Education & Empathy : 3 of 7 (42.9%)
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 Treatment Inefficacy
Not Followed Up
Description: Mr. Bailey reports that some of his attempted pain treatments have proven ineffective, causing him suffering and exasperation.
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Did you go to the hospital
Question
03:41 PM CDT
Tanner Bailey
I went to the hospital when I hurt myself picking up that box thirteen weeks ago. They looked me over but they couldn’t figure out what kind of back injury I had.
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Did the hospital recommend anything
Question
03:41 PM CDT
Tanner Bailey
All they did was tell me to take ibuprofen and do physical therapy. They couldn’t even tell me what was wrong, even after an MRI. It turned up nothing.
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What did the hospital diagnose you with
Question
03:42 PM CDT
Tanner Bailey
The ER did an MRI, but they can’t tell me what’s actually wrong with my back. My coworker drove me all the way out to the hospital the day I hurt myself, and there’s not a whole lot to show for it.
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Have your pain levels changed since your injury
Question
03:44 PM CDT
Model Statement: “I’m sorry that it’s been so difficult to find a proper treatment plan for your pain and that you haven’t always received enough relief. We’re going to figure out how best to treat your pain quickly and effectively.”
2 Chronic Back Pain
Followed Up
Description: Mr. Bailey reports severe back pain that has debilitated and frustrated him for many weeks.
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What brings you in today
Question
03:35 PM CDT
Tanner Bailey
I picked up this heavy box at work–with like, sound equipment and stuff in it–and ever since then, the pain in my lower back has been killing me. I think I need to be on opioids or something.
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I am sorry your back has continued to hurt so severely for so long, We’re going to determine the best plan of action to ease your pain
Empathize
03:38 PM CDT
Tanner Bailey
Hey, thanks.
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Have your pain levels changed since your injury
Question
03:44 PM CDT
Tanner Bailey
My back pain hasn’t gotten better at all. I feel like I’ve been in pain forever. I need it to stop.
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When does your pain occur
Question
03:45 PM CDT
Tanner Bailey
The pain starts when I wake up in the morning. It does fade away for a little bit during the day, but it’s not a reliable thing and it always comes back.
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I’m sorry that it’s been so difficult to find a proper treatment plan for your pain and that you haven’t always received enough relief. We’re going to figure out how best to treat your pain quickly and effectively.
Empathize
03:48 PM CDT
Tanner Bailey
I appreciate your saying that.
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Do you take opioids
Question
03:56 PM CDT
Tanner Bailey
I was taking them, but I’m out. It was my first time trying them, and I had my last one this morning. My friend only had a week’s worth after his surgery, so now I’m here for a prescription. My back hurts too much to wait it out.
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While the medication your friend gave you was effective for pain relief and even though he no longer needed it you should only take prescriptions that a healthcare provider can safely endorse and oversee
Educate
03:57 PM CDT
Tanner Bailey
Yeah, I guess that makes sense.
Model Statement: “I’m sorry your back has continued to hurt so severely for so long. We’re going to determine the best plan of action to ease your pain.”
3 Prescription Borrowing
Followed Up
Description: Mr. Bailey reports taking leftover pain medication given to him by a friend after his friend’s surgery.
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Do you take opioids
Question
03:56 PM CDT
Tanner Bailey
I was taking them, but I’m out. It was my first time trying them, and I had my last one this morning. My friend only had a week’s worth after his surgery, so now I’m here for a prescription. My back hurts too much to wait it out.
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While the medication your friend gave you was effective for pain relief and even though he no longer needed it you should only take prescriptions that a healthcare provider can safely endorse and oversee
Educate
03:57 PM CDT
Tanner Bailey
Yeah, I guess that makes sense.
Model Statement: “While the medication your friend gave you was effective for pain relief, and even though he no longer needed it, you should only take prescriptions that a healthcare provider can safely endorse and oversee.”
4 Prescription vs Over the Counter
Followed Up
Description: Mr. Bailey reports not filling an ibuprofen prescription so as to avoid the hassle of going through the pharmacy, and instead, he purchased and used over-the-counter ibuprofen.
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Was it over the counter (Clarified to: Did you take ibuprofen that was just over the counter?)
Question
03:58 PM CDT
Tanner Bailey
The hospital prescribed me ibuprofen, but I just bought some over the counter — prescriptions are such a hassle to fill and pick up and all that. Figured it’d be easier. (Clarified to: If the ibuprofen was over the counter)
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Prescription and over-the-counter medications are not always identical. you should always fill your prescription instead of buying them over the counter and always take your medication as prescribed
Educate
04:00 PM CDT
Tanner Bailey
Thank you. One more thing to think about, huh?
Model Statement: “Prescription and over the counter medications are not always identical. You should always fill your prescription instead of buying them over the counter, and always take your medications as prescribed.”
5 Dangers of Opioids
Not Followed Up
Description: Mr. Bailey reports taking opioids to treat his back pain.
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Does anything relieve the pain
Question
03:52 PM CDT
Tanner Bailey
Sometimes just shifting around–changing the way I’m sitting or lying–can help a little. Rest helps a little bit, too. Drinking kind of worked, but I did have to go up to three drinks a day. Ibuprofen didn’t work at all, but these opioids I tried–hydrocodone and acetaminophen–they actually stopped the pain.
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Do you have any type of allergies (Clarified to: What allergies do you have?)
Question
03:54 PM CDT
Tanner Bailey
I don’t have allergies. (Clarified to: what allergies I have)
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Can you tell me about your family history
Question
03:55 PM CDT
Tanner Bailey
My mom’s has depression. She’s also an alcoholic. My dad’s pretty healthy.
Model Statement: “Though it’s good that opioids have proven effective for you for pain relief, and that they could be again, they are addictive and dangerous. You should only take them if a healthcare provider determines it is a safe and logical option.”
6 Physical Activity
Not Followed Up
Description: Mr. Bailey reports that besides shifting positions while resting, and besides at-home exercises he tried that only exacerbated his pain, he has gone without physical activity due to wanting to rest.
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Does exertion make your pain worse
Question
03:50 PM CDT
Tanner Bailey
The pain is worst when I’m doing something. Walking, lifting, bending over. It makes it hard enough to move I can’t even go to the physical therapist like the ER doctors wanted. I tried some exercises at home and they just hurt too much.
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Does exercise make your pain worse
Question
03:50 PM CDT
Tanner Bailey
I can’t exercise. Which just stinks. I used to lift weights and do cardio three times a week. Now, every little thing hurts. I can’t bend or lift stuff, and even walking is just so painful. I tried some PT exercises for my back at home, but it just hurt so much.
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What is the pain like
Question
03:51 PM CDT
Model Statement: “While it’s great that shifting your position can lessen your back pain, remaining otherwise sedentary can actually increase it. You may feel better by taking slow, short-paced walks, stretching, or trying specific exercises. Despite the pain involved, physical therapy could also be an effective healing tool.”
7 Alcohol Use
Not Followed Up
Description: Mr. Bailey reports drinking alcohol to dull his back pain.
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Has your alcohol consumption endangered you
Question
04:04 PM CDT
Tanner Bailey
If you mean like, drinking at work or something, no, I’d never. I’ve just been at home.
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Can I examine your back
Question
04:05 PM CDT
Tanner Bailey
Have at it. [AUDIO COMING SOON]
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thank you
Question
04:05 PM CDT
Tanner Bailey
You’re welcome.
Tanner Bailey
Alright, let’s do it.
Tanner Bailey
Thanks for the tip.
Tanner Bailey
Got it.
Tanner Bailey
Fine by me.
Tanner Bailey
Aw, man. No more whiskey?
Tanner Bailey
I get it, but just so you know, you’re asking a lot of me.
Tanner Bailey
That sounds awful. Is this stuff really safe to take?
Tanner Bailey
I guess it’s worth the risk. I mean, I’ve got to do something.
Tanner Bailey
But it hurt so bad. That can’t be good for my back, can it?
Tanner Bailey
Alright . . . guess I gotta work through the pain a little bit.
Tanner Bailey
I mean, I know you’re not supposed to . . . but it did work a lot better than the ibuprofen.
Tanner Bailey
Okay, okay. I understand. Really. I knew it wasn’t a good idea . . . I just couldn’t find anything that worked. This time will be better.
Tanner Bailey
Thanks. You have a good one.
Model Statement: “Though alcohol has been effective for you as a back pain reliever, it’s a dangerous substance that could damage your health and behaviors. We will work to find you a treatment plan whose risks can be minimized and overseen.”