Patronising – How clever of you to notice!

Posted on September 27, 2007. Filed under: Journal from behind the desk... |


The longer I do this job, the more I realise you need to explain everything to everybody.  There should be a certain amount of assessing the patients level of intelligence that allows you to know how basic you need to make things, but despite this the patients brain may not be fully functioning.

I seem to be a few sandwiches short.

I have often worried I may be seen as patronising, and try not to come across in such a way. However I sometimes think perhaps I am not patronising enough!!

My most common statement is with the antibiotic trimethoprim, one dose every twelve hours.  I always point out that it’s worth making sure you will be awake 12 hours after taking the first one.  I know it’s daft, but I’ve had several patients that have moaned, that they took the first tablet straight after there 3pm appointment, and then had to set the alarm for 3am for the next 3 days!  Sure you want to take you medicine as soon as poss. to get it working, but no major harm would occur if you waited 4 hours!

The best example I can think of presently, was the chap who came in with decreased hearing, and was advised that ear wax was causing his problem and that he should use olive oil and then return in one week for ear syringing.

One week later and the wax in his ear was no softer and looked as if it hadn’t been treated. Now sometimes we find that the patient put the olive oil in the ear and then immediately put cotton wool in to stop the oil dripping out, which unfortunately absorbs the olive oil and leaves the wax untreated. So I asked the guy if he’d been using the olive oil, to which he replied:

“Yes, I’ve been drinking about 10mls twice daily”

Max : “Excellent….could you come back in a week, having put it in your ear canal rather than drinking it”

Was he daft?  Well not necessarily, he was told to use olive oil.  It’s just a case of not being given enough advice on how to use it.  You can guarentee I make sure all patients with ear wax know exactly what to do with olive oil when they come and see me.

On a similar note I have known people with Eustachian Tube Dysfunctions, who have been advised steam inhalation may help, and  think they needed to put the hot steam near their ears. This only relieves congestion if you can breath through your ears – stop trying!!

So I assume everybody is dim, and try not to come across as patronising, and if anyone accuses me of be patronising I’ll just say:

“Ohhh, how clever of you to notice!”

 I’m still looking for spooky nursing/medical stories, as Hallow-e’en fast approaches, so if you’ve got any for me or you just wanna read, materialise here….

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4 Responses to “Patronising – How clever of you to notice!”

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ummm….I know sometimes medication teaching makes you want to bang your head against the wall, but let’s face it…most folks are already stressed out about their ailment and really are not in a position to learn anything new very well, no matter how simple. One f/u study review of dc meds with our chemo patients showed that only 60% were taking meds as taught. I’ve had patients and caregivers with excellent verbalized understanding of meds, when/how to take them (etc) call back several hours later and you’d think from the questions that they ask– never received *any* instruction whatsoever. I try to chalk it up to stress, cause if you ponder it any other way you just wind up with frustration, or patronization…patients pick up on that and tend to have even more difficulty when they can sense this in you.

What a nice blog you’ve got going. I popped on from Moofies site. You might get a chuckle out of this..speaking of knowing how to take things or rather where to take things. I was getting a prescription at the pharmacy,they had new help there that day. Apparently, they gave me the right pills, but the wrong directions. I was told not to take them 2xqd P.O., but to insert them elsewhere!!
I was thankful to know better…and of course did check to make sure the pills were at least correct. I said to my Fireguy I would have felt like a dang Pez dispenser! He laughed himself silly.

i guess it is best to err on explaining more than less. i had a patient whao came with a seven year old prescription of Albendazole. She had been religiously giving it every day to her son to kill worms in the bowel. Lucky her son was alive and healthy when i saw. i am sure he has no intestinal parasites.

Good thing you didn’t tell him to drink a glass of tea after finishing a hot bath.

It could have taken him weeks to finish drinking that bath.


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