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For the collaborative discussion for this patient scenario please consider the following:
When you watched the clip of Chris having an ashtma attack, what did you think about the response of the Doctor when Chris said he felt like he was going to die. What would you say?
Discuss the pros and cons of the below responses with your cohort colleagues via the discussion forum (click on blue button at bottom of this section).
(1) You are not going to die. (this is what the Doctor in the clip said).
(2) What makes you think that Chris?
(3) If you just slow your breathing down you will be fine.
4) Everything will be ok, stop talking, to save your breath.
I feel like the Dr saying he isn’t going to die could be quite reassuring for Chris if it was said in a more kinder manner as this may put his mind at ease that they are going to help him and they will make hi feel better. However a con of this is that he may just feel like she is just saying that to are him feel better and she doesn’t know if he will die or not.
Asking Chris why he thinks he will die may be good as he will have chance to say his worries and fears and the doctor is able to put him at ease and correct him and tell him what medication is for helping with the different things he is having treatment for. On the other hand this may not be a good thing to ask Chris as he may panic more leading to it being harder for him to breathe and catch his breath.
If you slow your breathing down you will be fine, this could be good as it is giving Chris a goal to focus on therefore he may take his mind of he is going to die. However this could be bad as Chris is unable to slow his breathing down and this could make him go into a more state of panic rather than helping him.
I don’t feel like everything will be ok, stop talking, to save your breath is a good thing to say as Chris may think this is the last thing he will ever say as he is trying to tell people how he feels. Also this is very dismissive and isn’t letting hi say how he is feeling and he may be scared to speak and say something is wrong as if he speaks he is wasting his breath.
(1) You are not going to die. (this is what the Doctor in the clip said).
The way the doctor said this in the video clip was very blunt and could be considered dismissive of Chris’s fears and feelings. I agree with Lauren that if said in the right manner, it could be reassuring.(2) What makes you think that Chris?
I think that this question is valid in that it would give Chris the chance to express why he is feeling this way, however, during exacerbation of asthma it would be more important for Chris to save his breath and concentrate on his breathing.(3) If you just slow your breathing down you will be fine.
I think that of the 4 responses this would have been the most appropriate one at the time. Getting Chris to concentrate on his breathing would help him to slow it down and realise that he is not in fact going to die. As Lauren stated, this would give him a goal to focus on. I think in this situation the risk of it making Chris panic more would be slim.4) Everything will be ok, stop talking, to save your breath.
I think this is another way of reiterating point number 3. Although if said in the wrong way it could still be construed as being dismissive of Chris’s feelings. As Lauren pointed out, it may also close communication between the doctor and Chris as he may feel he cannot let the doctor know how he feel, i.e. if he is getting better or worse.1) You are not going to die. (this is what the Doctor in the clip said).
I think she used a closed question to get him to stop talking and reassure him at the same time.
(2) What makes you think that Chris?
this is a open question and will get him to talk more in a situation where he is gasping for every breath
(3) If you just slow your breathing down you will be fine.
The situation is uncontrollable hence this response will make Chris think he is not making an effort
4) Everything will be ok, stop talking, to save your breath.
This will response will make Chris feel he is being asked to shut up
(1) You are not going to die. (This is what the Doctor in the clip said).
This might seem blunt, but it is very important to encourage the patient to stay calm as panicking may worsen the asthma attack. Although it could be reassuring to the patient to let them know that they’re not going to die but the doctor could have communicated it in a more caring and compassionate way so that the patient would have felt more empowered therefore helping to calm down.(2) What makes you think that, Chris?
I think asking open questions is important to build a therapeutic relationship with the patient, however during an asthma attack is not the ideal time to make him speak more than necessary when he’s already finding it difficult to breathe.(3) If you just slow your breathing down, you will be fine.
Like the others have mentioned asking him to slow down his breathing and encouraging him to focus on a goal could be beneficial to calm him. When the patient is in a state of panic, I think it is very helpful when someone clearly specifies what needs to be done to help the situation.4) Everything will be ok, stop talking, to save your breath.
This statement feels like it’s undermining Chris’s feelings. There are definitely more skillful ways of communicating the same information in a more compassionate and empathetic way.
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