Tuesday, January 31, 2017

Nothing about Me without Me

FLASHBACK SERIES: Blog posts written during my medical school days at Pacific Northwest University - College of Osteopathic Medicine

by Kim Ha Wadsworth, OMS III

An attending physician is doing morning rounds with his health care team comprising of nurses, residents, and students. The group of eight stops in the hallway outside a patient's room to discuss the case. The patient is sleeping, but her family members overhear parts of the team's conversation from inside their room, something about "IV" and "herpes positive." Her family members do not understand what is going on and wonder if the team is saying that she is an IV drug user and that she has a sexually transmitted infection. In reality, the nurse is simply reporting a problem with the IV line during the night which was promptly fixed, and the resident is reading the lab test results that indicate positive for Herpes Simplex Virus 1 (typically causing "cold sores") but negative for HSV2 (common cause of genital herpes).

Communication in the healthcare setting is a delicate balance between privacy, efficiency, clarity, and synchronicity. In a patient-centered approach, the healthcare team prioritizes patient safety and understanding. As such, any information about the patient should be discussed in front of the patient, with further explanation as required for patient education. "Nothing about me without me."1 Informed, shared decision-making is the crux of patient-centered care.

1 Delbanco T, Berwick DM, Boufford JI, et al. Healthcare in a land called PeoplePower: nothing about me without me. Health Expect. 2001;4:144-150.