Lucie Lachance: the art of listening to patients

Rewarding careers can sometimes come out of the blue

Movement disorders are a collection of diseases and syndromes that cause abnormal or involuntary movements and that affect a person’s ability to produce and control how they move. A number of diseases can cause these problems, such as Parkinson’s, Tourette’s, and dyskinesia. Lucie Lachance is a nurse clinician specialist who describes how her career developed with the Movement Disorder Clinic at The Neuro and why patients are the focus of everything she does.

How did you choose your field?

I got into movement disorders a bit by chance. After doing my basic training as a nurse, I was asked in 2002 if I wanted to join a specialized movement disorder team that was being set up at The Neuro. I said sure, why not? I gave it a try and got along well with the doctors there. Step by step, we put together a team.

At first, we just had three neurologists and one nurse. Gradually, our team grew and was joined by specialists in physiotherapy, occupational therapy, speech therapy, social work and nutrition. I have developed my expertise in movement disorders, and particularly Parkinson’s disease, over the past twenty years as a member of this team.

What is a typical work day like for you?

I spend most of my days at the clinic. I arrive early at around 7:30 a.m. to take messages left by patients the night before. I also get ready for appointments that start when the clinic opens at 9:00 a.m. But I’m also available for patients throughout the day, and I’m constantly checking my phone messages between appointments. I like taking my messages right away, because I know there are anxious patients at the other end of the line who want their questions answered as quickly as possible.

I also have my “paperwork days” when I work on upcoming presentations and lectures about new research, pharmaceuticals, or advanced therapies that get nurses very involved in treating Parkinson’s.

What impact does your work have on patients’ lives?

I think the impact is very positive. Patients are generous, and they often give me good feedback. I think that a quality I have developed over the years is being able to listen to them. Listening is important so that you can understand symptoms. This is especially important for Parkinson’s, a disease that can fluctuate a lot. For example, a variation in the rate of dopamine release and medication effectiveness can vary for many patients. You have to take the time to understand what patients are saying.

“I may not have a solution to every single problem, but if I listen effectively to patients, I can clearly communicate their issue to their doctors by asking, for example, what can we do to make their life easier?”

We discuss the case and may suggest, for example, that a patient take their medication earlier in the day to see if that alleviates symptoms. We don’t necessarily have to make major treatment changes. But there is always some loop to close in the cycle of responding to the patient, communicating with the doctor, and getting back to the patient to discuss the solution.

How do you work as a team to help patients?

The clinic has a great interdisciplinary team that includes eight neurologists, all of whom have their own areas of expertise. They are all specialists in movement disorders and have their specific research field and interests. This creates a team that is very on top of everything related to movement disorders and Parkinson’s. Thanks to our physical therapy, occupational therapy, nutrition, and social work services, I think we cover a wide range of issues that patients may face. This is what makes the team such a rich resource.

Together, we are changing lives. For example, one of my patients in his fifties was having trouble working because of his Parkinson’s. We set up a meeting with a social worker to see if it was time for him to consider going on disability. We follow patients as a team for many years. For people with Parkinson’s, our follow-up starts with their diagnosis and can last for twenty years. For example, I have known some of the same patients since I joined the clinic in 2002. I’m close to them and have a great sense of empathy and even sympathy toward them. Our patients care about us, and we care about them.

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The Neuro (Montreal Neurological Institute-Hospital) is a bilingual academic healthcare institution. We are a McGill research and teaching institute; delivering high-quality patient care, as part of the Neuroscience Mission of the McGill University Health Centre. We are proud to be a Killam Institution, supported by the Killam Trusts.

 

 

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