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LIFE BEFORE DEATH -- Bedside Manner

Posted by Greg Schneider on March 17, 2012 at 9:54am
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Bedside Manner Short Film 30 of 50 in the LIFE Before Death documentary series about the global crisis in untreated pain and the dramatic life changing effect palliative care services can deliver to patients and their families around the world. In this Short Film we discover the importance of bedside manner and the benefits of a caring interpersonal approach by health professionals as it relates to the quality of life for their patients. "Often modern medicine is quite reductionist," reflects Dr Natalya Dinat (South Africa). "It goes down to the molecular. So we tend therefore to concentrate often on 'the liver', or what's happening in 'the brain'. And we forget that people are more than that. Even if you put all of those parts together you still don't get a person - we're greater than the sum of our parts. The pain area recognizes that. So it's a fascinating area because with a basic approach, and a compassionate approach, we're able to really make a difference in people's lives." "What patients really appreciate when they come to us is that we see them as people," continues Dr Dinat. "And we see them as people operating within a family, and within a household, and within a community. We don't see them as, you know, the lung cancer case in bed three." "The easy thing to do is to walk away and leave that person to die alone," challenges Mary Callaway (USA). "I've watched doctors change over the years," observes Dr David Morrison (Canada). "And we've now encouraged some of the medical staff to be much more sensitive and stop hiding behind the mechanics of their trade." "To reduce the barrier between a white-jacket person and a patient who is in so much pain and emotional distress, I feel more comfortable placing myself at the same level as them and not to be towering over them," reports Dr Rosa Tickoo (India). "We hear from the patient side all the time; 'If my doctor could be more open with me, be more transparent, tell me what's going on, not avoid eye contact, don't be afraid to touch me'," continues Dr Morrison. "So many times when people get to the point of days or hours from death, everybody stands back," reflects Callaway. "The health care professionals, the doctors, will come in but never touch them. And you can see a patient's eyes light up when that doctor just sits down, looks at them eye-to-eye - not hovering over them - and reaches out and touches them. It's that personal connection. But we haven't taught doctors how to do that. And once you teach them that - once you give them that skill it's incredible to see how much that empowers them." Featuring: Dr Natalya Dinat (South Africa), Dr Rosa Tickoo (India), Mary Callaway (USA), Dr David Morrison (Canada), Hugo (USA). LIFE Before Death comprises 50 short films themed around pain control and end of life issues, releasing one a week for a year from May 2011. A feature film will be released in early 2012, followed by the release of a television documentary in late 2012. The project is presented by the Lien Foundation and produced by Moonshine Movies. It is also supported by The International Association for the Study of Pain, The Mayday Fund, The Union for International Cancer Control and The Institute for Palliative Medicine at San Diego Hospice International Programs.

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  • Frances Shani Parker March 18, 2012 at 8:45am

    The beauty of being good hospice volunteers is in not thinking of anyone as "my kidney patient" or "my liver case." We go in expecting to deal with people in their wholeness state in need of enhancement, not in their "molecular state." 

    This wasn't mentioned in the article, but another similar area in which many doctors could improve is their condescending approach to patient care. Just as volunteers should approach patients with win-win personal growth expectations, so should doctors. Approaching them with a patronizing "I am your savior" attitude negates the mutual benefits they can both gain from the experience. This approach, which can be very intimidating for patients and caregivers, often results in a reluctance to communicate well and negatively impacts working in patients' best interests. Ultimately, we are all equal in the human family. Our knowledge, talents, degrees, etc. never make us superior to other people, never change the fact that we are all students and teachers.

    Frances Shani Parker

    Hospice and Nursing Homes Blog

  • Greg Schneider March 17, 2012 at 12:21pm

    The suggestions for good bedside manners are well known to hospice and palliative care volunteers.

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