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Communication, Culture and Conflict Dr Celia Gregson Specialist Registrar in Elderly and Internal Medicine Frenchay Hospital, Bristol.

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Presentation on theme: "Communication, Culture and Conflict Dr Celia Gregson Specialist Registrar in Elderly and Internal Medicine Frenchay Hospital, Bristol."— Presentation transcript:

1 Communication, Culture and Conflict Dr Celia Gregson Specialist Registrar in Elderly and Internal Medicine Frenchay Hospital, Bristol

2 Pitfalls Culture Language Dress Code Working Conditions Hierarchy

3 Stereotypes

4 How you see us….

5 How we see you….

6 Dress Code

7 No Jeans No Birkenstocks Leather Shoes, closed toe Smart trousers, skirt Shirt / blouse Tie White coats? Name badge ‘Naked from the elbow down’

8 Language

9 Communication within the NHS Patients / families / carers Nurses Team members (PRHO, F2, SHO, SpR, Consultant) The MDT: Physios, OTs, Social workers…. Discharge and referral letters Breaking bad news SOH

10 Communication with Patients Introduce yourself Explain management Ask for consent Consent forms Chaperone Involve in decisions, provide options – AUTONOMY Non-paternalistic

11 4 Principles of Good Medical Practice 1. Non-maleficence 2. Beneficence 3. Autonomy 4. Justice

12 Resuscitation DNAR 2222 Treatment vs Choice Autonomy The Form

13 How to talk the talk… To ‘open your bowels’ ‘Down below’ ‘Privates’ / ‘private parts’ LMP – last menstrual period ‘Bloating’ To ‘Pass wind’ Nauseous and Nausea and Nauseated Vomit, to be sick, to ‘throw up’ ‘Waterworks’ Examine the ‘back passage’

14 ‘Doctor I’ve lost a stone!’ 1 Stone = 14 Ibs = 6.35kgs 1 Ib (one pound) = 16 ounces = 454g 1 ounce = 28.35g

15 How tall are you? ‘Five eleven’ Five foot and eleven inches 5’11 1 foot (ft) = 12 inches = 30.48cm 1 inch = 2.54 cm

16 So…. I’m 5’3 and weigh 9st 5 …..what’s my BMI? My baby weighs 7lbs 7oz….. What does this all mean?

17 Another one… ‘How far can you walk on the flat before you get out of breath?’ ‘Oh, about 200 yards’ ‘Oh about half a mile’

18 Communication with nurses Never underestimate the power of a nurse and the impact they can have on your QOL! Grades A-G Teams Sister i/c Specialist nurses / nurse practitioners Bed managers Nurse

19 Communication with GPs On the phone Taking referrals Giving advice Discharge planning Seeking information Via letters Succinct Polite Normal language Copy to patient? – policy? CRUCIAL – Interface between primary and secondary care

20 Working Conditions

21 Wards Long Nightingale wards Curtains Bays Notes & stickers Notes trolleys Team based vs ward based Phlebotomists Ward clerks

22 The Medical Team Consultant Specialist Registrar - SpR Senior House Officer – SHO Foundation Year 2 – F2 Pre-registration House Officer – PRHO / Foundation Year 1 – F1 Medical Students

23 Documentation Clerking – routine / oncall / proformas Investigations Blood results Ward rounds Referrals to other colleagues..

24 Dear Urology SpR Thank you for seeing this charming 83 year old retired ventrioquist. He has had prostatic symptoms for 8 years, latterly with nocturia x 5. He has an irregular feeling prostate and a PSA of 12. Calcium, ALP and clotting are normal. No bony pain. MSU clear. Dr Bloggs would greatly value your assessment. Thank you. Dr Under-Bloggs 1749 SHO to Dr Bloggs

25 Ward round Meet the team Consultant lead Present new cases List of patients and their whereabouts Write in the notes Record necessary investigations

26 Ward Round Notes Date Time S O A P 27/03/06WR Mr Sharpknife 09.10 amday1 post appendectomy Lydia well in herself obs stable, apyrexial O/E: abdo soft, nontender, BS present IMP: Recovering well Plan: Stop ivi, eat and drink, cont Abs total 2/7 Little SHO 2273

27 Handover Working the shift system Hospital at Night Large numbers of patients Document instructions clearly in the notes Make plans for the weekend List all critical patients Reviews and by whom Investigations to be checked

28 Communication with colleagues ESSENTIAL Be professional Be polite Listen Do not be afraid to ask Positive feedback Keep your sense of humour

29 Teaching Grand Rounds Journal Clubs Departmental meetings Xray meetings Your colleagues – teach and be taught

30 Do you know…. Time to get competitive…..

31 NHS & medicine What is the name of this British GP and what is he famous for?

32 British Sports Which competition is this and who is this? Other than his sport, what is he infamous for?

33 British cinema Name this actor and his role – arguably the most famous figure in British cinema?

34 NHS & medicine What is this man infamous for and what is his name?

35 British Cuisine What is the name of these two famous British dishes and which one is always served on Friday in British hospitals?

36 British Television What is the name of this British comedy figure and what is she famous for?

37 British Landmarks Where is this street located and do any of you ever think you’ll work here?

38 Celebrities What is the name of this famous couple? What are their nicknames?

39 Last but not least.. Who is this and what’s she responsible for?

40 Any Questions?

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