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Heart attack

Talking to doctors & nurses

Someone who has a heart attack may know little about what is happening and may need to take in a lot of information in a short time. Good communication and exchange of information can make a difference to how patients react and their ability to cope.

Many people described excellent communication with their doctors (see 'Getting information'). One man found it important that doctors had explained everything they were doing and why they were doing it.  

 

It is important that doctors explain everything they are doing and why.

It is important that doctors explain everything they are doing and why.

Age at interview: 58
Sex: Male
Age at diagnosis: 57
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But where I have been lucky is like I said, my own cardiologist, my GP, the woman who runs the cardiac have just answered every question I've had. My own cardiologist has never said, well we don't do this. She's always like before she's adding another tablet, she explains why, why she feels the need for this and that and I think you feel a lot better in yourself. 

You feel as though it's being done as a partnership, rather than the impersonal approach of this, this and this, cheerio, we'll see you in a few months. I think that's been so important that has, really.

I think, like I say, communication, even if it's an admission of a lack of knowledge is so important because you really are in no man's land, because suddenly something's happened to you, that's going to affect you for the rest of your life and you know nothing about it because you haven't been expecting it. 

It's not something that was anticipated and I think whatever they do for people, always explain why they're doing what they're doing.  

I don't mean in a crisis slowing down and explaining, but in the general run of things always explain why they're doing what they're doing. And even if they say they don't know the answer to that question, but I'll go and find out. But there's nothing worse than having anything done to you or prescribed for you and nobody's explained why. 

Another had been grateful that the A&E consultant had squatted down to his level when he was explaining what had happened to him and what treatment and tests were required. A third describes how the way his consultant spoke to him gave him confidence.

 

He had confidence in his consultant because of the way he spoke to him.

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He had confidence in his consultant because of the way he spoke to him.

Age at interview: 46
Sex: Male
Age at diagnosis: 42
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But he had this air about him that I was, you know it was just his actions, his voice. I mean he wasn't very old, he was probably mid, he probably wasn't much older than me, if at all and he was just, I mean it just made me feel relaxed and felt like I was in good hands and that, all the time that meant so much to me that you know my trust was in these people and as long as I felt that they knew what they were doing, I was going to be all right and that things weren't going to get any worse. 

One man felt that communication was made much easier because he could have a one to one chat with the consultant' he felt comfortable asking questions and the consultant had the time to answer them. Many people remarked how good the cardiac nurses were at explaining procedures and giving information.

 

The cardiac nurses were very good at explaining procedures and giving information.

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The cardiac nurses were very good at explaining procedures and giving information.

Age at interview: 61
Sex: Male
Age at diagnosis: 49
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Rushed as they [the nurses] were, they always had time to talk to you about what was going on. They would explain procedures to you. I think you have to ask in some cases, but once you have asked, or once I had asked, they were quite willing to go through and tell you.

I think they want to be fairly convinced that you aren't going to panic or misconstrue what they're saying, so maybe they'll be a little bit guarded at first. But generally I think that they're there to help you get better and if they perceive that what you're asking is because you want to know and it's going to help you get better, they'll give you the right answers.

I didn't find anybody holding back. I think perhaps if you start saying things like, 'well I'm going to die after this aren't I?' [laughs], they won't do anything to alarm you there but in any case usually it's good news, you know. Once you're in hospital your chances are better every day. So they're all there to see that you, you get the best out of the treatment and if you let them see that you're not panicking, then that's fine.
 

In contrast, others would have liked more information and said that doctors' use of medical jargon and terminology got in the way of understanding.

 

It's difficult to understand when doctors use medical terminology and jargon.

It's difficult to understand when doctors use medical terminology and jargon.

Age at interview: 37
Sex: Female
Age at diagnosis: 36
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I think they need to sit down, you know, at the same level as you and explain things in a language that you understand because sometimes when they, when they say things, you know, you need to know all the procedures. When they speak in medical terms that's just no good for me, anyway, I don't understand all the medical terms. 

But, on the whole, the doctors and nurses were, were brilliant and, well, the ones that I've actually seen myself. No, no, everybody that I've seen, I haven't got no, no problems with anyone that I've seen, no.  

It must be difficult for, for them doing their jobs as well because, you know, they're trying to help somebody who's had a heart attack but, as much as they, it's hard, probably hard for them to understand the patient as it is for the patient to understand what the doctor's trying to say as well, so. And when you do have a heart attack you're all in shock and you don't know what you're talking about, anyway I didn't, just didn't have a clue.  

One man found out from other patients what an angiogram was, and would have worried less if doctors had explained the procedure to him when they first told him he would need one.

One woman thought that bedside manner could be improved if doctors sat down beside patients when talking to them. A cheerful, friendly approach also made a difference to several patients. One man, who had a severe heart attack, describes the different approaches taken by two consultants and the effect it had on him and his family.

 

Describes the very different approaches taken by two consultants and the effects on him and his...

Describes the very different approaches taken by two consultants and the effects on him and his...

Age at interview: 39
Sex: Male
Age at diagnosis: 37
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We had two very different experiences from consultants, now whether this is a difference between cardiologists and surgeons I don't know. The cardiologist, my wife and I called Dr Death because he just gives it pretty much as it is, and, and when I said that they'd called my family in on the Saturday night, they'd been there till ooh, maybe 10, 11 o'clock whatever on the Saturday some of them and they'd gone home.  

My family are 40 miles from here, they're not next door and then they were called back in at 1 o'clock in, it was early in the morning, in the early hours of Sunday morning they were called in to be told look you'd better come across, because we really don't think he's going to be here much longer. And on the Saturday they'd been arguing about whether they were going to do this balloon, so they'd already been talking about that before I got really bad. 

And the Dr Death as we call him, it's a good job I don't give you the names here isn't it, [laugh], had been saying, 'I don't think he'll be around next week', you know. Where as the surgeon is saying, 'Oh he'll be up and fine, he'll have no problems'. So you'd that kind of polar view, both from very senior people and my family didn't know which one to take, because they hung on this one, the positive one.  

I think he's probably going to think he's trying to give it like it could be, but he probably over does how bad it could be. You don't want an over realistic view but similarly you don't want to be told that just 'Well, no it, you could be dead', because I think everybody knows if it's heart, you know, if it's a serious heart problem, yes of course you could be dead, you wouldn't be here otherwise, just slightly overplayed it. But having said that I think I have surprised him and that's maybe because I'm young and as I said I was fit. 

Communication difficulties can add to the stress patients may experience in hospital. One woman explained how she dealt with conflicting instructions by her doctors. Another received different information from the nurses and the doctors, which left her wondering who she should believe. One man was not given enough information because of the poor handover between two nurses a couple of days after he was in hospital.

 

Her doctors gave her conflicting instructions.

Her doctors gave her conflicting instructions.

Age at interview: 84
Sex: Female
Age at diagnosis: 81
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Oh they argue. They do, they do. Some wanted to operate, some didn't. Some said this was good. Some, one doctor come along and said “I don't want you to get out of bed at all, now you stay right there and you do not move for twenty four hours”. 

Another doctor comes along, “What are you doing lying in bed, I want you walking up and down this ward.” I said, “well I don't know how I'm going to lie in bed and walk up and down the ward at the same time, it cannot be done doctor. 

It can't be done. Doctor so and so told me to lay in bed, you're telling me to get up.” And he marched off, so he probably went and had a row with the doctor that said this before, I don't know what happened. So I compromised and stayed in bed for a while, then I got up for a while, it seemed to work. 

 

The nurses told her strict bed rest, the doctors wanted her to have a treadmill test: she...

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The nurses told her strict bed rest, the doctors wanted her to have a treadmill test: she...

Age at interview: 63
Sex: Female
Age at diagnosis: 63
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But even though I'd had this heart attack, the doctors insisted that I had the treadmill test. I felt a bit of conflict and because the nurses were saying to me don't get out of bed, you're not to do any exercise and I got admonished for going to the toilet and walking and she said, 'no, you're not to get out of bed, if you want to go to the bathroom I come or we use other facilities'. 

And so they were telling me on the one hand, don't move, stand still, sit still and on the other hand I was being sent downstairs to have a treadmill test, which not really easy, it's quite a hard test. I just then felt quite confused of where do you go, what, who's right? Should I have had the treadmill test at that particular time and was that the proper, the proper procedure? 
 

 

He was given inadequate information because of the poor hand over between two nurses.

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He was given inadequate information because of the poor hand over between two nurses.

Age at interview: 64
Sex: Male
Age at diagnosis: 54
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Another thing that upset me at the time; you're allocated a nurse when you first get in to the unit. Now then, that nurse after two or three days, her father was taken seriously ill, so she was stood down. Allocated another nurse. So one nurse didn't know what the other one had told me and now I know I should have asked questions but you're not, you withdraw in to yourself. You're angry at being there. 

That was unfortunate, it shouldn't have happened but it did. My nurse, probably feeling, 'oh he's got a couple of days yet before he goes out, so I can brief him on everything.' Her father was taken ill, she was taken off my case and in fact she went home on holiday on leave. 

Her colleague was given my case and I presumed she must have told her everything and it was only when this colleague was in the next bed telling the new patient what was going to happen, I thought, 'I don't know anything about this'. So I asked her, 'talk to me please.'
 

When describing communication with their GPs, people clearly valued being given time to talk about how they felt and knowing that their problems were being appreciated. They also liked a doctor who 'called a spade a spade'.

 

He would prefer his GP to be more forthcoming with information.

He would prefer his GP to be more forthcoming with information.

Age at interview: 62
Sex: Male
Age at diagnosis: 56
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And the other comment I would just wish to make at this point in time, when I talk to my GP and they say, “Have you had a letter from the consultant yet?” “Oh yes, yes, we've had a letter.” “What does it say?” “Oh well, yeah you should take doxisorsan, that's right.” “What else?” “Yeah, he's referred you for an angiogram.” “Yeah, okay.” 

I've almost sort of almost got to tease the information out yet it's about me and it's me that's more concerned than either the consultant or the GP and sort of dragging that information out of the GP is a bit frustrating also. But I don't want this to be interpreted or seen as sort of disappointment with them, because I know, I firmly believe they're doing they're very, very best to keep me you know, as fit and healthy as they possibly can. 

I just think there are some sort of fine tuning that they could do with sort of minor, just minor changes to attitude and be much more open. Now it could well be some patients don't want to hear that, you've got the information, you just give me the treatment, you think what you want. But I'm the opposite. 

I like to know everything that they are saying about me and I like to find and I believe I have a right to hear that if it suits my personality and it does. I would much rather hear the very worst news about myself, than someone try and keep it from me. I would much rather have it, look me straight in the eye and tell us the worst. I cope with it, I'll take it, or I'll deal with as the best I can.

Last reviewed June 2017.

Last updated June 2017.

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