Sunday, July 1, 2012

tips in history taking



salam
oren : aku.
biru : patient
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nak masuk bab social history aku memang berdebar.
tapi aku start jugak. macam biasa lah ayat buku.



"it may be a litle bit sensitive for you. but i need to ask these questions because it may be related to your illness" 



kemudian aku senyap jap. buat saspen.



patient x keruan. 'pemenda student medic ni nak tanya?' dalam hati die kot.



then aku sambung, "emm, do u smoke, miss susan?"



'no, i dont' muke patient berkerut tahan sakit.



"what about alcohol?"



'alcohol, what is that?'



"for example whiskey, beer"



'owh', patient angguk paham then sambung, ' no, i dont take any alcohol.'



"another sensitive question, do u take drugs for pleasure?"



patient buat muka xpaham. 



aku cepat cepat tangkap, "for example, dadah or something like that?"



patient macam nak menangis, sakit sangat kot namun dia jawab jugak 



'nooooo, i dont take drugs like thaaaat.. why u are being like this, asking me lot of nonsense questions.. im having loose motion here, cramping abdomen and all and yet u asked me about drugs, smokes and everything..' 



(imagine okay. her tones sound like she was super annoying.)



aku speechless kejap. xpernah lagi jumpe patient macam ni.



kemudian aku sambung, "im sorry, i need to ask these questions because it may be related to your illness," 



jawapan yang aku boleh fikir time tuh. 



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dialog atas ni sedikit role-play history taking aku pagi tadi.



tadi time ECE. communication skills punye kelas.
im the lucky four (because there are four of us yang terpilih hari ni) today,
because im get chosen to interview 'patient tipu tipu' atau kitorang biasa gelar 'primer'.



things go all 'tunggang tebalik' bila the primer, madam radziah tuh berlakon sakit dengan sangat exaggerated.
i mean, she's like a real-life-patient-yang-kalau-boleh-doctor-want-to-avoid la.
she's really really in pain and easily get irritated.
macam mana nak deal dengan patient macam ni?



cer citer cer citer. ^_^



tips i got from Dr. Ng and Madam Radziah today are:



1) inform the patient awal awal lagi. maknanya, bagitahu patient tuh, history taking ni akan ambil masa 8-10 minutes. explain why u have to take the history and so on lah. pendek kata, make the patient understand first. :)



2) rephrase the ayat yang ini, "it may be a litle bit sensitive for you. but i need to ask these questions because it may be related to your illness".  tukar jadi "i would like to ask you few sensitive questions, because these questions are extremely important for me to know and i hope u can answer me properly". the point here, tell them that the questions are EXTREMELY IMPORTANT. so, the patient will understand the purpose of asking those questions. 



3) and please please please avoid any medical jargon, DONT USE lethargy to ask about tiredness. DONT USE yellowish discolouration of eyes to ask about jaundice. DONT USE hypertension, instead use high blood pressure. and so on. 



4) DONT ASSUME patient know what is alcohol? what is drugs? always provide some examples. :)

yang pasti, i think now i need to mantopkan lagi english aku.
my english sangatlah x fluent.
it seems like i cant construct sentences in a short time.
i tend to mixed up words when i speak in english. and that's suck.



omg. how to mantopkan aa?



kan best if i study kat oversea.
boleh mantopkan english aku teros. hehe



k lah bye.