The Art of Patient Care Blog

A Beautiful Pathway Lined with Trees ... Sam Abell 12x16 Photograph...

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The Art of Patient Care Blog contains a listing of all the new and/or updated pages on this site. Also included are visitor comments, editorials, article reviews, case studies, pertinent news items and other miscellaneous information all related to enhancing our ability to provide high quality, competent and compassionate care to patients who are looking to us for our knowledge and support.

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Protocols

It's becoming common practice to use protocols based on evidence-based medicine in writing orders and treating various illnesses. While this is helpful as a reminder of evidence-based guidelines and provides a checklist so that you don't forget certain things as you are writing orders, please try to avoid the pitfall of using the protocol as a cookbook and as a replacement for thinking and using proper clinical judgement about an individual case.

Protocols are written as a guide that will probably work for the majority of routine illnesses, but patient care is loaded with so many different variables, that what works for many or even most, will not work for all patients.

Remember that, no matter how much certain institutions want to standardize care for diseases, it is impossible with current technology to standardize individual patients. If it were possible, our computers could direct patient care, and there wouldn't be a need for doctors. There may come a time, I am told, when computers will be able to think and maybe even surpass human intelligence, but we're definitely not there yet, and I personally hope we never will be.

For now, the doctor, not the protocol, should be running the show.

Compassion

Compassion is an important component of patient care from both a therapeutic as well as a humanitarian viewpoint, yet its importance is little emphasized in our training.

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Nurses Week!

Beginning April 12th, Fibers.com kicked off their 2nd annual Nurses Week Design Challenge, where nurses and nurse-aficionados can create clever t-shirt designs in celebration of Nursing Week and the nursing profession. Users may submit designs using the simple yet powerful Fibers.com design tool.. no design skills necessary!

Three brilliant & creative winners will be chosen on May 16th to win over $2000 in prizes including an iPad2.

Visit the following link to view, participate, and vote in the contest:http://www.fibers.com/contests/nurses-week-2011

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Objectivity

Objectivity is another mark of professionalism in patient care - another goal for which to strive - but it's not always as easy as you might think.

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Clinical Judgment

Clinical judgment requires a balance between compassion, science and common sense. How do we sort out what is the best option when there are no textbooks or studies that tell us what to do?

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Case Study: Code Status

This case study demonstrates the problems you can get into if the predetermined code status is not followed properly.

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Call the Palliative Care Team Early

An recent article in the August 19, 2010 issue of the NEJM caught my attention - "Early Palliative Care for Patients with Metastatic Non-Small-Cell Lung Cancer", by Jennifer Temel, et al. The investigators found that when patients with newly diagnosed NSC lung cancer received early palliative care, the quality of life and mood were significantly higher at 12 weeks than those who received standard care. Furthermore, the group that received the less aggressive palliative care actually lived longer than the standard care group who had more aggressive care!

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Contextual Medical Errors

Contextual medical errors are very common. We must explore the literacy and the social history of our patients to be sure that treatment we prescribe can be carried out properly.

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Humility

I was happy to see an article appear in the Annals of Internal Medicine in this current issue (2010;153:200-201) written by Jack Coulehan entitled, "On Humility". This is a very well-written treatise on the art and virtue of humility in patient care, showing that it is not a sign of weakness as it is sometimes regarded, but rather an "unflinching self-awareness" that allows us to connect to patients, understand them and advocate for their welfare. Humility also wisely reminds us that despite all our knowledge, we still don't know everything and never will. We have to keep this always in the backs of our minds, so that we will never be so arrogant as to prevent us from learning from our patients, about life, death and humanity.

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Unexpected Death

Dealing with an unexpected death is never easy for healthcare providers. How can we help families and ourselves cope with these situations?

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Medicine Library

My online medicine library contains my favorite resources for medical diagnosis and treatment. I keep these bookmarked for easy access on my office desktop computer.

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Continuity of Care A Personal Voyage

Carol Stickney and Opal Bristow published a book (let) entitled Discharge Planning and Continuity of Care. Carol had gotten sick later in life and needed

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Politics and Patient Care

As much as I like to avoid the subject, I just can't ignore the importance of politics and discussions about health care in this country that directly effect the daily lives and livelihood of all healthcare providers and patients alike. One of my favorite blogs that helps provide insight and understanding among all the confusion is the ACP Advocacy Blog...

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Concierge Medicine - The Myths and Misconceptions

The concept of concierge medicine has emerged as an alternative to traditional medical practice. Many generalizations have been made that may not be accurate. Here is my experience.

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Altruism vs. Burnout

I have a concern about your statement that we should be concerned about the well being of the patients far more than our own (paraphrase).I beg to differ. There is a fine balance. If we do not look after our own well being we can not do a good job taking care of others. That is why we see the burn out,family discordance, drug abuse etc. and the stress to the point of distress. In this case charity must begin at home. - Lal Arora

{Point well-taken. You're right. Each of us has to find the right balance, which is sometimes difficult to discover these days when there is so much pressure to see more patients in less and less time. For more on this, see the page on Burnout. GJW}

New Resources on Medical Professionalism

I'd like to share the latest resources on many issues surrounding Medical Professionalism from the Institute on Medicine as a Profession at Columbia University.

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Saying No to Patients

The art of saying no in patient care sometimes depends on how well the health care provider can explain to patients why some medications or treatments may be ineffective or even harmful.

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Science and Patient Care

Here is a simple but eloquent story about making a connection between the science of medicine and caring for patients...

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Burnout

Burnout is a syndrome that can bring even the most compassionate physician to his/her knees, resulting in poor bedside manner and, even worse, poor patient care.

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The Doctor Patient Relationship

The doctor patient relationship is a special bond like no other. It needs to be respected and treated carefully as a partnership emphasizing equality and trust.

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Hospice Care

Hospice care can provide peace and comfort for terminally ill patients and their families.

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Palliative Care

Palliative care has become a specialty all its own, dealing with compassionate symptomatic control for suffering patients.

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The Art of Patient Care in Clinical Medicine

Introduction to The Art of Patient Care - a website dedicated to improving the quality of medical care by studying and emphasizing basic humanitarian concepts.

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Patient Rights

Knowing and understanding patient rights are an integral part of patient care. Here's where to find a summary of these rights.

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Narrative Medicine

The integration of Narrative Medicine into medical training appears to be an excellent method of teaching young professionals how to incorporate humanity and understanding into patient care.

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Continuity of Care

Talking about continuity of care isn't enough. We have to do something about it.

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Psychosomatic Disorders

Patients with psychosomatic disorders present special challenges to health care providers. How can we help from a primary care standpoint?

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Patient Centered Care

The healthcare industry in this country needs to refocus itself on patient centered care. What's good for the patient will also be good for the healthcare system.

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Advance Directive

Discussing the advance directive and code status with patients and families is an art unto itself.

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Evidence Based Medicine

Evidence based medicine has been popularized as the goal to strive for in medicine; perhaps the goal should be good patient care first.

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Patient Compliance

Poor patient compliance is a frequent and frustrating cause of poor outcomes in patient care.

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Health Information on the Web

How do you know which websites displaying health information are reliable?

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Medical Practice Models

There are different types of medical practice models from which to choose. How do they compare?

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Whole Patient Care

Whole patient care requires knowledge of the patient's background and emotional stresses blended with scientific medical knowledge for optimum care and treatment.

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Health Care Technology and Patient Care

Health care technology is growing at a rapid rate and has great potential for improving patient care but not without cost.

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Phone Calls

Phone calls are sometimes a large part of private practice in medicine. How should these be handled?

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Developing Good Communication Skills in Patient Care

How to develop good communication skills that will help immensely in taking care of patients in all kinds of situations.

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Medical References and Resources for The Art of Patient Care

A listing of medical references and resources relating to the art of healing and patient care.

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Your Comments on Patient Care

This is the place where you can add your own comments on patient care - experiences, concerns and ways to improve on the art of caring for patients.

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Sitemap for The Art of Patient Care

This page contains The Art of Patient Care sitemap with links to all the pages on this site.

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Chronic Pain Patients

Taking care of chronic pain patients is one of the greatest challenges for physicians and nurses of all specialties. What are the problems and how do we manage them?

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Search Page

This page will provide an easy way to access information on this site.

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About the Author

This page contains a brief biography of the author of The Art of Patient Care website along with disclaimers, disclosures and certifications of confidentiality.

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Geriatrics and Patient Care - Extra Compassion and Understanding Required

Geriatrics is a large part of primary as well as specialty care; and many of our elderly patients have a special need for kindness, understanding and compassion.

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It's All About the Money!

A good friend of mine and also my patient of many years had been struggling with inoperable lung cancer for about 15 months. He had gone through at least 2 courses of radiation therapy and many months of chemotherapy. Ultimately, his condition worsened. He developed severe bone pain from metastatic disease, increasing anorexia and generalized weakness to the point where he became bedridden and cared for by his devoted wife. As he lay in bed at home, my wife and I paid a social visit. At the same time, his priest had been visiting him as well. The priest said to him, "Wow, you must be special, having your doctor come to visit you at home! My patient and friend quipped with a smile, "It's because I still owe him money!"

He died a week later, but I'll never forget his humor and his great strength and courage at a time of tremendous suffering.

Medical Office Staff

Your medical office staff is extremely important in setting the tone of the office. Make sure their goals of patient care are in line with yours.

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Medical Ethics in Clinical Practice

A summary of basic medical ethics required for clinical practice and proper patient care.

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Communication with Medical Consultants

Communication with other medical consultants about your patient is necessary for proper coordination of care, patient safety and is a sign of your concern for the patient's welfare.

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Communication with Family Members

Communication with family members is extremely important and an integral part of patient care.

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