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医生,别让无心之举伤害患者

2017-12-12 韩立军 健康报医生频道

前几天,有位姓孙的患者来找我,说自己受到了惊吓,并给我讲了自己的经历。原来,他去一家医院做例行体检,在内科诊室量完血压后,正要站起来时,医生却严肃地大喝一声:“别动!”这一声“厉喝”如五雷轰顶,把他吓蒙了。


前几天,有位姓孙的患者来找我,说自己受到了惊吓,并给我讲了自己的经历。原来,他去一家医院做例行体检,在内科诊室量完血压后,正要站起来时,医生却严肃地大喝一声:“别动!”这一声“厉喝”如五雷轰顶,把他吓蒙了。

老孙的心脏似乎快要跳出胸腔,他迅速想:难道自己得了绝症?医生这么严肃,肯定不是一般的事情。他一边脑中胡思乱想,一边心脏咚咚乱跳,呆呆地坐在凳子上,不能动弹。又过了漫长而难挨的几分钟,医生再次给他量了血压,然后告诉他:你血压有点高。他惊魂未定地问:“我到底怎么了?”医生回答:“没事,就是单纯的血压高而已。”老孙这才长出了一口气,血压高他早就知道,可是医生在这样的环境与气氛下,用这样的口气说话,让他措手不及。

老孙的话让我想到曾听说的一件事:一位颇有名气的老中医为一位70多岁的老太太号脉,老中医闭着眼睛皱着眉为病人号脉,号完了右手号左手,末了又换成右手,而且边号脉,嘴还不断地“咝咝”吸溜两声。他每吸溜一声,老太太的心里就咯噔一下。最后,老中医突然惊呼一声“哎呀”,老太太一下紧张了“过去”。后虽因抢救保住了性命,但过度紧张导致的脑出血,却使患者永远地“瘫”在了床上。

这样的事虽然不多,但却说明了医生的一举一动乃至于面部表情看似平常,对于病人来说却是至关重要的,尤其是对重病患者和老年患者,更要讲究看病的“艺术”。作为医生,即使发现病情恶化,也一定要先不露声色,而后再委婉地说出来,以免病人接受不了,出现上述情况。

这两件事看似偶然,其实很普遍。临床工作中存在着大量类似的情况和案例,都是医生在错误的时间或错误的场合,使用了错误的语言或错误的表达。但需要明确,这里的“错误”并不是有心之错,医生让老孙“别动”,是因为两次测血压要有间隔,如果期间患者有活动量,测量的数值就会不准确。从这一方面说,医生是负责的,绝不是为了吓唬或者戏弄患者。还有老中医的口头习惯,可能也非故意,脉象诡异复杂、瞬息万变,诊脉需要定力和耐力,于细微之处见真知,老中医可能是发现了某种情况或变化,而发出下意识的情绪表达,绝不是为了故弄玄虚。但医生的这些无心之举,却“伤害”到了患者。

由此,笔者思考,医患双方的合作和互动究竟如何才能更和谐呢?

如今,各医院都在积极地进行硬件和软件建设,包括设备和人才的引进,这被称为医院两大实力象征。然而,如上面的两个案例,既不属于硬件不达标,也不属于软件实力不足,却都造成了不好的后果。医生在诊疗过程中的语气语调、手势动作、神态表情等“细枝末节”,都可能引发蝴蝶效应,带来一连串意想不到的后果。

从患者的角度来说,在某些情况下,并不十分看重医院的设备、技术、人才等高端“实力”,而更会在意很多细节,比如医生的态度和表情、言语和动作等,他们希望更多地得到医生的重视、鼓励、支持、关怀等。就像特鲁多说的那样,对待患者我们要“有时去治愈,常常去帮助,总是去安慰”。这提醒医患双方都要学会换位思考,尽量不要出现“不是问题的问题”。 (文/河北省邯郸市中心医院  韩立军)

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    2017-12-13 wsasdeffgcf

    医生对病人的人文关怀真的很重要

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=268996, encodeId=b365268996a1, content=医生对病人的人文关怀真的很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab581969258, createdName=wsasdeffgcf, createdTime=Wed Dec 13 01:35:41 CST 2017, time=2017-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268983, encodeId=415926898355, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Dec 13 00:10:45 CST 2017, time=2017-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268935, encodeId=768d2689350e, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Dec 12 22:24:30 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268931, encodeId=7cc62689318b, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Tue Dec 12 21:57:51 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268916, encodeId=5b6726891673, content=人文关怀.也是诊治的重要环节., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Tue Dec 12 21:07:44 CST 2017, time=2017-12-12, status=1, ipAttribution=)]
    2017-12-13 飛歌

    学习了很有用

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=268996, encodeId=b365268996a1, content=医生对病人的人文关怀真的很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab581969258, createdName=wsasdeffgcf, createdTime=Wed Dec 13 01:35:41 CST 2017, time=2017-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268983, encodeId=415926898355, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Dec 13 00:10:45 CST 2017, time=2017-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268935, encodeId=768d2689350e, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Dec 12 22:24:30 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268931, encodeId=7cc62689318b, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Tue Dec 12 21:57:51 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268916, encodeId=5b6726891673, content=人文关怀.也是诊治的重要环节., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Tue Dec 12 21:07:44 CST 2017, time=2017-12-12, status=1, ipAttribution=)]
    2017-12-12 三生有幸9135

    学习一下谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=268996, encodeId=b365268996a1, content=医生对病人的人文关怀真的很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab581969258, createdName=wsasdeffgcf, createdTime=Wed Dec 13 01:35:41 CST 2017, time=2017-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268983, encodeId=415926898355, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Dec 13 00:10:45 CST 2017, time=2017-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268935, encodeId=768d2689350e, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Dec 12 22:24:30 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268931, encodeId=7cc62689318b, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Tue Dec 12 21:57:51 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268916, encodeId=5b6726891673, content=人文关怀.也是诊治的重要环节., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Tue Dec 12 21:07:44 CST 2017, time=2017-12-12, status=1, ipAttribution=)]
    2017-12-12 Y—xianghai

    学习了新知识

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=268996, encodeId=b365268996a1, content=医生对病人的人文关怀真的很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab581969258, createdName=wsasdeffgcf, createdTime=Wed Dec 13 01:35:41 CST 2017, time=2017-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268983, encodeId=415926898355, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Dec 13 00:10:45 CST 2017, time=2017-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268935, encodeId=768d2689350e, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Dec 12 22:24:30 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268931, encodeId=7cc62689318b, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Tue Dec 12 21:57:51 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268916, encodeId=5b6726891673, content=人文关怀.也是诊治的重要环节., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Tue Dec 12 21:07:44 CST 2017, time=2017-12-12, status=1, ipAttribution=)]
    2017-12-12 1e0f8808m18(暂无匿称)

    人文关怀.也是诊治的重要环节.

    0

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感冒咳嗽到医院打几天吊针,在一些地方是再普通不过的事情。但是对武汉协和医院呼吸内科主任陶晓南而言,不给门诊患者开输液处方,却是坚守了22年的红线。过去3年,他只开出一张门诊输液处方,还是替其他医生“补锅”。

专家:“打击神药、控制耗材”没错……医生们的收入咋办?

不触及支付制度和薪酬体系改革这些“灵魂”,光想通过严控药占比、耗占比,禁用部分辅助用药和耗材就想清除医疗供销领域的诸多障碍,无异于隔靴搔痒。

悲痛!厦门市第二医院42岁急诊副主任潘海晖去世,女儿仅半岁

12月3日下午,厦门医学院附属医院(厦门市第二医院)急诊科副主任潘海晖去世,年仅42岁。

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