Lecture 32 - Challenging Interactions and Consultations

Question 1

Factors that can contribute to challenign interactions

Answer 1

Patient - personality, attitudes, culture, illness behavior

Doctor - burntout, distracted, depressed, junior

Illness - complexity, chronic, treatable

System - economic, health system, isolation, relationships

Question 2

Tips for talking with patients

Answer 2

• following their story
• summarise after the history of presenting complaint
• try not to think of next question (stops you fully listenign)
• silence, summaise
• try to see aptietns perspective

Question 3

BATHE technique

REBELES

Answer 3

B- backgroun - what is going on in your life
A - affect- what do you feel abot it?
T - trouble - what about the situations troubles you the msot
H - how are you hadnling this?
E - empathy

R- recognise the problem
E - express empathy
B - establish clear boundaries
E - emphasise the patients best interest
L - use inclusive language
S - focus on the solution

Question 4

NURSE respinse to emotion

Answer 4

Name - this has been so hard
Understand - it sounds like you feel abandoned
Respect - you have done so well to manage all this
Support - we will help you work this out
Explore - tell me more about what has upset you

Question 5

Angry patient

Answer 5

• respond to the emotion
• understand what is driving it
• respond again -repeat
• problem solve togheter