BEDSIDE MANNERS

Col Arsalan Bukhari, TI(M)Associate Professor of Orthopedics , Classified Orthopedic surgeon

HOD Department of Orthopedics

CMH Abbottabad

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DEFINITION

“The mannerisms with which a HEALTHCARE PROFESSIONAL

handles his / her patient .

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BASICS

A bedside manner refers most often to the way a medical professional (Doctor/ nurses) interacts and communicates with patients

Society concern about how the medical professionals interact with their patients has increased in the past few years.

Bedside manner directly affects the quality of care a patient receives

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A PATIENT’S FIRST VISIT TO THE HOSPITAL

no idea what kind of doctor/ staff he will come across.

Info from friends or family members who may have some prior experience with the doctor/ hospital staff

However, the patient doesn’t really know or have a feeling about what the visit will be like till it happens.

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HOW A HEALTHCARE PROFESSIONAL IS ASSESSED

From a personal point-of-view, the only initial way the patient has of evaluating a new physician / nursing staff is by his/her bedside manner.

This assessment, by the way, happens fairly quickly in the encounter – probably within the first 60 seconds.

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FACTUALLY

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BEDSIDE MANNER

IT IS ALL ABOUT THE TOTAL ATTITUDE OF HEALTHCARE PROFESSIONAL TOWARDS THEIR PATIENTS .

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FACTS TO REMEMBER

Patients feel helpless when they are ill.

They want to feel comfortable with the people with whom they are entrusting their lives.

They want to feel like someone is on their side when they are ill.

They need to feel that the person who is treating them is really concerned about them and has their best interests at heart.

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TYPES OF BEDSIDE MANNERS

Authoritarian or patronizing Timid Confused Dis interested Empathetic

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AUTHORITARIAN

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TIMID

Seen in commercial systems and business outlets

Healthcare professionals are too pleasing and on patients disposal

Counter productive

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CONFUSED

Poor impression Acute loss of patient trust Dissatisfaction

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DIS ORIENTED

Pre occupied Lack of knowledge Poor response to patients quarries Poor PDR

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EMPATHETIC

Caring Patient focused attention Knowledgeable Emotionally intelligent Max compliance Best PDR

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IN OUR DAILY PRACTICE

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ARE FOR THE VISIT

Spend a few minutes reviewing the patient's history and medical problems before you even enter the room.

Remind yourself about what happened on the last visit, what tests you ordered, what the results of those tests are, what prescriptions you wrote, etc.

Patients are impressed if you know what's going on with them ahead of time without having to look up or ask for a lot of information about them while you're in the room with them.

Try to anticipate their questions and how you are going to answer them before the visit, especially if the discussion is going to be about something serious or life changing.

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SIMPLE COURTESY

Knock before you enter. Always be polite and greet with a salaam Always inquire how the patient is feeling

today. Extend full attention. Never be rude or shout.

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GREETINGS

Greeting – Say a word or two to the patient firmly with conviction but with a smile………

“Nice to see you.” Or, “How are you?”

Never hug or embrace.

A pat on the upper back is okay but never more than that.

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MAKE EYE CONTACT

Talk to the patient with confident and re assuring eye contact

Let the patient know that you are there for the sole purpose of seeing him/her.

. Avoiding eye contact undermines patients trust

If you’re not looking at the person when s/he is talking to you, you will be perceived as not listening, even if you have heard and digested every single word.

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TALK TO THE PATIENT AND NOT HIS DOCUMENTS

With documents in every room, there is a tendency just to go in the room, right to the documents, and barely glance at the person whose life you have in your hands.

Patients notice this

Serious mistake

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LISTEN and ATTEND

Hear the patient out and attend his call always.

This is what patients complain about most – that their distress calls are not attended in

time.

The patient needs to feel that you understand

what is going on with them.

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RESPECT

Respect your patient's opinions, acknowledge his/her beliefs even if you don't agree.

NEVER be judgmental. Remain open-minded.

Never be so entrenched in your own opinions that you can't allow your self to see the other side.

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EXAMINE

The patient needs to feel that you’re at least concerned enough about his/her symptoms, that you will examine the area of complaint, even if you know you’re not going to find anything.

Mere attending by the doctor/ nursing staff in the ward many a times pacifies the patient and lessens their pain and anguish.

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COMMUNICATE Explain your findings and your diagnosis in

everyday lay terms as much as possible.

Exercise informed consent.

Little or no explanation from doctors is another big complaint from patients and families

The worst scenario is an ill informed and/or a dis interested doctor / nursing staff in the ward.

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DON'T DISCUSS YOUR OWN PROBLEMS WITH PATIENTS

Patients have not come to visit you to discuss your difficulties or limitations.

They have enough of their own. If you're having a bad day, don't show tantrums.

It's the mark of being a professional to surpass your own problems and difficulties in order to take care of theirs.

“Learn to smile withholding your tears”. This what a doctor is all about. (Buckman)

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FOLLOW UP

Make sure your patient gets timely follow up for the problems s/he is facing.

Let him/her know to call back if any unforeseen difficulties occur between now

and the next visit.

Empathetic care will enormously bolster your image among patients in the community

Patients always need a shoulder to lean onto.

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EPILOGUE

If you have good bedside manner, people will tell you and compliment you on it.

Lack of good bedside manners in a healthcare setup completely undermines all the efforts put into patient care and generates confrontations.

Remember we can improve what we can improve and what we can improve is “Ourselves”.

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TAKE HOME POINT

Religiously observe the bedside manners otherwise be ready to be sidelined………..

“A HEALTH CARE PERSON WHO PRACTICES BED SIDE MANNERS RELIGIOUSLY, IS BETTER THAN THE PRIEST WHO PRACTICES RELIGION AT BED SIDE”. ( HUTCHISON)

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BED SIDE MANNERS