Patient-Physician Communication - Essay Example

Nursing Name Institution Date 1. Good communication skills When a physician is handling a patient, the treatment given to the patient and diagnosis depends on the communication skills used explains Travaline et al (2005). They further adds that, those patients that understands their doctors are in a better position to accept their health problems, follow the prescriptions, have knowledge on their treatment ways and monitor their medication timetables. It is therefore necessary to embrace good communication skills when handling a patient especially in the counseling part. Many skills have been suggested for adoption but this paper discuses few skills that are applicable in Sarah’s case. One of the basic communication skills to use is being attentive (“health24 HIV/AIDS”, 2014). This involves giving the patient both physical and psychological concentration during the dialogue process. For one to effectively use this skill, (“health24 HIV/AIDS”, 2014), advocates for the SOLER slogan. This means that one should Squarely face the client during the interview. You should also be in an Open posture and avoid crossing arms or legs as may be interpreted otherwise by the client. In the slogan they further advises one to Lean towards the patient, as it would help in showing concern. Eye contact with the client is also important and lastly one should be Relaxed and avoid being nervous as much as possible. Listening is also important in the interview. Travaline et al (2005), says that collaborative communication is very important as it helps one to avoid running into conclusions. Giving the client time to explain her will help reveal the problem. In this skill, one should be able to interpret both the patient’s verbal and non - verbal communications. When listening, one should avoid distraction and evaluation of the client of either being wrong or correct. Another skill is being emphatic. Mercer and Reynolds (2002), explain empathy in nursing as multi – dimensional idea that involves understands of the patients side, feelings, situation, as well as responding accurately to the patient in a therapeutic way. During the exercise, one should be able to probe questions that trigger the client to give more information about their situation. Avoidance of conflict is necessary. According to Travaline et al (2005), one should not engage or give room for argument during the whole process. 2. Clinical signs and symptoms used in the interview with Sarah. From Sarah’s case the following clinical signs are drawn, which are symptoms for Psychosis (mental illness). Starting from the moment she enters the clinic and basing her reactions in the clinic, one can conclude that Sarah lacks interest with the other patients, that is why as she comes to the clinic she fails to talk to the other patients, and she is seen to walk restlessly looking at objects in the walls. Her response to other patients also suggests her disorder. According to ( “ psychosis – symptoms” n.d), lack of insight is a psychotic sign which involves the client not being in a position to notice that whatever they are doing is wrong or it’s in an unusual way. In this case, Sarah does not seem to notice that her walking up and down in the clinic is abnormal. The way she responds to her fellow patients is also an indication of lack of insight. Another symptom we see is delusions. (“Early Psychosis Intervention”, n.d, para 2) defines delusions as that state in which a patient holds onto a false belief about their condition. From Sarah’s scene, she believes that the schoolteacher used radiation to control her thoughts. One with delusions also feels that their thoughts are aired out and the people near them are able to know them. Sarah explains her fear in boarding the same train with others since she thinks that they are in a position to understand what she is thinking and this confirms the sign delusions. She also explains her situation as confusing and therefore clearly shows that she has mental illness. Her explanation of the situation frightening can mean that she usually gets hallucinations, which is a symptom of mental illness. Hallucinations are a case where the client hears some frightening sounds communicating into her mind. This can make her condition frightening. Later we see her believing that the doctor has the power to take everything away. 3. Education to Sarah’s medication Treatment of psychosis can be through different ways including the use olanzapine nocte, which treats early psychosis. A patient who goes through this medication process should understand the reason why and the correct schedule of the same. Medication reduces further scenarios of the illness. Treating psychosis using low dose of medicine has some side effects, which needs to be monitored closely. It is of great important for any patent to understand the side effects associated with olanzapine nocte. These side effects might start few hours, days or weeks after taking the medicine. The common side – effects as explained by (“Centre for Addiction and Mental Health”, 2012), are: gaining of weight which might affect the patients image, feeling of dizziness, one’s mouth becoming dry. They further explain that the patient might feel tired without having doing work, constipation, and spams in the muscles. However, these side effects may not apply to all psychotic patients. Nevertheless, these effects diminish with time and the patient may not experience them again. Research done by; Gaebel and Alp (2008), shows that between 40 – 60% of patients who suffer mental illness are obese and these affects their relationship with the society. Overuse of the same dose may also cause side – effects, which may include voluntary movement of the lips, tongue, fingers or jaws, a disorder called tardive dyskinesia. This disorder if diagnosed at early stages can be treated. In addition, one should not stop psychotic medication immediately the symptoms disappear because early discontinuation of the medication increases the risk of the symptoms re occurring (“Centre for Addiction and Mental Health”, 2012). Recovery from the first episode of psychosis can leave one in a state of confusion, frightened or overwhelmed. As a result, the patient should always look for a person to confide with during the healing process. The patient should ensure that they regularly meet with his therapist, as it would help regain one’s self-esteem. 4. Medical plan to address any compliance issue for a psychotic patient Non – compliance to treatment of psychosis may include early termination of the use of the medicine, lack of taking the medicine as prescribe or even lack of availing one for regular checkups. As a therapist, there are different ways of establishing whether the patient is adhering to the medication as prescribed. One of them is involving the patient in an interview; this will help you have an idea of how far the patient has gone with the medication and how regular she takes them. According to Tansella et al (2003), testing of urine, using of case – note evaluation and also using a rating scale can help determine the patients adherence to medication. They advocated for pre – discharge education of the patient on medication as well as the side effects expected. Acoording to their research, they found that the community plays a major role to the patients non - adherence to the medication and as a result encouraged contant of the community with the individual before discharging them from medication. Family therapy can also help in the treatment of psychotic patient. This is because it helps both the patient and their family to understand their situation and cope with it amicably. This may include a series of family meeting which may take up to six or more months, as well as planning on how to cope with later episodes of psychosis. Involving the patient in self – help groups can also help in the recovery of the same. Living around people who have the same challenges can assist one recover faster than when they are isolated. In case of aggression from the patient, involvement of specialist will help manage that challenge. Allowing the patient to use a yellow card scheme, which helps in reporting and side effects as early as possible, would help in the treatment of the problem. In conclusion, psychotic episodes are dangerous if not treated at the first episodes and requires both the patient and the doctor’s commitment not forgetting the victim’s family during the treatment process. If a medicine is found to have side effects on the patient, then the therapist must prescribe another medicine immediately. REFERENCES Travaline, J. Ruchinskas, R., &. D'Alonzo, G. (2005). Patient-Physician Communication: Why and How. The Journal of the American Osteopathic Association, Vol. 105, pp. 13-18. Health24 HIV/AIDS, (2014). Retrived from http://www.health24.com/Medical/HIV-AIDS/Counselling/Basic-communication-skills-20120721 Mercer, s. & Reynolds, W. (2002). Empathy and Quality Of Care. The British Journal of General Practice, vol. 52, pp. 9 – 12. Psychosis – Symptoms. (n.d.).Retreived from http://www.nhs.uk/Conditions/Psychosis/Pages/Symptoms.aspx Early Psychosis Intervention. (n.d.). Retrieved from http://www.earlypsychosis.ca/pages/curious/symptoms-of-psychosis Transella, M. Gray, R. Barbui, C, & Nosé, M, (2003). Clinical interventions for treatment non-adherence in psychosis: meta-analysis. The British Journal of Psychiatry, vol.183 (3), pp. 197-206; DOI: 10.1192/bjp.183.3.197 Gaebel, W & Ucok, A. (2008). Side effects of atypical antipsychotics: a brief overview. Official Journal of the Worlds Psychatric Association. Vol, 7, pp 58 – 62. Read More