Sunday, September 27, 2009

Identity theft

I've just remembered some things that particularly struck me during my Paeds rotation.

On ward rounds, the doctors would always say hi to the parent/s (usually mother, but sometimes father) - but instead of greeting them by name, they'd say, "Hi Mum, how's little Johnny going today?" I saw this time and time again - in fact, I never once saw a parent referred to by their name. I felt bad for the parents. Sure, the child is the one who's sick and needs attention, but it's damn hard for parents to give up work, or caring for their other children, to spend time in the hospital. And on top of all that, they lose their identity and are reduced to the generic "Mum" or "Dad".

I also felt bad because the parents often have no idea how long they'll be staying in hospital - that's par for the course, as it really depends on how quickly the child recovers. But for a parent who's never experienced this before, it must be so frustrating and daunting. Each day they wait for a visit from the doctors - sometimes first thing in the morning, often not before midday - to discover their fate, and often they're disappointed to find that they're stuck in the hospital for another day, or a weekend if it's Friday.

A couple of patient encounters particularly bugged me:

  • One 3-year-old child had been in hospital for weeks, and his poor Mum looked frazzled. I ended up taking a detailed history from her, and found out that she also had a 4-month-old child, had recently split from the father of the second child, and was going through a bitter legal dispute with him (he had assumed custody of the child). She had to sit there and entertain her sick, bored and cranky child each day, while also trying to deal with these legal and relationship stresses. I don't know how she did it. In the child's notes I was pleased to see that these issues had been identified, and that the social worker was involved.

  • During my farcical week of surgery, we went on a lightning quick ward round. One mother was confused because two groups of doctors had been to see her. Who was in charge? Who should she believe? It was clear that she had questions, but the doctors blew her off and she was left floundering. Another student and I trailed out of the room behind the team, and he said to me, "How would you evaluate that patient encounter?" I said, "Possibly one of the worst I've ever seen." He agreed. It was tempting to go back into the room and have a chat with the mother, but who were we to do that? We didn't have the information she needed. I wish I'd spoken up, but I'd only just met the doctors on my team - in fact, they hadn't bothered to give us their names, and never asked for our names. (That's a pet hate, by the way - it happens all the time.)
So endeth my random observations.


*C said...

And if their not the mum or dad, are they just "hey you!" They're dreadful stories. Addressing someone by their names is just well mannered.

PS. Happy Birthday. And no, I'm not psychic; I just saw the news on PD!

Lorraine @ Not Quite Nigella said...

Oh yes using names is such a nice touch. You actually feel like a person then (which is a nice concept).