NR 509 Week 4: Client Challenges Chamberlain University

NR 509 Week 4: Client Challenges Chamberlain University

Some clients present specific challenges during the interview and physical examination. Nurse practitioners (NPs) must be able to identify behaviors that impede the assessment and consider strategies to communicate effectively with these clients. This week, you will create a scenario that could occur in NP practice in which a client displays a challenging behavior, as assigned below.  

Argumentative client

Client Challenges: Argumentative Patients

One scenario encountered is an argumentative client, a middle-aged man whose pseudonym will be Mr. Alex. He had visited the clinic for a routine check-up. He had a rich history of being resistant and becoming confrontational in his previous visits. He was already agitated even before the beginning of the interview. After greeting him and introducing myself, he started lodging complaints about his prior visits claiming that no one took time to listen to him or address his problems. His defensive demeanor was indicative that he was turning argumentative.

Employing effective communication skills and strategies to promote a constructive dialogue with him is crucial. The NP must ensure that they are calm and that their language communicates understanding and empathy. It is essential to make direct eye contact with him, listen to him attentively, and give him undivided attention. Active listening would help to convey genuine interest in listening to him and the readiness to address his concerns.

It is important to empathize with his experiences and validate that he is right to be emotional. The difficulties he had faced in the healthcare setting must be acknowledged, and the patient must be assured that solutions to his problem would be found. The validation is vital in helping to build rapport and trust with him and promote an ample environment for transparent communication (Shanahan & Cunningham, 2021).

Reflective questioning can come in handy to address this argumentative behavior. Instead of directly arguing with Alex, the NP can rephrase his statements and reflect on whatever he said. For example, upon expressing his dissatisfaction with his prior services, one would respond, “It seems like the past services you have received at this healthcare center have been frustrating. Would you mind telling me what specifically did not work for you?” Reflective questioning helps to motivate the patient to go into detail on their concerns while maintaining productivity and focus in the conversation (Shanahan & Cunningham, 2021). He can later feel validated and heard, guiding the conversation toward identifying ways to resolve his problems.

It is also vital to educate the patient on his condition and the interventions that are essential in helping him to achieve positive health outcomes. The information must be presented clearly, avoiding complicated terms to promote understanding. Providing the client with evidence-based information enables them to make informed decisions concerning their health. As Bullington et al. (2019) note, adopting the strategies mentioned above helps to turn the conversation from a confrontational to a collaborative partnership to help the client to recognize the actual problems they are experiencing and enable cooperation in developing an individualized care plan.

Healthcare providers must also remain aware of their non-verbal communication. An open posture, facing the client, and leaning forward slightly is essential to demonstrate a genuine interest in engaging with the client (Bullington et al., 2019). Appropriate gestures and facial expressions should also support the client and show empathy. These non-verbal cues are vital in helping to establish a constructive therapeutic relationship and promote a sense of trust between healthcare providers and their patients.

To sum it up, interacting with argumentative clients is challenging for nurse practitioners and may affect the overall quality of care offered to these patients. Employing effective communication skills such as validation, active listening, patient education and reflective questioning can help overcome these hurdles. Healthcare workers should create a conducive environment that promotes transparent dialogues and collaborative decision-making to help the clients to realize enhanced patient outcomes and satisfaction with the care they are given in the hospital.

 

References

Bullington, J., Söderlund, M., Bos Sparén, E., Kneck, Å., Omérov, P., & Cronqvist, A. (2019). Communication skills in nursing: A phenomenologically-based communication training approach. Nurse Education in Practice, 39(39), 136–141. https://doi.org/10.1016/j.nepr.2019.08.011

Shanahan, T., & Cunningham, J. (2021). Keys to trust-building with patients. Journal of Christian Nursing, 38(2), E11–E14. https://doi.org/10.1097/cnj.0000000000000823