Peer Response – Interaction Between a Nurse Practitioner and an Adolescent Client

Peer Response – Interaction Between a Nurse Practitioner and an Adolescent Client

Response

Hello Sita,

Thank you for your post. I found your scenario to be well-developed and comprehensive. You effectively depicted the interaction between the nurse practitioner (NP) and the adolescent client, Jennifer, who is reluctant to answer questions. Your analysis of the potential impact of Jennifer’s behavior on the client-provider relationship was thorough and insightful. Additionally, the techniques you suggested to enhance communication and address Jennifer’s behavior were practical and evidence-based. Do you need urgent assignment help ? Reach out to us. We endeavor to assist you the best way possible.

As you mentioned, creating a comfortable and confidential environment is crucial in establishing trust and encouraging open communication with adolescent patients. I particularly appreciated your emphasis on informal conversations to help ease tension during sensitive discussions (Hardin et al., 2021). This approach can make Jennifer feel more at ease and increase her willingness to engage in the conversation. Furthermore, your plan for the encounter was well thought out and addressed the patient’s specific needs. Given her religious background and strained relationship with her parents, reassuring Jennifer about the confidentiality of the encounter and discussing the scope of confidentiality protection are essential steps to build trust.

Engaging in active listening, empathy, and validation are vital components of effective communication, and I’m glad you included them in your plan. Demonstrating understanding and respect for Jennifer’s concerns will create a supportive environment where she feels heard and valued (Hardin et al., 2021). I also appreciated that you highlighted the importance of assessing Jennifer’s healthcare needs, including her sexual health, because it shows your commitment to providing holistic care and addressing all aspects of her well-being. Offering free and affordable resources to promote her healthcare outcomes also demonstrates your dedication to patient-centered care (CDC, 2019).

Overall, your scenario and documentation were clear and concise and demonstrated a comprehensive understanding of how to address the challenges presented by an adolescent client who is reluctant to answer questions. Your attention to detail and application of evidence-based techniques will likely contribute to Jennifer’s positive client-provider relationship and improved health outcomes.

References

Centers for Disease Control and Prevention (CDC). (2019). Promoting adolescent health: Strategies for effective communication.

Hardin, S., Kaplow, R., & Sellers, D. (2021). Building trust in adolescent healthcare provider relationships. Journal of Pediatric Health Care, 35(3), 156-162.

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A) This scenario takes place in a rural family practice clinic. Nurse practitioner Wendy Jones is seeing a 17-year-old adolescent female patient, Jennifer Smith, for a physical examination needed for her high school sports team. The examination is conducted in the NP’s private clinic room, without the presence of the patient’s parents. While conducting the health history, the NP asks Jennifer about her status of being sexually active. Jennifer looks away and down at the floor. She becomes silent after the question is asked and is reluctant to answer the question. NP Wendy can tell this is a sensitive topic for the patient to open up about.

Peer Response – Interaction Between a Nurse Practitioner and an Adolescent Client

B) The patient, Jennifer, is portraying a challenging behavior of being reluctant to answer important health history questions. Adolescents who are reluctant to answer questions may be hesitant to trust healthcare providers who they have not built a relationship with. In addition, the lack of knowledge of the patient’s health care information remaining confidential without informing the patient’s parents is a barrier to building trust with the patient as well (Hardin et al., 2021).

C) The potential impact of the patient’s behavior on the patient-provider relationship may be decreased quality of care and suboptimal treatment for the patient. If the patient is engaging in risky sexual behaviors without discussing them with the NP, the patient may be at risk of sexually transmitted infections and pregnancy. The NP could help educate the patient on safer sex practices while also providing free or affordable contraceptive options. The lack of trust can impact the patient-provider relationship, resulting in the patient not being receptive to the plan of care the NP has to offer resulting in decreased health outcomes (Hardin et al., 2021).

D) Techniques that may aid in enhancing communication with the patient and addressing the patient’s behavior are providing a comfortable and confidential environment in order to be successful in gathering an accurate health history from the adolescent (Bickley, 2020). In addition, trust is a big factor in being able to communicate effectively with adolescents to help them engage openly during healthcare encounters. Adolescents should feel included and autonomous when discussing health care information. Some ways to allow these patients to feel less awkward during sensitive topic discussions include engaging in informal conversations to help ease tension (CDC, 2019). In addition, when the patient feels a real connection and care from the NP, this builds a sense of trust. Trust is built through support, patience, non-judgment, active listening, empathy, respect, and demonstrated care for the patient (Hardin et al., 2021). These strategies can help lower barriers to adolescents’ adhering to the treatment plan.

E) Date & Time of Encounter: 08/15/22 11:30 AM

Patient: Jennifer Smith, 17 years old

Reason for Encounter: Physical Assessment Requirement for High-School Sports Team

Subjective: Jennifer Smith is a 17-year-old high school student with a past medical history of scoliosis. She comes into the clinic for a physical assessment in order to participate on a sports team at her local high school. The patient informs the NP of being a Christian and having extremely religious parents. In addition, she mentions she does not have the best relationship with her parents.

Objective: Jennifer appears timid; their body language is closed, and the patient makes minimal eye contact with the NP. Jennifer challenges the health interview process by answering questions with one to two-word answers, not being engaged, and being reluctant to answer some important personal questions.

Assessment: The patient is reserved and hesitant to answer questions based on a lack of trust in the patient-provider relationship.

Plan:

Maintain a comfortable environment for the patient and show interest in the patient’s life while maintaining eye contact and open body language (Bickley, 2020).

Reassure the patient that the encounter will remain confidential, safe, and secure without informing the patient’s parents.

Discuss the scope of confidentiality protection (ACOG, 2020).

Engage in active listening and empathy while discussing the patient’s concerns.

Validate the patient’s concerns while remaining kind, respectful, and empathetic (Hardin et al., 2021).

Discuss sensitive topics in an open manner with the patient (CDC, 2019).

Assess the patient’s healthcare needs including sexual health care needs.

Discuss stress management, strategies for coping, and the patient’s support system.

Engage the patient in making health care decisions.

Provide free and affordable resources for the promotion of the patient’s healthcare outcomes.

Signed, Wendy Jones, NP

References

American College of Obstetricians and Gynecologists [ACOG]. (2020). Confidentiality in adolescent health care. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/confidentiality-in-adolescent-health-care

Bickley, L. S. (2020). Bates’ guide to physical examination and history taking (13th ed.). Wolters Kluwer Health.

Centers for Disease Control & Prevention [CDC]. (2019). Supporting one-on-one time with a healthcare provider. https://www.cdc.gov/healthyyouth/protective/factsheets/OneonOnetime_FactSheet.htm

Hardin, H. K., Bender, A. E., Hermann, C. P., & Speck, B. J. (2021). An integrative review of adolescent trust in the healthcare provider relationship. Journal of Advanced Nursing, 77(4), 1645-1655. doi: 10.1111/jan.14674