Heart racing, body frozen.

I could not conjure a response.

The evil held me back.

Suffocating me, strangling me.

Pulling at my limbs with a

force I could not bear to describe.

– Ensnared by zoe. e julies (2018)

The above extract was taken from the poem “Ensnared” written by an aspiring writer, Zoe E. Julies. The poem follows the journey of an individual overcome by circumstances too malevolent to comprehend. The use of this poem was inspired through my interaction with a patient during my general block. This patient was a middle-aged individual who had suffered second degree burns over their lower limbs. They were unable to adequately express themselves, repeated the same few phrases throughout our treatment and could not verbalise their pain nor frustration. I found this extract relevant to my experience as I was seen as a malicious intruder to the patient, although I continuously attempted to communicate my positive intentions. This reflection will provide a detailed analysis of the poem as well as the relevance of the poem to the position I was in with my patient. Furthermore, this reflection will discuss the ethical concerns I confronted while treating this patient.

Empathy may be interpreted as the personal occurrence of similarity between the feelings one experiences and those expressed by others. It involves the experience of the other person’s actual or inferred emotional state, but with marginal understanding of their emotional state (Decety & Jackson, 2004). Throughout my treatment I was confronted with emotions of deep concern for the well-being of my patient as they were unable to adequately express what they were feeling. Although there were family members mentioned in the file, I could not reach anyone to gain insight on what my patient could be trying to communicate. My patient was only able to utter a few meaningless phrases as answers to my questions throughout our treatment sessions. Within the context of the extract, “I could not conjure a response” refers to an all-encompassing force of evil which envelopes the individual, leaving them confused to their surroundings as they do not recognize the faces of those around them. Similarly, my patient was surrounded by a group of individuals, the multidisciplinary team, all performing different tasks and requiring different outcomes from the patient. In the extract, the individual loses their ability to form words in response to the commands being growled by those ensnaring them. Through my patient’s perspective I may have seemed like an intruder demanding answers to questions they could not comprehend. My patient made me aware through their facial expressions and body language when they felt fearful or were in pain during our treatment session. I was able to gain a sense of what they were feeling although they were not able to express themselves through words.

The phrase “body frozen” in the extract depicts the actions of those around the individual are of malicious intent, their every desire to torment the individual. Consequently, the individual is left feeling helpless, as if they cannot physically move their body in order to escape their circumstances. My patient struggled to mobilise independently and it almost seemed as if their body was frozen as a result of either physical or psychological trauma. Treatment of burn wounds causes a great deal of pain for the patient as the therapist needs to stretch the burned skin to ensure mobility of the affected limbs (Edgar & Brereton, 2004). However, to the patient it feels as if the therapist is, “pulling at my limbs with a force I could not bear to describe”.

Professionalism encompasses the knowledge of the prescribed and inferred expectations of behaviour accompanying the health administration profession (Garman, Evans, Krause & Anfossi, 2006). According to the Health Professions Council of South Africa (2016), a health care practitioner needs to adhere to the patient’s right to make their own informed decisions, the patient also needs to be part of the decision making process. However, it was difficult to arrive at a conclusion with my patient due to their inability to adequately communicate their thoughts of treatment. I, therefore, found it challenging to work with my patient as I was not absolutely certain they approve of the treatment. Additionally, health care professionals need to exercise compassion with their patients. Treatment sessions become trying at times as the patient could not communicate their confusion or inability to participate. I continuously reminded myself to refrain from losing hope as my patient relied on me for treatment, although it seemed they did not care to improve.

This reflection has improved my understanding of the role I play in the treatment of any patient I come into contact with. I need to be able to identify the difference between a patient who understands but is unwilling and a patient who cannot communicate their understanding or willingness to participate. In future, I should take a step back and find out more about my patient’s situation and why they behave the way they do. Instead of trying to treat them physically, I need to gain insight on their circumstances in order to treat them holistically. My ability to empathise with my patient could greatly improve their mood and attitude towards treatment immediately.

References

Decety, J., & Jackson, P. (2004). The Functional Architecture of Human Empathy. Behavioral and Cognitive Neuroscience Reviews, 3(2), 71-100. doi: 10.1177/1534582304267187

Edgar, D., & Brereton, M. (2004). Rehabilitation after burn injury. ABC of Burns, 329(5), 343-345.

Garman, A., Evans, R., Krause, M., & Anfossi, J. (2006). Professionalism. Journal of Helathcare Management, 51(4), 219-222.

Health Professions Council of South Africa. (2016). General Ethical Guidelines for Healthcare Professions (pp. 2-3). Pretoria: Health Professions Council of South Africa.

Health Professions Council of South Africa. (2016). National Patient’s Rights Charter (pp. 1-2). Pretoria: Health Professions Council of South Africa.