health needs of your command in a professional and expeditious manner. The sick call supervisor should encourage staff personnel to share interesting or infrequently seen medical cases with the health care team and, if deemed significant, incorporate those cases into the command’s inservice training programs. Sick call supervisors exercise the essential responsibility to address patient complaints, and in this capacity, the sick call supervisor serves as the patient contact representative. Complaints need to be evaluated fairly and objectively to identify the cause of problems and to act upon resolutions. Continuing education in the area of patient contact must be rigidly and aggressively supported.
The “right man for the job” keys the sick call supervisor to be an effective manager. In this regard, the senior hospital corpsman must understand the process of delegating authority to his staff and must maintain effective communications between departments and individuals. Facilitating a good sick call can be one of the most challenging assignments facing an independent duty corpsman. Sound leadership skills combined with effective management practices will result in a productive, effective sick call visit, satisfying the needs of the patient and command.
MEDICAL DIAGNOSIS AND TREATMENT
The concerns of the hospital corpsman when confronted with a patient are evaluation and diagnosis. This is especially important for injuries, trauma, and severe pain. When a patient comes to sick call, it is a must to obtain a careful history first, followed by a careful physical examination, diagnosis, and appropriate treatment within the skills of the hospital corpsman. An effective corpsman recognizes the limits of his or her expertise and obtains additional medical help when necessary.
The medical history plus the physical examination form the basis for establishing the diagnosis and instituting a course of treatment. The medical history makes the physical examination more meaningful and not just a mechanical routine,
The patient may be confused, nervous, fearful, insecure, resentful, and even argumentative. To deal with these emotions and attitudes, you will need a professional bedside manner. This can be achieved by cultivating a professional attitude, sincerity, understanding, mental maturity, and compassion. Corpsmen should never allow themselves to take a moralistic attitude or to condemn or condone a patient’s behavior.
MEDICAL HISTORY
The history taking begins when the patient arrives in sick call. The patient should be observed for any overt signs and symptoms, reactions to questions, alertness, attitude toward the corpsman and his or her illness, and level of intelligence. Before asking the patient direct questions, the corpsman should let the patient talk freely and listen to the patient’s story. Remember active listening is a valuable skill.
When the patient has related the story in his or her own words, it is time to ask specific questions. Keep the questions simple and on the patient’s level. Ask the patient to describe the problem or pain including the duration, nature, location, date and type of onset, and what relieves or aggravates it. Remember that each history is an individual experience and should not be stereotyped, but rather adjusted to each individual’s specific problem. Fear, confusion, rambling, exaggeration, and minimization are obstacles to eliciting a good medical history. They must be overcome to get the data necessary to establish a diagnosis.
The following outline is a helpful guideline to use in obtaining the medical history:
Biographical Data—Obtain the patient’s full name, age, sex, race, SSN, nationality, marital status, and occupation.
Chief Complaint—Main reason for coming to sick call.
History of Present Illness—Phrase questions so that the patient provides the needed information, and try to avoid leading questions. The patient should describe discomfort or unpleasant sensations. Have the patient elaborate on the chief complaint, including the date, mode, course, and duration of onset. Find out how each symptom first made its appearance, whether it was abrupt or gradual, how long it lasted, and whether it was persistent or intermittent. Determine the location and whether or not it radiates and where it radiates to. Determine if there are any lesser symptoms that accompany the major complaint. Note any absences or cessations of the symptoms and any cycles they undergo. Elicit information regarding any previous treatments, or self-treatment, and the effect of such treatment.