.W. is a 70-year-old male who presents to the outpatient clinic for worsening swelling of his bilateral lower extremities and orthopnea. The following NP has been assigned to his care for about 2 years now and is familiar with this patient having a diagnosis of congestive heart failure and non-compliance with medical management. On this occasion, D.W. becomes belligerent and argumentative to the NP after waiting 20 minutes over his appointed time. The patient states he had trouble finding parking, and once he did find a spot, he had to walk “miles” to get to the front entrance in pain and agony from his edematous condition. Further into the exam, the NP discusses the medication the patient is taking, including the diuretic Lasix. D.W. is confrontational, stating he stopped taking the medication because it didn’t seem to help; he frequently had to use the bathroom and disliked experiencing muscle cramps. He started yelling at the NP, belittling the practice and the rude receptionist he

Healthcare Consultation- An Interaction Between an NP and a Client-Response

Hello,

Thank you for your post. Your interaction with D.W. presents an intricate predicament requiring a tactful and compassionate approach. It is certainly true that D.W.’s confrontational style can have a significant impact on the dynamic between the client and the provider, sometimes leading to a strained and unsuccessful therapeutic alliance (Tschuschke et al., 2021). It is clear from your insightful examination of the possible effects on the nursing profession and the holistic delivery of care how important it is to deal with these complicated behaviors.

Your suggested methodologies for augmenting client communication are indeed fitting, as they underscore the paramount importance of prioritizing safety, upholding a composed demeanor, and engaging in active listening (Bird, 2022). Recognizing and affirming D.W.’s emotional state are pivotal measures in mitigating the intensity of the circumstance. The commendable aspect of your approach lies in your emphasis on proposing alternative interventions through a collaborative framework. This demonstrates a dedication to identifying solutions that are in harmony with the client’s unique requirements and apprehensions.

Subsequently, the exemplar documentation is highly comprehensive, offering a lucid depiction of the interaction, the conduct of the client, and the proposed interventions. It exemplifies a methodical and systematic approach to documenting complex interactions, a crucial aspect of seamless healthcare provision and adherence to legal requirements.

In essence, your analysis, proposed communication techniques, and documentation exhibit a commendable level of intellectual rigor and adherence to established norms in the realm of effectively managing complex patient behaviors. Incorporating evidence-based sources, such as Bates’ guide to physical examination and history taking, enhances the veracity and scholarly merit of your response. In its entirety, your approach evinces a commendable display of professionalism and a steadfast commitment to prioritizing the needs and well-being of patients amidst the complexities inherent in the healthcare domain.

 References

Bird, C. (2022, May 12). Active listening encourages patients to share their perspectives. Nursing Times. https://www.nursingtimes.net/students/active-listening-encourages-patients-to-share-their-perspective-12-05-2022/