Transcript Clinical Cases in Correctional Telemedicine

Sister Michelle Humke, CSJ, LMFT
(520) 628-7871
[email protected]
• Identify barriers and facilitators to helpful
communication
• Provide communication tools
• Provide tools for ensuring understanding

Improved medical care
◦ Provider has greater clarity about patient’s
needs
◦ Patient understands better how to follow
treatment plan

Reduced fear and stress for the patient

Patient
◦ Strong emotions
◦ Lack of medical knowledge
◦ Lack of familiarity with medical system

Medical Provider
◦ Lack of time
◦ Accustomed to medical jargon

Get emotional support
- Cannot expect provider to have the time
for that type of listening
◦ Talk with a trusted friend or family member
◦ Talk with a professional, such as a counselor
and/or minister
◦ Participate in a support group
◦ Write about your feelings

Identify a companion
◦ To provide emotional support
◦ To help remember
 Fear/Anxiety can cause memory problems
 Companion can remember what you want to say
 Companion can remember what the provider says
◦ To help identify important questions during the
conversation
◦ To help with translation, if English is difficult

Learn how provider’s office works
◦ Who can answer questions
◦ How to speak with provider
◦ How to deal with emergencies

Have documentation available
◦ Personal information
◦ Emergency contact information
◦ Medical history (including past negative
reactions)
◦ List of current medications
◦ Advanced directives and other legal
information
• Converse with companion
◦ What are current symptoms?
◦ What questions do you have?
◦ Make a list of what needs to be discussed with
provider
◦ After appointment discuss what happened

Use a notebook and possibly a tape
recorder
◦ Keep a record of anything related to health
concerns
◦ Make a list of questions for provider
◦ Take notes during appointments
◦ Use tape recorder during appointments, if
more helpful

Be present in the moment
◦ Fear and anxiety can affect concentration
◦ Breathe deeply
◦ Make eye contact
◦ Establish rapport
◦ Maintain a strong sense of self
◦ Use self-affirmations
• Self Affirmations
◦ I’m the only one who can really talk about my
own experience.
◦ It’s OK to ask for what I need.
◦ I’m not expected to understand technical
words
◦ I have a right to ask questions.
• Exercise - Be Present in the Moment
◦ Sit up straight in chair
◦ Rest feet on floor and feel connection to earth
◦ Breathe deeply and slowly
◦ Focus on where you are now, noticing sounds,
smells, colors
◦ Feel your inner strength and be present in the
moment

Actively participate
◦ Be prepared – “Facilitating the
Communication”
◦ Clearly state symptoms and other relevant
information
◦ Listen actively
◦ Communicate assertively
◦ Ask questions
◦ At end summarize the important points
◦ Clearly state symptoms and other
relevant information
 Avoid opinions
 Use facts
 Give examples
◦ Listen actively
 Be completely attentive
 Take notes
 Repeat back what you heard
“I want to check if I understood. You
said . . .”
• Communicate Assertively
◦ Express self without violating others
Aggressive
My needs
before others’
needs
Assertive
Openly express
my needs
Passive
Others’ needs
before my
needs
• Communicate Assertively
◦ State difficulties and concerns using
I-messages
 Begin sentence with “I”
 Follow with an expression of the emotion you’re
experiencing, such as “I’m afraid that” or “I’m
concerned that”
 Conclude sentence with an objective statement of
the concern, such as “my hair will fall out” or “I will
be in a lot of pain”
◦ Ask questions
 Do not be afraid of “stupid” questions
 Ask that provider use non-technical words
 Continue asking questions until you clearly
understand
◦ At end summarize the important points,
including
 What you need to do to care for your health
 When you need another appointment with this
provider and/or with any other medical providers
• Demonstration
• Role Play
◦ 1st Time
 A – Provider
 B – Patient
◦ 2nd Time
 A – Patient
 B - Provider
• You and your medical provider have the same
goal – helping you be as healthy as possible
• To work with your provider toward that goal,
you need to
◦ Prepare for your appointments
◦ Communicate well during your appointments
◦ Follow up as needed after your appointments
• An important part of working with your provider
is also expressing your appreciation to him or
her at the end of each appointment
• National Family Caregiver Association
◦ Although directed toward caregivers, much of
the information is also useful for the patient
◦ Website is www.nfcacares.org