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Patients & Relatives: “HCPs might not respond favourably”; “assessing staff receptiveness”; “feeling vulnerable”; “staff behaviours”
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| “II don’t think I would say anything to be honest I would be frightened to offend them in case they got upset and you would be thinking well they could be a bit awkward with you .. . you can tell the different ways nurses act and doctors, the way they are with you... we had nurses on there who were absolutely amazing and you would have a good laugh with them … and then you would get some that would be like ‘move, we’ve got to get that done,’ and you would be like “God it’s like you are in the army”. They were not very approachable - with them you would be like ‘I’m not saying a word because she has a chance to bite my head off’. (Patient9, F, Aged 52) |
| “I think it differs probably more according to personality than according to rank or function … I've had consultants that I've been very happy to ask questions of because the tone they set early on is one of sort of acceptance and erm engagement, and then I've had other consultants who you kind of feel are edging to get away and just get you done and dusted as soon as possible…I've still asked [questions] but I've not felt comfortable doing it.” (Patient5 M Aged 31) |
| “On a different day, … I would have dealt with it [Consultant’s attitude], but because it was about me I didn’t feel like I could …, I guess part of that might be confidence that you’re right and they’re wrong, because… there is something about being a patient that makes you feel tiny and inconsequential and inadequate …” (Patient4 F Aged 26) |
| “What you want to do when you, when you get onto a ward, even like a visitor, you want to get on well with the staff. Go in there and talk to them and em, and … speak to them in a ‘hey, you know, you haven’t done this’ - not in a nasty way.” [Relative2 M Aged 58] |
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Staff: HCPsactively&passivelychastising
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| “Sometimes…they [relatives] can maybe just ask something and sometimes one of the staff will turn around and be quite funny back and you think ‘well’ ” (Healthcare Assistant, F, Staff45) |
| “I think sometimes nurses do, if a patient rings the buzzer for something that we feel is insignificant say, some trivial issue [trivial in our eyes]… I think by the way we respond to that em often outside, well sometimes in our body manner and tone of voice when we talk to them we indicate that it is not popular “ (Staff Nurse, M, Staff41) |
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Fear of care being compromised
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Patients & Relatives: “HCPs might not look after patient well”; HCPs will be less empathetic
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| “I basically don’t want to upset this nurse because she’s looking after [patient] … and if I say something to upset her she might not look after [patient] as well as she would have done if I hadn’t said something”. (Relative2 M. Aged 58) |
| “In case, you know, their attitude towards me changed … because I think it does happen.” [Then, in relation to an incident kept from spouse] “[Spouse] wouldn’t [be concerned about asking] but I was the one that was lying in the bed, you know…” (Patient15 F Aged 58) |
| “I mean not that they would be [but] your treatment could be different somehow, you know ‘I’ll just leave her a bit, she’s cheeky her’… tell the other nurses ‘watch her - fussy woman over there’. Do you understand what I mean? That type of thing”. (Patient9 F Age 52) |
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Staff: HCPs speaking as patients & relatives
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| “You’ll hear patients when there’s no doctors around going ‘I can’t believe he did this’, ‘that was inappropriate’, they’ll sit in the waiting room and they’ll shout the odds about why [the clinic] is running behind or whatever … they know it’s wrong, they know something needs to be done about it, but they don’t want it to affect their treatment, and I totally understand that, you know I think we’re all like that to some extent…”. (Patient providing dual perspective as a healthcare professional) |
| “My [relative] was in hospital - and bear in mind that I am a senior person in the organisation and I have worked in health - but there were questions I was un-keen to ask…. Em worst thing I suppose to say - although I can’t imagine this being the case - but if you ask, if you are a difficult patient or you are a difficult relative will that somehow compromise my care? I’m not suggesting anything would be done like that but em it is that sort of thought you know, ‘If I am seen as being a trouble making family’ em you know ‘does it mean that you actually get a better level of care or a worse level of care?’ It is a terrible thing to think but it is basically what goes through your head.” (Healthcare professional reflecting experience as relative) |
