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Discussion

Difficult questions

I was hoping to get some advice on what to say in the following situations and how to answer some difficult questions. I don't always have the best communication skills and kind of stumble through my replies to these types of questions and statements. sometimes I think I do ok, sometimes I can tell the patient is frustrated with me.

"Is doctor ___ going to see me tomorrow? What time? Why can't they see me now?" I don't know which specific doctor is going to round the next day and I don't really know what time, I give them an estimate of 7-8. I want to say they can't see them now because their primary team has gone home and the in house hospitalist is too busy to come to bedside just to answer a patients questions, but I don't want it to sound like i'm saying they are not important.

"How many more days until I get to go home?"

"Am I going to die?????"

how do you respond to patients who are angry that their procedure isn't scheduled until the afternoon and they don't want to be NPO that long? Once a patient asked me when his surgery was scheduled, I looked it up for him, told him it's at 1 pm, he got so angry I had to step out of the room. When I came back he was drinking water and said we would just have to deal with it. usually their response is not THAT extreme, but they often are upset and ask if they can have the surgery moved up etc. which I know isn't possible.

How do you respond to patients who are angry that another patient (confused, etc.) is making too much noise?

Are their any other difficult questions you get a lot that you've gotten good at answering?

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    When a patient asks if they are going to die, I turn it around. Usually this is a question spurred by anxiety and talking about it helps. So you ask, in reply to that question "Do you feel like you are dying?" or "Do you think you are going to die?" or "You sound nervous. Tell me what makes you ask that?" That usually gets the conversation started.

    You have to realize you aren't going to have answers for things like a patient's frustration. Don't ever give specific times. Not for procedures, not for physician arrival, etc. - because once someone is an inpatient, they are subject to the influx of emergencies pushing them back.

    "I don't know when your doctor will arrive. What can I do to get you more comfortable? Can I answer any questions for you in the meantime?"

    "I know that noise is frustrating. Let me see if I can get you some ear plugs"

    "If you drink or eat, we will have to reschedule your procedure, which may make your stay here in the hospital even longer. I know it is uncomfortable to not be able to eat or drink. Would you like some mouth swabs?"

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    1 hour ago, misha said:

    "Is doctor ___ going to see me tomorrow?

    I will let the doctor know that you wish to speak to them.

    1 hour ago, misha said:

    How many more days until I get to go home?"

    The doctors want to make sure that they have done everything they can for you. When you go home is up to them.

    1 hour ago, misha said:

    Am I going to die?????

    We are doing everything we can to help you. Is there anything I can do to make you more comfortable?

    1 hour ago, misha said:

    how do you respond to patients who are angry that their procedure isn't scheduled until the afternoon and they don't want to be NPO that long

    I know it's really hard to go without eating that long. I'm sorry you're going through this. Is there anything else I can do to make you more comfortable?

    At the end of the day, people who are sick, in pain, scared, and/or angry, are going to complain and verbalize their discomfort. And they have all the time in the world to complain and vent. And sometimes when you ask if there's anything you can do to make them more comfortable, they will say "yeah get me out of here!" You can only do so much. Try not to take it personally.

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    Good advice already has been given, but...

    I think it's perfectly reasonable to explain to someone waiting on a procedure that sometimes emergencies happen that take staff or doctors away necessitating a change in schedule. Then offer something you CAN do for them.

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    Patient: “Am I going to die?”

    Me: “Tell me what your current understanding of your situation is.”

    From there you’ll have a better idea what to talk about/educate them on.

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