Doctor-Patient Relationship - Assignment Example

Problem Patient Assignment After reading the attached case study "Enlarged Pro , briefly outline steps you would take as a health care administrator to best manage this patients challenging behavior. Provide specific examples where appropriate. The patient’s behavior in this case study is challenging in such a way that he actually expresses what he feels is not right every time he experiences an unexpected signs or symptoms brought about by the surgical procedure performed on him aside from the difficulties he encountered from the time of hospital admission up to the date of discharge. If I am the health care administrator who assigned to handle this case, the following are the steps needed to ensure proper management of the patient diagnosed with enlarged prostate gland. First of all, a proper referral to urologist should be done. The urologist should explain to the patient all about the disease, enlarged prostate gland. This includes the description of the nature of the disease (e.g. signs and symptoms like dribbling, hesitancy, difficult urination, perineal pain), the best treatment for this condition and course of the disease if the patient will not undergo an operation. The pros and cons of prostatectomy should be elaborated further which includes the following: mortality rate, indication of the procedure, a brief explanation of how it is going to be performed, type of anesthesia, duration of the operation, possible complications and the symptoms (e.g. dribbling, hematuria, dysuria, incontinence) that the patient will experience after the operation which are only temporary and expected to resolve within 5 to 7 days. Also, I will emphasize the reasons for the insertion of the indwelling catheter with a urine bag (e.g. as a method of hemostasis) or any other tubes inserted to the patient’s body so that they will understand his condition well and why he needs to endure the uncomfortable feeling of those tubes. Explain properly that the catheter is only temporary but be open to the possibility that there is a risk of one is to one million cases of having permanent incontinence after prostatectomy. Likewise, in this case since the patient is still working and productive, it is mandatory to inform the patient the duration of the healing process (e.g. length of time the patient needs to recuperate from the operation, leave of absence, approximate day of return to work, the impact of the operation on the patient’s daily activity and social function). An additional reading material regarding enlarged prostate gland may be given to the patient after the clinic visit for more information. (Flecher 140) Secondly, after the patient agreed to undergo the operation, set a specific date with him and make sure that the hospital is informed and a bed is ready several days before the scheduled date of operation. Ensure that the process will go on a smoothly during the patient’s admission to that hospital by coordinating with the admitting department several days before the scheduled date of operation. I will follow it up so that all the details are complete and the patient will just need to sign the admitting form on the day of admission and avoid long waiting time before a room is ready for him. I will make it a point that the hospital which I am going to refer to the patient provides a good nursing and professional care with the patient’s comfort as its primary goal of service. In this way, all the other services especially the food service system, maintenance such as room cleanliness, heating system, bed mattress , pillows, linens are assured to be though not the best but at least gives comfort to a patient who is in the post-operative recovery phase. The billing section of such hospital must also be organized such as proper itemization by naming all the medications given during the entire hospitalization to avoid confusion. (Flecher 137, 140) Third, it is of prime importance that I coordinate with my friend, anesthesiologist and talk to him about my patient’s case. He should be able to meet him at least a day before the operation to help alleviate my patient’s worries like the type of anesthesia, how it is going to be given (e.g. if GA via endotracheal intubation) and what will the patient feel after waking up (e.g. abdominal pain and uncomfortable feeling over the throat area as a result of inserted instrument). (Flecher 137) Lastly, managing this case does not end after the operation but close follow up until after the patient is able to fully recover with all the symptoms resolved and was able to go back to work. Assignment # 2 Living with Dying Assignment Instructions Revisit the DIPEx.org website using the link below; Select the heading experiences/talking about, then select the sub topic Discovery (people discuss how bad news was broken to them). After reading the narrative, select two interviews to review in depth (e.g. [LD09]) For each interview selected: (1) assess how well the news was both given and received and justify your assessment. Also, (2) for each answer the question should anything have been done differently? If so, what should that have been. In my point of view, the bad news regarding the diagnosis of the patient on this interview 09 transcript was broken in a very straightforward manner. The doctor who blurted out the bad news to the patient did not show any sign of compassion at all. He immediately informed the patient about the diagnosis in a way which is so impersonal without any empathy whatsoever particularly on the part where he needs to tell the patient that the disease is an incurable one. This way of disclosing a serious and bad diagnosis will definitely have a devastating impact on the receiving end especially when it comes to the patient’s insight on the illness and coping up mechanisms. It is therefore advisable that before disclosing the bad news the doctor must approach the patient in a friendly manner. Also, he must establish some rapport and start a conversation by asking the patient how he is coping up with the illness showing some compassion at the same time. Then during the conversation, he (doctor) can either hold his hand or pat his shoulder as he try to gently tell him about the bad news regarding his diagnosis and try to explain things slowly with pauses using layman’s terms and wait for any signs that he truly understands what he were explaining to him especially the part where he need to inform him that what he has is an incurable disease. If the patient cries, then let him cry and wait until he stops and try to assess how he will take it before you continue disclosing the bad news. In Interview 27 Transcript, on the other hand, the patient was open about his poor prognosis and ready to know all the things in relation to his disease. Therefore, the doctor who handled his case did not have any difficulty in disclosing the diagnosis and explaining the terminal case. This patient is strong willed and logical wherein he preferred to be open and interested in knowing everything there is to understand including the worst case scenario in relation to his serious condition. He opted to face and struggle with courage in fighting cancer by preparing himself what is to come and accept the reality that he will soon suffer and experience the expected symptoms (e.g. cramp-like abdominal and back pains) brought about by the disease process rather than wasting his time and effort in asking questions or blaming himself or other people why he had this incurable disease. In this case, I was the doctor assigned to disclose the bad prognosis to this patient, I will make sure to gather all the necessary information regarding the patient like for example his behavior and insight regarding his condition and support system (next of kin, caregiver, financial resources, etc.). These data can help me visualize on how the patient will react to his bad prognosis as I disclose it to him and on the other hand I can also prepare myself what approach is more appropriate, with right words to use and timely so that the receiving end can more or less feel a little better despite the bad prognosis. In a patient who is open-minded, it is better to inform him all about the course of the disease rather than holding it back. These patients prefer to know all the aspects in relation to their condition so aside from the talk, I can give him reading materials or suggest some websites which he can search into to give him additional information. Cited Works Flecher, Martin. “Enlarge Prostate.” 137-140 “How Bad News Was Broken.” dipex.org. Read More