Free Essay

Reflective Practice Piece

In: Science

Submitted By baileyjm
Words 879
Pages 4
24th October 2013

Reflective Practise Piece

Description
The patient was attending, on her own, a 60 minute consultation with the resident Hearing Aid Audiologist. The lady came to us having been recommended by word of mouth by family and friends. She had been tested 6 months ago by another Specsavers Hearing practice, so access to a previous audiogram revealed a mild to moderate sensorineural hearing loss. No other case notes were available at the time of the consultation.

Key Issues
The key issues I found particularly interesting were: 1 Communication between the patient and the audiologist 2 Impact of case history forms 3 Hearing loss stigma

Reflection and Influencing Factors
According to Maltby (2009) client –centred problems solving is the most widely used approach to adult aural rehabilitation. I was keen to observe the rehabilitative process and reflect on its benefits. The audiologist was informed of the arrival of the patient and called the patient through to the consultation room. Formal introductions were made. Although the patient had previously had a hearing test, she seemed uneasy and a little tense. The audiologist explained the consultation process so the patient would feel more relaxed about the test.

The standard questions from the case history forms were asked and during the case history the patient started to relax and made much more eye contact with the audiologist. When asked if she felt she had a hearing problem she said her son said she did and that it was time to get it “sorted out”. She was aware that her hearing has been changing over a period of 5 years, but didn’t want to wear hearing devices due to the stigma of hearing loss. Hearing devices cosmetically are an issue – she didn’t want anyone to know that she will be wearing them. Since visiting her son she has had difficulty in hearing the television at what he considers to be a normal volume, and struggles to hear conversation when her friends are not facing her. The patient has an active lifestyle and is very social, and is feeling frustrated that she cannot hear clearly.

Following pure tone audiometry, the audiologist explained the results in a clear, concise manner using appropriate terminology. The patient understood how her hearing loss affected her understanding of words and speech, and she was able to link the results on the screen with her own impairment. I felt that the audiologist understood the needs of the patient by building up a good rapport and enabling the patient to feel safe and reassured. The audiologist recommended a mini RIC device for the patient and subsequently went on to book a fitting appointment. I personally feel that the patient had ownership of their hearing loss, and that the only thing holding her back was the cosmetic appearance of the hearing devices she had seen in the past, and overcoming her embarrassment. The audiologist demonstrated different fitting styles available to the patient, enabling the patient to make a decision using the best advice given to go ahead with the hearing devices.

Alternative Strategies
Drawing out information from patients about themselves and their hearing loss is vitally important for a client-centred approach to adult audiologic rehabilitation (Gagné & Jennings, 2011). This can be successfully attained by using open questions for example “What brought you here today” or “What effect does your hearing loss have on your life” (Maltby, 2009). The audiologist seized the opportunity to capture the patient’s story by using open questions, maintaining lots of eye contact and listening to the patient. The patient is on an emotional journey overcoming the stigma of hearing loss (McKnight, E. 2012).

Learning
The consultation was a very positive experience. By observing the audiologist using open questions it allowed me to see a relationship form between her and the patient. Case history forms alone cannot achieve this. Therefore, I need to develop my listening and questioning skills.

According to Gagné & Jennings (2011), a client-centred approach actively involves the patient in every decision made regarding their treatment, and counselling is the tool used to help identify and set goals to establish throughout the patient journey. I believe it is important to build a relationship of understanding between yourself and the patient and once this has been achieved, the patient can have the confidence to be involved more. Long term change is possible if the patient can be directly involved in decision making. Therefore, developing my communication and supportive skills will help me work towards achieving a client-centred program.

References

Maltby, M.T. (2009). Adult Aural Rehabilitation. Guernsey. Distance learning Ltd.

Gagné, J. P. And Jennings, M. B. (2011). Incorporating a Client-Centred Approach to Audiologic Rehabilitation. The ASHA Leader, [online]. Available from: http://www.asha.org/publications/leader/2011/110705/incorporating-a-patient-centered-audiologic-rehabilitation/. [Accessed 23rd October 2014].

McKnight, E. (2012, March 13). First Person on the Last Page: Understanding Stigma. The ASHA Leader, [online]. Available from: http://www.asha.org/Publications/leader/2012/120313/First-Person-on-the-Last-Page--Understanding-Stigma.htm. [Accessed 24th October 2013].

Wallhagen, M. I. (2009, July 10). The Stigma of Hearing Loss. Oxford Journals: The Gerontologist [online]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904535/. [Accessed 24th October 2013].

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