I work in a busy Emergency Department, Each day is different, different situations needs with different communication needs.
I think most importantly i should get to know my patient, what there needs are what they need completing and how i am going to get to this point.
To do this I firstly read the initial assessment of why they have attended ED. I read their notes and their history all of which was recorded.
The patient i am reflecting on i will call “JOHN” a sudo name for data protection reasons. I asked john if he knew where he was and why he was here?with no answer or reply i could tell from my assessment that john was scarred and confused.To help john feel less scared i entered the room introduced myself told him my name showed him my name badge, I had a bid friendly smile, made sure i was down to his level on the floor to have good eye contact .I spoke slowly and clearly
to make sure i did not give to much information at once. My confirmation that john wanted to talk to me was he shock his head and answered my questions. I asked do you know where you are? his response showed me that i needed to gather more information for his care home to be able to communicate better and effectively.
I knew that communication was going to be limited with this patient,so i forward thought found the care home phone number and name of the manager and rang them.
As barriers for communication were preventing me communicating effectively with my patient. I spoke to his main carer who was very helpful, Together we filled out a “THIS IS ME” booklet all about John. What his like and dislike were his family who were important to him, His life and his wishes and believes his background,how best they communicated with john. I believed this would help me have a better understanding and enable me to do my job better,
I knew if i did not have this important information i would have found it hard to understand Mr Smiths needs and how best to meet them,I learnt that he needed 5 minutes processing time before he was able to answer questions. That he did not like coffee only Tea,
I learnt that john likes to be addressed as MR SMITH that his mobility was limited and he needed assistance of two carers which would have been a risk to Mr Smiths health if i did not have this information i could them set a risk assessment and put a care plan in place .
Having this information firstly helped me relax Mr Smith and help feel safe and understood but secondly it helped me be able to explain what i had to do and what was going to happen like ECG, Bloods, Xray.
I took my time to explain and wait for a response, I had a good conversation with my patient even though he had Dementia.
I was able to confirm Mr Smith understood what the process was by his responses, giving enough time to reply without rushing , to be able to gain consent to complete my tasks, I was able to explain the risk if these procedures were not completed. I recorded all my finding and tasks completed in my daily notes. so all professionals working with Mr Smith had all off the correct information. And were also able to communicate effective as well.
My feedback was positive from my patient we had a good conversation which he shared his memory’s of his family, children, and work, He trusted me to be able to share this information and we laughed and he gave me advice. I was able to build my trust with my patient as he new i cared about was happened to him. I made sure i valued Mr Smith, By asking his permission before i completed any procedure and made sure i explained in detail what i was doing and why. This shows i valued and respected my patient.
Before i work on a task for any patient i always try and use my reflective model called GIBBS this helps me understand what barriers i may have, how i may feel , and what plan i need to put in place for good outcomes.
Mr Smith was confused and alone, I felt worried and sad for him as i knew how i was feel if that was one of my family members. I would have wanted someone to care and look after them .I knew that an older person with Dementia would need extra time and patients, Even though i work in a busy Emergency department i took the time to phone his home to get the right information to be able to care for my patient. I knew without this i would have had more barriers, He would not have understood me if i continued to overload information or talk to fast. The information which i needed my patient to understand would have not been understood properly, the wrong treatment may have been given. Recording all my finding for all involved is as important, to make sure all work together and prepare for the future, which i planned by sending “This is me ” booklet home with them so next time his carer could come with their patient with their booklet to be prepared.
Having learnt that different stages of dementia has different levels of understanding, someone not so advanced in the disease would need more information explained little by little, with longer processing times. I reflected that maybe in the past i did not reallise that the patient may not have been given enough processing time to answer the questions, and not the fact they had no Capacity or they did not understand.
I am more aware understanding and patient to these needs. I have learnt with my reflection to be more aware. I would put in place simple questions that are easier to answer so can be understood easier ,so i can communicate to the best of my knowledge with each patient i work with.