Comms 1 (ICE) Flashcards
Why do we need to learn about communication?
Receive information from patients
Communicate with other healthcare professionals
Communicate information with patients
What are some of the factors that affect the interaction between HCP and patient?
How you're feeling How well you know the patient Your knowledge and skillset Embarassment Your personal beliefs and morals Language barrier Bias and prejudice
How might personal values and beliefs of the patient affect the consultation?
Abdominal pain in females - not just gynecological
Confirmation bias - you want something to be true
Contraception - underage sex
Blood transfusion - Jehovah’s witnesses
Mental health - patients may come in with physical symptoms
Why do we give medical diagnoses?
Makes us feel good to be able to produce a definitive diagnosis and a plan of action?
Why do patients want a medical diagnosis?
They are anxious about what they could have
It gives them peace-of-mind to have an answer
The consultation itself can be a form of therapy
What does it mean to have ‘cognitive ease’ in a consultation?
We have seen something before and given a successful treatment, this gives us peace of mind when we see it again.
Every patient is unique but patterns emerge.
Why is it important to consider ICE?
Every patient doesn’t simply come with symptoms, they will come with ideas, concerns and expectations about their symptoms.
To get a mutually effective consultation we need to:
Consider and address a patients’ ICE
Recognise our own and not them dominate
Instead share them and come to a conclusion
What are some questions that you might like to use to involve ICE?
What brought you in today?
What can I do to help?
What were you hoping I could do for you today?
How is this affecting you and your daily life?
What are some of the questions the patient might have asked themselves before they have come to see you?
What has happened? Why has it happened? Why has it happened to me? Why now? What should I do about it? Should I go to the doctor? Is it serious? Can it be treated?
How does how I’m feeling as a HCP affect the interaction with a patient?
Physically unwell - difficult to make decisions and maintain motivation
Emotionally stressed - morale is low and demand from patients is high
Emotional impact of a distressed patient
Fearing patients
What are the costs of a diagnosis?
Patient’s perception of themselves and their abilities can be altered quite markedly for the worse.
e.g. higher sickness absence, increased helplessness, cut down in sport participation, increased panic attacks
What are heartsink patients?
Especially difficult patients, usually frequent attenders with incurable problems, demanding that you do something for them.
How do you give your patients your commitment?
We cannot commit ourselves deeply to every patient with whom with come into contact or we would be swamped.
However, we must give each of them a degree of commitment.
We must judge the appropriate level of commitment that we need to make to an individual who seeks our help.
What is an attitude?
Considered and permanent disposition or reaction to a person or a thing.
Often very visceral and instinctive.
Can change.
Govern our behaviour.
How to self-analyse after a consultation?
Do I know significantly more about this patient than I did before they came in through the door?
Was I curious?
Did I really listen?
Did I find out what really mattered to them?
Did I explore their agenda, including their beliefs and expectations?
Did I make an acceptable working diagnosis?
Did I use what they thought when I started explaining?
Did I give them the opportunity to be involved in decisions?
Did I explore their understanding of the treatment?
Did I make some attempt to check that they really understood?
Did we agree on the diagnosis, the management and the follow up?
Have I recorded the important information?
Was I friendly?
Did I do this in an appropriate timescale?
