Improving communication with patients - difficult interactions

A medical student learns to have confidence in their abilities and knowledge, and how that confidence can benefit patients.

'There was a patient with brain damage. Due to their condition, they would wander the wards, fiddle with things, shout and would have little regard for their own wellbeing or the wellbeing of others. Because of this, the patient required constant monitoring and talking to.

I observed the nurses’ attitude towards the patient and paused to consider my own attitude. Having been on the ward for a number of days, I had avoided interaction with the patient as much as possible. I felt this was to the detriment of my own learning as this was a unique patient that could offer a valuable learning experience. Giving it some more thought, I realised that my only contact with this patient had been curious, darting looks every so often when something happened or when struggling to hear the consultant over the patient’s shouts. I drew into question why I had acted in this way. Mental health was no mystery to me due to family experiences, working in care homes and working in sealed mental institutes; this was the first time I had experienced it within a hospital setting as a medical student so felt I was expected to behave in a certain way.

I was concerned that any interactions I may have with the patient may cause them more distress or interfere with the nurses. I didn’t back my experience to help me in being able to interact with them as a person. 
 

I was almost scared of putting myself in a situation with this patient who, through no fault of their own, had mental health issues. I was concerned that any interactions I may have with the patient may cause them more distress or interfere with the nurses. I didn’t back my experience to help me in being able to interact with them as a person. I felt the usual strategies employed with other patients would be ineffective.

Having recognised my own attitude and realising it to be irrational, when it was mentioned the patient needed to be weighed, I tentatively volunteered. I was fairly nervous to start with but, after they clearly calmed down following my usual introduction, I too felt more at ease and allowed my past experience to take over. Throughout the conversation, I enjoyed the ease of communication and was pleased to see the patient and the nurses seemed to enjoy it. It was the first time on the ward the patient seemed comfortable in bed and was engaged in conversation. Due to the importance of the conversation, I felt more engaged. I was keen to let the patient talk to further engage them so asked probing, relevant questions to progress the conversation effectively. That being said, there was a brief second where I missed a question as I briefly focused on my body language in fear it was incorrect. This made me realise the difficulty in trying to have an effective conversation without focusing on it.

As this was so successful, I was flushed with exhilaration and offered to weigh the next patient.

Following both interactions, the consultant who, unbeknownst to me had been watching, complimented me on my patient communication skills. This filled me with pride, a tad of self-consciousness and has given me the resolution not to shy away from more difficult interactions in the future.

This has taught me the importance of facing fear, building experience to allow you to naturally have a conversation without constantly focusing on body language etc.'