Re: Session 4 Topics

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Comments:
: : : 1. Patient-provider prototypes: : : : Paternalism- this area appears to include people of approximately 60 years and older. : : : They were raised to believe anything the provider said and not to question the provider's : : : knowledge. This patient is apt to be more compliant. In this age category, it seems there : : : is more acceptance of illness socially and more nurturing from family and friends. : : : Consumerism- this category I see as young professionals; lawyers, accountants, outside : : : of the medical profession having higher education, and a certain degree of authority and : : : power. They are used to having control. They also know they have a right to question : : : providers and have the resources to search for their own answers. : : : Mutuality- probably the best example is the one listed, health care workers. There is : : : usually a mutual respect between the two, the provider recognizing the knowledge of the : : : health care worker, and more of a willingness to "work together" when making decisions. : : : Default- people who must rely on Medicare or Medicaid. The provider has to provide : : : care under the conditions that are defined by the authorities. The patient has to accept this : : : treatment even if not pleased or satisfied, because they are unable to pay for the health : : : care otherwise. Both the provider and patient have less control which may lead to friction : : : between them. This can also lead to non-compliance on the patient's part, and a lack of : : : enthusiasm on the providers part. : : : 2. All sources of health information can be good or bad, it depends on their reliability and : : : credibility. National organizations that have research to back up their claims are probably : : : the best. Organizations such as the American Heart Association or American Cancer : : : Society have the funds to support the research that can provide consumers with facts. : : : Some sources that can do more harm than good are the "hear-say" sources. They tend : : : to relate to the "experiences" of the patient rather that the facts of the "illness". This can : : : occur when stories are relayed such as the "He said that she said...when cousin Fred : : : had...Aunt Myrtle fainted when they...Grandpa (who was 96) died when they...etc.,etc,etc. : : : 3. My "good" and "bad" patient experience will be of the same individual. Recently I was : : : assigned to care for a 50+ year old man. during his heart cath. The nurses who had been : : : caring for him told me he was grumpy, mean, non-compliant, etc., etc., etc., which : : : instantly put some dread in my mind as far as what I would encounter. I smiled at him and : : : introduced myself only to be greeted by a rather sour-looking, non-smiling face and I : : : thought, "Here we go". In the beginning I was very straight and professional but friendly : : : and encouraging at the same time. I quickly learned from his comments that: #1: he was : : : scared to death, #2: he was angry because his body had betrayed him by having a heart : : : attack, #3: he was realizing that he was not immortal, #4: he was used to being in control : : : of things and he was not. I kept at him and teased a little, gave him a little Versed (yea!), : : : and before long he was commenting how the procedure was not bad after all and we were : : : doing a great job and causing no pain. : : : As I took him to the recovery area, I squeezed his hand and wished him well. At this : : : point, he kept hold of my hand tightly and thanked me warmly. My "bad" patient of the : : : day turned out to be my "best" patient of the day and I felt good because I thought I just : : : might have made a little difference in the way he dealt with his illness.

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