Debrief - Lower back pain - Difficult patient
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With patients like this, it is important to show compassion and empathy. It is important that communication is paramount. With such difficult patients, it is important to try and defuse the situation as much as possible. Try and build a rapport so that they feel at ease by dispensing more information to you. It's important to show compassion and empathy regardless of their outlook or their presentation.
With this gentleman, he presented with back pain that has been long-standing, he has been seen by his GP and has had input, however, of no result, and became quite irritated by the fact that he was not getting the treatment that he felt he deserved. Also in this situation, it is important to manage patient expectations. With patients presenting with back pain, it is important to rule out red flags such as cauda equina or trauma, back injury. For this particular patient, I asked him if he had any tenderness, any numbness, any tenderness, any loss of bowel or urinary control, all of which he answered no to. Note that there was no trauma and the pain had been long-standing, that he has seen his GP about.
Because of this, I thought that the patient could be managed within an urgent care setting. Another point is when asked about his pain score, the patient said 10 out of 10. In this scenario, it is important to assess the patient, it is important to use your judgment of whether the patient pain score is 10 out of 10. In this case, the patient was comfortable, at rest and looked well. There was no grimace and there was no guarding.