Below is the discussion post with some

Below is the discussion post with some examples. After reading it, please answer the question on the bottom in bold entirely. Provide evidence-based information by using scholarly articles and include references within the last five years. Thank you. The Art of Being an NP-Everyone Please Read and Respond Good Morning everyone! I wanted to share some thoughts on what you cannot learn in textbooks about being an NP. I call it “the art of being an NP.” It’s about the approach and personality-style you use to help patients be as healthy as they can be, make good decision, or comply with recommended treatment. Delivering “Maybe” News- I think it’s important when delivering distressing news to be slow and gentle and avoid inflammatory statements that are upsetting to patients. You need them to listen and hear you and when they’re panic and scared that cannot happen. Abnormal results for example- -let’s say a patient has an abnormal Mammogram- it may be too harsh to open with “OK, so your mamm was abnormal and could be breast cancer!” Typically a patient knows they have abn test results when they are asked to come back in so they are already a bit worried. It may be better to say, “Your mamm showed something abnormal, but let’s talk about how often abn results come back and turn out to be nothing. They can represent a large lymph node, a shadow from US technique or a benign cyst. Now let’s talk about our worst fear. Could it be cancer? yes, this is a possibility and so we want to investigate further by doing advanced imaging, etc. You’ve got A, B and C risk factors BUT you’ve got C, D and E on your side. I am going to be straight with you every step of the way and we will get answers and a plan as soon as possible…” -Now let’s say a Married, Monogamous patient tests positive for an STI- Ugh!!! Right! Yes, Ugh!! You’ve got gently help them ask themselves the question “Has my spouse been unfaithful?” OR you’ve got to ask THEM if they’ve been unfaithful……Super awkward! But this is life, and we’re here TO TREAT PEOPLE and not judge them or help them decide how to live their lives. SO, I would open with: “Your swab came back positive for Gonorrhea which is an STI. While it is remotely possible to contract it other ways, 90% of the time it is through sexual contact. If you/your partner have outside relationships it would make sense that an STI might happen.” If the patient nods, says “OK” and doesn’t elaborate they may already know that they themselves are having outside relationships or their partner is or that they are in an unhappy situation. If this seems distressing to them and they become upset, then you’ve got to gently lead them to explore a discussion with their partner without accusations because the partner needs to be treated. “I’m sure the possibility of your partner being unfaithful is really distressing, but take some time to talk calmly and openly with your partner , let’s get you both treated and go from there.” A few key points here- -You should NOT draw any conclusions for your patient i.e., “Oh yea, if you’ve been faithful then your wife has probably been cheating” or ” Well, if you’ve been cheating then this is gonna happen” Maybe his partner was sexually assaulted recently? Who knows? -If they are the ones cheating, you as the provider don’t need them to admit it to you. It’s not your business. I had a patient who was having an affair (Female) so when she came up positive for an STI and was totally unphased by it I asked “is there a situation in your life that might explain this?” and she replied, “Yea, I think know what happened” and I left it at that. Gaining Their Buy-In on Treatment – I don’t know about all of you but I can tell you nothing will get me to refuse something faster than feeling bullied or shamed into doing something or not doing something. It does me no good to say “Look Sandra, you’re 40# overweight, you know better, lay off the donuts!” -You always do better to educate patients about the situation, gauge their response and then offer solutions when they are ready. So, “Ok Sandra, Your physical came out clean but your weight is higher than we’d like it for your age, height etc. Do you find that you lack energy or it’s holding you back from being active? I want to support you and help you avoid the things you, as an NP yourself already know about- diabetes, HTN etc” This approach opens the door for me to be honest and ask for help or demonstrate that I’m pre-contemplative…. -Now if a patient is overweight and their BP is elevated and their Fasting Glucose is elevated you could use stronger language, but still remember, it is their life and their decision and you cannot get too over-invested in their healthcare. So “Ok Sandra, Your weight is above where we like it and I am concerned you may be headed for some healthcare issues with the BP and glucose level such as stroke, heart disease and diabetes- it’s painting a picture to warn us and I’d like us to take action together to manage your weight. Where are you at with this in your mind?” Patients will be more likely to get on-board if you lead them to the bulls-eye instead of hitting it for them. And they’ve got to be more invested in a solution then you are. These are just three examples of the Art of being an NP. What are your thoughts? Is this helpful? Stuff you already know? Do you agree?

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