QUESTION
Reflect on the 3 most challenging patient encounters and discuss what was most challenging for each.
What did you learn from this experience?
What resources did you have available?
What evidence-based practice did you use for this patient?
What new skills are you learning?
What would you do differently?
How are you managing patient flow and volume?
Communicating and Feedback
Ask yourself the following self-reflective questions:
How might I improve on my skills and knowledge, and how do I communicate that back to my Preceptor?
How am I doing? What is missing?
What type of feedback am I receiving from my Preceptor?
Patient 1
A 50-year-old African-American female visits the clinic with the chief complaint of a breast lump and breast pain. The patient presented to the clinic startled by a swelling in her left breast, which she noticed while taking a shower
two weeks ago. She reported that she felt pain in her breast and nipple. She also mentioned that after a few days, her nipple in the left breast started turning red besides turning inwards and that it was discharging a clear fluid. She explained that the lump in the breast was more so painful when she pressed it with her hand. However, she felt some pain even without pressing it. She report taking OTC ibuprofen for pain relief. Pt denied family history of breast cancer
plan
Breast ultrasound ordered
Core biopsy ordered.
patient 2
A 34-year-old Caucasian female who presents to the clinic with lower abdominal pain. She reports pain in lower abdominal pain that radiates to her lower back for the last three days. The pain has been constant, is exacerbated by bowel movements and is lessens when she leans forward. She has been taking Motrin PRN with minimal relief. Pain is to the point that it is interfering with her daily life. She expects her period two days from now and that over the last few months she has noticed her menstrual cramps have become severe and menstrual flow is much heavier. She Reports significant pain with sexual intercourse and has also report fatigued than usual.
plan
Ibuprofen 800 mg PRN Q6 hrs for pain
Transvaginal Ultrasound to r/o endometriosis
patient 3
A 36 years-old Hispanic female G1P1 presents to the clinic with symptoms of pain during intercourse. Patient reports that she feels pain in the vaginal opening and deep in the pelvis. Patient defines the pain to be localized and distinct. Pt. rates the pain at 7 out of 10 and defines the pain to be a ripping, throbbing and aching sensation that increases with intercourse time length. Patient reports that her vagina is normally dry which causes pain upon intercourse. Patient reports that she gave birth six months ago and is currently breastfeeding. Her last PAP smear test was twelve months ago. Denies abdominal trauma, nausea, vomit and diarrhea. Patient reports that her menses were irregular with no related complications such as abnormal flows and excessive menstrual cramping. Denies vaginal discharge, increased urgency and frequency of urination. Denies dysuria. Denies bleeding between periods and painful periods. Patient. Denies taking any medications for the pain.
Plan
Pelvic ultrasound scheduled
Ospemifene 60 mg PO once a day with food.
Follow up
Patient to come back to the clinic after one month for follow up.
Pt is instructed to call the clinic If symptoms get worse
Patient 1: Waiting for Too Long
As a health care worker, I have learned that if a patient becomes angry for waiting too
long in line, there is an impatience experience that leads to anger if you finally attend to the
patient. The patient projects their emotions onto the healthcare workers. In the same sense,
patients cause problems for the caregivers (Breiten et al., 2018). In that case, transference can
be considered if a patient is seen as an outcome of contact with colleagues, physicians,
friends, or other patients.
Patient 1: Gimme-Patient Challenge
I have experienced another problem involving the gimme-patient in a caring
environment that health workers face. To some extent, it may be challenging to administer a
patient asked for sleeping medicine or attend an investigation in a patient-centered manner.
Sometimes the patients cannot evaluate and understand the ethics of declining some of the
requests in the health care process (Sperling et al., 2021). However, I have encountered
patients insisting that their decision is the best for their interest regardless of the
consequences. Based on the response of patient 1, she denied that family history is not linked
to any breast cancer conditions (Wald et al., 2013). The patient also examined her pain from
her pain to make some thoughts.
Patient 3: Frequent Flyers
Most patients influence endless flyers, as I have been experiencing in various
practices in my field. As I understand, due to the sheer volume of medical records. The client
may need to peruse for more information. The patient shows that she experienced reliance,
loneliness, and sacred or non-confidential to asking about what she was suffering from (Wald
et al., 2013). Understanding her feelings and needs for medication based on manifesting
problems was challenging. I realized this problem with the patient because she had a lot of
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reasonable complaints and diverse perceptions concerning her illness. Based on this
challenge, the patient seemed to be worried well, provided incorrect information, and wanted
clarification from the deeply detailed complaints.
I reflected on the most common patients and challenges we as health care providers
face in everyday work. Based on my knowledge, I have learned that the patients present
challenging issues in various situations requiring diversified solutions (Sperling et al., 2021).
It may take a long way to deal with problems concerning clinical interaction based on the
elements involved. The situations are more difficult and require practical interpersonal
communication skills. One should be ready mentally, and time-based for any potential
difficulties patient contacts before the client enters the intervention room. Visualization of
appropriate management and caring elements helps me anticipate any patient contacts that
can trigger me in such a manner.
The program-based training called "Difficult Clinician-Patient Relationships" was a
resourceful tool for understanding how to improve the difficulties in relationships with
patients. Then saying no in every situation in medical practice is the best way of making
proper a decision (Sperling et al., 2021). Even having difficulties with a patient visit can be
tolerated by learning to say no, which makes clients feel that they are part of decision
making. Physical examination has been the only way to offer detailed history information to
curb the patient’s dissatisfaction. I am still learning that new communication is based on
various practice environments (Sheehan et al., 2021). I would have guided policies to ensure
that patients understand their limits regardless of their rights provided by laws. Using systems
for booking and questing is the appropriate way I manage the customer flow. Raising revenue
and efficiency can improve patient flow based on fully staffed practices.
Reflective Part
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I should gain interpersonal communication skills. In most cases, I have heard patients
quoting time as a universal value between the health care providers and them. Some
challenges are associated with questions such as;" where were you? And why did I wait for
so long?" however, it requires more ethical demonstration like taking a deep breath for better
thoughts and presenting yourself apologetically. During my sessions at work, I usually show
the upset patients that I am sorry if even I am not guilty hence becoming a challenge. It is a
challenge to apologize for the inconvenience you have not caused (Sperling et al., 2021). I
have learned that patients direct their emotional feelings from a different situation to release
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