After receiving my second reminder letter a couple of weeks ago, I went for my routine cervical screening.
This is a necessary event for every woman but laying back on the plinth naked from the waist down, legs spread always makes me feel vulnerable; it’s such an intrusive procedure.
Even though my practice nurse was lovely, calm and reassuring, I started to spew words, trying to negate the awkwardness I felt, as she said, ‘just relax, it will be over in a minute or two’.
As I lay there I was thinking about the invasive procedures I do for my patients and the conversations we have about very personal care.
During an early shift, most of our patients need assistance with bowel care which leads to a very pungent smell on the ward. Now having worked on there for many years, I am used to the smell and the procedures so I have no embarrassment or worries about carrying them out (digital rectal stimulation, digital removal of faeces), but just because I am comfortable with it, doesn’t mean my patients are.
Of course no procedures are carried out without the patients’ verbal consent. Bowel care following spinal injury is a vital part of care to avoid long-term complications or bowel accidents; just like cervical screening, patients may not want it, but they know they need it.
Being sensitive to the patients’ anxieties/worries is an essential part of our roles – taking the time to explain the importance of procedures and making sure the patient has understood the rationale behind it, the choice they have and any alternatives is vital.
Sometimes this process can be time consuming and frustrating. Sometimes patients find it difficult to accept and question over and over if what we know is evidence-based practice. However, there is also a group of patients who do not want to ask questions and just agree with the plan of care without understanding what is involved because it is what we advise.
As well as making sure the patient has all the information they need to make an informed decision, we also have to be mindful of our behaviour when carrying out an intimate procedure. Some patients don’t want to talk about what was on the television last night while having an intermittent catheter passed into their bladder. They also might not want to hear us talk about our social lives with another nurse who is assisting with the bed bath.
I (as you’ve probably guessed) am a talker, but when I am doing an invasive procedure, I am guided by the patient as to whether they want to talk and what they want to talk about.
In my opinion, as soon as patients are admitted to hospital, they become vulnerable and we always need to be mindful of that.
Sian Rodger is health coaching nurse facilitator at the London Spinal Cord Injury Centre