I thought this was worth re-blogging today as last week I had a lesson in patient independence, or perhaps, autonomy.
I can’t give too much away to protect their anonymity.
Suffice it to say, this is one of our patients who ticks the box of being ‘housebound’ – which you will know I regard as a moveable feast, a condition open to interpretation and review.
I popped in with a Covid-booster.
It was drawn-up, just out of the cooler, quarter of a millilitre of immunological goodness.
My patient was surprised to see me.
‘I’ve come to give you your fourth jab!’ I said.
‘I don’t want it.’
There I was, syringe and sharps bin at the ready, face-masked, etc and he said no.
I said, ‘Oh, I didn’t realised, I am sorry, I didn’t mean to invade your privacy,’ (As with most house-calls in the UK I just knock the door and walk-in) (I can’t imagine they do that in America).
We had a short chat. He said he was doing fine.
He was attached to oxygen and in his bed.
Fine is a relative term.
I said cheerio and left.
Some might think, ‘What an ungrateful patient! The doctor went to all the trouble of…’ Others, ‘What a waste of vaccina! Shame!’
I thought, ‘What a guy.’
So many patients are easily cowed or railroaded into receiving treatments or investigations that they do not want, for someone to say, ‘No.’ Is not as straightforward as it might seem.
Most of us are easily manoeuvred or nudged into doing things we don’t necessarily want, it is part of what allows us to live in crowded cities and societies with too many rules and regulations.
At our best and our worst we are compliant.
My patient expressing their wishes, demonstrating their autonomy, their refusal to comply, to do what the doctor wants to avoid disappointment was, I thought, fantastic.
I had another patient who died a few months ago.
She was even more disabled.
She was equally vehement in her consent and assent. She required a talking-aid to communicate, something I can’t imagine.
Me, I am free to do what I want.
Ironically, had I refused the vaccine a year ago it would have caused a massive hoo-ha and potentially would have led to my unemployment.
Madness.
Here is to being human!
Dr Rod’s Odd Blog (almondemotion)
Carers in the health and social care sector are a frequent soft-target for complaint. You can blame them for anything, and they often are the butt of the frustrations of those they support.
You rarely hear complaints about the people running the agencies that employ the carers, ‘Those damn managers/executives/share-holders.’
Caring or, the work of an carer is one of the most intimate non-professional roles in our society.
An army of carers support our old, frail and vulnerable.
Many receive minimum wage.
Many also work to zero hours contracts.
No sick leave, no training, no holiday pay.
We love our mothers and fathers; we care about them although the system allows them to be supported by people who are treated in ways that you would consider inappropriate for those closest to you.
I had a patient complain about his carers today.
The thing is, he didn’t tell me that they…
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