Start by asking if she would like help and offering your arm. You did not see her walk in, so you do not know how much help she wants. A gentle question such as “Would you like to take my arm?” lets her decide. Patients who accept usually hold your arm just above the elbow or around your lower arm. Keep that arm relaxed at your side unless she also needs support for balance.
The guiding rule is simple. Never push or pull a visually impaired patient, even gently, and always ask before you touch anyone. When she takes your arm she will often walk slightly behind you. That position lets her feel each turn before it happens. Talk as you walk, and describe the path: the turn coming up, the narrow hallway, the chair by the door. Clear the route first by moving stray chairs and obstacles out of the hallway. Speak directly to the patient, not to a companion or to the waiting room. If you are called away, do not leave her standing in the hallway. Finish the walk or hand her to another staff member. Give her spoken information as you work, such as when you are reading her chart or leaving the room. Ask whether the family waiting outside should come back with her, since some patients prefer to be alone with the doctor.
Offer, do not grab. Ask first, describe the route, and let the patient set the pace. Safe, respectful handling of patients with severe visual impairment is part of the COA visual assessment content area.
Incorrect Answers
- A. Taking her hand touches her without permission and pulls her along. Leading by the hand also removes her control of the pace and gives her no warning of turns.
- B. Holding the arm and steering is pushing the patient. The guide walks in front, and the patient holds you, not the other way around.
- C. Handing her to a stranger is unsafe and a privacy problem. Escorting patients is staff work, and it should not be handed to another family in the waiting room.
Testing Pearls
- Always ask permission before touching a patient, and never push or pull.
- Offer your arm; the patient takes it above the elbow and walks slightly behind.
- Describe the route out loud, including turns, chairs, and doorways.
- Speak to the patient, using your name and hers, not to the companion.
- Never leave a guided patient alone in a hallway.
References
- American Academy of Ophthalmology. Ophthalmic Medical Assisting: An Independent Study Course. Chapter 16, Patients With Special Concerns.
