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Politeness and dignity on paediatric ward rounds
  1. S Shapey
  1. Paediatrics, Royal Shrewsbury Hospital, Shrewsbury, UK

Abstract

Introduction The principle of politeness is considered universal and cross cultural, and is deemed by the General Medical Council (GMC) to be a fundamental quality required by all doctors. The audit focused on ward rounds, as they have been identified as a major problem area where there is a lack of respect for patients' dignity. This audit was conducted to assess any differences between consultants' and registrars' levels of politeness and to ensure patients and carers are treated politely and considerately.

Methods Sixty eight ward round consultations were observed over a four week period, led by a number of different consultants and registrars. Consultations were assessed prospectively using a pro forma focusing on standards set by the GMC. Results of the consultations were recorded and analysed using Microsoft Excel.

Results Comparisons between the consultants and registrars focused on three aspects of politeness: talking at eye level: 84% and 50% (consultants and registrars respectively); introduction by name and grade: 80% and 60%; engaging with child when appropriate: 100% and 89%. Other factors of politeness and dignity monitored included: appropriate greeting (average 99%); knocking door before entering (16%); asking if convenient to enter (24%); using curtain when examining (83%), and taking leave of patient/parent (98%).

Conclusion This audit has demonstrated a difference in standards between consultants and registrars, highlighting a training need at registrar level. Not all doctors may consider “knocking before entering”, for example, as a necessary form of politeness, and thus it did not occur regularly. Therefore, there is a need for discussion and clear guidance on what is expected from all doctors, and further research into what constitutes “politeness” within the hospital setting is required.

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