Lecture 10: Handling Challenging Interactions Flashcards
Who could be the focus of a challenging interaction?
A client who is Angry Embarrassed Psychotic Manipulative Tearful Confused Demanding, Reminder of someone Hard to understand, hard to make myself understood
What is a challenging interaction?
Patient is not willing to, or unable to be cooperative
Situation elicits strong emotions from the client or pharmacist
Situation tests the professionalism of the pharmacist
The pharmacist must be emotionally competent, and socially skilled
How do challenging interactions arise?
The environment may be unsuitable (physically, sociopolitically)
Time constraints
Issues relate to developmental stages in life
Clients may have strong emotions (distress, anger, demanding)
Clients may have medical problems (confusion, psychiatric condition)
Cultural considerations
Why are challenging interactions difficult?
Makes it hard to do your job because of your natural flight/fight reaction, emotions, and you may be distracted by the patients movements, jumbled ideals, this prevents our usual logical flow.
How can we adjust the environment to handle challenging interactions?
Make environment the best you can (uncluttered space, a childrens toy area, a place to take someone for privacy)
If relatives insist on being present, may sometimes need to ask them to briefly step aside
Be clear about time constraints
Reduce background noise, especially for the clients who are hearing impaired.
How can challenging clients in different stages of their life be dealt with?
Children: always talk to child as well as parent.
If more than one child, find out which one the medication is for.
Always ask permission to examine the child e.g. To show how to instil eyedrops.
For adolescents, their developmental needs are primarily around self image, seeking full autonomy, independence, they could be experimenting with sex, drugs or alcohol.
Be especially sensitive to embarrassment and control, (they have a tendency to rebel)
Practice very discreetly and within the ethical and legal obligations as a pharmacist
How can we interact with the elderly if they are being challenging?
Elderly form a large part of the pharmacists client group.
Be aware of multiple problems/medication and special challenges
Note that they may be experiencing decreasing senses including vision, hearing, smell, and dextrous loss. This can lead to frustration and irritability
May also become more anxious, fearful about losing independence.
Need to handle the elderly sensitively, especially if you want to include family members in discussions
Remember that impaired vision and hearing does not mean they are stupid
So sometimes when you need to clarify, dont be condescending
Take time to offer and explain aides that can help e.g. Diagrams, demonostrations, written info, weekly dispensing packs, prepacked medication
Caring for spouse is very stressful, ask how carer is dokng.
How do you deal with clients with strong emotions?
Acknowledge emotions e.g. “I can see that you are angry, I am sorry)
Negotiate to explore it if appropriate.
Only explore enough to do your job and ensure safety
Take it seriously, but not personally
Remember, sfety is always the bottom line
How can anger/tearfulness be dealt with?
Acknowledge the emotion
Check intensity
Explore reasons why- without getting defensive
Screen for underlying reasons
If the client is calmer, move forward with the interaction
If not, it may be due to other past or present experience.
If emotion is really intense and unfathomable consider psychiatric/organic reasons e.g. P
If emotion escalates, set limits /get help
How can we deal with clients with medical problems?
Be aware of making assumptions e.g. Drugs with multiple uses
Establish what client has been told by their doctor,
Be careful when answering leading questions e.g. Is this tablet for cancer? Ask, “can you tell me what your doctor has told you”
How can we deal with drug seekers?
Set clear limits Give rationale, safety reasons, legal and ethical obligations. E.g. If asking for morphine, ask why the doctor has given you this Take action if they dont leave Report problems Seek advice and support for yourself Debrief with senior colleague
How can we deal with clients with confusion or psychiatric disorders?
Recognise own anxiety
Check who are the caregivers, in these cases you often need to work with family members or caregivers around medication adherence, with client consent.
Set limits. Ask for help if you are concerned about safety
How can we deal with clients from different cultures?
Greeting,
Check mutual understanding
Slow down, use pictures, ask questions in many ways, rephrase, repeat instructions, verify understanding, dont guess meaning of words
Give out instructions in different languages Use interpreters (can use staff, family, and trained interpreters)
Dont make assumptions e.g. Mealtimes vary widely across cultures, this can affect medication
