Using technical jargon with patients-EYE OPENER

Nurses General Nursing

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I had an experience today that I thought should be shared because it was such a powerful lesson. Yesterday, I had to attend a customer service training session that showed a video of a man talking about the loss of his son due to a med error. He did not want to sue the hospital, but wanted to use the opportunity to teach the staff what could have been better about the handling of his son's case. He said two things that stood out-Statistics make no difference to a family member when their loved one lay dying, and that a healthcare professional should never assume what a patient can understand about their family member's condition.

Today, I was working med/surg and was caring for a man who was not improving despite aggressive treatment of his condition. We spoke with the POA and it was decided that comfort care only was in order. Everything seemed to be in order, but some more family arrived and the POA was unable to explain to them why comfort care only was being given. Some felt we were "killing" him. I called the MD and arranged a family meeting, but by the looks on their faces, they were still not understanding. The MD was using a lot of jargon and statistics about his chances of survival. After she left, I stayed and slowly explained lab results and other things in plain English. After about one hour, one family member caught me and told me how "outstanding" I was that I took the time to listen to their concern and that I didn't treat him like a statistic.

It's a powerful thing to know you've made a difference in someone's difficult situation, particularly when the easy way would have been to simply say, "they just won't get it.". I'm glad that the training made me more aware of jargon use, and that a family may rest easier knowing absolutely everything was done to try to save their loved one.

His explanation worked well enough for the family to take the time to thank him and send him a box of chocolates.

But I agree with you, too, Leslie. Simple, clear explanations are usually the best.

Again, I suggest having the patient/family tell you in their own words what you just told them. That's when you can see if they really got it or not. Two minutes of communication follow-up can give you a second chance at bat if they haven't truly understood.

I used this technique with my kids for many years, and, boy, did it work wonders.

miranda, no one is disputing roy's kindness...and that is what the family was thanking him for.

i know roy, and i can understand why families/pts would be impressed with him.

i was hopefully giving him something to consider...

it'd take less of his time, and keeping it simple, enables the families to hear what they need to.

you should've heard my explanation about the birds/bees, to my kids when they were little.

i believe i was a little too graphic, and it wasn't pretty to a 6 yo.;)

i do believe i scared the living hell out of them, since 2 of them cried, "do i have to do THAT??", while the other one simply said "yuck".

since then, i've learned to keep it simple.:)

leslie

you should've heard my explanation about the birds/bees, to my kids when they were little.

i believe i was a little too graphic, and it wasn't pretty to a 6 yo.;)

i do believe i scared the living hell out of them, since 2 of them cried, "do i have to do THAT??", while the other one simply said "yuck".

since then, i've learned to keep it simple.:)

leslie

:hpygrp::dncgbby::hpygrp: That's how I used to milk more time out of bedtime when I was a kid- about 7 years old... just ask poor mom about where babies came from, and I was up for another hour :D And yes- it scarred me for life :D

:hpygrp::dncgbby::hpygrp: That's how I used to milk more time out of bedtime when I was a kid- about 7 years old... just ask poor mom about where babies came from, and I was up for another hour :D And yes- it scarred me for life :D

when my dtr was 3, we were in the supermarket.

i pregnant lady walked by and tiff asks if she/lady had a baby in her belly.

when i told her yes, she then asked me how 'it' got in there.

i thought i'd give her a 3yo response, by responding with, "the daddy put a baby seed in her tummy, and the seed grew and grew til it was ready to come out. (she hadn't been buying the stork story.:lol2:)

even w/something so simplisitc, she just looked at me and gave me a quiet "oh".

it was when she was 6 and her brother (who's 9 mos younger) went nuts on me after hearing my very graphic story.

fwiw, i told them both, with a grimace on my face, "no...you don't EVER have to do that.

now that both are 21, and i think they've changed their minds.

leslie

Specializes in ICU.

I just read MomRN's reply. A "DNR" does not mean "no care." It simply means no ventilator, no code drugs, and in some cases, no CPR. It does NOT mean you can't give meds such as cardizem, etc. You still treat the problem. You still do everything you can for the patient. I don't see how a DNR in this case meant "don't do anything," of course you would still try to convert the atrial-fib, unless the patient did not want that either. Even if you had called the doctor and said this patient wants to be a DNR, you still would treat the atrial fib~ you simply wouldn't place the patient on life-support.

I just read MomRN's reply. A "DNR" does not mean "no care." It simply means no ventilator, no code drugs, and in some cases, no CPR. It does NOT mean you can't give meds such as cardizem, etc. You still treat the problem. You still do everything you can for the patient. I don't see how a DNR in this case meant "don't do anything," of course you would still try to convert the atrial-fib, unless the patient did not want that either. Even if you had called the doctor and said this patient wants to be a DNR, you still would treat the atrial fib~ you simply wouldn't place the patient on life-support.

Exactly why detailed advanced directives are needed :) Not just no CPR, but IV fluids, tube feedings, dialysis, chemical interventions, etc.... If I'm ever circling the drain, they need to turn out the lights, and go get some coffee... :D And my POAH knows it :D

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