The Patch Adams Conundrum: Advice for Communicating with Patients

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This is a guest blog post written by Indianapolis accelerated nursing student Chase Christy. Chase is also a patient support partner at Community Health.

patch adams conundrum

If you haven't seen the movie "Patch Adams," you have no business being in health care. OK, that may be a bit of an overstatement, but it's definitely a movie worth seeing. It is based on the true story of Hunter Doherty "Patch" Adams, who is a real doctor based in Urbana, IL. He really does dress up as a clown to cheer up his patients (photo credit Wikipedia). Though I tend to veer towards witty comments and horrible puns rather than slapstick comedy, I must admit, I tend to be a bit of a jokester, much to the chagrin of all those around me at any given time.

When starting in a patient care role for the first time, I couldn't avoid the Patch Adams Conundrum: How should I act when communicating with my patients? Should I sit down and cry in their rooms? Should I be super solemn? Should I go to the extent of comedic props to cheer them up? I mean, it worked for Dr. Adams, right?

In my former lives, I've been in professions that require high aptitude in interpersonal communications. What I have learned over time is that it is always best to match the affect of those with whom we are attempting to connect. Obviously, it isn't helpful to pretend we are mirror images, but we can match it within reason. For example,  if a person is crying, take on a look of concern and comfort that person. If a person wants to joke around, joke around.

I am a patient support partner on the resource team at Community Health Network. One of the coolest parts of my job is the opportunity to float between units and hospitals according to staffing needs. In other words, I get to see a lot of different units and a lot of different kinds of patients, ranging from those who were barely admitted for inpatient observation on a short-stay unit, all the way to patients who are dying of cancer in the oncology unit.

Here are a couple of illustrations based on my personal experience.

Patients on a medical/surgical floor are often staying to recover from surgery or because of some acute problem that is serious but not dire. These types of patients often like to joke around, though certainly not always. They may be in high spirits or can easily be cheered up with some company and a conversation. While it is still wise to watch the patient's disposition before launching into a stand-up comedy routine, there is certainly more room to be lighthearted.

The oncology unit is another matter completely. Patients here are facing life-and-death decisions with their doctors. Some patients and families know that death is eminent. Many are in incredible discomfort because of chemotherapy or simply because the cancer is killing them. Patients are often facing frightening changes to their bodies as a symptom of their battle. I once spoke with a man who lost 100 pounds in the prior six months. Some patients are losing their hair. Needless to say, it’s not always the best idea to put on your clown nose. I've found that it is best in these moments to simply be kind, professional and serious, unless a patient invites you to be more lighthearted. It is our job as professionals to be strong and to give the patients someone safe and secure to hold onto in their weakest days.

There isn't one answer to the Patch Adams Conundrum - rather a spectrum of responses as diverse as the patients we serve. It is our job to be able to isolate the correct part of that spectrum at the correct moment. In doing so, we will form a strong connection with our patients and their families that is appropriate, and above all, appreciated, needed and constructive.