called 'White Coat hypertension' or 'white coat syndrome', a phenomenon in which patients' exhibit elevated blood pressure in a clinical setting but not in other areas. It is believed that this is due to the anxiety that some of us experience during a visit to the health clinic.
If you have ever been seriously ill, nothing is more comforting than the confident, knowledge-filled voice of your medical practitioner, walking you firmly through the steps of the whys and wherefores of your complaint and hopefully, your eventual cure and recovery. If you have to receive bedside care there is nothing more reassuring than the soothing voice of a nurse to help you through that difficult time. In Jamaica, we are blessed with some of the finest medical minds and devoted health practitioners, nurses, doctors and surgeons who are indeed very passionate about the care of their patients. I lift my hat to each and every one of these men and women who practise their profession with such skill and patience. Of course, I claim forgiveness for my bias as I have my favourites in Drs Bruce, McCartney, Frederick, Hardie, Sonia Davidson and of course, Professor Winston Davidson.
It must not be an easy task for a medical professional to have to speak with someone who is in pain and distress, who has been in an accident or else is bleeding; to ask them the right questions that will elicit responses that will lead to a correct diagnosis which will lead to relief. I am not sure if there is a module in communications or a course in proper 'bedside etiquette' which medical practitioners are required to complete.
If such a course exists, there are some heath care practitioners who would pass with flying colours and others who would have to do constant re-sits. For the medical professional there are some communications and customer service skills that they might be in need of even more than the ordinary professional, as it is they who come into contact with humanity and our physical suffering and frailty. Indeed it takes innate propensity, knowledge of, and ability to effectively apply face-to-face communications skills to practise successfully. For example, the voice tone and pitch can make a difference in effective delivery of care.
I am reading a paper, 'A Novel Bedside Communication Tool' by BP White and P Bradley (University of Cambridge Clinical School, UK, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, UK). Poor communication, they said " is a common cause of complaints to secondary care (Jangland 2009), and frequently patients are unaware of discharge dates, planned procedures and even who is looking after them (O'Leary 2010)."
"Currently, (at the time this paper was written) the vast majority of communication with inpatients and their relatives is verbal. A written communication tool could eliminate feelings of time pressure (Jacobowski 2010), and prevent the short-term amnesia that patients or relatives can suffer during a ward round, under the gaze of the health care team. This written tool would encourage active patient participation.
The paper pointed out that a study of American patients found that most (84 per cent) active participation behaviours (such as offering opinions, asking questions or expressing concern) were patient-initiated rather than prompted by doctors (Street 2005). This suggests that if patients are given an open means to communicate with their healthcare team, they may pro-actively use it."
The authors assert that improved patient-doctor communication results in improved biomedical outcomes (Kaplan 1989, Stewart 1995, Ward 2003). They proposed that opening a new channel of communication between patients, families, caregivers and healthcare professionals on the wards would improve the delivery of healthcare. They presented a novel written communication aid- the Care Communication Aid (CCA), with preliminary data from secondary and tertiary healthcare trials demonstrating its efficacy and shortcomings, and the reaction of both recipients and providers of healthcare to this novel approach.
"This bedside folder provides structured writing space that a patient or relatives can use when healthcare professionals are absent or otherwise occupied. The folder can be used to ask questions, or provide information for the staff. The folder is marked as confidential either for the patient alone, or jointly for the patient and relatives."
There are, of course, many other areas of bedside communications that can be explored, but this perhaps a tool that may be adopted, if it is not already being widely used.
Yvonne Grinam-Nicholson, (MBA, ABC) is a Business Communications Consultant with RO Communications Jamaica, specialising in business communications and financial publications. She can be contacted at: firstname.lastname@example.org. Visit her website at www.rocommunications.com and post your comments.