Patients and nutrition.

While preparing for your exams it’s good to keep in mind what your role will be in the not so far future, that being the person in charge of healing and recovery for delicate patients, no matter the specialty or age of your patients this will be your responsibility.

Up to 40 per cent of those admitted to hospital are underweight (Audit Commission, 2001) and many lose weight while in hospital. It is estimated that up to 60 per cent of hospital patients are clinically malnourished (Malnutrition Advisory Group, 2003).

The nutrition part of a patient as part of an integral approach for their recovery is a topic always overlooked while in the rounds, you focus more on treatment, lab results etc. and rarely take the time to think about your patients nutrition, this is something I always thought the best attendants had, a mind on the details, after all there is a good chance that an improved diet can help those in bed to recover faster.

Of course there is personnel attending nutrition for inpatients but as the person in charge of each one of the patients in your guard you should also have a saying in what they should be eating, absolutely no one likes boiled chicken and tasteless gelatin.

Thinking of nutrition as part of an integral therapy, it’s important to remember the requirements to improve granulation, scar formation, boost immune response, blood cell count, collagen formation etc. and use this knowledge to improve the patients nutrition, patients in recovery should have more fresh vegetables, fruits and nuts and in a greater variety to meet those requirements.

This is where you should aim your nutritional advice to increase nutrients available for a fast recovery, to make all possible requirements fulfilled during their treatment; this also means to improve overall nutrition while under your care. Of course nutrition is a topic both complicated and controversial for some institutions but that shouldn’t stop you from using your own logic to improve the patient’s nutrition while under your care, this means using all available information to improve a patient’s condition, using fresh food to meet the requirements without doing controversial practices.

Multivitamins, cold press juices, salads, fruit and nut snacks are all practices that should improve the available nutrients as well as quality proteins when available, use the patients family to help if necessary, the important part of this advice is that as future attendants you should keep in mind that there is a need to improve the nutrition of a patient while under your care that also can be reflected on the recovery process.

Thanks again for taking your time to read our posts, as always we invite you to visit us at www.usmleprepguide.com and check out our tutoring guides for the USMLE series, also if you have any comments please leave them at the bottom,

Patient Education.

One of my old time sayings (both to students and to myself) has always been “an educated patient is the best kind of patient” for my practice this has been a big revelation, when people understand what they have their treatment goes great, they are more compliant with treatment even if it takes a long  time or a really complicated schedule, their time for recovery is less than other patients and they seem to be more aware of their own behavior if that is the cause of their disease (diabetes makes a  good example).

Of course the time in each consultation increases but as I have seen only for first time patients, the follow ups are easy and fast, and at the beginning of this idea I also doubted it because it involved me talking more and taking more time with each patient on an already busy day, with time it balances itself, when you have quick follow ups you recover the time invested and so on, this way I’m having almost the same amount of time in my office as before, the real difference is my relation with patients and a better outcome.

What I also discovered is that by explaining all you can, you develop a different relation with your patients their attitude towards you is better; you find them more open to discuss their behavior and trusting more your opinion. Each day is better and also I find it easier to get along with patients while feeling more satisfied with my work.

When you think about the best way to make a patient compliant with their treatment, a way to make them more involved in their healing process and a way to improve trust issues within a doctor-patient relation one of the best ways to go is patient education and there is something more here, people really want to know what they have so they are really listening when they step into your office.

Explain them in their own words.

One of the first thing to have in mind is that normal people doesn’t really understand medical terms, even if they have an idea of what something means it might be the case that they have some other meaning for it so it’s important to explain what they have in the most simple terms you can find.

Try and use analogies, sometimes people understand better a concept when you use some other concept that helps get the idea more comprehensive, like explaining circulatory problems with faucets or plumbing, the idea is to make a patient more comfortable with a concept and make them understand their disease. Once a patient understands his/her disease explain them their options as well with details of how they work and what you expect as outcome for each line of treatment.

Also important is to explain anatomical parts in a way they can really understand. Again using analogies or models can help them understand pathology.

Check for comprehension.

Something important to keep in mind is to ask your patient about what you just explained them, try and ask them if they understood your explanation and see if they have the proper idea for that concept, sometimes it happens that patients understand things differently and you need to make another explanation or clarify their misunderstandings.

Ask them for doubts, sometimes people don’t ask because of what you might think of them, you have to give patients a level of confidence to make them trust you with their own ideas and opinions, you will be surprised to see how many patients don’t get it and still remain silent, check always for comprehension and any type of doubts, especially for treatment it’s really important to have a clear communication.

Helps them make informed decisions.

A patient that understand better a condition and his/her options for treatment can make a better decision and become more compliant with the treatment he/she decided, this is something that is more common in chronic diseases and long term treatments, and it is quite logical that you make better decisions about something you understand that say ordering in a foreign language.

People need to be informed to understand what you are doing with them, also important to keep a clear idea of what the treatment is going to do, what each medicine does, how do they work, and especially for procedures what you are going to do, how, if it hurts, why is important to make it etc.

Don’t trust me try it yourself.

All in all the strategy can help your patient outcomes if you try it, at first it may be a little hard since you have to think of how to explain each disease and treatment with practice it becomes really natural for you to explain your patients what they have, what you will be doing for them, what the results will be, and how long will it take, using images or models can increase comprehension and save you some time, but as any other part of your practice it doesn’t work if you don’t try it, you will see the results and then decide if you keep it or continue in antoher direction.

Also look for aids to help you teach your patients currently there are a lot of online services for patient education, AMA has some resources you can check http://www.ama-assn.org/ama/pub/physician-resources/patient-education-materials/atlas-of-human-body.page but also there are other companies dedicated to patient education you can check to help you increase your quality of service and reduce the chance of misunderstandings with your patients.

Again let me thank you for reading our blog and don’t forget to check our website www.usmleprepguide.com if you have any comments leave them below.