Please Note: This article is primarily intended for Doctors and medical undergraduate and post-graduate students but the last part may make an interesting read for Non-Medicos.
During the clinical round in the ward, many doctors allow only one relative or attendant to stay in the ward at the bedside of the patient.
The advantage is that the patient does not feel apprehensive with the relative near him. This is especially true for ladies and children. For patients not in their full consciousness, it may be necessary for someone to stay near him. The relative can supplement any information provided by the patient, such as his food intake, any fresh complaints, etc.
The doctor can also explain the patient’s conditions to the relative directly and instantaneously avoiding any omission due to the gap between the round taken and the relatives briefing.
But the disadvantages are that the relatives may talk with the patient, among themselves or on the mobile phone causing noise distraction. They may also interrupt the doctors in between the round by asking a question even if the doctor has gone to the next patient.
The privacy of the patients may also get compromised with the relatives trying to listen to what is happening with their patients and nearby patients and craning their neck to see when the doctors are examining nearby patients.
Some doctors ask all the relatives and attendants to stay out of the ward when the round is going on.
The advantages are a relatively quiet ward, there is no distraction by the relatives asking questions in between the round, and the privacy of the patients is better maintained. But there may be resentment among the relatives that even one relative is not allowed to stay with the patient. The relatives will not be able to interact with the doctors directly on the round.
In this situation, it is essential for the doctor to make it a point to brief each and every patient’s relatives after the round.
Some point may be forgotten by the time of the briefing. Therefore it is essential to note the specific points which need to be informed or discussed with the relatives after the briefing.
It also essential that the doctor keeps a record, that the condition and treatment of the patient have been discussed with the relatives. For example in many ICUs where not even a single relative is allowed to stay inside with patient, after the round, the senior resident or the consultant takes the list of the patient bed number wise and call one by one each of the patient’s relatives, brief them regarding the patient and take their signature on the list that the patient’s condition, treatment, progress, and prognosis has been explained in detail.
Some hospitals are even video-recording the briefing process for more transparency and safety.
There is a third variant for the clinical round which was practiced by Dr. Sharma (Fictional Name).
Dr. Sharma, a surgeon, was newly transferred to the Hospital. Dr. Verma (Fictional Name) was the other consultant in his unit and was working for some years in the hospital before Dr. Sharma got transferred there.
Dr. Sharma used to take the clinical round after all the relatives had been asked to wait outside the ward.
To his chagrin, he noticed that the almost all the patients on the follow-up visit used to consult Dr. Verma (Fictional Name) who was junior to him. Hardly any patient came to him on follow-up. Matters came to head when on a follow-up visit a patient’s relatives extolled the fine care Dr. Verma gave to their patient after his operation.
Seeing his frustrating the senior resident explained, “Sir, you are new here so the patient’s do not know you, whereas Dr. Verma is working for many years before you came here. Also, when he comes to see the patients in the ward after you have left, the relatives are present in the ward and interact directly with Dr. Verma. When you take the round the patient’s relatives are not in the ward, therefore many of them have not seen your face at all.”
From that day onwards, when taking the clinical ward round, Dr. Sharma asked all the relatives to be called inside and be present near the patient when he was taking the round.
So like Dr. Sharma, if you want to get popular among the patients and
their relatives, then take the clinical round in a jam packed ward.
(Based on allegedly true incident)
— ND
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost.
DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm.
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