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

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PATIENTS' ATTITUDES TOWARDS NURSE PRACTITIONERS IN FAMILY PRACTICE IN SLOVENIA

Metka Žitnik Šircelj, dipl. m. s.

MY, YOUR... OUR PATIENTS WHAT DOES THE LITERATURE SAY?

• Research studies of patients with several chronic diseases

show that such patients have a positive attitude towards the new work method (Fortin et al, 2010).

• Patients receive more practical advice on how to maintain
• r improve their medical condition and take their medicine

(Haidar, 2007).

• One advantage of nurse practitioners is better knowledge of

the patient’s living conditions, lifestyle and social status (Haidar, 2007).

• 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., 2007).

• Patients expect nurse practitioners to give them instructions on

how to live with the disease and how to prevent unwanted side effects of the disease and drugs (Laurant et al. 2008).

• With the help of a nurse practitioner the quality of the treatment

increases significantly and consequently the health and well-being

• f the patient improve (Redsell et al., 2007).
• The majority of patients treated by nurse practitioners have

emphasised that the biggest advantage is that they take more time to talk with them about their disease and how to live with it, consequently giving them more knowledge, motivation and understanding of the disease and of living with it (Haidar, 2007; Bonney, 2009; Vaughan, 2007).

IT IS NOT ALWAYS EASY BEING THE PATIENT

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WHAT DO OUR PATIENTS SAY?

CASE STUDY 1

• Newly-diagnosed COPD

patients (who have taken a spirometry test based on risk factors)

• Ages 32 to 75
• Men and women

CASE STUDY 2

• A female patient who came

in for a routine check-up and was simultaneously diagnosed with two diseases (type 2 diabetes and arterial hypertension)

• Aged 58

CASE STUDY 1

• “When you were explaining what COPD was, I liked it when

you drew lungs and what happens with the lobules if you smoke.”

• “You had a great impact on increasing my physical activity,

because I had just started exercising before we met and you gave me not only motivation to do it, but also a reason to. I can’t say I stopped smoking, but I went from smoking 20- 30 cigarettes/day to merely 3 cigarettes/day. A month from now I hope I won’t be smoking at all.”

CASE STUDY 2

• “I realised that this [disease] was serious. I thought I would

get better if I ate less sweets, even though my father had

• diabetes. You explained everything about both diseases. I’m

glad I have someone to turn to and that my health is

• improving. ‘’
• ‘’You always listen to me. I like coming by to chat on how to

proceed.”

• “I have to say you gave me the most information and instructions
• n

what to do. You’ve helped me the most. You explained everything about the disease, why it was important that I change my diet, and you sent me there [health education centre] for information about a proper diet.”

• “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 doctor’s too busy and hard to reach. Besides, we’re managing this [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
• f relations with patients and with their colleagues.
• It has been proved that good collegial relations among nurse

practitioners and doctors improve the

• utcome
• f

the treatment; however, it is too often the case that relations between these two working groups function on the principle

• f

hierarchy

• r

competitiveness, which harms patients (Klemenc, 2007).

• An American study from 2010 revealed that a group of

several women has a higher collective intelligence and makes better, more successful decisions, regardless of how smart and experienced the individuals in it are (Williams Woolley, 2010).

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TEAM WORK

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

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?

• I hoped that my work would be made easier. Or that at

least the treatment/managing of patients would improve. Luckily, both have come true.

• It has surpassed my expectations. I can no longer imagine

working in any other way. The reactions of patients are also very good and most

• f

them like going to a nurse practitioner.

PROBLEMS AND ADVANTAGES

ADVANTAGES

• The nurse practitioner works in the
• ffice next door and in the same shift

as I do.

• She takes time for the patient and

has an individual approach.

• I think separating prevention from

treatment is useful.

• The number of patients has reduced.
• I think it’s important that routine

check-ups start at age 30.

PROBLEMS

• Unresponsive

patients who receive an invitation to a check-up and don’t show up and don’t even inform us of it.

• It also bothers me that the

nurse practitioner has a lot

• f administrative work.

THE WORK OF A NURSE PRACTITIONER IN THE EYES OF THE DOCTOR

• It complements the work in family practice and takes on

some of the tasks of the family physician. It lightens the load.

• Now that our work is running smoothly, the needs for it are

so great that the nurse practitioner could easily fill up all her working hours just by working in my practice.

GOOD INTERPERSONAL RELATIONS

• Mutual respect and understanding are important.
• It is important that we spend a lot of time together, that

we work in the same shift, that we have frequent team meetings and solve problems as soon as they arise, no matter how small.

• 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.

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OUR TEAM BUILDING EXAMPLES OF GOOD PRACTICE

FIRST CHECK-UP IN FP CHECK-UP IN FP AFTER 1 YEAR WEIGHT 117 kg 93 kg 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 patient 37 years old patient

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THANK YOU FOR YOUR ATTENTION!