Clinical placements

Overweight patient showed me the importance of simply listening

My second clinical placement was with the district nurses. This involved lots of dressings, loads of learning, and the occasional pet under my feet.

My second clinical placement was with the district nurses. This involved lots of dressings, loads of learning, and the occasional pet under my feet.

My mentor and I were on a routine visit to a lovely, cheerful patient who needed her legs washed, creamed and dressed. Little did I know that I would learn a valuable lesson during this visit, and not just about which dressings to use.

As we had seen this patient numerous times and I knew the routine, my mentor let me lead the care. Everyone was happy with this and I was elated. I talked to my patient while washing and creaming her legs, and we spoke about all sorts of things – the weather, her family, her plans for Christmas and finally the suggestion of her having a Doppler assessment to check the blood flow in her legs.

The patient was reluctant to consent. My mentor and I were sure that compression dressings would improve her quality of life, so we explained the process, and how it was similar to having an ultrasound of your ankles. The patient was assured that she could have it done at home.

In the next couple of minutes, my learning curve took a sharp loop as I re-evaluated how I see overweight people. The patient admitted she had severe ‘white coat syndrome’ because of her childhood, and this is why she was reluctant to let us do the Doppler.

When growing up, she had been overweight, with weight particularly concentrated around her legs. She explained that health checks were not performed because the doctors and nurses had said that only losing weight would help. It appears she may have had other medical problems that contributed to her excess fluid, but no healthcare professionals had investigated.

My next words and actions had to be chosen carefully. I decided to just smile and listen to what she had to say.

The patient said it felt like a weight had been lifted from her shoulders because someone had stopped to actually listen to what was upsetting her.

 

Up until this moment, I had been short-sighted. I believed that most overweight people were reckless and did not care how their weight was causing their health to fail.

 

As a nursing student, you are always learning lessons. As much as some can sting, reflecting on these lessons truly can help you to learn. This patient had been emotionally bruised by the comments of the other health professionals who had cared for her.

 

From this visit onwards, I changed my judgemental ways and I demonstrated this by hugging my patient. She was in desperate need of a hug and welcomed me graciously. She needed someone to constructively listen to her. That person was me.

 

A week later when we saw her again for the Doppler test, she said ‘thank you for listening’. This is why I love my job and look forward to each shift.

 

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