Chapter 15 (16 in slides)

Question 1

Difficulties Sources within the health professional:

Experiences and biases

Answer 1

experiences, education, biases, and values

These factors can affect how you react to a particular patient.

Question 2

Difficulties Sources within the health professional:

Personality

Answer 2

your personality and how you deal with stress will play a large part in how you manage patient care situations

Question 3

Difficulties Sources within the health professional:

Emotional reactions

Answer 3

If you are attuned to monitoring your feelings, you can try to assess how much anger, fear, or guilt you bring to the interaction and try to manage those feelings before trying to manage the patient.

Question 4

Difficulties Sources within the health professional:

High expectations of personal performance

Answer 4

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Question 5

Difficulties Sources within the health professional:

Compassion fatigue

Answer 5

emotional, physical and psychological exhaustion due to exposure to chronic work-related stress.

Question 6

Difficulties Sources within Patients

Behaviors that elicit a negative response

Answer 6

such as
violence, anger, or self-harm behaviors

Question 7

Difficulties Sources within Patients

Behaviors that reject professional assistance

Answer 7

Adherence is defined as the extent to which a person’s behavior—taking medication, following a diet, and/or executing lifestyle changes—corresponds with agreed recommendations

Nonadherence is largely viewed in health care literature as a problem to be resolved

Question 8

Difficulties Sources within Patients

Socially unacceptable attitudes or behaviors (eg.
Racist patients)

Answer 8

patients who are needy, demanding, manipulative, help-rejecting, self-destructive, and racist.4

Question 9

Difficulties Sources within the environment

Sources within the environment

Answer 9

• Strangeness of health care setting to patient
• Tense, highly charged settings
• Strangeness of community or in-home setting to
  health professional
• Understaffed settings
• Unsafe settings

Question 10

Working with Patients Who are

Self-Destructive

Patients who are self-destructive deny health professionals

Answer 10

the affirmation they seek in
helping patients get well

Question 11

Working with Patients with a History
of Violent Behavior

Answer 11

• Patients with a history of violent behavior not
  only reject help, but can actually harm the
  health professional

Question 12

Showing Respect in
Difficult Situations

Answer 12

• Ensure structure and consistency of
  approach to care
• Set limits
• Focus on behavior, not on the patient’s
  character
• Establish good communication lines
• Be honest about problematic behavior.
• Avoid derogatory labels

Question 13

Evidence-based Guidelines for Showing
Respect in Difficult Conversations
(1 of 2)

Answer 13

1.Timeliness matters
2.The setting matters.
3.Establish goals for the conversation and practice in advance.
4.Start the conversation by communicating the big picture and why all involved should care.
5.Remember that the caring function is as important as other interventions.
6.Talk less and listen more.
7.State facts and observations to remain as objective as possible.
8.Set realistic expectations.
9.Ensure safety.
10.Conclude by clarifying expectations and summarizing the conversation.

Question 14

Professionals’ Mistakes and Making Apology

Disclosure of errors is difficult because:

Answer 14

• It requires humility and skill
• Some health professionals believe they are
  immune to error
• Errors are seen as a sign of failure
• There are few mechanisms in place to openly
  discuss why an error occurred
• Errors give rise to legal fears