How to talk to patients during your hospital work experience placement

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how talk to patients during hospital work experience Communication skills are terribly important for doctors. But what about your first ever encounter with patients? It’s likely to occur on a hospital work experience placement before any formal communications training.

I’ve just finished a ward round and am writing this over a quick cup of coffee before my first theatre case is anaesthetised and ready to go.

On the round we saw a variety of patients ranging from the very sickest patients in the hospital (that are not expected to survive their admission to hospital), to young, healthy individuals who have come in for a daycase operation today and are expected to leave tonight before I do.

Each patient I spoke to required some element of communication and in each case the skills required were slightly different.

Sometimes, as doctors we need to think about the communication skilks needed beforehand but most of the time we’re on autopilot.

So for example this morning I had to:

  • break some bad news to a dying patient
  • explain to some anxious parents that their daughter would probably be ok after we operate on her but that there is a 2-3% chance of something going wrong.
  • answer a young mans queries about when he can return to work after he is discharged
  • ask a 5 year old boy about his symptoms, to determine whether he is getting any better

I remember the first time I had to speak to a patient. I was 16, doing some hospital work experience. The junior doctor I was shadowing, probably bored with my incessant questions, asked me to have a chat to one of the patients. The patient it turned out was an elderly man with advanced cancer of the scrotum.

I remember being embarassed and finding the conversation difficult. The patient was nice enough and quite chatty but I found the whole experience hard. Why? Probably because I didn’t really know what to say or what to expect from the interaction.

One of the things medical school will teach you (if and when you get in) is a brilliant set of skills for communicating in any situation. As mentioned above, I barely think about my communication any more as it has become second nature.

But what if you are a work experience student, speaking to a patient for the very first time?

Here’s a simple set of rules you can use during your attachments to keep you looking smooth, maximise the benefit you get from patient interaction, and prevent too many awkward situations.

 

Rule 1: Remember you are not a doctor or a medial student (yet).
You are in a protected situation and can always let your supervising doctors know when you feel uncomfortable or need a break. Only get into patient interactions under supervision and where you feel comfortable. If you haven’t had any work experience yet, don’t worry, it’ll become pretty obvious when you start.

Rule 2: Keep your role clear
Always introduce yourself as a school or college student who is here to learn about medical careers and never as a pre-med or medical student. Mention the school or college you’re from to help keep things perfectly clear to everyone.
That way everyone is clear, and nobody expects you to do anything except smile and ask occasional questions. Easy.

Rule 3: Check
If you get into any patient interactions, (and you should if possible) after introducing yourself, check that they would like to chat. Don’t force yourself upon them, they may be tired, in pain, or upset.

Rule 4: Talking doesn’t necessarily have to be about investigations and diagnosis.
When chatting to patients, try and enjoy the experience. You don’t have to talk about their illness, sometimes patients prefer a good talk to take their mind of their immediate problem. Not all patients have visiting friends or relatives either. Hospitals are full of lonely people. Perhaps you can lift someones spirits for a moment or two.

Rule 5. Get permission
If a patient has an interesting illness and you wish to ask them about it ask the permission of the doctor looking after them first. Following that, ask the patients permission to ask talk about the reason they’ve come to hospital before you start asking any deep and meaningful medical questions.

Rule 6: Go with the flow
Let the patient lead the discussion about their condition. They’ll tell you everything they know in most cases. You can follow this up with further questions if you are interested in any particular aspect. For work experience students, questions are more useful when they are about the patients experience or feelings about their disease rather than specific symptoms or signs.

Rule 7: Escape (if needed)
End the discussion politely and promptly if you need to escape.
Normally you’ll be accompanied by one of the medical or nursing staff but occasionally you may need to end the chat very quickly. This may be for one of the following reasons:

  • You begin to feel faint. (a combination of a warm hospital ward, strange smells and visible drains or wounds can have a funny effect at times)
  • The patient becomes aggressive or unpleasant.
  • The patient becomes suddenly unwell. (In this situation you should alert one of the medical or nursing staff.)

If you hear about any interesting conditions or diseases, make a point of asking the junior doctors to explain a little more about it or perhaps read further. Make sure to keep some notes too, as this is all valuable material for your personal statement and interview.

That’s all there is to it. Stick to these principles and you’ll feel comfortable in your very first patient interactions and get the most out of your work experience.

Enjoy,

Leo

PS: I hope this helps keep you out of trouble. If you know anyone about to embark on some work experience or similar, pass on the advice, there’s an email link below. You might save someone’s day (or career!).


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I know it’s early but have you had any communication skills disasters yet? I have a few to share but I’ll see what others come up with first!

 

  • Jimmy Sa

    As a third year me student, I told a patient he’d probably had an MI when he had indigestion and was waiting for an ECG. I think I almost caused him to have one…

  • Helen

    Thanks. Will be great for my sister who has har GP placement next month

  • Phil Higgins

    I remember one of the secretaries misspeling the word “circumcised” on a patients letter.

    She wrote that “urological examination revealed that the patient is circus sized”

    That upset a few people but mainly got laughs from all the urologists

  • Rajan

    One of my consultants on work exp told me how a patient tried to sue him for not explaining something fully prior to surgery.
    Communication skills are the most important skill set that one develops at med school.

    Excellent post to keep people out of trouble Leo!