5/11/2014 MY, YOUR... OUR PATIENTS PATIENTS' ATTITUDES TOWARDS - PDF document

5/11/2014 MY, YOUR... OUR PATIENTS PATIENTS' ATTITUDES TOWARDS NURSE PRACTITIONERS IN FAMILY PRACTICE IN SLOVENIA Metka Žitnik Šircelj, dipl. m. s. WHAT DOES THE LITERATURE SAY? Patients have expressed great satisfaction with the treatment • received from nurse practitioners in family practice; they mention better communication as one of the advantages (Redsell et al., Research studies of patients with several chronic diseases • 2007). show that such patients have a positive attitude towards the new work method (Fortin et al, 2010). Patients expect nurse practitioners to give them instructions on • how to live with the disease and how to prevent unwanted side Patients receive more practical advice on how to maintain • or improve their medical condition and take their medicine effects of the disease and drugs (Laurant et al. 2008). (Haidar, 2007). With the help of a nurse practitioner the quality of the treatment • One advantage of nurse practitioners is better knowledge of increases significantly and consequently the health and well-being • of the patient improve (Redsell et al., 2007). the patient’s living conditions, lifestyle and social status (Haidar, 2007). IT IS NOT The majority of patients treated by nurse practitioners have • ALWAYS EASY emphasised that the biggest advantage is that they take more time to talk with them about their disease and how to BEING THE live with it, consequently giving them more knowledge, PATIENT motivation and understanding of the disease and of living with it (Haidar, 2007; Bonney, 2009; Vaughan, 2007). 1

5/11/2014 WHAT DO OUR PATIENTS SAY? CASE STUDY 1 “When you were explaining what COPD was, I liked it when • CASE STUDY 1 CASE STUDY 2 you drew lungs and what happens with the lobules if you smoke.” Newly-diagnosed COPD A female patient who came • • patients (who have taken a in for a routine check-up “You had a great impact on increasing my physical activity, • spirometry test based on and was simultaneously because I had just started exercising before we met and you risk factors) diagnosed with two diseases gave me not only motivation to do it, but also a reason to. I (type 2 diabetes and Ages 32 to 75 can’t say I stopped smoking, but I went from smoking 20- • arterial hypertension) 30 cigarettes/day to merely 3 cigarettes/day. A month Men and women • from now I hope I won’t be smoking at all.” Aged 58 • CASE STUDY 2 “I have to say you gave me the most information and instructions “I realised that this [disease] was serious. I thought I would • • on what to do. You’ve helped me the most. You explained get better if I ate less sweets, even though my father had everything about the disease, why it was important that I change diabetes. You explained everything about both diseases. I’m my diet, and you sent me there [health education centre] for glad I have someone to turn to and that my health is information about a proper diet.” improving. ‘’ “You’re easier to reach on the phone when something’s bothering • me. Then you tell me whether I should see the doctor or you. The ‘’You always listen to me. I like coming by to chat on how to • doctor’s too busy and hard to reach. Besides, we’re managing this proceed.” [disease] now.” “I think these practices are necessary, they help you. When you • learn you have someone to turn to or to give you advice and help you... It means a lot.” GOOD RELATIONS, GOOD WORK! During their work, nurse practitioners establish a wide range An American study from 2010 revealed that a group of • • of relations with patients and with their colleagues. several women has a higher collective intelligence and makes better, more successful decisions, regardless of how smart It has been proved that good collegial relations among nurse • and experienced the individuals in it are (Williams Woolley, practitioners and doctors improve the outcome of the 2010). treatment; however, it is too often the case that relations between these two working groups function on the principle of hierarchy or competitiveness, which harms patients (Klemenc, 2007). 2

5/11/2014 HOW DO THE DOCTORS OF FAMILY PRACTICE VIEW US? How did you imagine the work in family practice before starting • it? Has working there met your expectations? • In your opinion, which are the biggest problems and advantages of TEAM WORK • such a work method? How do you view the work of a nurse practitioner? • What do you find most important for good interpersonal • relations? PERCEPTIONS OF THE WORK, HAVE YOUR EXPECTATIONS BEEN MET? PROBLEMS AND ADVANTAGES I hoped that my work would be made easier. Or that at • ADVANTAGES PROBLEMS least the treatment/managing of patients would improve. Luckily, both have come true. The nurse practitioner works in the Unresponsive patients who • • office next door and in the same shift receive an invitation to a It has surpassed my expectations. I can no longer imagine as I do. • check-up and don’t show up working in any other way. The reactions of patients are also She takes time for the patient and and don’t even inform us of • very good and most of them like going to a nurse has an individual approach. it. practitioner. I think separating prevention from • It also bothers me that the treatment is useful. • nurse practitioner has a lot The number of patients has reduced. • of administrative work. I think it’s important that routine • check-ups start at age 30. THE WORK OF A NURSE PRACTITIONER IN THE EYES OF THE DOCTOR GOOD INTERPERSONAL RELATIONS Mutual respect and understanding are important. It complements the work in family practice and takes on • • some of the tasks of the family physician. It lightens the load. It is important that we spend a lot of time together, that • we work in the same shift, that we have frequent team Now that our work is running smoothly, the needs for it are • meetings and solve problems as soon as they arise, no matter so great that the nurse practitioner could easily fill up all her how small. working hours just by working in my practice. That we tell one another when we’re having a hard time, • when a patient exhausts us or angers us, and that we listen to and console one another. All of this is of course made easier with a good mood and • plenty of humour. 3

5/11/2014 EXAMPLES OF GOOD PRACTICE FIRST CHECK-UP CHECK-UP IN FP AFTER IN FP 1 YEAR OUR TEAM WEIGHT 117 kg 93 kg BUILDING HEIGHT 171.5 cm 171.5 cm BMI 40 32 BLOOD SUGAR 15.2 5.4 HbA1C / 5.9 CHOLESTEROL 6.0 5.2 TG 2.07 1.01 34 years old 37 years old patient patient 4

5/11/2014 THANK YOU FOR YOUR ATTENTION! 5