For immediate release: Wednesday, 6 November 2013
Doctors involved in end of life care should show that they care not just for the patient but also about the person.
Dr Euan Paterson, a GP facilitator with Macmillan Cancer Group, looks at the challenges of providing palliative care in a two-part series in MDDUS membership magazine Summons.
According to Dr Paterson, doctors should recognise the humanity in the individual under their care and, by drawing on their own experience of vulnerability, they can provide more compassionate care.
“For many doctors, palliative care is one of the most important and difficult aspects of their job,” says Dr Paterson. “Though the number of dying patients an average clinician will treat may be relatively small, the impact of a death for all those affected by it cannot be over emphasised.
“Dying patients and their loved ones are extremely vulnerable and good trusting relationships between all those involved are crucial to their wellbeing.”
As Dr Paterson explains, there are two key issues that promote a trusting relationship. “Firstly, the patient has to think that the professional is competent. Secondly, the patient has to feel that the professional genuinely cares.
“It is hard to think of any time more critical than the end of life when it is important to demonstrate not just caring for the patient but about the person – the need for compassion, the need to recognise the humanity in the individual under their care.
“Why does lack of compassion feature so frequently in patient complaints? It’s unlikely that most doctors lack the interpersonal skills necessary to demonstrate that they care.
“They should remember the vulnerability patients are likely to be experiencing. It is likely to be far removed from where they are in their own lives. What is routine and mundane for healthcare staff is likely to be unique and strange for patients.”
Dr Paterson continues: “The need to empathise underpins compassionate care. To metaphorically put on the patient’s shoes – think what they might be thinking and feel what they might be feeling – will afford a glimpse of the patient’s likely vulnerability.
“All doctors will have some experience of vulnerability and trying to remember how that felt will lead to more compassionate care.”
Demonstrating care can be relatively straightforward. Indeed, a risk is that this is so obvious it may get overlooked, particularly in the increasingly busy, indeed hostile working environment.
“Opening a door for someone, waiting to sit until the patient is seated, helping someone on with their coat – politeness and the simple courtesies can go a long way,” says Dr Paterson.
“Adding ‘a little touch’ to each encounter by doing something that is not task orientated but simply nice, an ‘unbidden act of human kindness’, will help the patient to feel genuinely cared about.
“Doctors can also make care much more personal by allowing patients to see the human behind the professional facade. The unrequested home visit when the GP ‘pops in’ or the consultant just pausing at the patient’s bedside – can be extremely powerful and therapeutic demonstrations of that individual’s importance.
“Unquestionably, doctors do not lack the knowledge or skills necessary to demonstrate that they care. However, the questions remain – will doctors choose to use their abilities? Will they choose to care?”
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