新編大學(xué)英語(yǔ)第四冊(cè)u(píng)nit10 Text B: Required Course: Bedside Manner 101

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UNIT 10 AFTER-CLASS READING 1; New College English (IV)

Required Course: Bedside Manner 101

1 Connie Cronin is the kind of nurse who loves to work the overnight shift on Christmas Eve to usher in the holiday with her patients. That's why she was so troubled one morning when she realized on her way home from work that she had all but ignored a patient ravaged with infections and confined to isolation. Cronin was the only person the patient would see all night, but because she was also the only nurse on duty, she avoided his gaze in her rush to finish her tasks. The next evening she headed straight to his room only to learn that he had died. "I abandoned that man during his last hours on Earth," she says.

2 Virtually every health worker has a story of regret over care not given to a needy patient. Such events were once the exception, but today, caregivers say, they are becoming the rule. One CEO of a large health and hospital system in Dallas, Texas, believes that doctors get pressure from all sides to reduce costs and it takes their focus off the patient. His opinion was echoed by other doctors, nurses and administrators, who attended the first national conference on "relationship-centered" care in December 1998.

3 As the conference title suggests, most health professionals agree on the need for doctors and nurses alike to practice better bedside manners during increasingly short sessions with patients. Studies show that the more comfortable patients feel with a caregiver, the more likely they are to reveal key medical facts and to follow medical instructions. Yet, 6 out of 10 doctors surveyed said that medical school had poorly prepared them to talk with patients. Also 7 out of 10 doctors surveyed said that insufficient time with patients was a serious problem.

4 Still, health care workers can take a number of steps to improve their talks with patients, according to Aaron Lazare, Dean of the University of Massachusetts Medical School. For example, after asking, "What brings you here today?" a doctor should try not to interrupt the patient's reply. A recent study showed that a doctor usually breaks in after just 18 seconds, but a patient who is allowed to speak freely will finish in two and a half minutes. A second key question, the Dean says, is, "What were you hoping I could do for you?" Doctors and nurses are often amazed by the answer. Patients want to be told that they don't have cancer. Other times they say, "Tell my wife not to leave me" or "Tell my boss I can't work."

5 A doctor's biggest mistake, researchers say, is intimidating patients into silence by tapping a pencil impatiently or keeping one hand on the exam room door handle. Dean Lazare says, "No visit should end without a doctor asking, 'Is there anything else you'd like to tell me?'" For their part, patients must speak up. Many people suffer from what medical professionals call the "good-patient syndrome", a reluctance to take up a nurse's time or a fear that a complaint isn't worth mentioning. One thing that frustrates doctors is that a number of patients wait until they are halfway out the door to bring up their most urgent concern.

6 To prevent these problems, Dean Lazare and others are helping medical and nursing schools create a list of communication "competencies", such as helping a patient discuss worries and delivering bad news gently. A few schools now require future health professionals to take a course each year to practice with actors simulating difficult cases. Students are videotaped so that they can see themselves backing away from a prostitute, sighing as an elderly man talks on and on, or glaring angrily when challenged. Soon students may conduct mock physicals and be graded on bedside manner as part of medical licensing exams.

7 No matter what formal training is offered, nurses and doctors will always find their own ways of meeting a patient's needs. Connie Cronin set up a network of nurses who were willing to cover for one another when the need arose. Thanks to that system, she was able to spend 45 minutes with a dying cancer patient while the woman waited for her husband in the middle of the night. He didn't arrive in time, but the patient had Cronin there to hold her hand through her final breath.

8 Dr. Bernie Siegel, a surgeon at Yale Medical School, has developed his own way for relating to his patients more effectively. He recently wrote a book called Love, Medicine, and Miracles, which tells of his life and experience in healing. In the 1970s he was a surgeon at Yale, had a wonderful wife and five beautiful children, but he was terribly unhappy. Like most doctors of his generation, he had been trained to keep an emotional distance from sick people and their families. He treated people's diseases and kept himself apart from their lives, but he was miserable behind the wall he had built between his patients and himself. He considered leaving medicine.

9 Then he decided that before he quit he would try a different way of doctoring. He would allow himself to care about the patients he was treating. Once he did this, he began to see that it was very strange to think of medicine as a profession where doctors stand apart from their patients. He knew that he had to deal with cancer but that cancers were growing inside of people. So he shaved his head, moved his desk against the wall, sat down by his patients, and asked them to call him by his first name, Bernie.

10 As Bernie, he now talks with his patients and tries to help them with their fears. One thing he tells everyone is that it is important to show appreciation to others. He often tells people to give a reminder of their love to their family that day a note, flowers, a card, a hug, or just say it out loud because everyone in the family needs reminders. He recommends that his patient say "I love you" to someone that day, starting with the one to whom it is the hardest to say, and who often needs it the most. He strongly believes that this "prescription" works well and has no side effects. It is helpful to the person who is ill as well as to those people who are not. Bernie is convinced that if people are to heal physically they must also heal emotionally. When his cancer patients are undergoing unpleasant treatments such as chemotherapy, expressions of love help both them and those who are close to them. His patients believe him because he takes the time to show his love and concern to them. Not all doctors can become Bernie Siegel, but all can learn to become more caring.