ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Clinical communication skills - verbal communication - version 2 of 2

Oh, hello there, Mrs Dawes is that right?

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Oh, hello there, Mrs Dawes is that right?

Yeah.

Good.

I'm Dr David, how can I help you today?

I'm sorry I might be wasting your time a bit but I've come because I'm not sleeping very well,

I'm just exhausted.

I just wondered if you could give me something, anything to help me sleep, some sleeping tablets.

Okay, it would really help me

if I could ask a few more questions about how you're feeling

and some of your symptoms and then we can sort of see how I can help you.

Would that be okay?

Yeah, that's fine, thank you.

Yes.

So why don't you tell me a bit more about what's brought you here today?

About a year ago, my husband and we split up and since then I've just not been coping very much.

I'm sorry to hear that.

I'm just tired all the time and the kids and the job and I just don't feel like managing very well.

I can't sleep.

OK, well why don't we just look at one of those things at a time.

Tell me a bit more about, you say, having trouble sleeping.

I just lie awake at night.

I don't know what time it is, but it just seems to go on and on and on the night.

I know, I must have gone to sleep, but in the morning I just feel so dreadful.

OK, and are you having problems with your appetite?

Yeah, I make the kids to dinner, but I just can't be bothered, I'm not bothered at all about it.

I don't know.

And what about life in general?

Have you lost your get up and go?

Sorry, I don't understand.

get up and get your energy levels?

Have you found that they're kind of low?

Yeah, I used to enjoy swimming with the kids and stuff but I just want to be on my own, I just can't be bothered.

I'm just not being a very good mum at the moment as well.

I'm just so exhausted really.

Just going back to your sleep, can you tell me a bit more about that, How much sleep are you getting each night?

I'd say I just lie awake and just think about him and her together, things that we used to do.

I just wake up exhausted.

Sounds like your lack of energy and lack of sleep and lack of appetite.

It seems to me that things seem to be really getting you down.

I'm just such a mess. At the moment.

I'm just not coping, I'm just exhausted.

You say you're a mess?

Well, look at me.

I just, you know, I just need some sleep.

OK.

It would be helpful for me just to sort of find out a bit more about home life

and work life and ask a few questions in that area.

Would that be okay?

Yeah, it's fine, sorry.

Yeah.

So, do you work?

I work in a job centre.

It gets a bit stressful at times.

We've got to see so many people.

Of course they're stressed.

I've got some patients who work in the same environment, it's very high pressure isn't it?

Yeah.

Some mornings I just can't be bothered to get out of bed and that's worrying me because I'm feeling sick.

You know, it's not good to have a sick record is it?

It's not like me.

And who else is at home with you?

I've got two kids.

One girl, one boy.

Richard, he's the youngest, he's seven.

Anne-Marie, she's nine.

Do they get to their father much?

No, he can't be bothered now.

He's got a new family.

He doesn't see them at all.

They're very good kids.

It must be quite hard on both you and them.

I try and be a good mum but it's very difficult.

Did you get any help or support from anyone else?

My mum, she's wonderful but she has arthritis.

So, you know, she does what she can.

Does she live locally?

Yeah, she's just round the corner and she picks the kids up from school.

And, yeah, she's an angel.

She helps me a lot.

What about you?

What about your hobbies and things you enjoy doing?

I used to enjoy going to the cinema with my friends.

Even line dancing, we used to go down to the village or line dancing.

But that's been a while ago.

I just...

Nobody wants a bit of misery around, do they?

And I'd rather be on my own now.

Yeah.

Thank you.

Well, I know you're not a doctor, but you must have had thoughts about what's causing all these feelings.

Had you thought about those type of things?

I guess I was on automatic pilot when he first left.

I guess that's why I'm in the state I am now.

I don't know, could I resent the kids?

I don't know, but I suppose that's why I keep going down.

I just feel everything's useless, I can't sleep, you know.

What tends to bother you the most?

Is it the sleep or your appetite or the energy or not coping with the kids?

For sleep, I just feel if I had a bit more energy, if I could just have something just to, you know, help me out with them,

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so I can do the normal things.

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That was going to be really what I was going to ask next.

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I mean, what were your thoughts about how he could help you today?

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Well, I just thought with...

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I know there's other things but sleeping tablets, I thought they might help.

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Would it be a good idea perhaps

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if we think about all the options available to you and then decide which ones may be best for you?

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Okay.

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What are the other options?

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Well you might have heard of some of the talking therapies,

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being able to sit down and talk with a trained counsellor about your feelings and about what's been happening.

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Well that held my sleep.

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Well that would make me be able to cope the next day through sleep.

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It may help you deal with some of your feelings.

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I take on board about the thought about using a sleeping tablet.

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I think that could be another option.

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Obviously one of the concerns we have is

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that we don't want to have you on sleeping tablets for a long period of time

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because there are issues about becoming dependent on them and reliant on them.

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We can use them for a short period of time, say for a week to help you get back into a bit more of a normal sleep pattern.

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Yeah, that sounds good.

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I mean, what about those two options?

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There's the option of the counsellor or perhaps My friend, she had counselling.

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She had counselling.

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Erm...

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I'd like...

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I mean, I just feel if I had some sleeping tablets that might just...

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give me a spur, really.

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And I'm quite happy with the counselling as well.

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OK, so you'd like to try both?

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Erm, I think that sounds a good idea.

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And would you be happy to be the counsellor here at the surgery?

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Yes, that'd be fine.

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OK, so I can organise that.

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I can speak to her and ask her to contact you to make an appointment.

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OK.

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It would also be really helpful for me as well if you could complete one of our HADS questionnaires.

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What's a HADS question?

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Sorry, it's a short questionnaire just asking some questions about your feelings

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and it'll help me to find out if there's any more help I can give you when I next see you.

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Is that OK?

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Yeah.

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From what you've told me today, I mean it sounds really for the last 12 months or so you've felt really low since you split from your husband.

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Yeah.

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Your sleep's not been good, your appetite's not been good.

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A mess.

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It sounds to me like your self-esteem's taken a real knock, isn't it?

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I certainly think the help we can give you with some counselling, which we have a counsellor that comes here in the surgery

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that will be a benefit to you

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and then we'll try this short course of sleep and tablet to try and get you back into a sleep pattern.

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OK.

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And then maybe I can see you in about two, three weeks' time.

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And I don't want you to think that you have to sort of manage all this by yourself.

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I mean that's why we're here, we're here to help and support you further.

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Yeah, OK.

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Let me do the prescription then.

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It's 12 Hadfield close.

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Yes, it is.

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Yeah.

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Okay, so that's gone to reception now, so you can pick that up on the way out.

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Okay. And, erm...

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I'll give you one of the Had's questionnaires as well.

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Okay.

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And complete that before we see you next time.

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Okay, thank you, Doctor.

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Thank you for that.

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Okay, see you next time.

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Thank you.

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Okay, bye-bye.

169

Thank you.

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