Dear Junior Doctors,
First things first, thank you. Thank you so so much for taking your time and making the sacrifices you do to become a doctor. I hope that you’re enjoying your training and feeling the difference you’re making. I’m writing this blog as a mum in hospital with her sick 12 week old son. As we’ve spent more time here than at home, I’ve seen A LOT of you guys, especially as my son has multiple diagnosis that are uncommon and rare. He’s great to learn from and I get that because I was just about to finish my nursing degree when he made an appearance. Before I go on, the majority of my time in hospital my son and I were very well cared for and I had great confidence in the staff. These are just a few blips I noticed occasionally.
So here’s observations I have made from the patients perspective, or should we say as my sons advocate.
1| “Hello, my name is…”
Now, as a recent healthcare student I know all about the “Hello, my name is” campaign by the amazingly strong Dr. Kate Granger, and you should too. However, during our stay there were more than a few occasions Dr’s did not introduce themselves. Often it was “Hi, is this Jaxon? I’m here to take it bloods”. So wait, who are you? A lot of the time I would have to ask “So are you the doctors looking after him today?” and try to discreetly tip my head upside down to read the name on the badge hanging from their lanyard, which often had a no named card in front of ID. This can really get us off to a bad start because I can get slightly defensive when someone just comes and tells me what they are going to do to my child, without telling me who they are. Don’t get me wrong, many Doctors did introduce themselves but it’s worth mentioning because ALL should. And it could really help because it’s the start to building rapport with the little lion cubs mama.
For more information on the #Hellomynameis campaign : https://hellomynameis.org.uk
2| Reintroduce yourself
This may seem tedious and it is not as important as other points I’d like to make but it follows on from the last. Being in hospital for more than a week, or even during a week, we see many doctors and healthcare professionals. General paediatricians, junior doctors, medical students, specialist consultants, play specialists, dietitians, support workers and more. I may have met you, you may have introduced yourself once before, I may think you’re great. But I’d much rather refer to you by name when asking a nurse for you or telling family members about you, than “the one with brown curly hair that saw him that time in that other room”. Rapport. Obviously after 3/4 times I’m not going to need you to keep introducing yourself, but you know, more than once at least please.
3| Examinations. Be gentle.
Ok so more mama bear, but this is reality. I know he’s not as fragile as he looks and I’ve watched him have lumbar punctures (yes more than one, 3 actually!), his heels pricked over 100 times (sadly I’m not exaggerating), cannulas inserted in every limb, clamps on his eyes for the ophthalmologist and much more. But that one junior doctor that came in and pressed so hard on his chest with a stethoscope that it left a mark and scrunched up his tiny 10 week old skin, will always make my blood boil. I know you can hear his heart by just resting the stethoscope on him, apparently you do not. Maybe you were nervous and tense and used to adults. I understand. But in future, for all other medical students, please, be gentle until someone tells you that you need to be otherwise. Better to be gentle and told by your senior to be a little more rough, than to be too rough and cause harm or distress (to mum more than baby).
This one is huge and should maybe have been number 1. Would you repeatedly try to insert a cannula in different parts of the body on an adult without informing them and gaining consent? No. My baby cannot consent, that is what I am here for. Ask me. Talk to me. I totally understand that bloods are needed and don’t get me wrong if we’re talking sepsis screening and he needs a cannula inserting for urgent reasons, then of course get it in. But, if its repeat bloods and you prick my baby more than 3x for 3 bottles with him screaming and don’t ask me for permission throughout and to continue, I’m going to want to prick you 300 times. I am his parent, his guardian, his voice. If you want to do something to him, you ask me. It’s highly unlikely I’m ever going to say no as it’s regarding his health. But there are occasions where I will say that’s enough, come back later for more. And if you’ve asked, I won’t see you as a heartless narcissist, which usually helps with future encounters.
I’ve mentioned this a couple of times, all of the above build rapport. But another recommendation from mum, is to ask a couple of questions to gather her background. Numerous occasions a lot of time was wasted explaining to me in intricate detail what LFTs, U’s&E’s, “salts in the blood” etc are. Whilst I’m not a doctor, I’ve spent three years training to be a nurse in 11 different settings and signed off over 2000 hours spent with patients and doctors, I know the lingo. Get to know a little about who you’re talking to. Some people want/need everything explaining, some people it goes over their head, for me I just wanted to cut to the results. I imagine Doctors are parents too (impressive!), so imagine breaking everything down to someone with the same knowledge as you. Spare a couple of seconds to ask what the patient wants to know. Not only does it tell you a little about who you’re talking to and build a little rapport showing an interest in getting to know them, it could also save you a lot of valuable time that you can spend elsewhere (which you need!).
Don’t forget the basics genius’! My favourite doctors were the ones that very simply came in, introduced themselves, asked how I was doing and what I understood, explained in a way that made sense to me as an individual, gained consent with everything and talked me through what they were doing with my precious child as well as sharing their thoughts. These doctors I’m speaking of were usually the ones that were consultants and had learnt this through years and years in practice. Now don’t get me wrong, not everyone is the same and that’s why it’s important you converse to know what the patient/carer wants and needs from you. Some people prefer not to know things, some people need to understand everything, others might hold you to your thoughts and complain when what you said isn’t quite right (a lot of the time I found myself saying “what do you think it is? I won’t hold it against you if it’s not right!”). However, these are the very basics that can save you time and build a relationship which can benefit you and the patient.
I have also written about breastfeeding Breastfeeding: No need to feel #Guiltitties (for those struggling with breastfeeding) and positive quotes Quotes to make you feel better on bad days (most people need to read this)