Thanks for sharing your thoughts. As mentioned in the discussion, some clients may present specific challenges to the interview and physical examination. Challenging encounters threaten the quality of life of those involved and are likely to lead to responses that negatively impact client care. Nurse practitioners must be able to identify behaviors that impede the assessment and consider strategies to provide care to these clients. With practice, you will also learn to anticipate behaviors and know how to respond. The Seven C’s of communication provide a checklist for making sure that your exchange with patients is well constructed and effective:
Discuss TWO communication strategies from the list above that you could implement in your clinical scenario to mitigate this behavior. Be sure to include at least ONE new scholarly source to support your discussion points.
Create a sample scenario based on your assigned topic. Describe potential client behaviors consistent with the concern listed.
Talkative patients are more likely to go through specific hospital processes or surgeries. Such clients always talk to ensure they are heard. Their talkativeness may also arise due to their need for assurance concerning their situation (Winner, 2017). Being anxious or excited can make talkative patients talk rapidly and offer detailed explanations about things that could not be required. One could also see them as rude or difficult to deal with as they tend to be preoccupied with their feelings. Such patients may prove dangerous when they cannot be controlled (Prykucki, 2018).
An example of such a scenario would be:
Client X goes to a clinic for a check-up. However, the doctor advises him that he might have to undergo surgery to relieve his pain. For client X, this will be the first time undergoing surgery. The doctor and nurse attending to him then inquire about his medical and family history, but he refuses to respond to their questions. Instead, he expresses his fear and concern and tells them how that will be the first surgery in his life. He does not stop talking and even offers suggestions for possible outcomes following the surgery. He even claims that one of his family members was once operated on and is now suffering from the surgery.
Discuss an appropriate and professional approach to address the behavior and communicate with the client.
Most healthcare givers are indecisive in setting up boundaries with this kind of patient because they fear being rude or inconsiderate (Allespach et al., 2017). Talkative patients might need somebody to show them attention and listen while they speak (Winner, 2017). In the first five to ten minutes, nurses, together with health care givers, should be very attentive to the talkative patients to find out what is contributing to their talkative Ness; for instance, anxiety may be a factor. At the same time, health caregivers should question the patient about what worries or bothers them so that they can concentrate on whatever seems alarming to them. Should it get out of control, the nurse and other health caregivers might take an assertive though sympathetic attitude by stating, “I see you are becoming talkative again” (Allespach et al., 2017). Healthcare givers can also utilize other techniques, including setting up ground directives like dealing with issues after a given period during the evaluation and inquiring about closed queries that only require a yes or no response (Prykucki, 2018).
Provide an example of how you would document the encounter.
Apart from the data collected during the experience, it is also essential to document the patient’s nonverbal cues, behaviors, and thoughts (Tabangcora, 2017). The exact statement might also be recorded if required, as they might act as a guide for mediations to be applied in the patient’s care program. As demonstrated:
Client X failed to answer what was being asked, though he expressed his issues and fear about the forthcoming surgical procedure.
Client X felt upset and uneasy.
He was profusely sweating in her hands, and her heart rate was fast.
He provided proposals for possible solutions.
Integration of Evidence: Provide support from a minimum of one scholarly in-text citation in addition to the textbook
According to Allespach et al. (2018), most physicians do not redirect talkative, chatty, or patients with poor attention. This behavior has resulted in a decrease in productive hospital visits, doctor and patient satisfaction, and suboptimal medical care. Following this observation, they recommend an effective strategy that doctors could use redirect patients who are difficult to handle during consultations. A 7 C “s” strategy involves calming down, connecting, concerning, cause, comforting, contracting, and continuity. They concluded that having effective communication improves the patient-doctor relationship, makes it possible to acquire accurate medical history, and helps doctors make a proper diagnosis and formulate appropriate treatment plans (Allespach et al., 2018). Thus, the 7C approach can make it easy for physicians to talk to and manage complex patients like those considered talkative.
Allespach, H., Marcus, E. N., & Bosire, K. M. (2018). Sailing on the ‘7 Cs’: teaching junior doctors how to redirect patients during complex consultations in primary care. Education for Primary Care, 29(1), 46-48.
Mohiuddin, A. K. (2019). Patient Behavior: an extensive review. Nurse Care Open Acces J, 6(3), 76-90.
Prykucki, B. (2018, December 18). How to effectively manage the talkative and silent members of a Group. MSU Extension. Retrieved March 7, 2022, from https://www.canr.msu.edu/news/how-to-effectively-manage-the-talkative-and-silent-members-of-a-group
(Links to an external site.)
Tabangcora, I. D. (2017, January 19). 7 types of challenging patients: How nurses can interview them. Nurseslabs. Retrieved March 7, 2022, from https://nurseslabs.com/7-types-challenging-patients-interview