The Road to Grande

“As you become your own advocate and your own steward, your life will beautifully transform.” 
― Miranda J. Barrett, A Woman's Truth: A Life Truly Worth Living

"Oh God! My foot! My foot! My foot!

Oh God! My foot! My foot! My foot!"

"Miss Dorsett, are you awake? We have to redraw a sample as it was hemolyzed and unable to be used for pre-surgical testing." 

I groggily peaked my head from the covers to face this person, who happened to be wearing a white coat and already poking around to find my hand in order to tie a tourniquet to retrieve a sample. Before I could ask who she was or to repeat what she had said, her next words were "now you'll just feel a prick", and just like that she had what she came for and vanished as quickly as she arrived and like clock work the cries of tanty in the bed behind resonated once again: 

"Oh God! My foot! My foot! My foot!

Oh God! My foot! My foot! My foot!"

So I wasn't dreaming! I frustratingly mouthed to myself as  I looked at my left hand and saw the IV being held down with surgical tape in the form of an "X".  Instantly the scene that had transpired earlier that morning in the clinic, replayed in my head. After my physical examination I had an episode of syncope when the doctor flushed the IV he placed seconds before. 

So I wasn't dreaming!

Fortunately, despite all of the events that occurred in the short span of time that my eyes were opened, I was able to get some sleep before being awakened again by another nurse and instructed to prepare for surgery. 

The parade of medical personnel doing their checks and talking around me as if I were unable to comprehend their words, was something I never imagined witnessing and certainly didn't appreciate. Throughout my entire hospital stay, there were 3 people overall, who made the effort to treat me as a person and not another body in a bed on the female medical ward.

My surgery was performed under local anesthesia (since that meant I would be discharged the same day) and I got to experience every poke, burn, conversation, cough, sneeze and power outage that occurred. I recall laying there with the operation room light blazing overhead and staring at the clock and thinking to myself, how the healthcare system in the Caribbean is in dire need of work, and the staff could use a few semesters of proper patient communication, surgical preparation etiquette and a very large dose of empathy. 

Following my experience as a patient, I vowed to conduct a self-evaluation at the end of my clinical skills sessions, and to practice from now, ways in which I can improve my communication skills which I hope will be reflected when I address my peers and colleagues, family and patients all of whom I am privileged to practice clinical examinations on, as a way to build a professional empathic repertoire.  

Here is a recap of what I learned from my Professionalism, Ethics and Communication in Healthcare (PECH) course over the last six semesters of medical school that are vital in being a great physician.

WHAT PECH HAS TAUGHT ME

1.RESPECT: The patient is a PERSON and as a result they deserve to be treated as such! 

2. EMPATHY: Place yourself in the patients shoes before you enter to speak to them. Spend a few minutes trying to feel their pain and confusion and tailor your time with them with that in mind. A little bit of empathy can change the outcome of an examination of the patient. 

3. STANDARD: Like everything else, we expect a certain level of standard when we go just about anywhere and it's no different when we have to receive healthcare. I mean why should healthcare of all things have a poor standard? I know in the public sector you can seldom change things solely within a matter of minutes, but you can ensure that the standard of care a patient receives while in your care is superb! Strive to treat every patient with the highest standard, as if you were treating the Queen. 

4. PUNCTUALITY: I've had a hard time with this last semester, especially on days when I didn't prepare for the next day's activity the night before. You recall that saying "time is money"? Well it's somewhat true. Time is very valuable and once wasted it cannot be regained, duplicated or multiplied. So ensure that you are very considerate of a person's time, from something as simple as arriving to lectures promptly, waking up when you should in order to beat the hustle at the maxi stop etc. This is definitely one area of my life I would like to improve upon in 2015. 

5. EXPLAIN: This may seem very simple, but one thing my trip to the hospital opened my eyes to was that as Physicians even as medical students, we get caught up in all of our medical jargon and forget that although that may make us seem highly knowledgeable, it also doesn't do any good when you're throwing jargon around at a patient and they have no idea of what you're saying or what "hemoptysis" means. Think about the patient here and how likely they are to comply with treatment of their ailment if they do not understand what is being said, the meaning of certain terms or if they misinterpret what you're saying. Clear communication is key in patient compliance and understanding. 

6. COMMUNICATION: We do it everyday and sadly we don't know how often throughout a 24 hour period we get it completely wrong. Our non-verbal communication which consists of our kinesics (body language), haptics (touch), occulesics (eye contact), and  vocalics (tone of voice) are all vital in daily communication. As a medical student,  being aware of the nonverbal ques a patient gives can allows us  to tailor our questions when taking the history, and it can also alert whomever you are communicating with, to whether or not you are actively and attentively listening. Verbal communication is also powerful and important. Sadly, we fail to realize that what we communicate through our nonverbal ques tend to affect how we are perceived and are viewed by others, how well we are respected and liked by others and even whether or not we are trusted by others. 

7. TRUST: Once damaged, it is hard to be restored. Build a trusting relationship initially with your patients, peers and friends and continue to work to maintain their trust by being honest, patient, consistent and transparent. 

So don't wait until tomorrow to start improving on the small things like respecting others, and being a bit more caring and considerate of the other person. The sooner you make the changes necessary to improve your life, the sooner those changes will take root and become healthy habits!