This blog concerns my cardio placement which was undertaken in ICU. A fellow student and I were to assess a patient who had been in the ward for at least 10 days. We read his History etc and went into his room. He was in his late 20’s and had been the victim of a punch which knocked him out. He was ‘coming around’ every so often lately so we were asked if we could perform a subjective and objective assessment on him.
On entering his room we were met by some members of his family. After introductions and reasons for being here were explained to all they willingly left so we could perform our duties. A nurse was in the room and she was performing her duties but we were ok to commence.
We started our subjective assessment. I was the first to ask him questions. And I was met with silence and a blank stare. After a few more tries I suggested to the other student (who was a female and the patient was a male) that she try the subjective questions. She got a slightly better response so we went with her asking the questions. He wasn’t very willing to engage with us overall. We persisted as best as we could and after 20 minutes the nurse was informed that we were finished. She went out into the waiting room and got the patient’s family to bring them back in. Just before we were going to leave his room he appeared more responsive and happy. I put this down to his family being back there with him. Just before we left he held his hand up to me as if to say thank you. I acknowledged this and told him we would be back to see him again at another time.
This perhaps indicated to me that sometimes it may pay to have someone who the patient is comfortable with in the room. This may help them engage or if required a family member can ask the questions on your behalf. I guess asking the nursing staff prior to seeing a patient like this can give you an indication of what kind of communication strategy you should use and more importantly if anyone should be in attendance to make it easier for all concerned!