Mrs. Schmidt is a 64-year-old woman who has beern staying at an acute care facil

Question

Mrs. Schmidt is a 64-year-old woman who has beern staying at an acute care facility for over 3 months now She has been suffering for several years from chronic obstructive pulmonary disease and was placed on mechanical ventilation last fall. She was initially admitted to your facility for a weaning trial from the mechanical ventilator. For the past 3 months, she has failed several trials of weaning. Last night, the physician informed her that she was to leave the acute facility, connected to the mechanical ventilation, and that no further trials will be initiated. This morning, you asked Mrs. Schmidt about her preparations for leaving the facility. In response, Mrs Schmidt starts crying dramatically and asks to see the attending physician. She is extremely upset, stating that no one had told her anything about this."She is adamantly asking for an extension of her stay and for another weaning trial. Two weeks later, Mrs. Schmidt is completely weaned from the mechanical ventilation However, she still has a Foley catheter (a thin, sterile tube inserted into the bladder to drain urine) in place, which she refuses to let go, saying that, she "cannot be without it. 1: What are some of the potential challenges for communicating with Mrs. Schmidt?

Explanation / Answer

1. Potential challenges for communicating with Mrs.Schmidt are :

She was a critically-minded patient and therefore, had the habit of questioning and disputing best evidence.

She had her professional confidence due to her knowledge and expectations from health care and hence challenged the best practices.

2. It is very much important to build an effective relationship between patient and the practitioner. This would develop trust and respect between them. Building up a good rapport would therefore assess challenges for communication.

3. Due to expansion of internet facility, health care awareness is scattered all over. Mrs.Schmidt had fundamental knowledge about the health care and so challenges the professionals about her treatments. She was a kind of affluent and Internet savvy patient, so presented her questions to the practitioner, hence making them disempowering.

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