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Advanced Emergency Nursing Blog from AENJ

The concepts, concerns, clinical practices, researches, and future of Advanced Emergency Nursing.

Monday, March 26, 2018

Giving Voice - the personal relations of patient relations

Blog 2018 – 3. Giving Voice - the personal relations of patient relations

I accompanied my wife to a medical appointment in ophthalmology recently. It was a high-volume setting, and the preliminary screening of scanning the optic nerve, checking visual acuity and intraocular pressures was done efficiently by an assistant of mature years who had first registered us, whose manner was polite (but pro forma) and only directions were given. She got in and out as quickly as possible. There was no discernable interaction on a personal basis. I asked my wife, wryly, "Do you think that she's done this before?"

We both discussed our perceptions and concluded "I think that you were processed!"  Clearly, the work was done, and no one was insulted, but it lacked personal warmth or interaction, however mundane.

As a nurse and former paramedic, I always had to interact directly with people. "What's bothering? How can we help?" Whether assessing, eliciting history and background, reassuring, explaining, teaching, or guiding the patient to use inner resources to distract from pain or persuade them to believe in their own recovery; it was necessary to engage the mind and create rapport.

In fact, our voices, and the words we used, were the most powerful drug and rescue tool that we had. Whether distracting the patient with a fractured hip (in the absence of any analgesia) from noticing the notorious potholes and railway tracks over which we were compelled to drive; or engaging the trust and defusing the hostility of a victim's friends demanding to know why we hadn't gotten there sooner to take care of him. In the former situation, skillful anticipatory driving {lessen the bump) and inducing a distracted focus (to lessen awareness) averted much pain. In the latter, "keep talking (focusing on the crowd's wishes and the patient's needs), keep doing (patient care), and keep moving (do the job and get out). Leaving with that trust, respect, and friendly mood not only marks success, but makes things easier for the next crew to be there.

It may just be that she was being nice and taking the initiative in keeping the flow moving for us. I don't doubt that she's good at her job and has years of satisfactory performance in her files. A few greetings, mild questions (even just the weather), and such are accepted as social lubricant. A few amenities go a long way in opening communication, establishing a relationship, and sometimes you discover that the patient has an interesting tale to tell and is a more interesting person. Do we have entitlement to social discourse? Should we expect to get it every time? No. But, it is a useful tool –that wasn't used.

Tom Trimble, RN
All opinions are solely those of the author.
Suggestion does not equal endorsement.
Readers must verify validity to their own practice.