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I am a bionic woman. After many surgeries, I am now the proud owner of two artificial knees and two artificial hips. Performing daily activities and being independent are wonderful gifts that many of us take for granted.
I learned valuable lessons while my joints were failing, and as I recovered from my surgeries. What I learned from my experiences can be applied to the patients in all our offices. There are many people who are considerate when faced with someone who needs help. Yet, I am still amazed at how many people seem oblivious to the challenges other people face. I am always stunned when this neglect occurs in a health care setting.
When using a walker, crutch or cane, entering a medical office is the first of many challenges. Look at the door to access your practice. How does it open? Does it require a pull or a push? Both can be tricky. If a patient is not alone, no problem. But if they are alone, the struggle begins.
Let’s talk first about the doors that pull open. A patient must step back to open the door. Then they must try and thrust themselves into the doorway to prevent the door from closing. Not exactly a safe maneuver. And if the door opens in, the patient has a new set of challenges. Both hands are on the walker or crutches. So the patient must use their head, shoulder or walker to push the door open. Not exactly a graceful entrance and it can throw a person off balance. And if there is a vestibule with two doors and a small space between them, life gets even more interesting.
Understand that if a person is using a walker or crutches, they are using them for support and strength. Removing a hand from the walker or crutch can affect a patient’s stability. I am amazed when office staff and patients in the reception area can watch someone struggle without offering help. We can’t control how other people respond. But, we can make certain our staff is aware of the importance of helping when a patient is struggling to navigate our offices. Think about the positive impact of offering a helping hand without waiting to be asked.
Furniture selection for the reception area is important. Chairs with straight backs are good for patients using a walker or cane. Sitting on furniture that is too low or too soft is disastrous for someone with physical disabilities or the elderly. Also be certain you have several chairs with arms in your office. People with disabilities learn that it is never safe to use their walker for support as they stand. Walkers can tip forward and cause a person to lose their balance or fall. Patients learn to use the arms on a chair to push up to a standing position and then safely transfer to the walker.
Many times I heard my name called at a doctor’s office to go back to the exam room. The technician or nurse was halfway down the hall while I was still trying to get out of my chair. I was already self-conscious about how slow I was moving, but the tech rushing away only made me feel worse. My response is to hurry to try to keep up, but this is not actually safe. When someone is in pain or recovering from some injury or surgery, I can assure you that they are not moving slowly to aggravate you. They are moving at the speed that allows them to feel safe and stable while minimizing their discomfort or pain. Slow down! The exam can’t start until the patient arrives in the room. So show them respect and compassion. Reassure the patient that you want them to take the time that they need.
Changing positions from seated to standing can take some time as well. It is vital that the patient feels secure before moving. Many people will stand still for a moment to get their weight redistributed and muscles engaged. Then, when comfortable, will begin to move forward. Generally, allow your patients to get up on their own. When a person has to use a walker or crutches, most will learn what works best for them. You can politely ask if they need or want your help, but don’t force it on them. If they do want help, ask them what they want you to do, rather than presuming you know.
Your staff can assist your patients in many different ways. Just being aware of physical limitations is a start. If the footplate on the examination chair is in a raised position, it allows a patient to walk up to the chair, turn and sit. When they feel the chair behind their legs, they can then lower themselves onto the chair using the armrests for support. Staff can then move the walker, cane or crutches out of the way for the examination. Never ask a patient who is disabled, either temporarily or permanently, to step up on the footplate and then try and turn around to sit in the chair. Once they sit, ask if they want the footplate put back down. Most people will want this unless they have long legs. Another source of discomfort is letting legs just hang with no support under them. It can be very painful, especially on a post-surgical patient since gravity will pull the leg down. If their feet don’t reach the footplate, place a large book or platform on the footplate to support their feet and relieve the pull on their legs. This also applies to people who are short. Try and make your patients comfortable if at all possible.
If the patient had surgery recently, staying in one position without being able to move can make the patient uncomfortable. When they are uncomfortable, they can’t concentrate and respond well. Be aware of this. If a patient is moving and repositioning themselves a lot, ask them if they need to stand or move. Just changing position or moving a little can relieve this discomfort. Sometimes offering a small footstool and allowing them to elevate their leg will also help.
These are all simple and inexpensive things to do that can have a big impact. Being aware of your patient’s needs and limitations and responding appropriately will mean a lot to your patients. They will remember your kindness and consideration.
What ideas do you have to make your patients more comfortable? Share them below in the comments section.