Most of my patients are pretty old and therefore pretty deaf. Or else, they are dysarthric (slurred speech). In any case, communication is not the easiest thing in the world. My default is to come into a room talking as loud as possible, to the point where rare patients with normal hearing will ask me why I am yelling so loud.
It seems like lately, I've been cursed by janitorial staff while I'm examining patients. I'm trying to communicate with the patient, and all of a sudden, someone will come in to very, very noisily change the trash bag. Yesterday at work, it seem like every patient I saw suddenly needed their trash bag changed. Then I went to a different floor to escape, and the same guy was changing all the trash bags there too. It was like he was following me!
I don't know what the right etiquette is in that situation. I don't want to keep that guy from doing his job, which is an important and not particularly glamorous job, but I also need to be able to do mine. But I don't want to be the arrogant doctor who won't let the staff do their work.
Wait five minutes for the bag change.ReplyDelete
Five minutes is a long time to stand there, staring at a patient in silence. If I see 30 patients in a day, that's over two hours of waiting for garbage bags to be changed.Delete
Why is a janitor (or any nonmedical staff) entering a patient room while medical staff is present? How is that respecting a patient's privacy? I certainly wouldn't want to be exposed (whether physically during examination or by words being spoken about my condition) in front of any nonmedical staff.ReplyDelete
Because hospitals are busy places, and staff usually don't have the luxury of waiting for the doctor to be finished to do their work.Delete
Also, all staff working in a hospital should be trained to respect patients' confidentiality, so while it isn't ideal to have a non-medical staff person present during an exam, at the very least they shouldn't be violating patients' privacy.Delete
The other doctors working there, if any, may have a useful opinion on this problem.Delete
I agree. This is a very important point. Having another person in the room changing the trash can have a big impact on your exam if your patient is embarrassed or ashamed to say something or be examined in front of another stranger. We all have our insecurities.Delete
After a year or two doing inpatient psychiatric consults, I finally decided to ask people to come back if they came in to do something in a patient's room (including other doctors and nurses) while I was in the middle of a consult. I really don't want to be thought of as an asshole, but it's my job to do the right thing by my patient, not to be the nicest doctor in the hospital.
What do you do if your patients are in ward rooms, then? If you're doing a consult in bed 3 it's not really fair to the patient in bed 2 to have to wait for their doctor/nurse...Delete
As a patient, I remember staff coming in to change the trash bags very loudly around 5am daily. They made no effort to be quiet and it was quite frustrating. I wrote some feedback about it very politely when I got my survey.ReplyDelete
As a therapist, I frequently run into people trying to wax or wet mop the floor while I am in the patient's room. I am usually standing and they will just mop around me. I'm pretty sure it's not very safe, and it is at least a bit awkward, but like you said I realize these people have a very unglamorous job.
Great this is wonderful information Thanks..ReplyDelete
If you enter the room & feel that you can't do your job without more quiet/privacy, is locking the door an option? I guess you'd only do this if a. the patient didn't pose a risk to you, b. someone -eg. a janitor- was likely to enter and make noise during the consult. (Would placing the trash-can outside, before locking the door, be doable?)ReplyDelete
Or maybe carry your own 'please do not disturb-examination in progress' to put on the outside of door.ReplyDelete
I like this answerDelete