Communication Issues

I found the first week of my placement in a very acute setting quite confronting, as it is so different from any of my past clinics. Communicating with patients is a lot more difficult than in your standard outpatient setting. Many of the patients that are not sedated have trachys in situ so are unable to verbalise their concerns or feelings. Subsequently, I found myself in an intensive one week lip-reading course. It is very easy for patients to get frustrated if people don't take the time to decipher what they are trying to say. And whilst writing and alphabet boards can be helpful, they aren't an option for all patients. For example an elderly woman with GB (in hospital for over 4 months) communicates mainly through nodding, as she has little motor recovery apart from some neck flexors. I found that in trying to speak with her, you had to take the time to ask her questions that she was able to answer in this manner. She also had issues with pain, and some treatments she had to undergo (manual hyperinflation and suctioning) were quite unpleasant. When doing this we were able to tell from her facial expressions when she was uncomfortable or in pain and adjust the treatment accordingly, which helps to build trust and patient confidence. I'm learning to have a more overall view of the patient during treatment, which is difficult when you are suctioning or bagging for the first time and just trying not to look completely incompetent.