Difficult communication with patients

These patients include young children (covered elsewhere), the deaf, the mute, the confused, those with learning difficulties and those with limited understanding of the English language.

All of these patients may be in pain, regardless of the reason for their presentation. While angulated or shortened long bones are obvious indicators of pain, you may not so easily establish the existence of occult fractures, head, chest or abdominal pain.

So what are the possible solutions?

• Listen to family members and carers
• Seek the opinion of nursing colleagues
• Look for physiological clues, e.g. increased heart rate, increased BP
• Provide appropriate tools: an interpreter, multilingual printed information, pain measurement scales, someone proficient in sign language for the deaf, a dedicated learning needs nurse, a writing board for the mute, are some examples
• Titration of analgesic therapy
• Common sense