Explaining procedures
Discussing the details of a procedure (for example,
endoscopy) with patients is often included in objective structured clinical
examinations, and as a doctor you will always be required to inform
patients sufficiently and involve them in decisions about any procedure
they may require.
Introduction
Introduce yourself appropriately to the patient, check
if they have any prior knowledge of the procedure, if they have ever had
the procedure before, or if they know someone who has. Then explain the
purpose of the procedure, its approximate duration, and how they can expect
to feel immediately afterwards.
Preparation
Certain procedures may require the patient to stop
eating, drinking, or taking specific medication, so they must be informed
of this. If there are many details for the patient to remember then writing
it down for them or advising them to take notes may make things easier.
Anaesthetic
Explain whether or not the patient will require
anaesthesia or sedation. If optional then discuss both the potential
benefits and the drawbacks with the patient. Describe how it will be
administered. Also check whether the patient has ever had a reaction to the
anaesthetic.
Risks and complications
Find out if the patient suffers from any medical
conditions that may pose a risk during the procedure. In addition, make the
patient aware of possible complications that can arise, without forgetting
to give reassurance.
After the procedure
Tell the patient:
- How long they
will need to remain in hospital
- Whether they
can eat or drink immediately
- If they can
drive, take public transport, or need to be accompanied home
- When they can
expect to return to work (if applicable)
- When they can
expect to be given the results (if a diagnostic procedure).
Finally, answer any questions the patient might have,
identify any concerns, and ensure all the information that you have
provided is understood. Avoid using unexplained medical jargon.
Temidayo Lampejo, fourth year medical student, Imperial College,
London
Email: temi.lampejo@imperial.ac.uk
studentBMJ 2005;13:397- 440 November ISSN 0966-6494
