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Visiting The Sick : Good Bedside Manners
by Dr. Anjana Maitra

The other day when I went to visit a colleague in hospital, who was recovering after an operation, I was taken aback to see her room full of people (relatives, friends, neighbors etc), all talking at the top of their voices and having tea and snacks as well. The scene reminded me more of a party than a hospital room. This set me thinking. Do we have good bedside manners? A chat with some doctors, matrons and nurses revealed some important do’s and don’ts about visitors in hospitals.

The first thing to keep in mind is to create as less noise as possible. The “Silence Please” sign in most hospitals is largely ignored. Talk to the patient or to his relatives in a low, soothing voice. Talking loudly may disturb patients in the nearby beds also and jars on the nerves of the sick person you are visiting. Open and close doors softly, do not call out to anyone loudly and avoid wearing high heeled sandals which go “clop clop” in the corridors.

The duration of time one should stay depends on several factors. If the patient is only an acquaintance and you are there as a social obligation ten minutes is enough. If however you are visiting a close friend, you can stay longer. However if you find the room is crowded and others are waiting to see the patient, it is better not to take too long.

The visiting hours in the hospitals should be strictly adhered to, otherwise it interferes with their routine. Even when the patient is at home, one should avoid visiting him at odd hours like early in the morning, late afternoon or at mealtimes, as this may interfere with the normal functioning of the household. Late mornings and early evenings are the best time to visit the sick.

Talking too much to a patient or staying too long may tire him out. So it is better to restrict oneself. It is also not advisable to talk to his relatives in a hushed tone or to take them out of the room –this may alarm the patient.

We Indians have a habit of carrying food stuffs (home made or otherwise) for the patient. But this is widely frowned upon by most doctors. In hospitals which provide food, the patient gets his or her food as per the diet requirements specified by the doctor. In other cases the doctor advises the patient’s relatives about the food to be given. I remember my aunt bringing ‘puri aloo’ for my cousin who was put on a bland no fat diet and my cousin spent hours agonizing over the dilemma to give in to temptation or to annoy her aunt. Imagine bringing ‘dhoklas’ for a patient on a liquid diet. So it is best to avoid bringing foodstuff for the patient, but if you must, perhaps fruits are the best bet.

Though carrying flowers as a ‘get well’ sign is quite common, some patients may be allergic to the pollen, so be careful. Also in our Indian customs different flowers symbolize different meanings. For example some communities regards lilies as a symbol of friendship and love, whereas to a Christian they may symbolize death.

One should also be sensitive about the topics of conversation with the patient. While you may be dying to tell him about the wonderful cricket match you have seen, he may be wanting to describe his aches and pains. So lend him a patient ear and listen to his woes. Don’t interrupt him mid way and relate how your uncle had exactly the same symptoms. Also never alarm the patient by describing another case where the patient underwent a similar operation and deteriorated or died. Discuss only positive things as the hospital atmosphere is negative to most people.
Giving armchair advice to the patient or his relatives is absolutely taboo. Let them go by their doctor’s advice only. Even if you are a doctor, refrain from giving medical advice as this will only confuse the patient and may even compound matters. Also don’t press them to consult Dr X, just because you think he is a wonderful doctor. Never undermine the patient’s faith in his doctor. Do not interfere with the medicines by suggesting other remedies (Ayurvedic, Homeopathic or home made ones), specially if the patient’s condition is not too stable.

Another don’t is crowding around a patient’s bed. Some people feel claustrophobic in the presence of a crowd and a ring of people around his bed worsens this feeling. Others (eg girls or ladies) may feel uncomfortable to be in a prone position with people staring at her from each side of the bed. If there are too many visitors in the room, one can wait outside and go in by turns.
The ‘No Visitors’ sign on a patient’s door is often ignored, say doctors. This sign is usually out up when the patient is very weak and talking will tire him out or when he is prone to infections. As visitors we should respect this sign. We can call the attendant/relative outside and enquire about the health of the patient.

Small children should not be brought to visit patients in hospitals as far as possible. This is due to two reasons. Firstly the hospital is teeming with germs and a child catches an infection quickly. Secondly children get very bored in an enclosed place and may get fidgety or noisy, thus disturbing the patients.

A newborn is very susceptible to infection, specially air borne diseases. If you are not in good health stay away from the baby. Most hospitals keep the babies away from the mother’s rooms during visiting hours. Even when the baby is at home and you are visiting don’t handle him till you have washed your hands. Doctors also frown upon our Indian custom of well meaning elderly relatives/friends/neighbors offering all kinds of advice to the new mother. This only confuses her.
A mention must be made about visitors who come to see a patient immediately before or after an operation. Remember this is a very crucial time and only close family members must be present. A Nurse recalls a case when the entire office staff of a patient came to see him just before he was to be wheeled into the operation theatre for a minor surgery. He was quite disturbed to see so many people and kept asking if he will recover or not. After an operation the patient is groggy and one should not disturb him or try to make small talk. He needs rest at that time.

Also one should be careful when visiting a sick child. A chirpy active and cheerful child may be grumpy when he is sick. Don’t coax him to smile or make small talk. Also don’t bring any foodstuff (including chocolates and sweets) without talking to his parents about what he is allowed to eat. If you have brought a toy or a box of chocolates give it quietly to his parents and leave it to them to decide whether the child can have it or not.

Last but not the least don’t buttonhole the doctor and enquire about the exact nature of the illness, its cause and the treatment being followed. The doctor is not obliged to give lengthy explanations to all and sundry.

Thus the few tips mentioned above can go a long way in making you a welcome visitor at a patient’s bedside.

Images under license with Gettyimages.com

9-Jun-2008
 
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