I enrolled in Word on the Wards right after returning from my clinical rotation at an acute care hospital because I wanted to improve my patient-centered care and gain more experience working with patients in the inpatient setting. While UCSF’s physical therapy curriculum has classes that emphasize skills including motivational interviewing and identifying change language, it is not very often that we actually get to work with patients while focusing primarily on these skills. In addition to these skills, Word on the Wards provided me with the opportunity to practice interprofessional communication with another healthcare student in ways that the Interprofessional Education sessions at UCSF just can’t simulate. While most of my patient interactions were positive and felt productive, it was the more challenging patients whose sessions taught me about the importance of entering the room with an open mind, being flexible with your agenda, and really taking the time to listen to a patient in order to provide him or her with the best and most supportive care.
During my last session, my partner and I worked with a patient who was in the hospital for alcohol dependence and chronic pain. Before entering his room, we agreed upon a few key points we wanted to bring up with him about his drinking habits and his social situation. However, when talking to the patient we both realized that it may be more therapeutic to just let the patient vent and express his frustrations rather than trying to push our own agenda. While he said he was agreeable to changing his drinking habits, he did not express any faith in the good intentions of his healthcare team or the various community services aimed at helping individuals cope with alcohol addiction. In order to meet our patient where he was at, we decided to keep the conversation focused on learning about his current living situation, support system, and personal history. His frustration with chronic pain and his decision to self-medicate using alcohol created a vicious circle that was difficult for him to break particularly because he lacks a reliable support system or stable living situation. After speaking with our patient, we rounded with his nurse and suggested that perhaps a visit from a member of the pain management team would be helpful. Since he seemed to be in the contemplation stage of change, we thought that the patient would benefit from speaking with someone who can not only connect with him on the frustrating reality of coping with chronic pain but also provide alternative ways of coping that the patient may not have considered. Raising the patient’s awareness may help to move him closer towards the “preparation” stage and plant the seeds for real change.
Beyond my one-on-one patient interactions, my experience at SF General has showed me the value in listening and letting patients teach you what they need rather than imposing goals and knowledge onto patients. Working with patients whose social, economic, and health histories do not reflect my own experience taught me how changing your own perspective and leaving biases at the door is important when establishing the necessary trust in a therapeutic relationship. Moving forward as a clinician, I will strive to integrate the lessons and skills that Word on the Wards taught me in order to provide more patient-centered, interdisciplinary, and compassionate care.