the challenging patient encounter Flashcards
what are examples of challenging encounters
longer encounters: translators
personality disorder
drug seeking
delivering bad news
behavioral issues!
ability to participate in decision making, informed consent requires?
compliance
patient satisfaction ( taken away if they cant speak the language)
language barriers create patient safety and compliance issues
when talking to a patient with limited English proficiency you should?
talk to the patient, avoid jargon, talk in short sentences, use a trained interpreter (in person is preferable)
if you use an in person interpreter how should they be positioned?
behind the line of vision so that the doctor maintains eye contact with the patient
examples of empathy with an interpreter
facial expression, eye contact, acknowldgement, power of human touch
guidelines on using interpreters (3) - in person
ask for exact translation
place interpreter out of sight line
write down key points, instructions and have interpreter transcribe
check comprehension by asking patient to summarize
phone translation services things to remember
move the phone or patient so you can maintain eye contact
body language is super important
establish roles
get ID number of the translator
keep them on the line for the physical exam and closing
documentation of a translator includes
name of translator
include ID
if family member was used; indicate patient was in agreement
hearing impaired encounter
face them
check for understanding (tell me what you understand)
ask if they need to lip read
do not shout
low vision/blind patient encounter
introduce yourself
offer to orient them to the room
face the patient !!!!
ask them how you can help with position changes
**remember blind does not mean cognitively impaired
cognitive impairment encounter
talk to patients
ask if you can talk to caregiver/family member if you need
pictures/visual aids may be helpful
teach back system
patient has understood the treatment plan/education by having them demonstrate or tell you about it
what questions do you have?
