Am I dumb to figure out patient’s mood? Am I judgmental?
In today’s journal, I will discuss two issues listed above.
It happened at least twice that XXX and I had opposite interpretation of patient’s mood. Fist patient was the one we saw on 7-20-2011. The patient came in to discuss CVS. She did some research and learned a lot of information about CVS, some are right, some are wrong. When we started to talk, I felt she was confused with what she’s learned. Later XXX commented that she was nervous and anxious, and after talking to me for a while, she calmed down. I didn’t feel the same way because she talked a lot about what she learned. If she talked less and looked sad, I might think she was nervous and anxious. The second patient came in yesterday with abnormal SS for DS (1/10). She was quite and looked sad. So was her husband. I considered them to be tense and stressed out or overwhelmed by the high risk SS result. In contrast, XXX thought they were not nervous but already had a plan. They knew what they wanted before they came in.
That made me think why my thought about their mood is completely opposite to what XXX thought. Culture plays a role for sure. Experience might also contribute. In addition, when people feel nervous, they could behave in an opposite way to disguise their nervousness, especially in front of other people rather than their family members.
Judgmental issue popped into my mind after the patient we saw yesterday. She is on subutex, a medicine that treats opioid addition. When we prepared the case, XXX mentioned that I should ask what kind of opioid she abused. Then I asked “are you on any medication or any drug?” she only told me subutex and I didn’t ask more. I felt I should but I felt uncomfortable to ask “did you use any recreational drug?” I don’t know why I feel it is not good to ask directly, or maybe I should ask in an indirect way. I don’t think I am judging her when taking pedigree because I was focusing on information honestly. So my main point is I don’t want them to feel bad or feel that I think they did something bad. Is it judgmental? Similar thing happens when I asked number of pregnancy. One patient answered that “I have two daughters.” I can feel she defended for herself and was not comfortable to expose, maybe, her personal life. And I asked further “any miscarriages?” she did say one. Actually in her chart, it recorded more than once. But I didn’t explore more because I feel if I asked more the patient would feel I don’t trust her or I was probing her intentionally. I think I might focus too much on the rapport to explore deeply for the facts we need. So I let patients control questions I suppose to ask. I think I should be brave and pay attention to my tone and pace when asking sensitive questions to sensitive patients so I won’t impress them that I offend them (I honestly don’t want at all!).
