Scrubs

Car clinic: on getting optimal hubside manner

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Panic overtakes me as I assess the situation. No need for a stethoscope—I hear an audible undulating rumble that didn’t exist before. Watching the gauges, I note that the vitals are obviously out of whack. Instead of maintaining the usual rpm, the needle jumps high, dabbling for a few seconds before returning to baseline. Repeat cycle in irregular rhythm. At this point, I have no idea what is happening. I only know that something is very wrong—my car is sick.

I take my car to the local mechanic, hand him my keys and ask for a call when he has discovered the problem. My heart skips a beat as I realize I am leaving the well-being of my car, my pride and joy, in the hands of a perfect stranger. Later, the mechanic calls me with a diagnosis and cost estimate. If I’m lucky, he gives me a choice between treatment options. I still have no idea what the problem is, don’t understand the technical lingo and have no idea if the price is reasonable, but because I need my reliable transport to and from work, I agree to the plan of care.

Are you confident collecting and documenting patient data, at ease empowering patients to ask questions amid a myriad of technical medical jargon, but clueless when taking your own car to the clinic? Don’t panic. Just go back to the basics: your nursing skills. As a nurse, you have an advantage when it comes to car care. Talk to the technician as you would a physician. Here’s how to get the most out of your auto repair.

Taking in the Car
There are certain times of the day and certain days of the week when it’s best to bring in your car for service. Shift nurses have a particular edge because they often don’t have to do it during the times that most of the rest of the workforce must (before 8 a.m., after 5 p.m.), and can avoid the wait.

You’re most likely to beat the rush if you book midweek and midday. As with clinics, setting up an appointment is best. Depending on urgency, your mechanic may be able to get you in without an appointment. Still, without calling ahead, be prepared for treatment on a first-come, first-served basis.

Describing the Symptoms
Every day, nurses coax patients to share their symptoms, so we should be adept at doing so ourselves. In addition, we know the importance of thorough documentation in order to get the outcome we need.

A differential diagnosis requires gathering as much information as possible. Nurses look for signs in addition to symptoms. Often, patients are unable to tell us what’s wrong, so we have to use our nursing skills of assessment and observation to dig up the clues.

Your car can’t talk, either, but it has other ways of communicating pathology. When describing the issues to your mechanic for a diagnosis, more is always better. When in doubt, think about what you document on your own patients.

* Describe the problem.
* When did the problem start?
* What makes it better or worse?
* Do you notice the problem at certain times but not at others?
* What is the frequency of the problem?

In addition, your mechanic may want to know how various speeds, temperature and weather affect the issue. No detail is insignificant. If you can imitate a strange sound for your technician, don’t be bashful. Even a simple description of a new smell could make or break a diagnosis…and your wallet.

Diagnosis
Both auto technicians and doctors make diagnoses. It’s their job to translate that into human-speak, and nurses are often the voice of reason here for the patients. Because nurses are so adept at translating complicated issues for civilians, we can help coax an auto technician to do same.

If your mechanic is miles ahead, mumbling auto lingo, the most important thing is to ask him to slow down. Be an advocate for yourself and ask questions. If you don’t understand what’s really wrong with the car or why auto surgery is required, say so. If an explanation over the phone doesn’t make sense, ask to come in to the shop and see for yourself. Sometimes a visual of the problem will make more sense than simply hearing it. If you still don’t understand, ask if your technician can refer you to another source or website.

Second Opinions
Again, nurses are well versed in the smart but most sensitive way to broach a second opinion. We understand the ego of “the expert,” but have also experienced firsthand how a second opinion can save a life (or a limb). Use this knowledge to save a car’s engine…or at least a bunch of money to fix it.

When possible, take your car to the same technician each time. Someone who is familiar with your vehicle and knows its history may have an easier time (and be more efficient) at fixes. Just as you would probably discourage your patients from “doctor hopping,” it’s best to establish a trustworthy relationship with your local mechanic. Building rapport opens communication on both ends. Besides, a mechanic is likely to be more honest and open with an established client than with an unknown walk-in. A trustworthy technician won’t be intimidated by a second opinion and will even tell you when he doesn’t know.

How Do You Know if You’re Dealing with an “Expert?”
Referrals and years of experience are good indicators. Although certification programs do exist for mechanics, we know that even in nursing, book smarts are still not the same as real-life practice.

While there may be no clear-cut signs that a second opinion is needed, you should be especially savvy in certain situations. If your car breaks down in an unfamiliar location and you require towing, especially to an unknown mechanic, advocate for yourself. In the worst-case scenario, the mechanic knows he’s your only option for a quick fix and may try to finagle more money than it’s worth.

Treatment
When there are treatment options, nurses know how to ask the right questions on behalf of the patients, and how to coach patients to be advocates for the right options.

After the diagnosis, you may have multiple options to choose from:

* Do I go with the cheaper or more expensive part?
* Do I fix the problem now or down the road?

When considering treatment options, you must think about your current finances—can you afford to fix it now or do you need to wait until later?

Also think about long-term versus short-term. A short-term solution could be cheaper now, but may cost more when future repairs are required.

When deciding between treatments, we may have to consider price, vehicle longevity and safety issues. Just as patients must weigh costs (financial and otherwise), nurses must examine what we value most.

Optimal Hubside Manner
The most important factor in getting optimal hubside manner is to develop a trusting relationship with your technician. When you feel comfortable asking questions and volunteering information, and your technician knows and has a history with your car, you are primed for success.

Source: Henry Tilford, Store Manager of Goodyear – Fishers Tire and Service

Sara Beth Furey, RN, BSN, CPN
Sara Beth Furey, RN, BSN, CPN is a nurse and professional writer. Her unique educational background consists of a BSN from Indiana University (IUPUI) and a BA in both English and biology from Butler University. Writing pursuits have sent her foraging for wild edibles, exploring auto repair shops to learn about “hubside manner” and investigating countless other topics. Past publications include magazine articles as well as educational materials.

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