Very often, we're faced with patients and relatives not telling the truth in the first instance. The reasons are plentiful. Some of them might need more time to develop trust. Some might simply prefer not to tell the truth. Some will not like that particular doctor for no apparent reason, and will promptly tell everything to another. For some, there are hidden agenda..
Well, I must say, the word 'hidden agenda' is sort of a magic word for us the Membership holders. We're forced to adopt the thinking that hidden agenda are there to stay for every Ethics & Communication Skills cases. Hidden agenda is hidden concern by the patients or relatives in regards, which serves to be the key to open up opportunities for further discussion or sometimes, it might well be the prerequisite for task accomplishment.
Allow me to share an atypical 'hidden agenda' incidence which was experienced by one of my colleagues days ago.
A young lady was admitted for allegedly ingested detergent liquid for parasuicidal attempt. She was otherwise well apart from some epigastric discomfort. A lavage and all other proper management measures had already been undertaken. My colleague needed to move on to see the rest of the wards before moving on to run the clinic.
As an MRCPian with extensive 'awareness' on the issue of hidden agenda, my colleague of course had elicited the very reason behind her parasuicidal attempt, ie, she found out that her husband was having an affair (Of course, this is after some repeated questioning, not volunteered). Her relatives were practically encircling her with intense concern, asking repeatedly about her conditions. My colleague practically failed to carry out his ward rounds, in the presence of so many visitors. Worse still, the relatives at one point were trying to suggest that NO EFFECTIVE treatment had been given, and threatened to take this matter to a complaint.
Nothing happened eventually. But an interesting point to illustrate here.
The patient committed suicide because of his act of seeing another women. You brought her looking for help and treatment. We gave help and treatment. You still have guilt (logically, he should). The patient refused to talk to him. He sensed a even stronger share of guilt and wanted a way out. The way out is simple - repeatedly showed concern by questioning the medical staffs, even to a point of irrelevance. And if they refused to hear anymore, it's their fault! Not my guilt anymore! How about the care of other patients? Don't care, not my problem!
This might be a over-simplified attempted deciphering of his thoughts. Nonetheless, one should recognise that some patients or relatives are just inherently selfish. It's their nature. Especially so, at the very juncture of escaping from guilt.
Well, I must say, the word 'hidden agenda' is sort of a magic word for us the Membership holders. We're forced to adopt the thinking that hidden agenda are there to stay for every Ethics & Communication Skills cases. Hidden agenda is hidden concern by the patients or relatives in regards, which serves to be the key to open up opportunities for further discussion or sometimes, it might well be the prerequisite for task accomplishment.
Allow me to share an atypical 'hidden agenda' incidence which was experienced by one of my colleagues days ago.
A young lady was admitted for allegedly ingested detergent liquid for parasuicidal attempt. She was otherwise well apart from some epigastric discomfort. A lavage and all other proper management measures had already been undertaken. My colleague needed to move on to see the rest of the wards before moving on to run the clinic.
As an MRCPian with extensive 'awareness' on the issue of hidden agenda, my colleague of course had elicited the very reason behind her parasuicidal attempt, ie, she found out that her husband was having an affair (Of course, this is after some repeated questioning, not volunteered). Her relatives were practically encircling her with intense concern, asking repeatedly about her conditions. My colleague practically failed to carry out his ward rounds, in the presence of so many visitors. Worse still, the relatives at one point were trying to suggest that NO EFFECTIVE treatment had been given, and threatened to take this matter to a complaint.
Nothing happened eventually. But an interesting point to illustrate here.
The patient committed suicide because of his act of seeing another women. You brought her looking for help and treatment. We gave help and treatment. You still have guilt (logically, he should). The patient refused to talk to him. He sensed a even stronger share of guilt and wanted a way out. The way out is simple - repeatedly showed concern by questioning the medical staffs, even to a point of irrelevance. And if they refused to hear anymore, it's their fault! Not my guilt anymore! How about the care of other patients? Don't care, not my problem!
This might be a over-simplified attempted deciphering of his thoughts. Nonetheless, one should recognise that some patients or relatives are just inherently selfish. It's their nature. Especially so, at the very juncture of escaping from guilt.
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