I have a ‘pet project’, I really want to see “Please bear with me, I have known trauma” cards brought into all medical settings (especially hospitals and dental practices).
‘Exemption’, ‘the action of freeing or state of being free from an obligation or liability imposed on others’…
Such an exemption card might just help to regulate and support people who, especially in alien environments, need additional back up; need to offer an “explanation” - WITHOUT offering an explanation!
This year we have had the misfortune of encountering first hand how someone who has known trauma is “managed” in a health care setting. The verdict is…very mixed, some good examples but some really concerning and worrying issues.
Let's explain. C was taken ill, which in itself is actually an indication of how she has ignored health care for herself as a result of previous experiences in medical environments. Anyway, she was unwell to the point of needing hospital treatment. We went together, because she would not go otherwise. The overall picture was a day and night in the emergency department and 3 days on a ward.
So, what have we learned? Sadly, things we already knew but experiencing them together has highlighted to C that this is not "paranoia" or her "being difficult" which she has always believed.
What went well?
It was understood that she needed a support person with her, and this was not challenged. There were a few members of staff who recognised the signs of her finding things hard and asked what they could do, on being told, they were both empathic and kind. Offering clear descriptions of what was happening and why, to reassure.
In the ward as part of a care plan she was asked about any current abuse and anyone she needed to prevent contacting her during her time there. This was reassuring, although the timing of the conversation was challenging.
We have encountered kindness, especially from nurses, in the follow up appointments that have occurred but I do wonder at the impact at having a second person with you and how some people don’t have such a choice available.
Our local surgery advertise that ‘chaperones’ are offered to patients if needed, but are these surgery employees? Would they be ‘impartial’ if the patient was struggling with the clinician? How supportive are they to your needs?
What was difficult?
The all male ambulance crew for starters.
The conversation about abuse in the middle of a 5-bed ward, once this was written down, C overheard the information being shared between nurses by another patient's bed, leaving her feeling very exposed. The timing and sensitivity of this information and place to share it needs careful thought.
A change of shift brought with it a new staff member who was insistent that C change into a hospital gown, having already had multiple intimate tests. When I challenged, she could only say that "we like it, but it's not policy”. The more junior nurses were far more understanding and reassured that it was fine to keep your own clothes. We don't want to be difficult, but an awareness of how vulnerable and the lack of control that people experience is vital and providing any safety should be paramount.
As the ‘support person’ I was very tired (after such a long night in A&E) and my temper was fraying - but even I began back-peddling when it felt like this new duty staff member potentially had influence over C’s ongoing care. I became slighting paranoid and very apologetic, mimicking the feelings that C has always believed about herself hey!
At another follow up appointment, I perceived ‘impatience’ from the technician, and just a total LACK of what might be the impact of nudity…touch…on the patient.
Have you had one of these tests previously? How did you find it? Would be really pertinent questions to ask, to establish how the person sat in front of you might be feeling in that moment.
It’s common sense, surely?!
We need to redress the balance, we need to give the patient back some power; a “Please bear with me, I have known trauma” card would offer an explanation for certain behaviours…and might just encourage the member of staff to show a bit more patience - to their patients eh!
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