Tuesday, 9 December 2008

My name is...

One of the things that was drummed into me again and again at medical school was the importance of introducing myself to my patients. In every single undergraduate clinical exam and every single postgraduate exam I have every sat, there have been marks allocated for introducing myself to the patient at the start of the interaction.

Personally, I used to think that being told this again and again and again was really tedious. After all, it’s just good manners isn’t it? I always introduce myself when I meet a new person and patients are no exception.

“Mr Smith? Good morning, my name is Michael. I’m one of the anaesthetists, do you mind if I ask you a few questions?”

or

“Mr Smith? Good morning, my name is Dr Anderson. I’m one of the anaesthetists, do you mind if I ask you a few questions?”

When I first started my anaesthetic training just over a year ago, that was how I’d introduce myself to my patients.

When I first started my anaesthetic training just over a year ago, I’d frequently get blank, uncomprehending looks from the person that I was talking to. Sometimes, people would try to be polite, but it soon became obvious that they had no idea who I was or what I was planning to do to them. You see, it became very obvious, very quickly that, generally, people have very little idea what anaesthetists do, so introducing myself as an anaesthetist didn’t shed much light.

Since starting my anaesthetic training, I’ve had some cracking comments about my job – often from people who (I thought) really should know better.

“Oh, I didn’t know you had to be a doctor to be an anaesthetist!” – from one of FashionGirl’s friends

“If you’re an anaesthetist, all you do is give an injection – and that’s it. Well, that’s what happened when I had my operation. Why do you have to train for seven years to learn how to do that?” – from my own mother

“Once the patient is asleep, you guys don’t do anything do you?” – from a surgical FY1 doctor

“But what do you DO?! I don’t understand what you do. NOBODY understands what you do.” – from my former housemate who is a cardiology registrar (he was v drunk at the time).

“So, are you a doctor then?” – from a patient just after a ten-minute discussion about epidurals, invasive lines and HDU after care.

…and it goes on and on and on.

Over the year or so I’ve been doing the job, I’ve noticed that my simple introduction to the patient is starting to sound more like a job description. These days, I’ll say something like:

“Mr Smith? Good morning, my name is Dr Anderson. I’ll be the anaesthetic doctor for your operation later on today. It’s my job to give you your anaesthetic and to look after you while the surgeon is operating. Do you mind if I ask you a few questions?”

It’s a bit wordy, but it seems to set the tone a bit better and I seem to get a few fewer blank looks.

8 comments:

madsadgirl said...

I suppose it is a bit of a problem understanding what an anaesthetist does when all you remember about them is that they stuck a needle in you and asked you to count backwards. If you are not aware of anything that happens to you after that, then the anaesthetist has done a pretty good job. And if he has done a good job you are unlikely to see him again during your hospital stay.

Dr Michael Anderson said...

Yeah, this is very true MSG. It would be better if more anaesthetists went to check on their post-op patients as a matter of routine.

Hospital Lab Tech said...

Well in Holby Shitty et al the anaesthetists have all the time in the world to parade around the wards and know each and every patient and not only do they know the patient's name, they even know the name of the person (or people!)the patient is sleeping with and all their other woes.

Come on, keep up! Get delving into every aspect of your patients' personal lives and all will be well.

DrJDR said...

I wonder what you think about the whole 'first names' question? That is, should you (the doctor) introduce yourself by your first name - such as 'My name is James, I'm a forensic psychiatrist'? I remember being told off in an exam for doing this kind of thing, and since then I've always been very careful not to use my first name and stick to surname - ie 'my name is Dr Blunt' (well it isn't really, of course). I think that this does set the professional boundaries very clearly which I think is important for patients. I used to constantly cringe when hearing young nursing staff / assistants breezily addressing sick old men and women on their first meeting by using their first names. I always thought this inappropriate, and personally I would not like to be called by my first name by someone I had never met. Professionalism in medicine as a whole is something which has really suffered, and which I think we need to keep going. Patients expect us to act in a professional manner, and when we do this gives them confidence in us.

Dr Michael Anderson said...

HLT,
I worked out that I'll give about 40 anaesthetics in a normal week, obviously I'll be swanning around and gossipping about my patient's sex lives because I've got nothing better to do!

Nurse To Doc said...

I get some stupid comments about being a medical student.

At least three people have asked me what I am studying and when I say "Medicine" they have asked what type of nursing I want to do. I can only imagine what they think an anaesthetist does.

Anonymous said...

I thought about being an anaesthetist for a while and got the same comments regarding people not knowing you had to be a doctor! They were also stunned when I told them it was anaesthetists who ran ITU.

Also used to introduce myself as 'Dr' Jane Smith when I became an obstetrician as if I just said 'I'm Jane Smith, the obstetrician' or 'I'm Miss Smith' then loads of people thought I was a midwife.

Dr Michael Anderson said...

DrJDR,
You pose a good question that I've not really thought about in any sort of depth. I shall ponder and post on this...

Nurse to doc & anon, you touch on something that is just sooooo common. Female working in hospital = nurse (or midwife) seems to be an automatic assumption in a lot of people's heads. I remember being a house officer on a consultant ward round and the patient was convinced that I was doctor and the consultant, SpR and SHO (all female) were the nurses. I think these assumptions will change with time, but it will take a while.