Transcript IMG Communication

An approach to Communication
Challenges in Psychiatry
Raed Hawa
Communication
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Why important?
Role as a physician
Professionalism
Satisfaction
Connecting with patients
Minimize complaints
Lost in Translation
Personal Experience
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“ where you’re from?”
“we don’t beat our wives”
“ I don’t understand what you’re saying”
“what? Repeat that again”
“I had a mickey and a joint or two”
Lost in Translation
Explain This!
•“He is my mother”
•“I push the mathematics”
Lost in Translation
Abbreviations and Slang
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ASAP
AWOL
Out of the blue
The blues
Cold turkey
Special K
Under my skin
Communication
ER Rounds
• During am rounds, the ER psychiatrist listens to the presentation by the
PGY4 resident on call. The case is about a homeless patient who presents
with psychotic symptoms. The staff asks for a differential. The resident
who is preparing for his STACER provides text book answers with evidence
based support for a comprehensive management plan. You, the PGY1, on
your ER psychiatry rotation stay quiet throughout the interaction.
• What do you think the staff’s perception of you?
Communication
Inpatient Rounds
• It is busy on the inpatient ward. After discussion with
your staff you decide that a patient that was
admitted the night before is ok for discharge. The SW
comes to see you and comments that the patient is
not ready for discharge. You get frustrated as there
has been pressure on you to free beds for patients in
ER. You are too busy to discuss your decision any
further.
• What would you do?
Oncall Triage
• It is 3am. You are oncall in the ER, and the
nurse calls you to see a “suicidal” patient. As
you go in, she is unable to give you any details
about why the patient is here and very little of
the paperwork has been done including a
triage assessment. No collateral has been
requested from other hospitals despite a
recent stay there.
• What would you do?
Communication
Inpatient Evaluation
• At your final ITER during your inpatient
rotation, your supervisor mentions for the first
time that the nurses have felt that they were
not involved in management, discussion and
discharge of patients.
• What do you do?
Communication
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Verbal- tone
Non Verbal- Body language
Collaborative teams and hierarchy
Personalities- eg dominator, blocker, attention
seeker, and evader
• Topics- sexuality/drug/religious beliefs
• Assumptions- families “in the west”
Tips from An Old Age Resident
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Don’t be Late! If you are, call in
Speak up if you don’t understand something
Ask questions during small group classes
Use the resident lunch time to ask senior
residents for advice if you are unsure
• Ask for regular feedback – especially midterm
feedback to avoid any surprises