I recently worked in my local general practice during my medical school holidays. The phlebotomist was due to take sick leave and I was asked if I would cover a few of the sessions. During my clinical training in hospital I had taken many blood samples and although slightly hesitant, agreed.
My first day went well: the patients were keen to talk to me about my training and my confidence improved. I called my last patient, a lady in her mid-50s with epilepsy and learning difficulties who was attending with her carer. Her carer noted that it may be a difficult task (the last two attempts to take her blood had been unsuccessful). I noted that she was on carbamazepine and her blood levels had not been checked for some time. The patient had capacity and understood the need to have her blood taken, but refused every time I tried. Repeated sugar bribes from her carer and encouragement from both of us was to no avail.
After 30 minutes I reassured her again and explained it really wouldn't be too painful. She then calmly held out her arm and with continued reassurance from myself let me take a blood sample. Upon reflection I needed the half an hour talking with her to gain her trust. During this time I learnt a lot about communicating with patients with learning difficulties and the value of patience in addressing their emotional needs.1 The role of GPs in addressing these needs and the skills required are key. A 30-minute consultation slot may be worth many 10 minute slots. Indeed, in this time I learnt valuable skills that will be useful, whatever area of medicine I choose.
- © British Journal of General Practice 2012