I recently did a neurology placement at shenton park in the outpatients department. During my time at shenton park I worked very closely with each of my patients and got to know them quite well, as i'm sure other students have done also. I tried to establish good relationships with my patients as i believe that having good rapor will help to get the most out of treatment. However during this placment there were times where patients were speaking to me in confidence, as "friends" rather than patients, where i had to decide to either build better rapor by engaging with these patients, or maintain my professionalism by not engaging in certain areas of conversation.
The incidents i have referred to generally involved male patients making inapropriate jokes or remarks or telling me inapropriate information. Some of the comments were racial, some were sexual, some involved making a joke and some involved telling me about their past experiences. These patients must having seen me as a fellow male and as someone who would share their views and humour. I did not approve of many of the comments that were made however there were some comments that were made that had i not been the physio, i would have been happy to joke about. This was where found it difficult to draw the line, when patients were discussing things that as a professional are innappropriate for you to discuss, when in actual fact you personally have no problems with what is being said (i.e. if it were you and a mate just joking around). In these situations i had to choose to distance myself from the patient by not engaging in the area of conversation (and thereby maintaining my proffesionalism), or to build good relationships with the patients by relating to them as i would with any other friend.
In the end i generally opted to refrain from engaging in conversations that i thought may offend other staff or patients even though i personally was not offended. I found that this was most easily done by maintaining friendly conversation but simply redirecting the topic of conversation to something less offensive. In this way i was able to maintain my professionalism without making the patient feel that i was offended or disapproved of them. In some situations the patients would continue to revert back to the innappropriate topic in which case i would have to tell them as politely but firmly that it was not appropriate for that particular time and place.
As physio's we are required to be the patients friend (especially in settings where there is a lot of contact time) whilst still maintaining a strictly professional realtionship with them. As such I think that deciding where to draw the line can be quite difficult.I did make genuine friendships with some patients and would have loved to joke around with them, but felt that i had to maintain a level of professionalism.
Subscribe to:
Post Comments (Atom)
2 comments:
I can definitely sympathise with you on this one. I have had patients tell innapropriate jokes or make innapropriate comments to me on a number of occasions and it makes you feel very awkward. I find it particularly offensive when patients make racist comments, like you said.
It can be very difficult to know what to do. You certainly don't want to laugh, but you also don't want to come across as acting superior. I think its important to maintain a friendship with these patients but make it clear that everyone has different opinions and beliefs and that you personally dont appreciate racism etc... If you have a good rapport with a patient they will accept your opinions as well.
I agree with you both. I've recently come across similar patients on my neuro placement, where inappropriate behaviour is much more frequent than what I found on other placements - probably due to frontal lobe behaviour. I've found it's important to inform the patient that their comments are inappropriate for physio, rather than simply ignoring the issue and redirecting the conversation.. This is easier said than done because, as you both said, it can be quite awkward to draw attention to a patient's unsuitable comments..
Post a Comment