“Sit on my bed and talk to me,” Ms. Keochareon said.
The students hesitated, saying they had been taught not to do that, to prevent
transmission of germs. What they knew of nursing in hospitals — “I’m here to
take your vitals, give you your medicine, okay, bye,” was different, after all.
That’s excerpted from a fascinating NY Times
article, http://www.nytimes.com/2013/01/11/us/fatally-ill-and-making-herself-the-lesson.html?pagewanted=1&_r=0&nl=todaysheadlines&emc=edit_th_20130111.
Martha Keochareon, a 59-year-old woman who’d
graduated from Holyoke Community College nursing school in 1993, was dying from
pancreatic cancer. She asked her alma mater if they’d be interested in having
their students see her for intimate exploration of the dying process. They were
indeed interested, and Ms. Keochareon was delighted to teach the students they
sent.
One instructor observed that when students
eventually ran out of asking her medical questions, they practiced what she
called “therapeutic communication” instead. “The way we’ve learned in school
and haven’t applied enough is just saying, ‘I’m glad to be with you; you must
be frustrated; you look uncomfortable.’ And let the patient just talk and talk
and talk, and see where they’re at.”
Ms. Keochareon died December 29, having pioneered a
profound teaching tool. I hope this sort of heart-to-heart teaching spreads.
During my first few days in my psychiatric rotation in medical school, I was asked to do a mental status exam in front of all the other students and attending in our small group. At the time, due to no fault of my own, I had not learned the mental status exam. Let's just say, I adlibed, lol! Eventually an attending took over, but I did get some very interesting out of the box responses before the exam became the standard.
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