Putting Patients at Ease

UCEM‘s PR Supervisor, Assistant Sub-Professor Egerton Yorick Davis IV, has kindly released the new UCEM guideline, ‘Putting Patients at Ease’, to the LitFL team. This marvel of pedagogical pedantry was assembled by a crack team of educators under the direction of the incomparable Professor Harry Stickler. It serves as a guide for MUPPETs to a key Waiting Room medicine competency: the art of instantly and effortlessly putting patients at ease. The guideline adheres to the Sticklerian philosophy that the best way to learn how to do something is to first learn how NOT to do it.

So, without further ado, here are some UCEM-sanctioned pearls for how NOT to put your patient at ease, how NOT to build rapport and how NOT to make the patient think you’re the right doc for the job.

While introducing yourself to the patient, say:
  • “Oh, you’re not Mr Smith? Whose clinical records are these then?”
  • “Are you sure you’re not Mr Smith? Are you in the right cubicle?”
  • “Mr Smith, sorry about the delay… I’ve just been examining the wrong patient.”
  • “Sorry, my mistake Mrs. Smith, I understand now. You’re not his grand-mother, you’re his wife.”
While examining a patient:
  • swing you stethoscope around your neck, such that you hit yourself in the eye and a juicy periorbital hematoma starts to form.
  • scream “What the hell is that?!?”
  • mention to the patient’s father, “he really doesn’t look anything like you, does he?”
  • squeeze the abdomen so hard that the patient lets out an involuntary fart.
  • gently pat your non-pregnant patient on the belly and say, “well, you’re sure getting big… Tell me again, when are you due?”
Before a procedure:
  • vomit or drip sweat onto the patient.
  • start reading a textbook in front of the patient. After 2 minutes turn the book the right way up.
  • inquire of the patient, “Are you sure it’s this leg, I mean arm?”
  • say to the patient, “I’m feeling a bit shaky, can I have one of your beta-blockers?”
  • reassure the patient that “if this doesn’t work out we can always refer you to Plastics.”
  • explain to the patient with abdominal pain, “Look we’ve got no idea what’s going on, so we’re going to cut you open. OK?”
  • confidently assert, “Don’t worry about a thing, I’m much smarter than I look.”
During a procedure, say:
  • to the nurse: “Hmm, have I given the local anesthetic yet?”
  • “I wish I’d seen this done before”.
  • “Damn it, I should have used my dominant hand for that bit”.
  • “You know, maybe we should just start this all over again.”
  • “I think its stuck”  (this is especially effective during a speculum exam).
  • “Oh, no…”
  • “It’s OK, I’ll just hold this here until help arrives.”
After a procedure, say:
  • “Wow, that was great – my first one!”
  • “Wasn’t there another swab around here somewhere?”
  • “Well, at least it went better than the last one I did.”
  • “Mr. Smith, it appears that my hand has been glued to your head.”
  • “Just remind me, what did I say was wrong with you?”
Utopian College of Emergency for Medicine

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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