Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
Caring for Patients
There will be times in the outdoors when you’re called upon to become a caregiver. The technical issues aside, there is an art form to taking care of patients. Recall how you feel when you are ill. You may be frightened, needy, weak, vulnerable, confused, or even panicked. You are in need of help, and may become dependent in a unique way. Health care professionals are (hopefully) instructed that the style of their interactions with patients is as important in the immediate and continued healing processes as are some the decisions they make about interventions, medications, and other forms of direct patient care.
Stanford Hospital & Clinics, where I practice emergency medicine, has just inaugurated a program to reinforce the principles of caring for patients. These are just as applicable in the wilderness as they are in the hospital. Here are some of the principles, adapted for outdoor use:
Connect with people by calling them by their proper name or the name they prefer. If you aren’t certain what to call someone, ask. When you inquire, they will likely respond with their preferred greeting.
Introduce yourself and explain your level of training. Let the patient know that you are there to help and will do your best.
Communicate what you are going to do, how long it will take, and what outcome you seek. You may need to do this multiple times during an encounter. Sometimes you will not know all the details. If that’s the case, it’s okay to explain what is happening as soon as you feel like you know enough to provide an explanation. In general, patients crave communication.
Ask for permission if you are going to do something to a patient. Obviously, there may be times when a patient is in a dire situation and you need to move quickly, but most of the time, you have time to ask for permission if you are going to remove items of clothing, move a painful limb, offer a medication, and so forth.
Respond to the patient’s questions or requests promptly. If you know how long it is going to take for something to happen, inform the patient. Setting expectations is a huge part of the caregiver-patient encounter.
Anticipate the patient’s needs. Your ability to do this will often depend on your experience, level of training, and expertise. Part of this is informing the patient what to expect, particularly if it is something important that you want them to communicate. “Please let me know if your pain increases” is an example of being concerned, asking for an important alert, and understanding what might happen next.
Exit the scene courteously and with an explanation of what will follow. It is distressing for a patient to be left hanging without any understanding of their situation or next steps, or a sense of hope.
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