After reading “War Dances” by Sherman Alexie, many good questions came up that we explored in blog posts and in class. In her blog, “War Dances,” Sara wrote, “We blame people for their conditions.” This led to the question: What is your philosophy on treating patients with addiction and unhealthy lifestyle choices?
Maritza discusses the warm blanket that the father in the story desires, and views it as a metaphor for our “longing for a sense of comfort.” This led us ask: How can we give patients the “un-thin” blanket? Aside from medication and treatment, how do we comfort patients?
Jessie writes, “I am an LNA and it can be so difficult to chart some times and staying later no one wants to do…” This idea led to the questions: What is your philosophy on getting “work done” vs. “taking care” of your patients? How can healthcare workers achieve this balance without burning out or getting behind on paperwork?
After our small group discussions in class, you came to some conclusions. Please take a moment to put your response to one of the above questions in writing and add it as a comment to this post.
I think that there is a major difference in “getting your work done” and “taking care”. In my experience, I have had doctors who don’t put any extra effort into taking care of their patients besides getting the job done. They come in, ask the basic questions, prescribe you a medication and send you on your way. Other doctors, greet you first had, ask you whats going on, asks personal questions regarding your life that doesn’t always have to do with why you’re seeing them that day, but it makes you as the patient, feel like more of a human being than something being treated on. Certain doctors have more of an advantage than others to do more than just “get there work done”. When you go to the doctors for something simple that only takes one trip like an ear infection, then the doctors main job is to ask you your symptoms and treat them to make you feel better. When you go to doctors who specialize in more serious things like cancer, you are forced to see them more than once and therefore it’s inevitable that you will build some type of relationship with them. Whether it is a good and personal one is another question. When a doctor is dealing with a long term patient who has something like cancer that requires multiple check up appointments, personal moments are more likely to come up. You don’t just get to prescribe medication to cancer patients and send them off, you must watch them and take care of them while they are going through chemotherapy and testing medications. It is extremely important for every patient to feel like they are being cared for by their doctor and not just “treated” for their illness. Empathy from a doctor ties into this a lot, because showing empathy often leads to breaking barriers that you wouldn’t have been able to break before and talk about personal things.
Responding to Maritza’s post, we can give patients the “un-thin” blanket by giving them as much support as we can. If we can not sit down with them and show them empathy, we can at least be sympathetic and LISTEN to them. A lot of the time people just want to be heard and accepted. We can show them a sense of comfort by being sentimental in their time of need and asking if they are okay.
I believe that people should never be turned down care, because we should care about everyone around us. We all have our own stories, and we should be accepting of all walks of life, even if we do not agree with it. Even if you are not accepting, that is no reason to not give care or even let someone die.
I was talking to my boyfriend about this, and he is in finance. He disagreed with me as he was concerned with who would be paying for this care for the people who are doing it to themselves. I do see that point, if you are concerned about everyone using their assets for one person who seems to be destroying them.
In the end I held true to my point and he held true to his. But he did say to me, I am proud of you for thinking that way because that’s how a doctor should think.
It is the role of a doctor in a community to treat every patient, no matter the subjective feelings are toward the patient. I believe that there are so many reasons behind why people become under the influence of drugs, alcohol, and other unhealthy lifestyle choices. A lot of the times, a doctor may only be treating the superficial problem, when in reality, there is a deeper problem affecting the patient that a lot of times, are hidden from doctors out of embarrassment or discomfort. I believe that doctors will never truly treat the patient until they dig deeper to see the reason why a person succumbs to their bad lifestyle choices. To be able to treat these underlying issues , the first step is gaining the trust of the patient. Trust is essential in effective communication. In utilizing narrative medicine, the doctor should create a safe space and show the patient that they are allowed to unwrap their life problems with the doctor. Then the physician should listen. Whether it is socioeconomic status, mental illness, or an unhealthy living environment that is causing the patient to cave in to unhealthy impulses, everything in the doctor’s power should be used to show the patient that they are not alone in their struggles. Then, once the patient has revealed their internal struggles, the doctor may be able to relieve the external stressors of the patient and hopefully guide them away from bad lifestyle habits.
My philosophy on treating patients with addiction and unhealthy lifestyle choices is to just treat. They are patients and they have the right to treatment. The may keep coming back, but that is what they do. If they want to keep doing the same thing it is their choice, but you cannot just not treat someone just because you think they had there “3 strikes”. One day hopefully they will realize what they are doing to themselves and this will hopefully happen, but if it doesn’t then I cannot do anything about the choices they make. It is their decision to do that to themselves, but it is my job to treat patients and do all I can for them.
When Sarah brought up the issue that “we blame other people for their conditions,” I had to spend a few minutes thinking about my stance on the matter. While discussing, my group and I talked about how a woman diagnosed with breast cancer is looked at much more sympathetically than a woman diagnosed with lung cancer after smoking cigarettes for twenty years. When health care providers treat patients with addiction and unhealthy lifestyle choices, it is not okay to stop caring and especially not okay to stop treating. Doctors shouldn’t have the choice to treat some patients and not others. There is hope for all patients, even if it is higher in some than others. As the law stands, everyone has a right to the hospital regardless of conditions and income. Everybody deserves a chance.
Sara wrote that , “We blame people for their conditions.” In regards to treating patients with addiction and unhealthy lifestyle choices, I think we only have one choice on the matter. We treat the patient as they come in. Part of going into the medical field is the art of treating patients, all patients. There is no choosing individual patients to treat. The medical field is not selective. Working in a psychiatric care unit, I have seen many patients come in with substance abuse and need proper treatment. For the 8 months I have been working there, I have seen a particular patient get admitted four different times for the same condition (alcohol abuse and heroin addiction). We treat him, he gets better in the unit, gets a treatment care plan, and is discharged. A week goes by, we see him again. Now does this mean we stop giving him a treatment plan each time he comes in? No. We as medical professionals are the stepping stone in these peoples lives to want to get better, but we can’t force it, therefore as a stepping stone, we are there to support and to encourage, but when they fall off the wagon, we are there to support and encourage and treat again. So, while we can blame people for their conditions, we have to be the support mechanism to allow those unhealthy lifestyle choices to dissipate, no matter how many times they come in seeking help.
Prompt: What is your philosophy on treating patients with addiction and unhealthy lifestyle choices?
My philosophy on treating patients with addiction and unhealthy lifestyle choices is that one health care provider can only do so much, and there’s a point where it’s up to the patient to help him/herself. There comes a point where, as a healthcare provider, you can’t help the person anymore. Yes, you’re required to help all your patients, but if they won’t help themselves, then there’s no point in helping them. It becomes counter-productive to be wasting time on someone who doesn’t want to be treated when there are other patients that need care and that want to be helped.
I believe this because I’ve dealt with a lot of people in my family who have addictions and unhealthy lifestyle choices, and they didn’t want to help themselves, and some of them died because of their unhealthy choices and addictions. Watching someone die because they chose their addiction over their life is the most frustrating and confusing thing someone can go through, and I think that there really are some people who cannot be helped.
In class, someone brought up alcoholics who need liver transplants, and I think that they should be treated, but I feel that other patients who didn’t abuse their bodies to need a transplant should be top priority.
Sometimes it’s up to the patient to help themselves and be a art of their own healing process. As a healthcare provider, I think that we are supposed to offer help and point the patient in the right direction, but they have to take the baton from there and be responsible for their own actions and their own decisions.
It’s not that I don’t want addicts and people with poor health choices to be refused treatment, I just think that there is a point where the patient needs to take responsibility, and if he/she can’t do that, then there isn’t really a point in helping them.
In our culture, we are focused on disease as being caused by one single pathogen. I think this is why we have such a different approach when it comes to addiction. It is not a disease that is caused by a pathogen so we tend to blame the people for their conditions. I can see how it is often an individuals choices that lead to addiction, but it is not necessarily a real choice due to social determinants.
I think it is important that health care providers treat all patients, with all diseases the same. Every patient should receive the same compassion and medical effort no matter what disease they present with. Becoming a health care provider is a choice people make. It is not a conditional occupation where you can choose who to treat and who to leave helpless. If someone does not feel that they should help people with unhealthy lifestyle choices then that person should not necessarily go into health care. I completely understand that it would be frustrating to put effort into helping people who are hurting themselves, but it part of the job. I could’t imagine not treating someone in need.
I believe a way to give patients that “thin blanket” is to hear what the patient has to say and connect with them. In class we talked about how some doctors talk to their patients while on a computer and that does not really make the patient feel like the doctor is listening.
My major doctrine for treating patients with addiction is to not take anything personally, and to understand that people are flawed, this makes it much easier. Being close to addiction leaves you pretty jaded to people suffering from addiction because you naturally, almost as if its a knee-jerk reaction superimpose your addict in the shoes of your patient. I think it is very easy to blame these people, say that their choices are entirely their own and that they deserve the fate that they have chosen, but this is a seriously incorrect view. There is no plausible way to understand every facet of another’s life, and you would be a fool to assume that they chose this life. For instance, it is very easy to look at my loved one and say that they are an addict by choice. However, your snap judgement would fail to capture the years of depression, heartache, divorce, countless losses and other nasty curve balls of life that would almost certainly drive anyone to want to escape. I try to be as empathetic as I can and ask a lot of questions without judgement, I think this is the best way to reach people in crisis due to addiction. Others I work with are not so understanding, I know many EMT’s that will “slam” narcan as fast as they can to “f–k with the junkies” simply because they like watching the reaction and having some battle story to brag to their friends about. Having an addict as a parent has taught me a great deal about leveling with people, a lesson I feel is vastly under appreciated in our culture. But like anyone, they are human and make mistakes. Who are any of us to judge?