Why Should You Care About Your Patients?

Posted by Patrick Lickiss on Aug 3, 2011 in Assessment, General, Research | 0 comments

Do you care about your patients or do you approach them like an auto mechanic would a malfunctioning car?  It’s an important distinction that sometimes gets lost in the shuffle of what we do day in and day out.  A call which is routine for a skilled practitioner may be anything but routine for a frightened patient.  About a year ago, I wrote about the importance of actually listening to your patients when you ask a question.  This idea of caring falls along the same lines.

I recently came across an abstract which looked at the benefits of a “caring” assessment in an ambulance service in Sweden ^[1].  According to the researchers, one of the major findings was that understanding of the patient’s “lifeworld” was vital for a complete evaluation of the patient’s condition.  What the heck is a lifeworld?  It sounds pretty new age if you ask me.

According to Webster’s dictionary, lifeworld is “the sum total of physical surroundings and everyday experiences that make up an individual’s world”. Well that makes a little more sense.  Basically, it’s the recognition that each patient has a series of experiences which alter their perception of the situation they find themselves in.  What are the chances that “lifeworld” could impact a patient’s disease process and the medical care best suited for them?  Probably pretty good.

In fact, the researchers found that a “medical only” assessment presented an “obstacle to a full understanding of the individual, and thereby the illness per se”. ^[1] The likelihood is that you perform this “caring assessment” on a regular basis.  Think about a patient complaining of chest pain and shortness of breath.  Is your top differential diagnosis cardiac?  At the very least it should be a “must not miss” diagnosis.  Now a good practitioner would start asking the patient about when the symptoms started.  If you find out that the patient just lost her husband to a long battle with cancer and that their wedding anniversary is today, does that change your differential diagnosis?  Probably.  My hope is that all of you actually take the patient’s “lifeworld” into account when building a differential and determining treatment.  Remember to actually listen to your patient’s narrative, you can learn a lot.

In the end, the abstract for this article doesn’t include any numerical results and doesn’t quantify why one assessment is better than another.  While that would have been nice, I don’t know that it’s really necessary.  A lot of this is just common sense.  If you ask the patient about their situation and listen to the answers in a caring manner, you’re more likely to get the whole story.  If you get the whole story, you’re more likely to make the right treatment decision and the patient is more likely to feel like their suffering was reduced.  They feel this way not because you treated their symptoms, but because you connected with them and took the time to listen and understand them.  It may take a little more effort, but I think it’s worthwhile.

CITED ARTICLES
[1] - Wireklint, SB & Dahlberg, K: “Caring assessment in the Swedish ambulance service relieves suffering and enables safe decisions”. International Emergency Nursing 2011 July; 19(3): 113-9.

Image via Flickr