Recently whilst on my cardio placement I was required to treat a patient who spoke almost no English and was acutely unwell. I saw this patient with my curtin clinical tutor. Throughout the treatment the patient appeared to be indicating that they had some form of chest pain or problem and head pain. In response to this we arranged for some pain medication and also decreased the amount that had been planned for the session.
In discussion with my supervisor after seeing this patient she said to me that with patients like this one it is really important to be extra cautious with your treatment, even if they are indicating that they feel ok because of the communication barrier. You can never be sure if they have actually understood what you’ve said or whether there response is just a generic response to all questions they don’t understand. You also need to increase your observations of physical signs and symptoms as this may be your first indication that something may not be right, whereas if a patient speaks fluent English they may be able to indicate to you before that point that something is not right and you can act a lot earlier. This situation just re-iterates the fact that every patient needs to be approached on an individual basis, there is no recipe and alterations need to be made as required, particularly in this case when the patients health and safety may be compromised if additional caution is not executed.
I think that the values from this situation can not only be applied to treating patients who speak little English in a cardio setting but to many different settings. It is very important for us to not forget to constantly be altering our treatments and closely monitoring the non-verbal signs and symptoms. For example on my paediatrics placement my supervisor taught me that when performing stretches on a child to always watch their face because that will tell you a lot more about how they’re coping than what they say verbally. Hopefully now and even as experienced clinicians we will always consider the extra factors that are ever present when treating patients.
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1 comment:
That's a good point, everyone tends to freak out a little when encountering a patient with a significant communication barrier but there is a lot that can be gained by more physical observation of the patient. I guess when subjective info is limited, we can compensate by gaining more objective info.
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