How Narrative Medicine Can Improve The Physician Patient Relationship?

This paper will recount the development and history of narrative therapy and provide a brief background assessment on the founders and significant contributors to the postmodern approach of Narrative Therapy. The role of the therapist, the theory of change, the target of intervention, the assessment from this approach, and what the approach says about normalcy, health, and pathology will be presented. It will also discuss how narrative therapy might work with and be sensitive to the cultural and diversity factors and give some examples of intervention from this approach. It will then discus the case using concepts and ideas from narrative therapy and the application of the essential ideas of the narrative therapy in the case and, where appropriate,

As stated previously, Story Theory is a very simple practice theory. As shown the main concepts are combined to give the theory its’ meaning and efficacy. There are two main relationships expressed. The primary one is that between the nurse and the patient and family. This relationship is created as a consequence of a health challenge, and involves developing the patient’s story. The patient as the story teller is respected and the nurse’s role is to support and

This paper will look at the logic of narrative therapy by focusing on 5 major points. This paper will begin by discussing how the narrative approach defines and perceives problems. It will address how narrative therapy views the nature of the relationship between the client and the professional. This paper will look at how problems are solved using the narrative approach. It will also focus on three main techniques used in narrative therapy, which will include externalization, deconstruction and re-authoring. This paper will also include a short narrative critique of the medical model.

All too often in regards to medical treatment, physicians are taught everything known about the scientific approaches to disease but still fail to realize the important details of how the disease impacts the individual. Many physicians do not show empathy to their patients and instead just focus on the current diagnosis and the probable outcome. This creates a divide between patient and provider and can even lead to negative feelings of the patient that far outweigh the diagnosis itself. A feeling of hopelessness and despair may accompany the empty feeling that comes with failing to explore the patient’s perspective on care. In this essay, Parrish states,

Discussion how “words of comfort” encapsulated the books take on medicine, I feel that these words are showing us how in medicine being a caring and sympathetic health care provider is important. (Verghese, 2009) In the book relationships with patients is shown to be as important as the care they are providing. Knowing how much technology and medicine has advanced in the last years I feel that no matter how good the scientific side of it is there has to be a relationship with the health care providers and patients. It is proven that a positive relationship helps a patient recover faster. Relationships can help in many ways just having someone to talk to, give feedback, and encouragement are all way relationships are able to benefit and speed up recovery. (Brainline, 2015)

When asked what trait a physician bears in the 21st century, most would agree with compassion. Pierre Elias author of the narrative essay, “Insensible Losses: When The Medical Community Forgets The Family”, argues that physicians may be compassionate when it comes to their patients, but “lack a systematic approach to communicating with families when a patient’s health deteriorates unexpectedly, requiring a change in care providers” (Elias 707). Pierre Elias is a medical student from Duke University. He is nearing the end of his clinical rotations when he is forced by his inner moral conscience to deliver difficult news to a patient’s family whom no other physician makes time for.

A doctor’s mind and heart are very much involved in the patient’s road to recovery. Evidence in support of this statement is shown in William Carlos William poem “ The Red Wheelbarrow, and his essay “The Practice.” Also, in Jack Coulehan poems “The Man with Stars Inside Him, The Six Hundred Pound Man,” and the article “What’s a good doctor and how do you make one?” Individually, each reading and poem has expressed doctor’s emotions with their patients, and what characteristics have guided them into becoming a good doctor. The readings are a representation of how doctors are in fact remorseful when it comes to their patients. While reading these articles, I realize that doctors have been restricted to how much emotion they are allowed to show. All doctors have their weaknesses and their strengths, and they should be vocal about them especially when it comes to treating their patients.

The video presented the ethics and boundaries and factors that affect those boundaries such as addiction, abuse, absent role models, and patients assuming the professional shares the same feelings as he or she does. Then the video discusses issues the doctor may incur such as “special treatment” of patients, time management, poor awareness of feelings, and the response to the patient.

That situation with the younger doctor made me think of the reading Narrative Medicine which is about aiming to introduce into everyday medical practice the use of narrative (story telling) as an instrument to gather and understand information about the patient's history and illness. Having knowledge of their psychological and physical state is very helpful. When Dr. Charon spoke with the 36-year-old Dominican man, she didn’t take over the conversation. She listened and it touched him because he says, “No one has ever let me do this before.” This made me really think about my family’s interactions with doctors and nurses since my teen years to present. Her diabetes began to spiral out of control and it never really stabilized. Over the course of the years, she was hospitalized

One thing that did not go as I expected was maintaining professional boundaries with a patient because one of the patients was using appropriate word and make me uncomfortable during the second weeks of clinical which is I didn’t expect to be happening. The second experience that did not go as expected was unexpected behavioral change during community group discussions

Patient provider relationships play a pivotal role in the healthcare process. This relationship helps to bridge the gap between ailments of the patient and the diagnosis and care of the provider. The need for this relationship and its propensity to create the catalyst for patients need to be fulfilled is second only to the medical knowledge of the provider and the patient 's willingness to get better. As we have moved from a biomedical perspective to a biopsychosocial perspective the relationship between provider and patient has changed from physician centered modes of communication to more of a patient centered style of communication. And with the change of view we find that a strong and cohesive bond between patient and provider is the key to the advancement and overall quality of care for the patient. According to The Impact of Patient-Centered Care on Outcomes a patient centered approach to care has a correlation to a better healthcare outcome. Focusing on the patient increases compliance of the patient.

The most gratifying experience for me was my interaction with patients. Along the course of their hospital stay, I established a kind of relationship that allowed me to not only see them as patients, but to see them as real people. Each patient had a unique story; a story that defined them a individuals and that had led them to this point in their lives. The patient presenting with a Lupus flare was a 42-year-old female that had to give up her job and career because of the chronic disabilities the disease brought over the years. She had developed chronic kidney disease and was on dialysis waiting to match for a donor kidney. Over the years she had given up hope, and this attitude had an impact on her marriage. Her husband wanted to donate

Nurses, on the other hand, seek to understand the experiences of their patients to provide care that is effective for meeting the patient’s needs. “For health providers…the need to understand the integrity of a patient's life course may be central to understanding or diagnosing the illness itself or in seeking amelioration by treatment plans of ambitious or conservative design” (“Medicine, Nursing…”). Narrative psychology can provide a foundation for nurses to effectively acquire this understanding and provide patient care on a more intimate level.

Physicians provide care based on their educations and experiences, and if patients do not feel like

Lying in medicine seems to be a requirement for doctors because they think that truthful information can hurt patients (Bok 222). According to doctors, while they are telling the truth, patients may have a heart attack or their psychological mechanism might be alleged. Furthermore, death comes more quickly. However, these are so rare and considering these universal is an overgeneralization. In addition, doctors consider their patient as a child and see them like a blind, suffering and passive toy (M.Smith and M.Weil 22); hence, doctors think that they can make choices for their patients without telling the truth to patients. However, this opinion just shows doctors’ paternalistic view (Bok 227).