Nurse Practitioner Consultation

4921 words 20 pages
For the purpose of this essay, I will discuss the case of a five years old patient presenting to my place of work with the symptom of shortness of breath (SOB). To maintain confidentiality the pseudonym “Ryan” will be used to refer to the child and Ryan’s mother will be frequently referred to as “mum”.
As this assignment is a critical evaluation of my own practice, elements of it will be written in the first person. Webb (1992) considers writing in the first person acceptable when personal experiences and opinions have played a significant role in shaping the ideas presented.

My current role is that of unscheduled care practitioner (paediatric specialist) within a health centre, which aims to compliment the services of local GP
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Children cope better when they are fully informed of what to expect. With regards to this, Howells and Lopez (2008) states that informing children and parents of what will happen reduces anxiety and uncertainty.

The initial moments during a consultation are crucial in establishing a trusting rapport and evidence links the quality of communication to clinical outcomes (Gask and Usherwood, 2002). The success of a consultation depends on how well the patient and clinician communicate with each other (Kaufman, 2008). When dealing with paediatric patients, enhanced communication skills are required, as the practitioner needs to communicate effectively with both the parent/guardian who is often the historian, and the child. This requires the practitioner to continuously ‘switch’ language from a level which is suitable to the parents, to a level appropriate to the age and level of understanding of the child (Cahill and Papergeorgiou, 2007).

I felt that the initial encounter went well. Ryan was calm and cooperative. Mum appeared open and relaxed, responded well to my opening statements and was forthcoming with information. I felt that I built up a good rapport with both child and mother.


‘Taking a patient history is like playing detective searching for clues, collecting information without bias, yet staying on track to solve the puzzle’ (Walsh, Crumbie and Reveley, 2001). The history is regarded as the most important part of the


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