Sometimes a small effort can make a big impact. During my clinical rotation, I saw a patient who was admitted with diabetic ketoacidosis. During our initial conversation, it was clear that he was positive, optimistic, and eager to learn about diabetes nutrition and wanted to make lifestyle changes. I gave a diabetic education and answered his questions. I assumed that my initial assessment would be my only interaction with the patient and that he would make progress after being discharged. However, the patient was not only not discharged but he was eventually scheduled for a below the knee amputation and due for reassessment.
Reading the social services note in the electronic medical record revealed that the patient was having a difficult time coping with the reality of his upcoming surgery. My conversation with the patient for his reassessment was a completely different experience. The patient expressed frustration with the food and room service. He felt like he did not have control over his meals because of the carbohydrate restrictions. He was angry and upset. The menus at the hospital do not include nutrition information for each menu item, so the patient had to rely on the operators to pick foods and determine his diet. I was able to find an old version of the menu that was no longer being used, but included grams of carbohydrates for most of the menu items. This allowed the patient to plan out his meals for the day and have more control over what he was going to eat before he called the operators.
Finding the menu was simple, easy, and did not take much time, but it had a significant impact on the patient. It gave him more control and it helped him to be part of the process instead of a passive bystander. The patient asked for my supervisor to come to his room so he could express how important this was for him and how much it had improved his state of mind. What was a seemingly small effort on my part ended up having an outsized impact for the patient. I learned that you never know how much a person is struggling, even if they appear not to be, and that a small gesture can go a long way.
Reading the social services note in the electronic medical record revealed that the patient was having a difficult time coping with the reality of his upcoming surgery. My conversation with the patient for his reassessment was a completely different experience. The patient expressed frustration with the food and room service. He felt like he did not have control over his meals because of the carbohydrate restrictions. He was angry and upset. The menus at the hospital do not include nutrition information for each menu item, so the patient had to rely on the operators to pick foods and determine his diet. I was able to find an old version of the menu that was no longer being used, but included grams of carbohydrates for most of the menu items. This allowed the patient to plan out his meals for the day and have more control over what he was going to eat before he called the operators.
Finding the menu was simple, easy, and did not take much time, but it had a significant impact on the patient. It gave him more control and it helped him to be part of the process instead of a passive bystander. The patient asked for my supervisor to come to his room so he could express how important this was for him and how much it had improved his state of mind. What was a seemingly small effort on my part ended up having an outsized impact for the patient. I learned that you never know how much a person is struggling, even if they appear not to be, and that a small gesture can go a long way.
