Clinical reflection examples11/18/2023 There was no gastro on call over the weekend, so he was waiting for his scope on Monday. He had presented on the Friday with a litre of haematemesis witnessed in A&E. We had a fifty-one-year old gentleman with NASH who had presented with haematemesis on our ITU outreach list. I would like to look at the patient feedback forms and see whether there is scope to ask them about choices in their care. When I am working with patients in future, I will endeavour to give them as much choice as possible over their care, even down to when I take their blood. I realized that we would do well to remember how vulnerable patients feel, and that we need to earn our patient’s trust and it is often best to tread carefully at the start. That comment stayed with me, and I wondered today if this child’s behaviour over the blood sample was driven by the need to exert some power over what was being done to him. ![]() She said she felt as though she and her daughter were victims in the machinery of the healthcare system. When I thought back over this case later that evening, I recalled talking to a parent of a sick child a few months ago and she said how much she hated her powerlessness. However, I could feel myself getting angry with him and only just managed to control that. I thought I dealt with this situation well by letting the patient eat his lunch and coming back later and I was glad that I asked him why he had been so distressed, because I learned something from that. I have to say I admired him in a way for his strategy. He said he had to make a fuss ‘so that I would be careful.’ I said I could understand his logic but that perhaps in future he did not need to make quite so much fuss. I asked him why he had been so distressed. He stopped crying and calmly watched the blood enter the specimen tube. The minute the needle touched his skin, he was quiet. I was a terribly busy that shift and could have done without this, but something made me curious about this child’s behaviour. He swore and shouted, cried, and tried running away. I dealt with each argument, but he became increasingly distressed. He wanted his mum to have her blood taken first. There then followed every excuse he could think of as to why he should not have his blood taken then. When I came back, he said he did not want his blood taken. I thought this was a reasonable request and said I would come back. He looked at me suspiciously and told me he wanted to eat his lunch first. I introduced myself as I had not met him before. On the morning in question, I needed to take a blood sample from him. He did not like being in hospital and he did not like being told what to do. He knew all about doctors and nurses, blood tests and operations. It is no wonder that many of us shy away from doing it.ĬLICK THE TABS/BUTTONS BELOW TO VIEW EXAMPLESĪ failed kidney transplant patient, he had spent large part of his life in and out of hospital even though he was only seven. ![]()
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