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Reflection on Case History 2

   

Added on  2019-09-30

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GP New trainers course – Case History 2Case study 2Reflecting and giving constructive feedback - Most important attributes in teaching and training. IntroductionOne day a nurse requested me whether I could authorize a prescription for a patient he had seen with a mild temperature and an abdominal pain whom he thought was having a UTI. Instead of authorizing the prescription, I felt that I should examine this patient. On examination I found out that he has a very tender abdomen with some guarding. His urine had trace of leucocytes and blood, but otherwise normal. Patient needed immediate admission to the hospital for further assessment.In this situation I decided to assess the patient rather than prescribing as requested by the nurse. It prompted me to examine the patient due to lack of information provided by the nurse to be confident that he had a UTI. This particular nurse was new to the practice and I was not quite aware of his competence levels either. I found it hard to disagree with this senior nurse, (even though he is new to our practice) and instead of prescribing, straight away deciding to go and assess the patient. I felt difficult in disagreeing with his diagnosis but after explaining the reasons he agreed. I felt it even harder as he had a trainee nurse with him as well shadowing his consultations. Apparently his trainee has checked this patient’s urine sample and had told him that it is abnormal rather than he himself, double checking what was the real abnormality. It served to be a good learning lesson for the trainee as well as he had no knowledge about urine dip stick abnormalities. I examined the patient with the nurses and explained to them why it can’t be a UTI. I did give them the opportunity to examine the patient. Also they were present when I took a detailed history. Once I have dealt with the patient I wanted to reflect on this situation and to think about the best way I could use this situation to educate the nurses. I wanted to be as constructive as possible.I gathered information. Then I decided to discuss the situation briefly with the nurse involved. We then decided it would be a good learning opportunity. I have learnt from my trainer’s conferences and workshops about Significant Event Analysis (SEA). SEAs are a good source of learning if everyone take it as a learning experience. So I wanted to make this a learning experience to the nurse and the trainee nurse as well. So we prepared for the SEA meeting. Advised the nurse to write the incident and to look at what he would have done differently. I also advised to read about diagnosing a UTI and differential diagnosis of abdominal pain. Also we discussed about best way of seeking advice if he was unsure about the diagnosis. Better to ask for an assessment rather than asking for a prescription. If I did fail to assess the patient and had given the prescription, I would have certainly put the patient at risk.
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