The Whole Patient

I’ll never forget the social worker who came to visit me in hospital, a few short days after my diagnosis. She asked me if I was feeling anything in particular after my diagnosis. Angry? Depressed? Wanting to talk? She even asked if Mum and Dad needed to leave the room. I had to convince her that I was feeling fine, as she didn’t seem to want to believe me.

It still frustrates me today that this was the way that these emotional issues were dealt with.

Having the social worker come in like that made me feel isolated. Her presence, and her questions that day were based on assumptions that I did not appreciate. I didn’t feel like a normal patient. It didn’t make these issues feel normal. Even if I was feeling something that day, I certainly didn’t feel comfortable discussing it in front of a stranger who thought she knew me.

What really frustrates me, is the fact that I had been surrounded by medical professionals for days in the hospital. Doctors, nurses, dieticians, specialists. Yet I can’t recall one of them asking me how I was. I don’t mean my blood glucose levels. Or the hospital food. Or why I didn’t eat my white bread sandwich before bed. I mean how I was feeling after a diagnosis with a condition that would affect me for the rest of my life.

The healthcare professionals I was surrounded by at the time were the ones I felt most comfortable around. While I certainly don’t expect them to fill the role of a counsellor or a friend, I don’t think it’s too much to ask them to look at the whole patient. To simply ask something like “how’s it all going.” To show some empathy, where necessary. To help me feel normal, and understood. Sometimes, that’s all we need. Other times, they can help us find greater support.

During last Tuesday’s OzDOC chat, there was a debate over whether patients felt that they were on the same level as a healthcare professional during consultations. I believe that this is a very individual issue, that comes down to both the patient and the healthcare professional.

Some patients contribute to feeling on the same level as a healthcare professional. They are very motivated, switched on, and not afraid to speak up or search for what they want. However we are all different, and not everyone is as vocal in nature.

This is where it is the responsibility of a healthcare professional to make the patient feel on the same level. Some healthcare professionals I have encountered certainly don’t seem to live in the real world where day to day management of diabetes is concerned. Some lack the ability to look beyond what’s written in the charts for an explanation. 

Yet other healthcare professionals are able to discuss diabetes management in a very supportive and constructive manner. They are able to motivate the patient and praise their self management behaviours. They are able to see the whole patient.

When emotional wellbeing is prioritised in my diabetes care, I feel motivated to improve on what is contained in my chart. My healthcare professional only needs to put down that chart for a moment, and take a look at the whole patient sitting in front of it.

3 thoughts on “The Whole Patient

  1. Interesting point of view. In the hospital setting, I think thats why a social worker is there. Often, Drs are too overworked to have the time for that chat. I wish I had been given access to a social worker. I think their roles are undervalued. They are more than just a friendly ear – theyre the ones who get you access to good doctors, who organise any home follow ups, who tell you about support services. I work with elderly patients and I’m always recommending to them to speak to a social worker when they get hospitalised and feel that the doctors are ignoring them, so the social worker can go in to bat for them.

    But outside the emergency setting, in clinic, I think that your point of view is very relevant, and often they ignore the mental side (which is sometimes the bigger side) and glide over how we’re feeling.

    Luckily my educator is amazing but it must be very hard for patients who don’t know how to self-advocate.

  2. Actually nurses and credentialed Diabetes Educators are the ones that make referrals and organise home visits or medical follow up. Given i have 15 years experience working in ED’s and a total of 37 years working in health, in particular mental health, i think i know exactly what transpires in hospital settings. Social workers are not first line when it come to issues pertaining to emotional and mental wellbeing, social workers are generally called in by doctors and nurses if the patient presents with “social” issues such as getting a Centrelink sickness benefit or needing support to help get a pet into boarding for the duration of hospitalisation, etc………….

    Frank you have every right to be angry and upset at the conduct of the social worker whom treated you with such a prescriptive approach. Unfortunately some social workers have a limited understanding of their scope of practise. A social worker can do post grad education to acquire skills in mental health. Given the complexity of diabetes and the psychoneuroendocrinological aspects a sound knowledge and background in the sciences, including mental health sciences is essential when dealing with the emotional needs of a person with diabetes.

    This is NOT a question of not being able to “self advocate” every patient has the right to be treated with respect and dignity, regardless of your level of ability to advocate!

    I would advise any person whom is treated with such disregard and disrespect to complain to the Health Complaints Commission in relation to social workers. For concerns or complaints about all other health care professionals you can submit a complaint or concern to AHPRA.

  3. It is worth noting that a degree in social work does NOT meet the criteria to be a diabetes educators.

    I had an unfortunate experience with a social worker whom inferred they were a DE. The social worker not having a proper understanding of the National Law breached confidentiality, Being a VERY EXPERIENCED SELF ADVOCATE, upon confronting the SW it was evident the SW had no ability or experience to apply matters of a medical legal nature to the area of practise undertaken by the SW . It is important all health care providers do not practise outside their scope and field of expertise.

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