Arun Patel Hypertension and Type 2 Diabetes shadow health Education & Empathy

Arun Patel Hypertension and Type 2 Diabetes shadow health Education & Empathy

Education & Empathy: 5 of 8 (62.5%)

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.

Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made
Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient

1 Distress Over Chronic Illness
Followed Up

Description: Mr. Patel reports distress over having two chronic illnesses.

whats the primary reason for your visit

Question
01:00 AM CDT

I’m here to check up on some numbers that I have for my diabetes and my hypertension. Guess they’re not looking too hot.

I know that a diagnosis can be frightening, and that keeping your diabetes under control is difficult and stressful. However, this is a manageable condition, and you have the chance to greatly improve your situation with diet and exercise

Educate
01:03 AM CDT

Alright. I get it.

do you check your blood sugar

Question
01:06 AM CDT

I check my blood sugar . . . sometimes. I know with diabetes, you have to check it every day, but I don’t have a lot of time, and needles are tough for me.

you need to check you blood sugar regularly and keep a record. I know that you dint like needles but if you dont monitor your diabetes you could end up needing insulin, which involves injections. you should aim to use your glucometer at least four times a week

Educate
01:09 AM CDT

Yeah, you’re probably right.

Model Statement: “I know that a diabetes diagnosis can be frightening, and that keeping your diabetes under control is difficult and stressful. However, this is a manageable condition, and you have the chance to greatly improve your situation with diet and exercise.”

2 Family Difficulties
Not Encountered

Description: Mr. Patel reports a strain on his family relationships due to his recent decision to go back to school to study film.

Model Statement: “I’m sorry to hear that you are having a hard time with your family. I’m sure that is adding to your current stress and anxiety.”

3 Financial Pressure
Followed Up

Description: Mr. Patel reports that he is on a tight budget and has some financial struggles.

what level of income do you make

Question
01:15 AM CDT

I make around $25,000 off of my graduate school stipend. I have to be pretty careful with my budget.

family history

Question
01:15 AM CDT

My folks have some stuff going on, which is probably why I’ve got some stuff going on. My dad has hypertension like me, and my mom has diabetes like me. She has high cholesterol, too.

i am sorry to hear that you are having a hard time with your family. I am sure that is adding to current stress and anxiety

Empathize
01:16 AM CDT

Ha, thanks.

i am sorry about your financial difficulties

Empathize
01:17 AM CDT

Thank you.

Model Statement: “I’m sorry that you are having some financial difficulties, and that those concerns are affecting the lifestyle decisions you make. That sounds stressful.”

4 Generalized Anxiety Disorder
Followed Up

Description: Mr. Patel reports that he has Generalized Anxiety Disorder.

how you deal with your anxiety

Question
01:20 AM CDT

Usually when I’m anxious, I just breathe slow and take a few minutes, but I’ve been so much more worried lately it doesn’t work very well. Honestly, the only new thing I’ve been doing to deal with all this stress is eat comfort food. I’ve probably gained 15 pounds since I last came to the doctor three months ago.

managing you anxiety can be challenging, and I’m sorry it has made such a huge impact on your life

Empathize
01:21 AM CDT

Thanks for saying that.

a healthy diet is important to control your hypertension and disbetes

Educate
01:22 AM CDT

Good to know.

in order to manage your diabetes and hypertension, you will need to manage your weight

Educate
01:24 AM CDT

I hadn’t thought of that.

I appreciate it.

Yeah. Got it.

Alright. I’ll stop taking my other medication.

I’ll start keeping snacks in my school bag.

I’ll let you now right away if I see anything like that.

Alright – I can do that.

Alright. I will.

Thanks for the heads up.

Ah. Alright.

Gotcha.

Hmm. Alright.

Ok. See you later.

Model Statement: “I know that managing your Generalized Anxiety Disorder can be challenging, and I’m sorry that it has had such a big impact on your life. We can talk about ways to lessen your overall stress level. It may be time to consider incorporating non-pharmacological methods into your GAD treatment, such as counseling or community support groups.”

5 Chronic Illness Management
Followed Up

Description: Mr. Patel reports that he does not regularly monitor his high blood pressure or type 2 diabetes.

whats the primary reason for your visit

Question
01:00 AM CDT

I’m here to check up on some numbers that I have for my diabetes and my hypertension. Guess they’re not looking too hot.

I know that a diagnosis can be frightening, and that keeping your diabetes under control is difficult and stressful. However, this is a manageable condition, and you have the chance to greatly improve your situation with diet and exercise

Educate
01:03 AM CDT

Alright. I get it.

how long have you had these conditions

Question
01:04 AM CDT

I got diagnosed with diabetes five years ago, and hypertension a year ago. But for the more recent stuff . . . over the past three or so months, I’ve gained some weight and felt pretty fatigued. And for probably a month now, I’ve had to pee way more and drink way more water.

do you check your blood sugar

Question
01:06 AM CDT

I check my blood sugar . . . sometimes. I know with diabetes, you have to check it every day, but I don’t have a lot of time, and needles are tough for me.

you need to check you blood sugar regularly and keep a record. I know that you dint like needles but if you dont monitor your diabetes you could end up needing insulin, which involves injections. you should aim to use your glucometer at least four times a week

Educate
01:09 AM CDT

Yeah, you’re probably right.

Model Statement: “You need to regularly check your blood pressure and blood sugar readings in order to manage your hypertension and type 2 diabetes. You should keep a log of your blood pressure and blood sugar readings. Uncontrolled high blood pressure or blood sugar is dangerous and could lead to extreme health complications down the road. I know that you don’t like needles, but f you don’t monitor your diabetes you could end up needing insulin, which involves injections. You should aim to use your glucometer at least four times a week, and eventually check your blood sugar daily.”

6 Activity Level
Not Followed Up

Description: Mr. Patel reports that he does not exercise and is living a more sedentary lifestyle.

do you exercise

Question
01:13 AM CDT

I don’t exercise. I just don’t have the time.

tell me about your diet

Question
01:13 AM CDT

Model Statement: “I know that you have a sedentary lifestyle and a busy schedule. I understand how difficult it is for you to summon the energy and motivation necessary for regular physical activity, let alone make the time for it. However, regular physical activity can help you in managing your anxiety, high blood pressure, and type 2 diabetes.”

7 Diet
Not Followed Up

Description: Mr. Patel reports that he primarily eats take-out food and does not feel that he has the energy to cook or pay attention to what he eats.

tell me about your diet

Question
01:13 AM CDT

My diet could be better, to be honest. I eat a lot of carbs and fried foods, and I tend to go for pizza when I’ve had a really bad day. I don’t feel like my diet is out of control exactly, but I’ve been thinking about cutting down.

do you drink

Question
01:13 AM CDT

I never drink.

what level of income do you make

Question
01:15 AM CDT

Model Statement: “I know that a busy schedule and financial limitations can make it very difficult to plan nutritious meals, but a healthy diet is important for managing your diabetes and hypertension. You may want to think about getting in touch with a nutritionist who can help you figure out a dietary regimen that will work for you.”

8 Weight Control
Followed Up

Description: Mr. Patel reports that he does not attempt to manage his weight.

how you deal with your anxiety

Question
01:20 AM CDT

Usually when I’m anxious, I just breathe slow and take a few minutes, but I’ve been so much more worried lately it doesn’t work very well. Honestly, the only new thing I’ve been doing to deal with all this stress is eat comfort food. I’ve probably gained 15 pounds since I last came to the doctor three months ago.

managing you anxiety can be challenging, and I’m sorry it has made such a huge impact on your life

Empathize
01:21 AM CDT

Thanks for saying that.

a healthy diet is important to control your hypertension and disbetes

Educate
01:22 AM CDT

Good to know.

in order to manage your diabetes and hypertension, you will need to manage your weight

Educate
01:24 AM CDT

I hadn’t thought of that.

I appreciate it.

Yeah. Got it.

Alright. I’ll stop taking my other medication.

I’ll start keeping snacks in my school bag.

I’ll let you now right away if I see anything like that.

Alright – I can do that.

Alright. I will.

Thanks for the heads up.

Ah. Alright.

Gotcha.

Hmm. Alright.

Ok. See you later.

Model Statement: “Maintaining a healthy weight is important to managing your type 2 diabetes and hypertension. Being overweight puts additional stress on your body to control your blood sugar levels through insulin; it can also complicate your hypertension. In order to help get your high blood pressure and diabetes under control you will need to manage your weight.”