{"id":297,"date":"2023-03-30T12:41:53","date_gmt":"2023-03-30T16:41:53","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/?post_type=chapter&#038;p=297"},"modified":"2023-09-25T17:54:31","modified_gmt":"2023-09-25T21:54:31","slug":"difficult-discussions","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/chapter\/difficult-discussions\/","title":{"raw":"Difficult conversations: Communicating a life-altering diagnosis","rendered":"Difficult conversations: Communicating a life-altering diagnosis"},"content":{"raw":"<p style=\"text-align: left\"><span id=\"x_m_8691576559407433342gmail-docs-internal-guid-fb23a14e-7fff-203d-0e13-786b0c9929c2\" style=\"color: #000000\">Communicating a difficult diagnosis or the findings of critical results to a client is a challenging but essential aspect of Advanced Practice Nursing practice. This is a fundamental clinical experience for MN and NP students that expands upon the theoretical understanding of specific topics addressed in their education program. Students may not have an opportunity to see or engage in these discussions in their clinical experiences so this simulation will provide students with an opportunity to apply their learning and develop therapeutic communications skills. Using the Serious Illness Conversation Guide (Ariadne Labs, 2016) as a framework for difficult discussions, this simulation will offer an immersive clinical experience to enhance preparedness and optimize comprehensive care to vulnerable patients. <\/span><span id=\"x_m_8691576559407433342gmail-docs-internal-guid-fb23a14e-7fff-203d-0e13-786b0c9929c2\" style=\"color: #000000\"><br aria-hidden=\"true\" \/><\/span><\/p>\r\n&nbsp;\r\n<div>\r\n<p id=\"x_m_8691576559407433342gmail-docs-internal-guid-75f2cbd4-7fff-ef7b-56e1-1ea280015ae1\" dir=\"ltr\" style=\"text-align: left\"><span style=\"color: #000000\">Learning Outcomes<\/span><\/p>\r\n<p dir=\"ltr\" style=\"text-align: left\"><span style=\"color: #000000\">After completing these simulations the student will be able to:\u00a0<\/span><\/p>\r\n\r\n<ul>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\">Initiate and develop a therapeutic relationship with the client.<\/span><\/li>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\">Communicate a difficult diagnosis or the findings of critical results to the client and\/or family.<\/span><\/li>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\">Use therapeutic communication strategies to ensure client-centered care.<\/span><\/li>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\">Provide guidance, health teaching and therapeutic interventions as indicated.<\/span><\/li>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\">Demonstrate a clinical encounter that fosters and ensures positive therapeutic relationships involving patient-informed treatment plans. <\/span><\/li>\r\n<\/ul>\r\n<\/div>\r\n<h1>COPD Difficult Discussion<\/h1>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Matthew (he\/him) is a 50-year-old cisgendered male that came to the Toronto Family Health Center last week for a persistent cough, occasionally productive x 3 months. Matthew reported his cough is typically worse in the mornings and his sputum is mostly clear and white. For the past 6 months, Matthew noticed feeling increasingly short of breath when exercising at the gym. He denied having any fever, chills, nausea, vomiting, or unexplained weight loss.\u00a0The NP did a physical exam and referred Matthew to a nearby clinic to do a spirometry test.\u00a0Matthew is now back at the office to review the results. <\/span><\/p>\r\n&nbsp;\r\n\r\n[embed]https:\/\/youtu.be\/61dJv8q3VlM[\/embed]\r\n<h1>HSIL Difficult Discussions<\/h1>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Sana (she\/her) is a 39-year-old cisfemale that came to the Toronto Family Health Centre two weeks ago for her routine pap smear. Her previous pap tests have been normal. Sana is now back at the office to review the results. <\/span><\/p>\r\n&nbsp;\r\n\r\n[embed]https:\/\/youtu.be\/GLRoya_onuQ[\/embed]\r\n\r\n&nbsp;\r\n<h1>STI Difficult Discussions<\/h1>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Sarah (she\/her) is a 23-year-old female that came to Toronto Family Health Center last week complaining of abnormal vaginal discharge and dysuria for one week. Sarah had recently become sexually active with one cisgendered male partner. She was unsure of his sexual history. She had been having unprotected vaginal intercourse with him for the past month and has been using the pull-out method. The NP completed the physical exam and collected cervical and vaginal swabs. Sarah is now back at the office to review the results of the tests.<\/span><\/p>\r\n&nbsp;\r\n\r\n[embed]https:\/\/youtu.be\/SVcgvoj1buk[\/embed]\r\n\r\n&nbsp;\r\n\r\n<span>For more information on this actor simulation, please contact:<\/span>\r\n\r\n<span>Erin Ziegler, PhD, NP, Assistant Professor<\/span>\r\n\r\n<span>Daphne Cockwell School of Nursing, Toronto Metropolitan University<\/span>\r\n\r\n<span>Email:<\/span>\u00a0<a href=\"eziegler@torontomu.ca\" target=\"_blank\" rel=\"noopener\">eziegler@torontomu.ca<\/a>\r\n\r\nFunding for this project was provided by the Daphne Cockwell School of Nursing-FDC Simulation Grant","rendered":"<p style=\"text-align: left\"><span id=\"x_m_8691576559407433342gmail-docs-internal-guid-fb23a14e-7fff-203d-0e13-786b0c9929c2\" style=\"color: #000000\">Communicating a difficult diagnosis or the findings of critical results to a client is a challenging but essential aspect of Advanced Practice Nursing practice. This is a fundamental clinical experience for MN and NP students that expands upon the theoretical understanding of specific topics addressed in their education program. Students may not have an opportunity to see or engage in these discussions in their clinical experiences so this simulation will provide students with an opportunity to apply their learning and develop therapeutic communications skills. Using the Serious Illness Conversation Guide (Ariadne Labs, 2016) as a framework for difficult discussions, this simulation will offer an immersive clinical experience to enhance preparedness and optimize comprehensive care to vulnerable patients. <\/span><span style=\"color: #000000\"><br aria-hidden=\"true\" \/><\/span><\/p>\n<p>&nbsp;<\/p>\n<div>\n<p id=\"x_m_8691576559407433342gmail-docs-internal-guid-75f2cbd4-7fff-ef7b-56e1-1ea280015ae1\" dir=\"ltr\" style=\"text-align: left\"><span style=\"color: #000000\">Learning Outcomes<\/span><\/p>\n<p dir=\"ltr\" style=\"text-align: left\"><span style=\"color: #000000\">After completing these simulations the student will be able to:\u00a0<\/span><\/p>\n<ul>\n<li style=\"text-align: left\"><span style=\"color: #000000\">Initiate and develop a therapeutic relationship with the client.<\/span><\/li>\n<li style=\"text-align: left\"><span style=\"color: #000000\">Communicate a difficult diagnosis or the findings of critical results to the client and\/or family.<\/span><\/li>\n<li style=\"text-align: left\"><span style=\"color: #000000\">Use therapeutic communication strategies to ensure client-centered care.<\/span><\/li>\n<li style=\"text-align: left\"><span style=\"color: #000000\">Provide guidance, health teaching and therapeutic interventions as indicated.<\/span><\/li>\n<li style=\"text-align: left\"><span style=\"color: #000000\">Demonstrate a clinical encounter that fosters and ensures positive therapeutic relationships involving patient-informed treatment plans. <\/span><\/li>\n<\/ul>\n<\/div>\n<h1>COPD Difficult Discussion<\/h1>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Matthew (he\/him) is a 50-year-old cisgendered male that came to the Toronto Family Health Center last week for a persistent cough, occasionally productive x 3 months. Matthew reported his cough is typically worse in the mornings and his sputum is mostly clear and white. For the past 6 months, Matthew noticed feeling increasingly short of breath when exercising at the gym. He denied having any fever, chills, nausea, vomiting, or unexplained weight loss.\u00a0The NP did a physical exam and referred Matthew to a nearby clinic to do a spirometry test.\u00a0Matthew is now back at the office to review the results. <\/span><\/p>\n<p>&nbsp;<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"COPD Difficult Discussions\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/61dJv8q3VlM?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h1>HSIL Difficult Discussions<\/h1>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Sana (she\/her) is a 39-year-old cisfemale that came to the Toronto Family Health Centre two weeks ago for her routine pap smear. Her previous pap tests have been normal. Sana is now back at the office to review the results. <\/span><\/p>\n<p>&nbsp;<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-2\" title=\"HSIL Difficult Discussions\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/GLRoya_onuQ?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h1>STI Difficult Discussions<\/h1>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Sarah (she\/her) is a 23-year-old female that came to Toronto Family Health Center last week complaining of abnormal vaginal discharge and dysuria for one week. Sarah had recently become sexually active with one cisgendered male partner. She was unsure of his sexual history. She had been having unprotected vaginal intercourse with him for the past month and has been using the pull-out method. The NP completed the physical exam and collected cervical and vaginal swabs. Sarah is now back at the office to review the results of the tests.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-3\" title=\"STI Difficult Discussions\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/SVcgvoj1buk?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<p><span>For more information on this actor simulation, please contact:<\/span><\/p>\n<p><span>Erin Ziegler, PhD, NP, Assistant Professor<\/span><\/p>\n<p><span>Daphne Cockwell School of Nursing, Toronto Metropolitan University<\/span><\/p>\n<p><span>Email:<\/span>\u00a0<a href=\"eziegler@torontomu.ca\" target=\"_blank\" rel=\"noopener\">eziegler@torontomu.ca<\/a><\/p>\n<p>Funding for this project was provided by the Daphne Cockwell School of Nursing-FDC Simulation Grant<\/p>\n","protected":false},"author":111,"menu_order":2,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-297","chapter","type-chapter","status-publish","hentry"],"part":146,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/pressbooks\/v2\/chapters\/297","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/wp\/v2\/users\/111"}],"version-history":[{"count":7,"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/pressbooks\/v2\/chapters\/297\/revisions"}],"predecessor-version":[{"id":392,"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/pressbooks\/v2\/chapters\/297\/revisions\/392"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/pressbooks\/v2\/parts\/146"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/pressbooks\/v2\/chapters\/297\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/wp\/v2\/media?parent=297"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/pressbooks\/v2\/chapter-type?post=297"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/wp\/v2\/contributor?post=297"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/opennursing\/wp-json\/wp\/v2\/license?post=297"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}