NR 509 WEEK 2 DISCUSSION – GRADED AN A

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NR 509 WEEK 2 DISCUSSION – GRADED AN A Week 2 Discussion a. Create a sample scenario based on your assigned topic. Describe potential client behaviors consistent with the concern listed. b.... Discuss an appropriate and professional approach to address the behavior and communicate with the client. c. Provide an example of how you would document the encounter. Sample scenario for argumentative client Vinny is a provider in a busy family practice who has been practicing for the past 9years as an FNP in this clinic. Glancing at the next day's clinic schedule, he can see that one of his most argumentative patients is scheduled to arrive at 8:00 AM. This patient, Mr. Cousins has chronic medical and psychiatric issues, is abrasive and argumentative, and frequently demands more time than his other patients. Vinny is concerned that tomorrow's 20-minute appointment will last over an hour. It is evident that Vinny is demonstrating anticipatory emotional stress and labor prior to seeing his patient (Itzhaki, et al, 2018). During the appointment the next day, Mr. Cousins tells Vinny that his current inhaler for asthma is not working, so he did some online research and is convinced by his findings of a conclusion and demands a change to a stronger asthma inhaler based on his online research. Vinny assesses Mr. Cousins adherence to his current treatment plan and finds out that Mr. Cousins has not been following the suggested treatment and continues as a heavy smoker who does not want to reduce or stop smoking. Vinny explains to him the importance of adhering to the treatment plan to prevent deteriorating health as well as reducing exposure to asthma triggers. Mr. Cousins argues back believing that his current inhaler does not work. The visit is well over the 20-minute mark and Vinny sees that this is going nowhere, so he employs a professional approach of involving Mr. Cousins in the decision-making process. Vinny reviews the online research with Mr. Cousins and helps him understand the technical terms of the research. At the end, Mr. Cousins was able to see that while the new treatment plan would be great, it still required consistent adherence to the plan and reducing triggers like smoking, consequently, he decides to continue with his current treatment regimen. By involving the patient in shared decision-making, the provider was able to explain the difficulty and try to find common ground, then focus on highlighting solutions and resolve areas of disagreement. According to Bickley, et al, 2021, argumentative patients need to know that they are been heard. However, insufficient time impacts patient consultations as there is not always time for the patient to verbalize, and for the provider to appreciate the valuable contribution that the patient brings in having the lived experience of the condition. My documentation of this encounter will capture patient’s argument and emphasis the education on adherence to treatment plan provided to the patient. Also document the shared decision- making approach used to de-escalate the situation and the outcome of the intervention. References: Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' guide to physical examination and history taking (13th ed.). Wolters Kluwer. Itzhaki M., Bluvstein I., Peles Bortz A., etal (2018). Mental Health Nurse's Exposure to Workplace Violence Leads to Job Stress, Which Leads to Reduced Professional Quality of Life. Front Psychiatry. 2018;9:59. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835109/# [Show More]

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