Recently, while on my musculoskeletal placement, I was treating a woman who had cervicogenic headaches. I met her in the waiting room for the first time and her husband was with her. I hadn't had a family member attend with a patient in the outpatient clinic before but I didn't think it would be an issue, so I didn't object when he accompanied us in to the cubicle.
From the first minute of the subjective assessment I could tellk that he was quite imposing. As I asked questions, his wife would begin to answer and then he would interupt and answer it instead. He would use comments such as 'what she means is...' or 'what she is trying to say is...' His wife was not of another background or spoke another language, she was Australian, understood me perfectly well and was very capable of answering the questions herself, she just didn't get a chance. I got very frustrated and was so surprised that this man was treating his wife in this way and that she was letting him get away with it. During the objective assessement of her Cx AROM, her husband said "you don't need to test that, she can move her neck perfectly fine, that's not her problem". I was frustrated but also felt confronted by him. I explained that I had to do a full assessment of her neck so that I can work out what may be causing the headaches. As I went through the assessment from then on I was very careful in explaining exactly what I was doing and why. Her husband was still quite pushy during the rest of the assessment and treatment but I felt that becuase I had allowed it to become an issue I couldn't just ask him to leave the cubicle.
The next time I saw the patient, her husband was there with her again. I asked him if he would not mind waiting in the waiting room and he didn't look pleased. I explained that it would be a more effective treatment if I was able to treat his wife alone as we would be able to focus solely on her neck problem, and that I would fill him on on how it went after the treatment session.
Whilst in the cubicle, his wife was much more talketive and seemed to 'come out of her shell' - I was able to do a much better session as she was a lot more relaxed and also was able to gain a much clearer picture of her headaches than I had at the previous session.
This taught me that if an issue arises, to deal with it straight away. I've had family attend while I've treated patients before in other settings and it hasn't been a problem but in this case it was. I've also learnt that communication is the key! Her husband was quite happy to sit and wait after I had explained to him why.
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1 comment:
I think what you did was fair enough. If he had behaved himself the first time then maybe you would have let him sit in on the subsequent Rx sessions. But because he caused a disturbance to you and your Rx session then you did the right thing by telling him to wait outside. Nicely put to him also, obviously he is keen on his partner recovering and you mention that her Rx will be more effective if he remains outside.
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