We are taught throughout our course that building rapport and trust with our patients is essential, and i certainly agree. As we see some of out pts on a very regular basis this trust can build naturally, however last week i found that some people were so comfortable that they confided in me more as a friend rather than their health professional.
2 pts i saw last week highlighted this; during a subjective with a 65yo man, simple questioning of hand numbness (as he previously had thoracic outlet syndrome) led him to tell me about his impotence problem and his current treatment to rectify this. He seemed to feel it was necessary to tell me even after i tried to move the conversation along. Another lady confided in me how she was a victim of domestic voiolence with her ex husband and started telling me all the horrible things that he had done to her in great detail. In both these cases i managed to change the conversation eventually, but in doing so felt like i might appear rude and uncaring.
I know i can change the subjective to more yes/no questions but thats not always appropriate. I guess i need to either learn to not be affected by patients' emotional problems, or not allow those conversations to happen in the first place. Has anyone else found it difficult in that fine line of being genuinely compassionate and caring and becoming someone patients' feel they can confide in?
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As you may of heard in my groups seminar on domestic violence(DV), that health professionals are the major form of outlet for pt suffering from DV. This goes undetected in majority of cases. So i would encourage people to talk about that but also encourage that the best person to speak to about that is a DV hotline/refuge. The sex impotence pt is a whole different issue. That is probably one i would agree to change the subject but mention to them to see their GP.
Really good advice Dickie. As was said, sometimes, we - as PTs - are the sounding board people use. Most of the time simply listening is enough. People just want to be heard - by someone. When the conversation heads in a direction that is not just "sounding off" - such as DV - this is where you may need to acknowledge your limitations and direct the patient to someone/where who can help them. It may be an organisation, another allied health colleague (e.g. social worker), GP or other. The trick is learning the difference between "sounding off" and "I need help".
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