Consulation Esssay With Case Study

Consultation Essay with Case Study

Student’s Name:

Institution Affiliated:

Professor’s Name:

Course Code:

Date:

Case Study

Jane, a 30-year old single woman, living in the eastern side of the country was arrested by

police on October 21, 2017, for organizing with other radicalized thieves to rob a favorite

business man in the town. Jane is a commercial sex worker. Upon reaching the corridor of justice

or court, she was remanded in custody for a fortnight waiting for the case to be mentioned as

investigations into the criminal allegations continues. On October 27, 2017, at 10.05 AM, Jane

always complained of stomach cramps, muscle spasms, joint pain, vomiting and nausea, fever

and feeling sickly. She was rushed into a hospital present in the prison. Fortunately, Dr. Smith

was available to carry physical examination on her. The outcome of physical examination

revealed that body temperature, blood pressure, and heartbeat rate were significantly high. Dr.

Smith managed to trace various spots both in the left and right hands suggesting injections were

taking place. The doctor investigated into the medical history Jane and learned that she has never

suffered any major medical complications in the recent years.

An inquiry in the social life of Jane showed that Jane was leaving with his boyfriend,

Michael Allan. Both Michael and Jane were strong addict of heroin and alcohol. Jane said that

her father was a heavy drinker and died when she was at the age of 10 years. Her mother was left

with the burden of taking care of Jane’s siblings. At the age of 15, Jane was introduced to

drinking and smoking habits by Michael. Due to financial constraints, Jane dropped out of high

school when she had attained the age of 16 years. Two years later, she started living with her

boyfriend, Michael. Michael played a role of magnetizing Jane into heroin lifestyle. Jane

explained to Dr. Smith that she consumed at least 0.5 grams of heroin daily so that her body can

function well. Jane claimed, as tears ran down the face, that her boyfriend Michael was

unemployed and she was forced to work all night in streets to get money to pay house rent and

procure heroin. Michael was not aware that Jane was doing prostitution because she lied to him

that she is employed in a six-star hotel. Jane further reported to Dr. Smith she took estimated

four or five bottles of beer before going for commercial sex work in the streets.

If the night passed without enough money to buy heroin, Jane opted for valium. Jane

revealed to Dr. Smith that the primary purpose of using alcohol and heroine was to keep her

going throughout the night while pursuing commercial sex. Jane used condom when in

commercial sex but she engaged in sex with Michael without a condom. A further diagnostic test

using urine of Jane indicated that heroin and alcohol were present in the blood. Jane scored 17 on

Clinical Opiate Withdrawal Scale suggesting the effect of heroin is moderate (Barbosa-Leiker, et

al. 2015, p.219). Therefore, she is diagnosed with opiate dependence. Wutchiett, et al. (2015,

p.28) treatment of opiate dependency will involve use of methadone.

Consultation Models

This descriptive and incisive research think tanks that Neighbor, 1987 and Bryne and

Long, 1976 are consultation models that perfectly fit in the case study of Jane and Michael.

Argument for Neighbor, 1987 Model

Neighbor consultation model is perchance one of the popular model uncovered by Roger

Neighbor in 1987. Roger provided a five-stage model which encompass connecting,

summarizing, handing over, safety net and housekeeping that he believed will assist medical

practitioners to carry out consultation skillfully, intuitively and efficiently (Denness 2013,

p.594). Connecting component of the model involves the doctor establishing excellent rapport

with a patient like Jane. A doctor is anticipated to evaluate and examine a patient using his or her

perspectives. Summarizing involves break down of patient’s point of view into reason (s) why a

patient comes to see a doctor. If the summary made by a doctor is not correct, a patient is given a

widened opportunity to initiate an amendment.

Handing over encompass the processes where a doctor and a patient engage in a

negotiation to establish management plan. Additionally, Li et al. (2017, p.1770) safety netting

procedure compels a doctor to put in place a contingency plan in the moment of worse scenarios

that provides an answer to a question, what if? Finally, housekeeping stage instructs a doctor to

acknowledge and deal with any emotional concern before proceeding to see the next patient.

This is to ensure emotions does not exert adverse impact when a doctor in conducting following

consultation. In a nutshell, Neighbor model embraces patient centricity, easy to follow and recall

as well as easily conceivable hence a sound model for a case study involving Jane and Michael

(Denness 2013, p.594).

Argument for the Byrne and Long Model

Beaumont (2012, p.12) states that Bryne and Long used estimated three years in

conducting deep research about a consultation model that can be used by a doctor. Bryne and

Long penned down their findings in 1976 and proposed a six-phase consultation technique

(Beaumont 2012, p.12). Arguably, the first phase involves a doctor striking a rapport with the

patient. The second phase encompasses the doctor using different strategies to attempt or actually

establish the reason (s) why the patient came to the hospital. The third phase entails a doctor

ought to perform physical and verbal examination on a patient. The doctor can also perform both

oral and physical examination that is key in the case study presented in this research paper. The

fourth phase take account of the doctor and patient considering the issue at hand.

The fifth phase entails the doctor and a patient setting in place treatment plan or further

investigation. The doctor is allowed to make treatment plan either with or without patient input.

Beaumont (2012, p.12) the last phase mandates the doctor to terminate consultation processes.

The study selected Bryne and Long paradigm because it inaugurates that idea of a doctor

involving a patient when taking into account a problem and foster patient centricity. Denness

(2013, p.594) learned that Bryne and Long paragon could help the doctor to structure and

articulate consultations logically.

Communication Models

Many scholars have shown that patient-doctor communication is the central component

of delivering genuine care. Therefore, effective communication between the doctor and a patient

must be present. Thurston (2012, p.49) effective communication provides a platform where the

doctor can establish an excellent inter-personal relationship with a patient, foster accurate

sharing of information and ensure patient views or pleas are incorporated in every step of

decision making. Also, sound patient-doctor communication dispenses right ways of regulating

emotions of a patient. Thurston (2012, p.49), the patient, is likely to get satisfied with care if the

doctor communicates timely and efficiently. What is more, different communication models can

be used by patient and doctor to bolster sharing of the information. Whichever communication

model used, it must be placed in a better position of facilitating effective communication. On that

account, this research paper believes that transactional and interactive communication models are

the best for the case study involving Jane and Michael.

Transactional Model

Transactional model is peradventure one of the commonly used models of

communication in the contemporary world. This model speculates that people in the world are

brought together using communication (Rekawati, Sri & Susilorini 2017, p.49). Human beings

can keep communication alive through embracing transactional strategies. For instance, Jane as a

patient and the doctor can connect to each other through transactional communication.

Transaction model involves sender and receiver of the message simultaneously. Since patient-

doctor communication requires interpersonal communication, transactional model becomes very

handy in facilitating sharing of accurate information and data (Rekawati, Sri & Susilorini 2017,

p.49). Healthcare field is characterized by talks and interactions between doctors and patient that

is exclusively a form of transactional communication. In summary, transaction model of

communication avails opportunity for a doctor and the patient to listen or talk to each other

during the physical examination that is going to facilitate diagnosis and in-depth inquiries. The

study selected transactional model for examining patient because it provides verbal feedback,

reliable and valid.

Interactive Model

Antoni Llopis-Lorente et al. (2017, P.15515) asserts that interactive model of

communication is a revamped form of linear model. Linear model of communication is viewed

as one way communication. However, interactive model claims that communication processes

and procedures occur in duality. The interactive model is known for providing feedback either in

verbal or non-verbal means. A doctor can use interactive communication approaches when

assessing the problem that is confronting a patient. This study recommends that interactive

model should involve face-to-face communication between a patient and a doctor as opposed to

using of technologies. This valuable descriptive study chose interactive model of communication

because it is placed in a better position of influencing patient and doctor views throughout

treatment (Antoni Llopis-Lorente et al. 2017, P.15515). It also presents a flexible environment

where a patient and doctor can think logically before responding to the question asked.

Discussion of Diagnosis and Differential Diagnosis

Diagnosis of Jane as a patient will involve determining the specific disease or condition

that best describes the signs and symptoms displayed. Also, the medical history, physical

examination, and diagnostic tests are a critical component of diagnoses. The symptoms of Jane

were stomach cramps, muscle spasms, joint pain, fever, feeling sickly, vomiting and nausea. The

physical examination revealed that the body temperature and blood pressure were significantly

high. Jane had unprecedented hear beat rate. The diagnostic test using the urine sample of Jane

indicate presence of heroin and alcohol. However, the alcohol level was higher than heroin. As a

result, this study has to conduct a differential diagnosis since there are symptoms of heroin and

alcohol withdrawals that are similar (Boscarino et al. 2017, p.185).

High blood pressure, body temperature and heartbeat rate, fever, nausea, and vomiting as

well as sweating that were common in Jane’s medical report are similar signs and symptoms of

alcohol and heroin withdrawal. Alcohol and opioid intoxication can have symptoms that

resemble each other. On the contrary, opiate intoxication does not cause seizures (Boscarino et

al. 2017, p.185). Jane did not suffer from any seizures and significant mental disturbance when

she can in the hospital hence the study rightfully diagnoses her with opioid dependence.

Treatment Strategy

After Jane has been diagnosed with opioid dependence, the next will involve formulation

of treatment strategy. This will include use of pharmacologic treatment strategy where opiate

intoxication present in the blood of Jane flushed out. Food and Drug Administration (FDA)

approved methadone and buprenorphine as the only medicines that can use to treat patients

suffering from opioid withdrawal symptoms (McCarty, Frank and Denmead 2009, p.359). On

that account, Jane will be handled using methadone. Jane is given 40mg of methadone to be

taken orally for the next five days and a review conducted on the sixth day. Jane is moreover

advice to report to the hospital in case new signs re-emerge or any medical concerns. The

research selected methadone for treatment or maintaining of opioid addiction because its

pharmacokinetics and pharmacodynamics are slower at the beginning and increases effectiveness

as therapy progresses.

Understanding of Physiological and Pharmaceutical Issues Relating to the Presenting

Symptoms

Physiological is a branch of biology that deals with the standard functions of animals and

plants and their organs. Once a person has taken opioid and alcohol, the normal function of the

body is affected (Redmond and Krystal 2014, p.449). Many studies have shown that opioid drugs

produce pharmacological actions by attacking neuronal cell membranes. Opioid play a role in

preventing release of neurotransmitter can cause major changes in the central nervous system of

the body. Pain, a common symptom of opioid withdrawal, often come about when the activity of

a primary sensory neuron is increased as a result of taking a stimulant. Therefore, the pain Jane

witnessed after withdrawing from alcohol and opioid for the last seven days can be attributed to

opioid addiction. Ghelardini Di Cesare and Bianchi (2015, p.220), the pharmaceutical issue of

opioid, can be evaluated from the standpoint of painkiller. Opioid, for many years, has been used

as the painkiller to relieve pain. Walwyn, Miotto & Evans (2010, p. 161) opioid drugs usually

carries out its function of pain relieve by attaching itself to opioid receptors located in the brain,

spinal cord, and another strategic body part. They, therefore, reduces transmition of pain

messages to the brain.

Legal, professional and ethical issues

Prescription of opioid drugs for treatment of opioid addiction and withdrawal for

outpatient like Jane is strictly done within the dictates of the laws of a country. Cohen et al.

(2012, p.105) methadone is categorized as schedule II narcotic and can only be prescribed on the

grounds of treating and maintaining opioid dependence. The law compels healthcare

professionals in the country to register with Drug Enforcement Administration and Narcotic

Treatment Program for them to use opioid in managing substance abuse in a population. Medical

practitioners are not allowed to sell methadone over the counter unless patience comes with a

medical prescription from a qualified physician.

Cohen et al. (2012, p.107) any medical practitioners that include nurses, doctors and

pharmacists caught selling the opioid drug over the counter are likely to be faced with the full

force of the law. Healthcare professionals are expected to give correct dosage to a patient

otherwise over dosage comes with adverse effects. What is more, studies have shown that

narcotic drugs are illegal in many countries. Any person caught using opioid medications for

substance abuse is a candidate for jail. However, when opioid are manufactured for medical

purpose becomes legitimate because it is used to relieve pains that affect human health.

Evaluation of Consultation

Evaluation of consultation is essential to ensure a doctor provide quality care to a patient.

The consultation model used by Dr. Smith when assessing Jane’s problem should be crammed

with correct sharing of the information and procedures. Bryant‐Lukosius et al. (2014, p.520), the

doctor, is predominantly expected to create good rapport with the patient before digging deeper

into consultations. This study feels that consultation models used in the case study dispensed

expert advice and counseling to Jane based on entrenched knowledge that provided insight into

underlying problem. Importantly, consultation strategies used in the research paper embraced

patient centricity. All consultation processes revolved around the issues a patient had raised.

Reflection

The inquiries are guided by crucial consideration. All the treatment procedure followed

must aim at promoting safety of the patient as well as underpinning quality care. Clinical

symptoms shown by Jane and physical examination were the basis of diagnoses. The doctor-

patient communication is supposed to be led by patient centricity and establishing rapport. The

study reflects that communication and consultation models using in any health care system are

essential is fostering correct diagnoses. The doctor should be positioned in a better capacity of

handling any worries and emotional concerns arising from a patient.

Conclusion

This research paper entails substance abuse. It started by providing a case study involving

Jane and Michael who were substance addict. The inquiry discussed Neighbor and Bryne and

Long consultation models and offered reasons for selecting them. Interactive and transactional

are preferred communication model in the case study. The diagnosis and differential diagnoses

for Jane was opioid dependence. Treatment strategy for opioid dependence presented in the

study. The study went ahead to deliver insight about physiological and pharmaceutical issues

consistent with symptoms of opioid withdrawal. The study has examined various legal,

professional and ethical issues to be considered when using opioid as a drug in medical field.

Evaluation of consultation and reflection critiqued in the study.

Reference Lists

Antoni Llopis-Lorente et al., 2017. Interactive models of communication at the nanoscale using

nanoparticles that talk to one another. Nature Communications, 8, p.15511-15530.

Barbosa-Leiker et al., 2015. Examining the factor structure of the Clinical Opiate Withdrawal

Scale: A secondary data analysis from the National Drug Abuse Treatment Clinical Trials

Network (CTN) 0003. Drug and Alcohol Dependence, 152, pp.218–223.

Beaumont, R., 2012. Health/Medical Consultation Models. Communication skills for doctors,

Pharmacies and Nurses, 109(5), pp. 1-27

Boscarino, J.A., Rukstalis, M.R., Hoffman, S.N., Han, J.J., Erlich, P.M., Ross, S., Gerhard, G.S.

and Stewart, W.F., 2011. Prevalence of prescription opioid-use disorder among chronic

pain patients: comparison of the DSM-5 vs. DSM-4 diagnostic criteria. Journal of

addictive diseases, 30(3), pp.185-194.

Bryant‐Lukosius, D., DiCenso, A., Browne, G. and Pinelli, J., 2014. Advanced practice nursing

roles: development, implementation and evaluation. Journal of Advanced Nursing, 48(5),

pp.519-529.

Cohen, M.J., Jasser, S., Herron, P.D. and Margolis, C.G., 2012. Ethical perspectives: Opioid

treatment of chronic pain in the context of addiction. The Clinical journal of pain, 18(4),

pp.S99-S107.

Denness, C., 2013. What are consultation models for?. InnovAiT, 6(9), pp.592-599.

Ghelardini, C., Di Cesare Mannelli, L., and Bianchi, E., 2015. The pharmacological basis of

opioids. Clinical Cases in Mineral and Bone Metabolism, 12(3), 219–221.

http://doi.org/10.11138/ccmbm/2015.12.3.219

Li et al., 2017. Interaction—A missing piece of the jigsaw in interpreter-mediated medical

consultation models. Patient Education and Counseling, 100(9), pp.1769–1771.

McCarty, D., Frank, R.G. and Denmead, G.C., 2009. Methadone maintenance and state

Medicaid managed care programs. The Milbank Quarterly, 77(3), pp.341-362.

Redmond Jr, D.E. and Krystal, J.H., 2014. Multiple mechanisms of withdrawal from opioid

drugs. Annual review of neuroscience, 7(1), pp.443-478.

Rekawati Susilaningrum, Sri Utami & Susilorini Susilorini, 2017. DEVELOPMENT OF

TRANSACTIONAL COMMUNICATION MODEL FOR MIDWIFE AND

POSTPARTUM MOTHER ON EXCLUSIVE BREASTFEEDING. Jurnal Ners, 12(1),

pp.49–59.

Thurston, J.R., 2012. Effective doctor-patient communication--a hit or a myth? WMJ : official

publication of the State Medical Society of Wisconsin, 111(2), p.49.

Walwyn, W. M., Miotto, K. A., & Evans, C. J., 2010. Opioid pharmaceuticals and addiction: The

issues, and research directions seeking solutions. Drug and Alcohol Dependence, 108(3),

156–165. http://doi.org/10.1016/j.drugalcdep.2010.01.001

Wutchiett, Frimpong & D’aunno, 2015. Area-level attributes and program resources as

predictors of methadone dosage patterns. Drug and Alcohol Dependence, 146, pp.e27–

e28.

Place new order. It's free, fast and safe

Paper type

Deadline

Page count

550 words

Total price: $ 15.00

Our customers say

Jeff Curtis

USA, Student

"I'm fully satisfied with the essay I've just received. When I read it, I felt like it was exactly what I wanted to say, but couldn’t find the necessary words. Thank you!"

Ian McGregor

UK, Student

"I don’t know what I would do without your assistance! With your help, I met my deadline just in time and the work was very professional. I will be back in several days with another assignment!"

Shannon Williams

Canada, Student

"It was the perfect experience! I enjoyed working with my writer, he delivered my work on time and followed all the guidelines about the referencing and contents."

Consulation Esssay with Case Study

Place new order. It's free, fast and safe

Our customers say

Jeff Curtis

Ian McGregor

Shannon Williams