The benefits of a little chit-chat

Hi all, trust you had a good 2-week break! I am currently doing my Cardio placement. As of yet I have not run into any noteable problems/situations, questions or queries. ( I believe we may still be in the "breaking-in" period). While the majority of patients have had very interesting (and complex!) medical histories, I do not believe that sharing them is the point of this blogging exercise. I have thus racked my brain trying to think about what to share with you. And then it hit me! - communication!

I'm not necessarily talking about open/closed questioning or analysis of body language - I am talking about the art of simply having a chat to someone. I guess in a way it can come down to personal preference, but I know that if I put myself in a patient's position I am much more receptive, feel more comfortable and willing to engage with the health professional if they simply take the time to have a few words with you other than your health. This makes them seem interested in you and therefore, from a patients perspective, I believe the fundamentals for trust and confidence in your health professional emerge. And this! - is absolutely critical to developing good relationship with your patient!

So here is an example: I currently have a pt with end-stage COPD. He was willing to tolerate the subjective/objective assessment but really was pretty much tired of the whole process at this stage. "I mean, whats the point?". So realizing this early on in talking to him, I made an extra effort to respond to comments he would make. Such as: he enjoys fishing. So I would recount a few tales of fishing in my youth and go on to praise the fishing skills of my father and brother - big fish tales included of course!!. And this would therefore get him going and soon enough we would be having a good ole chat and laughs. Now I know this is not very time efficient, especially if you have a large case load. However, I do believe that it can actually hasten further treatments down the road as your patient may actually be more willing to get up and get going with you because you have spent the time and effort fostering this relationship.

So, back to this individual. He really didn't have much interest to get up and walk nor any desire to do any other exercises. He in fact was more interested in charging me $$ for time spent with him. Yep got expensive, ausculation was in the $100's and a walk was really out of the question considering my budget!! (a joke - just to clear up any confusion). However, once a good open line of communication was started and we both got to learn a little about each other, I had no problems getting him to do whatever I wanted and he was actually more interested and motivated in doing his treatment.

I have encountered this type of situation more so in this placement more so than in any others. I guess by this stage, these resp. pts often have heard/seen it all and often are at a very progressed state of their disease. Thus, while there are still benefits to be had by doing treatments, the motivation may be lacking. By being friendly and being interested in the person themselves and not only their condition or the job you have to do - you may have the power to help restore some motivation and increase their compliance.

Note: there will always be those pts that will be difficult no matter what you try!

So, if you aren't having much luck with treatment, try changing tactics and having a little "idle chit-chat" instead and see what transpires!

Have a good week,

Donelle.