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    (Original post by Helenia)
    There's quite a difference between a (student) nurse-led pre-admissions clinic consultation and a doctor-led one...
    I am aware of that, even though i had my own one to one time, doesn't mean i was aware of the other members of staff what they had to do. A quick squeeze of the hand, or a smile can make a massive difference
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    (Original post by Subcutaneous)
    I am aware of that, even though i had my own one to one time, doesn't mean i was aware of the other members of staff what they had to do. A quick squeeze of the hand, or a smile can make a massive difference
    Of course it can, and that's just something that should be natural as a human being.

    However, you can smile all you like, it's not going to stop someone in mid-flow about all the medical problems they've ever had and how you are the only doctor who's going to be able to sort everything out... In fact smiling probably makes that worse
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    (Original post by Helenia)
    Of course it can, and that's just something that should be natural as a human being.

    However, you can smile all you like, it's not going to stop someone in mid-flow about all the medical problems they've ever had and how you are the only doctor who's going to be able to sort everything out... In fact smiling probably makes that worse

    No it won't cure them..blatently. However when it comes down to compassion and care, as much as you have a job to do and make sure it gets done, its doing it WITH compassion and care. Ie when doing a catheterisation, being aware of the patients dignity, privacy, maybe for those having long term catheters. When breaking bad news, doing it appropiately- just explaining what you're doing and why whilst you're doing it can help ease the paient and let them feel incontrol of what is happening. You don't have to spend an extra 5 minutes sitting down with them and having a cup of tea
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    (Original post by gildartz)
    Good point, but i guess it's debatable whether small acts of compassion such as the ones you noted will have a considerable effect upon someone in a critical condition.

    In his statement, the archibishop aknowledges that most people are grateful for the compassion shown by the NHS, but it's simple stories of doctors in some hospitals not acting with compassion that leads him to the conclusion that the NHS as a whole needs to act with more compassion. So I guess that would raise the question as to why the entire NHS should be attacked when most of the time, doctors do act with compassion.
    I can only give an example from my own experience.

    A patient was lying semi-conscious while I was doing his obs. He looked so sad lying there and appeared completely oblivious to my presence. I felt really sorry for him and took his hand and held it for a few seconds. He tightened his hand around mine, smiled and seemed to relax.

    It only took a few seconds but I hope that in some way I brought some comfort to him.
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    (Original post by Subcutaneous)
    No it won't cure them..blatently. However when it comes down to compassion and care, as much as you have a job to do and make sure it gets done, its doing it WITH compassion and care. Ie when doing a catheterisation, being aware of the patients dignity, privacy, maybe for those having long term catheters. When breaking bad news, doing it appropiately- just explaining what you're doing and why whilst you're doing it can help ease the paient and let them feel incontrol of what is happening. You don't have to spend an extra 5 minutes sitting down with them and having a cup of tea
    *sigh* Never mind. If you think that we all just whack catheters in with the curtains open and no explanation, or run round our ward round saying "Hi, you've got cancer, bye," my going over it again and again is not going to change your mind.

    I doubt you'll find many people on here who disagree with you about treating patients with care and dignity. It's just not always as easy as you might think.
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    (Original post by Phalanges)
    This from the catholic church, whose compassion extends to dealing sensitively with people going through serious difficulties in their lives by forcing them to do hail mary's and confess, damning people to eternal damnation for any number of reason, and extending about as much compassion to those critical of them as the Romans did to Jesus.

    Maybe he should get his own house in order before trying to attack others.
    Maybe you should stop stereotyping a whole organisation that has brought far more comfort and help to people than you ever will.

    And for the record, most people who have confessed their sins and received absolution are glad to say their penance in gratitude. Those who don't like it tend to move on to other pastures.
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    (Original post by Helenia)
    *sigh* Never mind. If you think that we all just whack catheters in with the curtains open and no explanation, or run round our ward round saying "Hi, you've got cancer, bye," my going over it again and again is not going to change your mind.

    I doubt you'll find many people on here who disagree with you about treating patients with care and dignity. It's just not always as easy as you might think.

    did i say this is what i think everyone or even doctors do? Please don't jump to assumptions

    I was making the point as much as its ahrd to make time for patients and delivery the best care and treatment you can, what you can do- do it right. Believe it or not a lot of professionals do forget to close the curtains when helping a patient get changed, and will leave a patient on a commode as they've gone on their break-
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    (Original post by puddlejumper)
    Maybe you should stop stereotyping a whole organisation that has brought far more comfort and help to people than you ever will.

    And for the record, most people who have confessed their sins and received absolution are glad to say their penance in gratitude. Those who don't like it tend to move on to other pastures.
    Tell me, are the teachings on contraception and abortion not a central tenent of the Catholic faith?? Of course, I know individuals who do what they like, but there is not organised 'other interpretation'. Such teachings in Africa are to put it mildly less than helpful in steming the AIDS epidemic. However you don't see the Pope go and confort African families now do you??

    It always puzzles me, you wouldn't trust someone who wasn't a architect/builder/otherwise qualified to manage building your house, so why trust the teachings of a lifelong celibate on sex?? All religions are characterised by the wish to indoctrinate the young and sometimes crass inflexibility.
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    (Original post by Subcutaneous)
    did i say this is what i think everyone or even doctors do? Please don't jump to assumptions

    I was making the point as much as its ahrd to make time for patients and delivery the best care and treatment you can, what you can do- do it right. Believe it or not a lot of professionals do forget to close the curtains when helping a patient get changed, and will leave a patient on a commode as they've gone on their break-
    With the greatest of respect, as a student you don't truely take responsibility the same way as a RN would - you might emulate that reponsibility, but when the **** hits the fan, your supervisor is responsible for you. Not so when you're qualified. To pretend otherwise is not compatible with probity.
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    (Original post by Subcutaneous)
    Its also important to bare in mind, many religions have a spectrum of beliefs, from fundamental to liberal- different catholics hold different views, it's very common
    Sigh. You really like care models and ICE and theory etc don't you?? The central tenent of Catholic faith is basically the Pope is infallible and what he says should be obeyed. There is plainly not much if any scope for teaching of other interpretations. Catholics who do what they like are well aware of the 'rules' and willingly choose to do otherwise, thats got nothing to do with interpretation - thats them saying, well in this case my religion is not compatible with my best interests.
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    (Original post by Wangers)
    Sigh. You really like care models and ICE and theory etc don't you?? The central tenent of Catholic faith is basically the Pope is infallible and what he says should be obeyed. There is plainly not much if any scope for teaching of other interpretations. Catholics who do what they like are well aware of the 'rules' and willingly choose to do otherwise, thats got nothing to do with interpretation - thats them saying, well in this case my religion is not compatible with my best interests.

    How the **** is that a care model? The spectrum of beliefs of the catholic church are something i learnt from a-level! Plus it's only common sense to know, as much as a belief system says XYZ, in reality the members of that church have their own views and DO pick and choose. When considering a last offices procedure, for example a patient who may be muslim, if they request something which isn't inline wit their beliefs, we won't ignore it or do it another way because 'they're a muslim and this is what the muslim faith believes'.
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    (Original post by Subcutaneous)
    No it won't cure them..blatently. However when it comes down to compassion and care, as much as you have a job to do and make sure it gets done, its doing it WITH compassion and care. Ie when doing a catheterisation, being aware of the patients dignity, privacy, maybe for those having long term catheters. When breaking bad news, doing it appropiately- just explaining what you're doing and why whilst you're doing it can help ease the paient and let them feel incontrol of what is happening. You don't have to spend an extra 5 minutes sitting down with them and having a cup of tea
    I think Helen & I certainly would consider those sorts of things as just being professional rather than especially compassionate!

    Doing core jobs in a compassionate & caring way is very doable & adds minimal time. But it's the patient/relative expectations & blurred lines of what they consider the doctors job to be at any specific moment & what we consider our job priorities that the grey comes in as to whether we're compassionate enough perhaps?


    So my examples:
    Preadmissions clinic
    - Patient: So now I'm going to find out & have re-explained everything about why i'm having this operation & what will happen while I'm in hospital. It's really important that doctor has lots of details about everything in my life. While I'm here I also want to ask the doctor about these other health things too...
    - Doctor doing preadmissions clinic: Are there anaesthetic issues at present? Is their drug chart complete?

    Hospital at night cover
    - Patient: Oh, I have a really itchy foot right now - why doesn't the doctor care enough to come this instant & prescribe me my usual emollients?
    - Patient relatives: I'd really like to rediscuss all these complex issues with the doctor looking after my relative right now, just so it's all really clear to me, then please can ask lots of questions and vent.
    - Nursing staff projecting their fears: Oh dear, this patient doesn't look very well at all. It says here in the notes from the Palliative Care Consultant today that they're for 'palliative care and symptom control only'. They don't have any symptoms right now. But all their family are here. I should probably bleep the on-call doctor because they should do something.
    - Doctor doing night cover: I'm trying to keep the patients (who are for any helpful medical interventions that we can offer) alive overnight. Then hopefully tomorrow any more subtle issues can be addressed by the regular team who know them, including specialists as appropriate, when the hospital has a vaguely sensible staffing level again. Oh - there goes the crash bleep again...


    (Original post by Helenia)
    However, you can smile all you like, it's not going to stop someone in mid-flow about all the medical problems they've ever had and how you are the only doctor who's going to be able to sort everything out... In fact smiling probably makes that worse
    Medical student sitting - only feedback I got was that I was too nice.

    (Edited for making more grammatical sense!)
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    (Original post by puddlejumper)
    Maybe you should stop stereotyping a whole organisation that has brought far more comfort and help to people than you ever will.
    It's also caused far more tragedy, broken up far more families, and killed far more people both indirectly and directly than I ever will.

    So I dare say we're about even.
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    (Original post by Phalanges)
    It's also caused far more tragedy, broken up far more families, and killed far more people both indirectly and directly than I ever will.

    So I dare say we're about even.
    This came to mind: http://www.private-eye.co.uk/covers....254&issue=1254
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    (Original post by Phalanges)
    It's also caused far more tragedy, broken up far more families, and killed far more people both indirectly and directly than I ever will.

    So I dare say we're about even.
    The Catholic Church has very serious problems, yes. But surely this doesn't mean that organised religion is always wrong!
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    (Original post by Elles)
    I think Helen & I certainly would consider those sorts of things as just being professional rather than especially compassionate!

    Doing core jobs in a compassionate & caring way is very doable & adds minimal time. But it's the patient/relative expectations & blurred lines of what they consider the doctors job to be at any specific moment & what we consider our job priorities that the grey comes in as to whether we're compassionate enough perhaps?


    So my examples:
    Preadmissions clinic
    - Patient: So now I'm going to find out & have re-explained everything about why i'm having this operation & what will happen while I'm in hospital. It's really important that doctor has lots of details about everything in my life. While I'm here I also want to ask the doctor about these other health things too...
    - Doctor doing preadmissions clinic: Are there anaesthetic issues at present? Is their drug chart complete?

    Hospital at night cover
    - Patient: Oh, I have a really itchy foot right now - why doesn't the doctor care enough to come & prescribe me my usual emollients right now?
    - Patient relatives: I'd really like to rediscuss all these complex issues with the doctors looking after my relative right now, just so it's all really clear to me, I can ask lots of questions and vent.
    - Nursing staff projecting their fears: Oh dear, this patient doesn't look very well at all. It says here in the notes from the Palliative Care Consultant that they're for 'palliative care and symptom control only'. They don't have any symptoms right now. But all their family are here. I should probably bleep the on-call doctor because they should do something.
    - Doctor doing night cover: I'm trying to keep patients, who are for have helpful medical interventions that we can offer, alive overnight. Then hopefully tomorrow any more subtle issues can be addressed by the regular team who know them, including specialists as appropriate, when the hospital has a vaguely sensible staffing level again. Oh - there goes the crash bleep again...




    Medical student sitting - only feedback I got was that I was too nice.
    I agree the patients view of what should be done is very different to the staffs, I had a patient recently who wanted me to look at his leg as it was itchy, when at the same time he was complaining of chest pain, and i had to focus on what i considered more important than what he did. I probably came across like i didn't care, and his leg was looked at later- but he made a fuss about how long it took. However just an explanation is suffice. I think being professional and being compassionate go hand in hand, and overlap - it's all part of holistic care.

    My point is that as much as people use the 'oh but theres not enough time' excuse- there are ways around it regardless of views of what care and compassion is, i believe what the archbishop was discussing was major issues, which can be resolved - ie leaving a patient soiled, not checking pressure areas, rude comments.

    However it should also make us aware of our daily duties, and how we can improve them to improve the patients satisfaction. I know sometimes if there are a lot of turns to do i won't explain whats happening, and just tell the patient we're turning them- if i maybe communicated a bit more, or explained why- it would make a big difference
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    (Original post by Ignoramus)
    The Catholic Church has very serious problems, yes. But surely this doesn't mean that organised religion is always wrong!
    It is true that religions do to some extent broadcast morality, however, morality exists independent of religion and the 'backstory' to those morals is not really necessary.
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    (Original post by Ignoramus)
    The Catholic Church has very serious problems, yes. But surely this doesn't mean that organised religion is always wrong!
    I fail to see how it can be right. The main reason for the support of organised religion is that it teaches people morals, and yet religion is responsible for more deaths than anything else.

    Society can exist perfectly well without religion. Godless people do not descend into uncivilised hordes incapable of differentiating right from wrong. They just have less reasons to kill each other.
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    (Original post by Phalanges)
    I fail to see how it can be right. The main reason for the support of organised religion is that it teaches people morals, and yet religion is responsible for more deaths than anything else.

    Society can exist perfectly well without religion. Godless people do not descend into uncivilised hordes incapable of differentiating right from wrong. They just have less reasons to kill each other.
    Yes but it's entirely possible for religion to exist without it being responsible for peoples' deaths. The fact that History hasn't shown this is no reason why it shouldn't be true.

    Religion has its benefits which can exist independent of its detrimental effects on humanity. In my opinion Christianity should not give people reasons to kill each other (for example) and the fact that organised religion is responsible for death suggests to me that the way in which organised religion exists today is wrong. But that doesn't mean it can't exist in a form that's beneficial for people.
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    (Original post by Phalanges)
    I fail to see how it can be right. The main reason for the support of organised religion is that it teaches people morals, and yet religion is responsible for more deaths than anything else.

    Society can exist perfectly well without religion. Godless people do not descend into uncivilised hordes incapable of differentiating right from wrong. They just have less reasons to kill each other.
    I guess you can't really blame religion for the deaths. I'd say that the blame lies with the religious believers who interpret their religion in their own way, and sometimes their interpretations lead to violent acts. However I guess the various contradictions in some religions don't help at all.
 
 
 
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