Treating the whole patient

Treating the whole patient
Treating the whole patient

I recently walked into an exam room prepared to do an annual exam on a patient I've been seeing regularly for about three years. I know the patient fairly well, having delivered her first baby two years ago.

I greeted her and asked how she was as I sat down and logged onto the computer. Her response was a flat, “Okay.” But as I looked up, her face told me that she was anything but okay.

“What's bothering you?” I asked, expecting a medical-related complaint. The patient burst into tears and told me that her mom had recently died, very suddenly and unexpectedly.

I stopped entering her history on the computer and asked her if she wanted to talk about it. She spent the next 20 minutes crying and describing her overwhelming grief.  

The patient confided to me that she was unable to sleep, and was barely able to function in her everyday life. She felt guilty that her son was witnessing her grief. She told me she'd seen her primary care doctor the week before, but he'd essentially blown her off, telling her that she'd get over it soon.

The patient's annual exam became the last priority for me at this point. We discussed initiating antidepressants, I arranged a consult with a grief counselor, and we explored coping techniques to help her get through each day, so she could go back to work and care for son. Only after I felt that she had the resources she needed did we move on to her pap smear and birth control.

I spent so much time with this patient that I was playing catch-up for the rest of the day, but I didn't mind. This is why I became a midwife – to provide comprehensive care to my patients. For me, this means going beyond the breast and pelvic exams and getting to know my patients. As part of my profession I'm commited to care for the whole woman, mind and body.

Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.

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