NR 509 Week 4 Discussion; Client Challenges - Argumentative Encounter
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NP tries her best to de-escalate the situation before it goes any further. While Danielle is listening and hearing Mr. Cox out, she is empathetic about his pain, non-judgmental, and watches her tone and body language during the encounter but also knows her boundaries. The more the NP listened, acknowledged, and validated the client’s pain the less argumentative he was. By the end of the visit Mr. Cox understood the reasoning behind his clinician’s decisions whether he agreed or not. Before Mr. Cox left Danielle called one of her recommended pain management specialists who she refers to many patients and was able to set up a visit for Mr. Cox that day. Danielle did this because she is empathetic to his situation. She knows that drug addiction is an illness and Mr. Cox does have chronic pain so he is suffering but also knows that because of his drug addiction and tolerance he has developed significant psychological, behavioral, and emotional problems that could very well be due to under or overprescribing of opioids (Dydyk et al., 2022). An example of my documentation for this encounter is as follows: Mr. Cox is a known patient of Danielle NP and Dr. Goedert in the clinic. During today’s visit Mr. Cox was requesting a refill on medication that was given 2 weeks prior and had used the prescription inappropriately due to pancreatitis flare up and increase in pain. Danielle NP had given the patient recommendations on different pain specialists to follow-up with due to the patient’s history and medication but instead returned to the clinic. When Danielle NP spoke of the pain management specialist during this visit the patient grew increasingly upset shouting “I am not drug seeking,” also that the NP does not want to help him and does not believe or care about his pain. The NP denied those allegations. The NP was able to de-escalate the situation with the patient by better communication skills. The NP then called the referred pain management specialist and coordinated a visit for the patient that day. References Bell, R., Fenton, J., Henry, S., Kravitz, R. (2018). Communication About Chronic Pain and Opioid in Primary Care: Impact on Patient and Physician Visit Experience. International Association for the Study of Pain. 159;2. https://www.hanys.org/quality/collaboratives_and_learning_networks/opioids/docs/communicati on_about_chronic_pain_and_opioids.pdf Dydyk, A., Haddad, S., Lindsay, L., Porter, B., Sizemore, D. (2022). NP Safe Prescribing of Controlled Substances While Avoiding Drug Diversion. StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK564518/ Discussion response: Matthew, I totally agree with how this doctor handled this patient interaction. It would be one thing if the patient had called and requested to have the specific doctor prior to the appointment and not pointing out why but to come into the office and disrespect his staff is unacceptable. He stood up for his staff which is the right thing to do. I used to be staff in the Emergency Dept where I witnessed different kinds of racism every single shift. It is unfortunate but most of the time we need to maintain
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