Sensitive Discussions with Patients Depending on the patient and their condition, there may need to be a sensitive subject discussed with them. You need to be comfortable speaking with them, so that they are put at ease, and the more often you have these discussions, the easier it will become. Medicare and Insurer Questions Medicare and some other insurance companies require a series of what some may consider personal and invasive questions. Considering almost all of the Medicare patients are 60+, it may be that they are not comfortable discussing their younger and more flamboyant days with a younger person, or even a person of their own age. The look on the face of a 70-year-old man, with his wife in the room with him, can be one of a deer in the headlights, when asked how many sexual partners he had in his life. You can just see him thinking, what do I say? There are a few tricks to help ease the tension around some of the more invasive questions. First, explain to the patient that these questionsare a requirement of Medicare or their insurer, and you are simply doing what is required in your job. Next, if it seems appropriate, any questions that could be embarrassing to answer in front of a spouse of other family member, jot it down on paper, and show it to the patient, giving them an opportunity to write an answer if they prefer not to verbalize it. On one occasion, an 84-year-old woman was asked about the number of sexual partners in her life, while her 25-year-old granddaughter expected her to say her one and only true love, her grandpa. The elderly woman said she would estimate about 20, her granddaughters face turned every shade of red imaginable. Some things are just better left unsaid, and put on paper. Other health related questions that need to be recorded for the physician can also put some patients into an uncomfortable state of mind. Questions regarding bladder incontinence or bowel habits are very important for the physician to know, but some patients are reluctant to discuss them. Be very factual, and type information or write as you ask, sometimes the best approach is not to maintain eye contact with certain topics. Related: Healthy Food & Drink Choices End of Life Discussions When a patient receives a diagnosis that involves a terminal illness, it often does not register with them right away, and they need some time to process the information. In most cases they schedule a follow up visit with the
physician, however quite often the nurse is the first point of medical contact after the diagnosis. You may have orders to discuss DNR’s and other subjects relating to end of life care, and while it’s not a great subject to discuss, it is a necessary one. If other family members are present, it can be quite difficult, and it’s something that unfortunately must continue. Give the patient and family a break if at all possible, stepping out of the room for 10 minutes can allow them time to discuss things privately. Cover the subject, and then move on, however be sure to ask the patient and family if they have questions of concerns that need to be addressed. As a nurse, there will be times that sensitive subjects must be discussed with patients, its simply part of the job. Combining sympathy and understanding with professionalism is the approach that works best for most patients and health care providers. Social workers may also be available to assist in discussions involving end of life care, and in many cases, it is better to involve them from the start. Not every conversation with a patient is going to be pleasant and simple, but these conversations are necessary and a part of a nurse’s job. We take the bad with the good, and remember that questions and discussions are for the good of the patient. Related: International Nurses Association - What's Your Superpower? Tshirt
Please follow us on Facebook, Linkedin, Pinterest and Twitter