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Journal Entry: Challenging Patient Encounters

Challenging patient encounters are attributed to healthcare provider (HCP) and patient factors. HCP factors range from situational stressors to poor communication proficiencies to negative bias toward a particular health condition. Patient factors include nonobservance to medical advice, inadequately described symptoms, and personality disarrays (Eukel et al., 2021). The journal is about my three challenging patient encounters, learned and acquired proficiencies, evidence-based practice, patient flow and volume management, communication, and feedback.

Difficult Patient Encounters

I encountered a 57-year old African American female that reported to the clinic with severe lower abdomen pain. Her agitation made it difficult for us to draw blood for tests. She could not allow us to take a blood sample for testing because we rejected removing blood from where she wanted since it was not the right vein. Furthermore, she detested a dipstick test. We injected her pain medicine and referred her to LabCorp for a blood draw. Two days later, she came back to the clinic, narrating that she ended up in the emergency room due to the pain, and it was discovered she had a urinary tract infection.

Also, I met P.T., a 25-year old African American female hat reported to the health facility with severe abdominal pain. Also, she had a five-month-old baby. I discovered that she had initially been diagnosed with UTI and given an antibiotic prescription for seven days. The issue is that she abandoned the medication after three days when she felt better. I informed her that the bacterium was still in the body because she did not complete the dose. After refilling her migraine medicine, I informed her to go home and complete the dose. She got upset that I had not prescribed another antibiotic because she believed the one I had given her was not effective.

In addition, I came across J.D., a 35-year old Asian American woman that visited the health center with complaints of virginal itching and discharge. The patient stated that the discharge had been progressive and persistent for three weeks. She indicated that she had one partner and pointed out that she did not have a record of any STIs. On further investing the patient, she was reluctant to provide more details as she perceived that her privacy was being intruded. Also, she was not willing to undergo cultural tests. I spent a huge amount of time with the patient persuading her to provide useful information and convincing her to cooperate with the team.

Lessons learned and Resources Used

I have learned from the experiences above that tolerance, decisiveness, compassion, and emotional intelligence are needed for an HCP to deal with individuals from diverse backgrounds (DeNicola et al., 2020). Several patients infer gynaecological issues from a cultural perspective; thus, inadequate health literacy to comprehend the dynamics of treating such conditions. HCP has the responsibility to enlighten patients to eradicate medical and cultural misconceptions. The resources I deployed to manage the above patient encounters include clinical examination equipment for diagnostic assessment and printed material to create awareness and further edify patients concerning their conditions.

Evidence-Based Practice Applied and Proficiencies Gained

I utilized an open communication approach to guarantee extensive comprehension between the patient and me. Moral considerations such as justice, sovereignty, and beneficence fostered my ability to communicate with patients insightfully and effectively (Chauhan et al., 2020). The application of EBP lab tests established the foundation for precise lab tests and referrals translating to accurate diagnosis (Lockwood, 2019). The proficiency I gained is that utilizing reflective comments plays a critical role in comforting and making the patient feel better.

What I Would Do Differently

For the patient that is upset that the antibiotic that I had given her did not work, I will have a lengthy friendly talk with her. I will educate her on the essence and importance of following instructions and finishing the prescribed medication. In addition, I will create awareness of the effects of not adhering to instructions pertaining to a particular medicine and not completing the dosa. This will help her infer the essence of continuing with the medications and ensure she completes the dosage.

Patient Flow and Volume Management

I will deploy the triaging approach to manage the flow of patients. The scheme will ensure that I prioritize patients with critical conditions to ensure that their situations do not exacerbate. When dealing with many patients, I will multitask to minimize the time I spend on an individual. I will deploy the first-come-first-served policy to manage the flow and volume of patients is first-come-first

Communicating and Feedback

I will persistently reflect on EBP, progressive learning, and clinical procedures and guidelines to enhance my proficiency and acquaintance (Eukel et al., 2021). I will keenly observe my preceptor’s steps and actions in different situations to optimize the opportunity to comprehend gynaecological issues better. So far, I am on the right track, but according to the feedback from my preceptor, I have o focus more on the utilization of IT in diagnosis and treatment.


Chauhan et al. (2020). The Safety of Health Care for Ethnic Minority Patients: a Systematic Review. International Journal of Equity Health, 19(118), 1-25.

DeNicola et al. (2020). Telehealth Interventions to Improve Obstetric and Gynecologic Health Outcomes. Obstetrics & Gynecology, 135(2), 371-382.

Eukel et al. (2021). Managing Difficult Patient Encounters: Simulation Design, Findings, and Call to Action. American Journal of Pharmaceutical Education, 85(7), 1-5.

Lockwood, C. J. (2019). Key Points for Today’s Well-Woman Exam: A Guide for ob/gyns. Contemporary OB/GYN, 64(1), 23–29. points-todays-well-woman-exam-guide-obgyns


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