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Concepts of therapeutic communication
Basic concepts of Therapeutic communication
Concepts of therapeutic communication
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Clinical Decision Making
Decision making is part of our daily routine. We make decisions every day not just in our personal lives but also in our profession. As a healthcare professional, making a sound clinical decision is vital to accurately diagnosed a patient, and to establish an effective treatment intervention for them. Crist, McVay & Marocco (2016) stated that physical therapists make a myriad of decisions every day. These clinical decisions that we make impact the outcome of our treatment interventions. So, improving our clinical decision making skills is something that we need to work on every day to be able to come up with a sound clinical judgement that will be beneficial for our patient.
My clinical decision-making skills have evolved over time. I remember when
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So, we have to make sure that they are patient-centered and tailored specifically for them. Klein (2005) shared 5 rules for good decision making and these are: 1. Being aware of the base rate. 2. You have to make sure that the data that you gathered are truly relevant rather than just salient or important. 3. Seek for reasons why your decisions may be wrong and entertain alternative hypothesis 4. Ask questions that would disprove, rather than confirm your current hypothesis 5. Remember that you are wrong more often than you think (p.782). These are good pointers that will help us in making our clinical decisions. Marewski & Gigerenzer (2012) discussed how heuristics help clinician make a good medical decision when faced with situations where time, knowledge and resources are limited. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors (Marewski & Gigerenzer, 2012). For me, fast-and-frugal heuristics framework can be applied when we do screens for patients who will benefit from
Making a clinical decision is a skill that needs to be acquired, and nurses are accountable for any decision that is made, so they need to understand how they make decisions (Nursing and Midwifery Council (NMC), 2015). A greater understanding of how nurses make decision is essential to follow research and development of decision making skills (Clark et al, 2009) . A first step to a decision making process may entail understanding a framework or model. Baumann and Deber (1986) define decision making as situations in which a choice is made among a number of possible alternatives often involving values given to different outcomes”.
This decision also has to be evaluated on the basis of internal criteria. For the internal criteria, a person has to look inside oneself to evaluate the decision. Does the person feel satisfied with the decision and promote these values? The doctor’s decision does not give the inner sense of contentment; we experience “hate, discontent…confusion” (Panicola 71). Nobody wants to become a liar, thus it is not consistent with the kind of a person one would want to become.
Values of caution and knowledge coincide in driving Welch to his conclusion of overdiagnosis due to society’s enthusiasm for everything medical. Welch concludes early on that the benefit of sticking to tried and true forms of healthcare overrides the belief that
Patients are ultimately responsible for their own health and wellbeing and should be held responsible for the consequences of their decisions and actions. All people have the right to refuse treatment even where refusal may result in harm to themselves or in their own death and providers are legally bound to respect their decision. If patients cannot decide for themselves, but have previously decided to refuse treatment while still competent, their decision is legally binding. Where a patient's views are not known, the doctor has a responsibility to make a decision, but should consult other healthcare professionals and people close to the patient.
As the field of healthcare has changed, new diseases and disorders have developed. It is impossible for one doctor to know how to recognize and treat every disease in the world. With evidence-based guidelines, they can come close. These guidelines may not have a perfect success rate, but they can make diagnosing illness easier.
have to make decisions that are needed at that moment. Not only is the patient the focus but
...3) Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. Journal of American Medical Informatics Association 10(6): 523-530.
...2011). Risk assessment has evolved and research has shown that Structured Professional Judgement emerges as the most promising way forward in risk assessment, as it includes both static and dynamic risk factors, and combines statistical accuracy with clinical experience.
... be in the patient’s best interest and getting the best results for the trial.
With the help of physical therapists, people are able to get their body back. They construct elasticity, muscle, and life back into their patients. Their goals are to terminate people’s pain, help with range of motion, and give them their sense of confidence back. The meaning of physical therapy is a profession in the medical field that deals with helping individuals preserve, repair, and improve movement. However, physical therapy is not only limited to one type of personnel. There are many different specialties of physical therapy one can study. For example, physical therapy can range from: orthopedic, geriatrics, neurological, cardiopulmonary, pediatrics, athletics, and general physical therapy. The question that comes to mind when thinking about physical therapy is, “How does one chose the path of physical therapy?” Physical therapy is emotionally and physically demanding and the progress of a patient, depending on their situation, typically moves slowly. Nonetheless, people who find it rewarding are very happy with their choice of career. The thought of making an improvement in peoples’ lives is an important quality to have for those who would like to enter into the field.
This paper will discuss three theories of decision-making that can be adopted in nursing practice, additionally how decision-making theories are able to be implemented and used. Decision-making in nursing is adopted through the critical thinking process that provides each nurse a model to make the best choices, solve problems and to meet goals in clinical practice (Berman & Kozier 2018, pp. 199-200; Levett-Jones & Hoffman 2013, pp. 4-5). Effective decision-making in nursing is a vital component and part of the role of a registered nurse; each year a substantial number of patients die due to medical errors and poor decision-making (Levett-Jones & Hoffman 2013, pp. 4-5; Nibbelink & Brewer 2017, p. 3). Through the use of effective decision making
During workdays, physical therapists meet with their patients and discuss their goals. To achieve them, the physical therapists work with the patients and create plans that map out routines of exercise and stretches. Every time a patient returns to the office, the physical therapists examine and observe how they are progressing and determine how to help them even more (O*NET Online). They then begin to modify the old plans and find better ways for the patient to make a full recovery (O*NET Online). They also converse with the patient and their families to inform them of how to make the recovery go smoothly and quickly. The outcome of this treatment is that people who were injured or ill would recuperate and uphold a healthy life. Physical therapists use their knowledge of human biology to know how to challenge the patients with precaution and achieve a successful recovery (America’s Top 300 Jobs: A Complete Career Handbook). The physical therapists have to work with the patient to understand each other and their ideas. Also, physical therapists tend to talk with other physicians, occupational therapists, nurses, social workers, and physical therapists to find the best path to being healthy (Ameri...
Pearson (2013) clarifies “clinical decision making is essential to every aspect of care delivered to a patient” (p. 214). It is the ability to blend information and make decisions that will later be implemented in the situation. Evidence-based decision making involves choosing from a variety of possibilities and combining the knowledge through research and the scientific evaluation of one’s practice. The purpose of this paper is to analyze my decision of administering ativan by advocating for the patient and anticipating her change prior to confirming signs; which provided a therapeutic response.
Physical therapy is the most exciting healthcare profession. Being able to wake up every morning to help other people who have problems with their body is amazing. From joints to muscles, spinal cord, heart disease, lower back pain, head injuries, arthritis, fractures, and many other disabling conditions a physical therapist will be by your side one hundred percent. The job of a physical therapist is to evaluate your problem or difficulties. Once the evaluation is completed the therapist provides the patient an assessment test. This test usually checks for muscle strength, joint motion, flexibility, balance, and coordination. They also check for any neurological problems and analyze your movement and range of motion. Next, the physical therapist
...ns. Patients should not be so medically ill that they are unable to make this decision. Patients should be fully conscious and understand the implications of their decision. Everything should be documented possibly even videotaped that way the doctor doesn’t lose their job, receive a lawsuit or worst jail!