hey guys- two for me today too!
I have an interesting patient at the moment that has what appears to be an ascending paralysis. On admission to hospital 3 months ago they were walking and now they are unable to even maintain static sitting as the paralysis has ascended up to their trunk. The doctors have tried every known test to try and determine the cause and they have absolutely no clue what is going on. The patient is obviously and understandably becoming more and more distressed, upset and frustrated and is now convinced that she has gone mad. And the patient is constantly asking me wether they will walk again or be able to look after their two young children again! I am finding it hard to answer- I mean I have just been saying that I don’t know because I don’t know the diagnosis! I just find it hard to treat a patient with such a prominent psychological element- because you just have to be so careful about what you say!
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3 comments:
I totally agree that this is a difficult situation. I have discussed this with my friend, and we both agreed that we should only tell the truth (ie. say don't know when we don't know, say it's not going to get better when that's the case). And no point trying to minimise the truth as they need to be prepared for the future possibilities. I agree with you that we can only be sensitive with the patients feelings.
I agree. You have to be very careful about what you say to patients. Even when you think you have conveyed a point, the pt may have gotten a completely different idea. It;s like examples you hear about pts who have hardly moved because at some stage someone has told them they have a "subluxed spine". I think being realistic, but sensitive is the best way to approach it.
Agreed. You do need to be honest, realistic and sensitive. However, if possible, try to add in a hopeful comment - not a dishonest one. But hope is important.
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